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Advocates: Fentanyl testing strips are working in Minnesota, but stigma prevents more widespread use

Advocates hope education and awareness will help reduce stigma around fentanyl testing strips, which are seen as a tool to reduce overdose deaths.

Fentanyl testing strips
The stigma around fentanyl testing strips has kept some users from testing their drugs.
MinnPost photo by Corey Anderson

When Mark Wiger’s daughter found a bag of powder on the side of the road on July 14, 2022, she thought it was cocaine. She texted a friend to ask where to get fentanyl testing strips, but her friend did not see the message until the next morning. 

It was too late. Jessica (Jess) Wiger unknowingly took fentanyl and died of an overdose. She was 39.

Her father and others who have lost loved ones to fentanyl, a potent synthetic opioid, are left wondering if testing strips that show whether a substance contains fentanyl could have saved lives if more people knew how to get them and how to use them. 

The testing strips, which the Minnesota Legislature made legal in July 2021, are catching on among more drug users, say advocates working to fight the opioid epidemic. But the stigma around fentanyl testing strips has kept some users from testing their drugs.

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From 2020-21, the number of fentanyl overdose deaths in Minnesota increased from 560 to 834 people, according to the Minnesota Department of Health. Policy makers saw the testing strips as one tool that could help reduce that number, especially among drug users who wanted to avoid fentanyl. To get a positive or negative result from a testing strip, a person must dissolve a small amount of the substance in water and dip the strip into the water for 15 seconds before letting the strip sit flat for five minutes. One line on the strip indicates a positive result whereas two lines indicate a negative result.

Jessica (Jess) Wiger with her dog, Linus.
Courtesy of Mark Wiger
Jessica (Jess) Wiger with her dog, Linus.
The Steve Rummler Hope Network, a nonprofit that focuses on opioid overdose prevention, education, and advocacy, was among the first organizations in Minnesota to distribute the test strips. Since the group began distributing in September 2021, Steven Rummler Hope Network has distributed about 122,000 strips throughout Minnesota. That includes nearly 28,000 strips so far this year. 

Alicia House, executive director for the Steve Rummler Hope Network, said the organization puts fentanyl testing strips into their overdose prevention kits. Along with fentanyl testing strips, there is also a QR code people can scan which links to an anonymous survey where people can talk about their using habits and request more fentanyl testing strips.

According to House, 90% of people who reported a positive result of fentanyl from the fentanyl testing strips changed their substance use by doing one or more of the following:

  • 35% used the substance with a group or with one other person
  • 33% decided not to use the substance at all
  • 32% had naloxone on them while using the substance
  • 22% used a smaller dose of the substance

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“I think the true overdose prevention potential of fentanyl testing strips lies in the impact they can have in substance use practices,” House said. “With the knowledge of their drug containing fentanyl, many individuals are using caution or not using the drug at all.”

Advocates at another organization who distribute fentanyl testing strips said the strips are most useful for people who are not seeking fentanyl in their substance of choice.

Justin McNeal, Director of Justice Involved Programs at Minnesota Recovery Connection, said people who are experimenting with drugs or do not use opioids are examples of people who demonstrate fentanyl testing strips can be successful.

Despite the usefulness of fentanyl testing strips, McNeal said he has also seen a downside to the strips while working three nights a week at Simpson Housing Services, a homeless shelter network in Minneapolis: People who are in “full-blown” addiction and often use fentanyl testing strips to seek fentanyl.

McNeal said harm reduction training and overall education around fentanyl are crucial in aiding people toward recovery. He added how important it is to erase shame around using fentanyl testing strips.

“I’ve done trainings where people think that reversing an overdose or testing your drugs is enabling a person, but reversing an overdose is just allowing someone to live,” McNeal said. 

While McNeal thinks fentanyl testing strips are making a difference in the Twin Cities, he thinks it is just one tool to prevent deaths and is not enough. 

One measure he thinks would prevent even more deaths is setting up overdose prevention centers, which are places where people are monitored while they use their substances. If a person would overdose while at an overdose prevention center, there would be immediate attention in order to reverse the overdose.

McNeal said having an overdose prevention center in the Twin Cities would lower the number of overdoses and aid people in establishing trust so they can have better success with making recovery connections. 

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“If people can go to a place where they feel safe and they’re not going to be judged for where they’re at in their substance use, the chances of them getting well are much higher than us just shaming them and saying ‘figure it out, just quit,’” McNeal said. 

House and McNeal both talked about the stigma surrounding substance abuse, saying many people struggle to reach out for help in fear of being judged or not feeling “worthy” of help. 

House said the conversation toward helping people who are struggling needs to start with “Hey, how do we make sure we keep you alive and safe” rather than telling people, “Don’t use.” 

Edward Krumpotich, the Upper Midwest Policy Lead for the National Harm Reduction Coalition, said fentanyl is the most widely used drug in the state of Minnesota. 

“Fentanyl testing strips are one answer to a very large problem,” Krumpotich said. “Fentanyl test strips do a great job of analyzing what is in our drug supply dealing with fentanyl, but if we don’t also look at the others [drugs] we’re hitting too much of a one-sided issue.” 

For example, fentanyl can be found in drugs ranging from marijuana to cocaine to methamphetamine, but most people are using the strips for opioids, like pressed pills and heroin, according to the CDC. 

In order to address this, Krumpotich said the goal should be to “bring addiction out of the shadows.” Some substance users fear incarceration, so decriminalizing drug paraphernalia would aid users towards being more open about their struggles with addiction, he said. 

Krumpotich stressed the importance of treating substance users with empathy and meeting them where they are at with healthy boundaries. 

“We all know an addict; we know someone with substance use disorder,” Krumpotich said. “We’ve got to treat the disease and we’ve got to love the human.” 

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Since his daughter’s death, Wiger has been working with legislators and organizations, like the Steve Rummler Hope Network, to have fentanyl testing strips more readily available around the Twin Cities. 

Eight months ago, Wiger did not know much about fentanyl. Today, he uses his involvement in Steve Rummler Hope Network, like being a part of the public awareness committee, as a way to cope with his grief. He knows more about fentanyl than he had ever hoped to know.

“I promised to Jessica I would lead a life where I experience the wonder, zest, and the joy of living, and that that’s what I was doing in my retirement pre-July 14, because that is what Jess wanted,” Wiger said. “But at the same time, I don’t want other families to experience this heartbreak.”

Madison Roth is a University of Minnesota journalism student on assignment with MinnPost for the spring 2023 semester.