Sometimes, the key to advancing public health strategies to a problem is conducting the relevant research. But what happens when the research results don’t align with the law? That was the dilemma facing Maryland lawmakers earlier this year after the FORECAST study was published. 

The study, supported by the Bloomberg American Health Initiative and conducted by researchers here at the Johns Hopkins Bloomberg School of Public Health and Brown University, set out to determine whether drug testing technologies could accurately detect fentanyl in street drugs, and whether people who use drugs would use those technologies. 

The study results were promising: easy-to-use test strips were highly accurate at detecting fentanyl in samples of street drugs, and people who use drugs were eager to have a way to know what they were consuming. 

But when officials here in Maryland wanted to look at how they might facilitate turning the research into action on the ground, they hit a roadblock. Drug testing equipment was considered paraphernalia under state law, and was therefore illegal. 

Drug checking as a harm reduction strategy – where people who use drugs are able to test their drugs so that they know exactly what they contain – has been around for a long time. It became popular in the nightlife and music scenes in Europe during the 1990s, and has also been found at music festivals and other settings in the U.S. 

As fentanyl has emerged in recent years as a critical threat to life in the United States, more and more advocates and officials are looking for solutions. The FORECAST study results confirmed that drug checking has the potential to be among the public health solutions that can be deployed to help people stay safe.

But there is a patchwork of state laws governing the legality of drug checking activities, and officials in many places are now looking at how they can address the disconnect. That’s what happened in Maryland. Working with the Drug Policy Alliance, lawmakers were able to amend state law to make sure fentanyl test strips would no longer be considered drug paraphernalia under the law. 

City council members in Washington, D.C., took similar action, enacting emergency legislation to allow harm reduction service providers to hand out test kits. 

These critical actions have cleared the way for public health agencies and organizations to begin piloting programs to distribute fentanyl testing kits to people who use drugs. 

To learn more, read about the FORECAST study results, read more about drug checking from the Drug Policy Alliance, and listen to the American Health Podcast episode on harm reduction