CLEVELAND, Ohio – Waverly Willis didn’t hesitate to say yes when the Alcohol, Drug Addiction and Mental Health Services Board of Cuyahoga County asked him to hand out free fentanyl test strips at his Urban Kutz barbershops. He knew that for some drug users, the test strips could mean the difference between life and death.
The test strips let users test drugs such as cocaine to determine if they’ve been mixed with fentanyl, the powerful opioid that has been a factor in a lion’s share of deaths in recent years in Northeast Ohio and elsewhere in the U.S.
Willis, himself an alcohol and drug addict who has been in recovery for 14 years, said he’s gotten some initial feedback from drug users who said they tossed out their drugs after discovering it also contained fentanyl.
“At that point, you’re at a crossroads,” he said. “You’re thinking, ‘I could possibly die after taking this drug.”
Willis is among more than a dozen Cuyahoga County business owners who have partnered with the ADAMHS Board to distribute the test strips. The ADAMHS Board also provides the test strips to healthcare centers and the city of Cleveland, which hands them out to the city’s homeless population.
At each of the locations, a person can walk in and take a free test strip. Anyone who requests them will not be questioned by law enforcement, officials have said.
“This is a harm reduction tool,” ADAMHS Board CEO Scott Osiecki said. “We don’t promote drug use or condone drug use, but what we want is to keep people alive and as safe as possible.”
Experts believe drug dealers mix fentanyl and cocaine to expand the fentanyl market beyond opioid users. But officials say cocaine users may not be aware the drug is being mixed with the powerful opioid, substantially increasing the risk of overdose deaths.
The mixing of fentanyl and other drugs has kept fentanyl-related overdose deaths stable in Cuyahoga County, even as deaths attributed to other drugs have declined, officials have said. Fentanyl is estimated to be a factor in 398 overdose deaths this year in Cuyahoga County, the same number as 2018.
The ADAMHS Board has been supplying fentanyl test strips since last year, when its 2018 budget included $15,000 for Circle Health Services to buy and distribute them.
The ADAMHS Board’s 2019 budget includes a total of $45,000 to buy and distribute test strips. Circle Health Services and the Care Alliance Health Center each received $15,000; the remaining $15,000 was used to buy test strips to distribute throughout the community, said Beth Zietlow-DeJesus, the ADAMHS Board’s director of external affairs.
Each test strip costs $1, and they come in packs of 100. Most local businesses were given a single box, but they could request more once their supplies ran out, Zietlow-DeJesus said.
“We handed out less, thinking they could ask for more if they needed it,” she said.
The West Side Beverage and Deli on State Road at Leopold Avenue displayed the test strips for roughly 10 days before they ran out and needed to request more, owner George Abboud said.
Abboud, who assumed ownership of the store last year but has lived in Cleveland for more than four decades, said he decided to participate in the program because he’s seen news coverage of the devastation caused by the opioid epidemic.
“I thought it was a good way to help people,” Abboud said. “It’s helping people out to make sure they stay alive.”
The ADAMHS Board has already distributed 13,000 of the 15,000 test strips it bought for its grassroots campaign. It gave 5,000 test strips to the city of Cleveland to hand out at homeless shelters.
It’s difficult to gauge the effect the test strips are having in the community, but anecdotal evidence offers encouraging results. The ADAMHS Board started handing them out to local businesses after a mixture of fentanyl and crack-cocaine was linked to 18 deaths over an eight-day period that included Memorial Day Weekend. Officials did not see a similar spike in overdose deaths near the Fourth of July, Zietlow-DeJesus said.
The ADAMHS Board is starting to gather community feedback to gauge the program’s effectiveness. Zietlow-DeJesus said businesses will be asked to gather anonymous responses to two questions: Did you use the test strip, and did it change your behavior?
The ADAMHS Board expects to run out of test strips well before the end of the year, so officials are working to find ways to buy more. Community health centers like Circle Health and Care Alliance may be able to obtain their own test strips, Zietlow-DeJesus said.
Officials believe the test strips are worth investing in as one part of the effort to combat the opioid epidemic, along with treatment and education, Osiecki said.
“It’s critical because we are saving lives,” Osiecki said. “We want to make sure people have an opportunity to realize what they are taking.”
The Cuyahoga County Medical Examiner’s Office has urged anyone using opioids or dealing with opioid addiction to contact Project DAWN at 216-778-5677 or the ADAMHS Board at 216-623-6888.