Drug Checking Laws and their Association with Drug-related Mortality

• In Event: Measuring Illicit Fentanyl Markets and Evaluating Overdose Intervention

Abstract

Background/Objectives: Drug checking equipment (DCE), including test strips and other testing equipment, is a key component of harm reduction strategies aimed at reducing fatal and non-fatal overdoses among individuals using drugs by detecting the presence of harmful, potent additives in a user’s supply. Over the past decade, and in response to increasing contamination of drug supplies with fentanyl and other synthetic opioids, many states have decriminalized or otherwise increased access to drug checking equipment.  

Methods: Utilizing a legal epidemiology framework, we describe adoption and expansion of laws providing legal protections for the possession, distribution, and/or sale of drug checking equipment between 2010 and 2024. We catalog which equipment and which drugs are explicitly specified in the state laws, whether the laws apply to minors, and whether protections for DCE was covered by Good Samaritan Laws (GSL). We then apply difference-in-difference methods to examine associations between these policies and drug-related mortality, linking the policy data to annual data from the CDC’s National Vital Statistics System.   

Results:By the end of 2024, all 51 states had a law (including a GSL) that increased access to DCE; 14 states already had a law by 2010 or never specifically criminalized possession of DCE and 34 adopted new laws.  36 states passed a GSL that covered DCE, 33 passed a law allowing possession of DCE, 30 passed a law allowing free distribution of DCE, and 33 states passed a law allowing sales of DCE. There is a weak, negative association between the passage of any these laws or passage of laws related to possession and state-level drug-involved mortality and a weak positive association between the passage of laws related to the free distribution or sales of DCE and drug-involved mortality.   

Implications:The passage of additional legal protections for possession, distribution, and sales of DCE was common with all states adopting some form of law by 2024. There does not appear to be a statistically significant effect of these policies on drug-related mortality, but future research should explore whether these policies were reactive to increases in drug-related mortality rather than trying to prospectively reduce such mortality.

Author

• Sarah Axeen, University of Southern California
  Presenting Author