FAYETTEVILLE -- Brittany Kelly sat in the bed of her pickup near the Castle at Wilson Park in Fayetteville one Friday morning in late October hoping to save a life and not caring if she broke the law while doing so.
Kelly is co-founder of the Matt Adams Foundation for Opioid Recovery, a local nonprofit group that focuses on the distribution of naloxone opioid overdose reversal kits, according to the foundation's website. The group also distributes harm reduction material while working to break down the stigma and encourage hope, healing and second chances, according to its website.
The foundation honors Adams, who accidentally overdosed in 2017 after several years of sobriety. Kelly is Adams' sister.
Kelly said when her brother overdosed, there was no one to administer a naloxone kit, which could have saved him. The kits contain the opioid antagonist naloxone, which can temporarily reverse an opioid overdose, as well as instructions on its use and how to help someone who may have overdosed.
The foundation has distributed more than 6,000 kits, according to its website. Kelly said she gave away 50 kits that Friday morning in the park.
Kelly was also offering fentanyl test strips, which can detect the presence of fentanyl in other drugs. The foundation has distributed more than 10,000 test strips, according to its website.
Under Arkansas law, the test strips are considered drug paraphernalia and possession of them is a felony, according to Washington County Prosecuting Attorney Matt Durrett.
Federal agencies have said fentanyl use is increasing rapidly, and fentanyl is being found in other drugs, which increases the chances of a fatal overdose.
A study on law enforcement seizures of pills containing fentanyl was published in March in Drug and Alcohol Dependence magazine and funded by the National Institute on Drug Abuse, part of the National Institutes of Health.
The United States hit a record high in overdose deaths, according to the most recent Centers for Disease Control and Prevention data, which estimated that nearly 106,000 people died from drug overdoses in the 12-month period ending October 2021. This rise is largely driven by illicit fentanyl and other synthetic opioids, according to the CDC.
Illicit fentanyl is highly potent, cheaply made and easily transported, making it a profitable narcotic, according to the study. While people may seek out illicit fentanyl intentionally, many aren't aware the drugs they are using -- including heroin, cocaine, methamphetamine or benzodiazepines -- may actually be fentanyl or have been adulterated or contaminated with fentanyl.
Because fentanyl is about 50 times more potent than heroin and a lethal dose may be as small as 2 milligrams, using a drug laced with fentanyl can greatly increase overdose risk.
According to the Drug Enforcement Administration, traffickers can typically purchase a kilogram of fentanyl powder for a few thousand dollars from a Chinese supplier, transform it into hundreds of thousands of pills, and sell the counterfeit pills for millions of dollars in profit. If a particular batch has 1.5 milligrams of fentanyl per pill, approximately 666,666 counterfeit pills can be manufactured from 1 kilogram of pure fentanyl.
"An increase in illicit pills containing fentanyl points to a new and increasingly dangerous period in the United States," said Nora D. Volkow, director of the drug abuse institute. "Pills are often taken or snorted by people who are more naive to drug use and who have lower tolerances. When a pill is contaminated with fentanyl, as is now often the case, poisoning can easily occur."
Poisoning is injury or death due to swallowing, inhaling, touching or injecting various drugs, chemicals, venoms or gases. Many substances -- such as drugs and carbon monoxide -- are poisonous only in higher concentrations or dosages, according to the Mayo Clinic.
Data from Central Emergency Medical Services in Fayetteville indicates that the number of calls for reported drug overdoses is growing in Washington County as well.
The ambulance service also reported that the use of naloxone, or Narcan, is increasing as well. In 2020, the service responded to 445 reported overdoses and Narcan was administered in 230 instances; the number of overdose responses in 2021 was 494, and Narcan was administered 328 times. From January through October 2022, the number of overdose calls was 371, and Narcan was administered 224 times.
"It has become a standard practice in our industry," CEMS Chief Steve Harrison said of the use of the naloxone kits.
Chief Tom Jenkins with the Rogers Fire Department also said his department's ambulance crews are seeing more frequent overdose calls and more use of Narcan.
"I can tell you anecdotally without a doubt we are seeing more and more overdose calls," Jenkins said. "We are seeing calls involving opioids, including fentanyl, much more frequently."
Benton and Washington counties are designated as "High Intensity Drug Trafficking Areas" under a grant program aimed at reducing drug trafficking and drug abuse. The program is administered by the Office of National Drug Control Policy and the DEA and the CDC play a role. The program provides funding and other resources to local law enforcement agencies in areas where the manufacture, transportation and distribution of drugs meet certain criteria, according to Jay Cantrell, chief deputy with the Washington County sheriff's office.
Fentanyl use is growing rapidly, according to information gathered in high-intensity areas and reported by the National Institute on Drug Abuse. Law enforcement agencies nationwide seized 290,304 pills containing fentanyl in 2018, according to the institute. The number increased to 9,649,551 pills in 2021.
Benton County Prosecutor Nathan Smith said he can't recall a case involving fentanyl test strips, but fentanyl and other opioids are a growing problem. He said police seized more than 60 fentanyl pills in one recent investigation.
"It's been an issue, and it's incredibly lethal," Smith said.
Investigators have seized more than 500 fentanyl pills in 2022, according to information from the 4th Judicial District Drug Task Force.
"It's technically illegal, but it's not something we prioritize," Capt. Brad Renfro with the Fayetteville Police Department said of fentanyl test strips. "We're more interested in the people who are selling the drugs themselves."
Smith and Durrett said they would have to consider all aspects of any case, but fentanyl test strips alone would most likely not trigger a decision to prosecute someone.
The legal issue surrounding the use of fentanyl test strips isn't limited to Arkansas. Other states have similar laws, according to the American Addiction Centers Oxford Treatment Center website.
Overdose deaths have gone up more than 70% over the past five years in Alabama, Arkansas, Louisiana, Mississippi and Tennessee, according to the Oxford Treatment Center report. In 2021, 48 out of 67 drug-related deaths in Mississippi were caused by fentanyl overdoses. However, fentanyl test strips remain illegal to possess and distribute in much of the U.S., including Alabama, Arkansas, Florida, Georgia, Kentucky, most of Louisiana, Mississippi, Tennessee and West Virginia.
Kelly said she understands Arkansas law makes the possession of fentanyl test strips illegal. Arkansas law allows for the protection of "Good Samaritans" who administer naloxone to individuals who may be overdosing and she said test strips that can save lives by alerting people to the presence of fentanyl shouldn't be banned. She said she and others plan to work on changing the law when the state Legislature meets next year. In the meantime, she will continue working to help people.
"I know that what I'm doing is helping them right now," she said. "People can't recover if they are not alive. I'm just giving them that chance."
Matt Adams Foundation hotline
Naloxone is an opioid overdose reversal drug. Anyone interested in obtaining a naloxone kit can message the hotline at 479-222-0532.
Source: NWA Democrat-Gazette