Helping Bay Area drug users survive, not abstain: free test kits find deadly fentanyl

Amid a surge of deaths due to contamination, advocates urge testing of recreational drugs.

Fentanyl can hide. But cheap paper tests, increasingly available at the Bay Area’s social hotspots and universities, are finding it.

In a desperate race to reduce poisonings caused by pills or powders that are unknowingly tainted by fentanyl, advocates are distributing free tests that can quickly detect even tiny traces of the deadly synthetic opioid.

“It’s important for people to check their drugs,” said Dean Shold, who co-founded the Oakland-based test distribution nonprofit FentCheck with Alison Heller amid a surge of fentanyl-related deaths in the Bay Area. Cocaine, MDMA and other recreational drugs, as well as counterfeit Adderall, Xanax, Ativan, Percocet and Valium pills, can be tainted.

“Two milligrams that can kill you,” he said, “and you’ll never know.”

In a tireless campaign, FentCheck volunteers visit dozens of bars, restaurants and other venues in Oakland, Berkeley, Albany, Alameda and San Francisco to fill plastic bowls with more than 1,000 free tests every week. The businesses donate between $125 to $300 a month to help support the cost of supplies, most within easy reach of restrooms, pinball machines or cash registers.

Local universities, including UC Berkeley, Stanford, San Jose State, Santa Clara University and UC Santa Cruz, are distributing the tests at student health clinics or on dormitory shelves. Tests are also available at Bay Area public health clinics, at CVS and online sites such as FentCheck.org, dancesafe.org, bunkpolice.com, and even Amazon.com.

Fentanyl overdoses are now the leading cause of death for 18 to 45-year-olds — most of them caused by unintentional ingestion by young, novice and casual drug users. There were 4,362 fentanyl-related deaths in that age group in California in 2022, according to the California Department of Public Health. Fentanyl cannot be seen, smelled or tasted.

Stanford sophomore and history buff Eitan Weiner died from fentanyl toxicity in 2020 from ingesting counterfeit Percocet pills. Charlie Ternan, a Santa Clara University economics major, died only three weeks before his graduation in May 2020 after taking a tainted Percocet pill for back pain.

In her last hours of life, 26-year-old Hope Noel Warrick of Morgan Hill realized she was in trouble after taking what she trusted to be pure cocaine. An investigation of her 2023 death shows she searched the internet for “how to tell if there is fentnynl (sic) in something,” according to Santa Clara County District Attorney Jeff Rosen.

The test distribution campaigns are borrowing from the “harm reduction” model that has saved many lives in other public health emergencies, such as condom distribution and needle exchange to prevent HIV. The basic principle: Don’t tell people they can’t do something, because that doesn’t work. Rather, offer a way to reduce risk.

In some states, such as Texas, the test strips are illegal under an anti-paraphernalia law from the 1970s-era “War On Drugs” that bans materials used for testing and analyzing illicit substances.

California, in contrast, has committed $4 million to distribute the tests as part of Gov. Gavin Newsom’s $1 billion overall plan to tackle the fentanyl crisis.

History shows that “harm reduction” interventions can save lives and cause no increase in the frequency of the behavior, said UC San Francisco psychiatrist and epidemiologist Dr. Alex Bazazi, who studies fentanyl contamination and is part of a UCSF team that distributes fentanyl test strips to high-risk drug users.

“It just gives people the tools to do it more safely,” he said. “It empowers people with the knowledge to reduce their own risk.”

The steps to test for fentanyl are straightforward. First, a sample of the product is dissolved into a bottle cap-size amount of water. Then the test strip is dipped into the water for 15 seconds. Results are revealed after three minutes. Like a pregnancy or COVID-19 test, lines indicate whether it’s positive or negative.

Because the tests require water and some finesse, they may be impractical for people who are homeless or unstable, said Bazazi. But they can be life-saving for drug users at home, a party or a bar, where many fentanyl poisonings occur.

At UC Santa Cruz, the “Party Like a Slug” Peer Education Program provides test strips, two per person, free and confidentially at various times and campus locations. UC Berkeley supplies tests at the campus pharmacy and Sproul Hall’s Center for Support and Intervention. San Jose State University’s tests are available at the Student Wellness Center, no questions asked.

“One should assume that any drug obtained off the illicit market could be laced with fentanyl,” warns Stanford, which last fall installed 100 shelves holding free tests and overdose-reversing Narcan in dormitories across campus.

FentCheck was conceived in 2019 after Shold, a computer scientist who worked as chief technology officer at Alameda Health System, and Heller, an activist with experience distributing clean needles in Oakland and San Francisco’s Tenderloin District, met at Burning Man and shared their despair about the growing threat of fentanyl.

The project started small, with tests distributed at a few New Year’s Eve parties.

But the effort has been quickly embraced by some of the Bay Area’s most popular hipster scenes. In the East Bay, for instance, tests can be found at Earthly Coffee and Tea, King Kog Bicycle Shop, Tattoo 13, Pizzeria Violetta, East Bay Booksellers and many clubs, bars and restaurants.  A map on FentCheck’s website shows each site.

“Fentanyl is in everything at this point,” said Jason Lujick, who distributes the tests at his two Oakland bars, The Legionnaire Saloon and Beeryland.

“People think fentanyl is just killing the addict on the street,” he said, “but it’s the folks who think that one little bump of cocaine on a Friday night is going to be fine — then 20 minutes later, they’re dead.”

It’s not known why fentanyl is appearing in so many other drugs, said UCSF’s Bazazi.

One theory is that dealers are mixing up their supplies. In the past, it was easy to distinguish between products like sticky black heroin and powdery white stimulants, like cocaine, he said. But fentanyl and stimulants are both white powders.

Another theory is that drugs are accidentally contaminated while being handled.

“Folks say ‘I trust my guy,'” said Heller. “Well, sometimes that guy makes a mistake. He may not clean a scale. Or he may reuse a baggy.”

Even more insidious is the trend to deliberately taint supplies such as counterfeit pills, crudely pressed and sold online or via SnapChat. These pills are purchased unknowingly by people — typically young adults — who think a pill is authentic.

“This is part of the new normal,” said Heller. “Our motto is: Don’t do drugs without us.”