Fentanyl is killing Texans at an alarming rate, but it isn’t commonly screened for in drug tests

Fentanyl testing must be done separately from standard tests that look for the so-called “federal five” controlled substances.

By Alexandra HartNovember 21, 2023 1:03 pm,

Fentanyl is a leading killer of Americans under the age of 50. It’s become such a problem that here in Texas, the state has launched the “One Pill Kills” campaign to raise awareness of the drug’s deadliness.  

 And yet hospitals, rehab programs and the criminal justice system often fail to test for the opioid in routine drug tests, despite its rising death toll. 

The Dallas Morning News investigated why as part of their Deadly Fake series, which explores the impact of the fentanyl crisis in North Texas. Sharon Grigsby, city columnist for the Dallas Morning News, spoke with the Standard about why fentanyl testing is lacking. Listen to the interview above or read the transcript below.

This transcript has been edited lightly for clarity:

Texas Standard: It probably comes as a surprise to many that fentanyl isn’t tested for in routine drug testing, especially given all the attention that you and others and the state has been trying to draw to this fentanyl crisis. What is tested for routinely in these drug tests and why isn’t fentanyl on that list?

Sharon Grigsby: Well, we were as surprised as you are. What we learned was that back in the 1980s, the federal government established what became known as the federal five drug panel. It tested for amphetamines, for cocaine, marijuana, PCP and opioids. So many people just thought that because that opioid category is in there that it would cover fentanyl.

But because fentanyl is a synthetic opioid, the standard test can’t detect it. And that’s why there have been calls for changing that federal five to a federal six.

Well so are there circumstances or in certain facilities where fentanyl is routinely tested or is it just not happening?

So the testing differs from setting to setting.

So real quickly, let me take the courts. There’s no governing standard there that’s exempt from FDA standards. So in one North Texas county, we found a young woman who had been high virtually 24/7 on fentanyl. Yet for months, she had passed her probationary drug tests. And why that is the case is that testing for fentanyl still has to be purchased as a separate test or an additional panel to an existing rapid test.

Now, the tests are pretty accurate, but cutting through the courts and the county bureaucracy, finding the money to cover the court’s costs… What we found is actually the only judicial system in North Texas that routinely tests all drug offenders is Collin County.

Why Collin County? Do you know?

Yes. They made a commitment almost a year ago because of the increasing number of people dying as a result of fentanyl that they were going to find the money in the budget. And of course, this is probation in courts, which comes from the state, not the county budget, as well as some grants to test everyone for that drug.

Well, what are the advantages to widespread fentanyl testing? I mean, it would seem to me that if you can spot someone who is using, perhaps you can sort of do some forensics and find out where sources are coming from, that kind of thing.

Yes, that’s one way that it’s very helpful. It allows police and other law enforcement to go in and stop what often is a drug that people don’t even know they’re taking and to get it off the streets.

There also are medical reasons, though, too, because, for instance, people come in and say “hey, I’m hooked on Xanax or I’m hooked on Percocet,” maybe even hooked on heroin. And what ends up happening is when they can do a test, they find out it’s fentanyl and the medical detox for fentanyl is very different site for Xanax or heroin.

So we can save lives if you know what you’re dealing with.

Exactly. As opposed to the fact that, you know, sometimes an overdose survivor walks out of an ER and they think that they just overdosed on one thing when they actually were taking a drug that wasn’t what they were thinking.

Sharon, you report that a new rapid fentanyl test has recently been approved. How long do you think until we see widespread use or is there an obstacle there?

I believe early next year that test is going to loosen up some of the logjam that has been created. It gets, as people who have read this story know, quite complicated because there are different rules for different places.

But I believe the new test will allow us to better identify what the problem is, both in the courts and in clinical hospital settings. And those are the two areas I think that our experts agree are most in need of it.

If you found the reporting above valuable, please consider making a donation to support it here. Your gift helps pay for everything you find on texasstandard.org and KUT.org. Thanks for donating today.