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FILE - In this June 6, 2017 file photo, a reporter holds up an example of the amount of fentanyl that can be deadly after a news conference about deaths from fentanyl exposure, at DEA Headquarters in Arlington Va. Some large law enforcement agencies have recently abandoned the routine chemical field tests out of concern that officers could be exposed to opioids that can be absorbed through the skin or inhaled. Even a minute amount of the most potent drugs, such as fentanyl, can cause violent illness or death. (AP Photo/Jacquelyn Martin, File)
As Iowa grapples with a dramatic increase in overdose deaths involving fentanyl, some experts and activists say the best-proven solutions are currently criminalized in the state.
Advocates of harm reduction — a set of strategies to reduce the negative effects of drug use — say Iowa’s laws are counterproductive to the goal of lowering overdose deaths and getting people with substance use disorders into treatment.
Attorney General Tom Miller threw his voice into the discussion last month, when he called on the Legislature to legalize fentanyl test strips, which can test drugs for fentanyl, and expand access to naloxone, a medication that can reduce the effects of a drug overdose.
Fentanyl is a synthetic opioid that is used in medical settings, often for the treatment of severe pain. It can be up to 100 times stronger than morphine, meaning it takes a much smaller amount to cause an overdose.
The presence of illicit fentanyl, and its involvement in opioid overdoses, has shot up in Iowa in recent years, leading officials to search for solutions to the trend.
Allowing for testing would be a welcome policy change, according to Andrea Weber, a clinical assistant professor of psychiatry at the University of Iowa. Weber said legalizing testing strips is “low-hanging fruit” and would help people who aren’t trying to do fentanyl avoid consuming deadly amounts.
Fentanyl test strips are currently classified as paraphernalia under Iowa law, which carries a simple misdemeanor charge, punishable by a fine of up to $855 and 30 days in jail.
But Debra Krause, the director of the Iowa Harm Reduction Coalition, said fentanyl test strips are not enough to solve the ongoing opioid crisis. She said she wants to see broader deployment of naloxone, a more robust good Samaritan law, and syringe service programs in the state.
“I’m always going to be for the legalization of fentanyl test strips, it’s just not going to solve the opiate crisis,” she said. “We’ve been talking to the attorney general and (Iowa Department of Public Health) for literally five years, and we have the science. Harm reduction has the science and the evidence-based research.”
Syringe service programs, also known as syringe exchanges or needle exchanges, are programs that provide clean needles to intravenous drug users with the goal of preventing the spread of diseases like HIV and hepatitis C.
According to the Foundation for AIDS Research, syringe service programs are legal by state or local law in 39 states. They are illegal in Iowa.
Weber said syringe service programs provide more than just clean syringes for drug users. They often offer counseling, evaluations for treatment for substance use disorder, and testing for common blood-borne infections.
While some people are concerned syringe service programs encourage or condone drug use, studies on sites in other states over decades have shown them to do the opposite. People who access syringe service programs are far more likely to reduce their use of drugs and get into treatment for substance use disorder than those who do not.
“In the grand scheme of things, it’s an investment in a community that can help take care of people who use drugs, provide them with things like sterile supplies, but have tons of dividends in the back end as far as making it much easier and more likely that people are going to do really positive things for their health,” she said.
Officials are sounding the alarm now, in part, because the state has seen a dramatic increase in overdose deaths that involved fentanyl and in fentanyl seizures by law enforcement.
Iowa has one of the lowest drug overdose rates in the country, but the rate has been increasing, mostly due to opioids — deaths went up 34% between 2019 and 2021, according to the governor’s office. Fentanyl was involved in 83% of opioid deaths last year, and drug overdose deaths increased 120% among Iowans under 25 in the last two years.
Fentanyl is often found in illicit pills that are sold on the black market and disguised as real pharmaceutical drugs like OxyContin and Xanax, officials said. It’s also mixed into what’s being sold as heroin, cocaine, and methamphetamine.
Pills containing fentanyl are not coming from legitimate pharmacies, but pressed by criminal organizations to look like pharmaceutical drugs. The fentanyl being found in illicit pills and substances is made in clandestine labs rather than official pharmaceutical labs, Weber said, which means the potency and purity can vary widely.
According to data provided by the Iowa Department of Public Safety, officials seized more than 7 kilograms of fentanyl by itself in 127 cases last year. In hundreds of other cases officials found fentanyl in mixtures with heroin or other drugs.
It’s an extraordinary increase from 2018, when the weight of fentanyl alone found by law enforcement was only about 10 grams in 34 different cases.
Legislation has been proposed in previous years to set up needle exchanges similar to what exists in other states, but none have garnered enough support to get to a floor vote.
A Senate bill sponsored by 10 Democrats was proposed last year, but it didn’t reach a subcommittee meeting. A similar bill creating a pilot program in the House last year did not get to a subcommittee.
In an emailed statement, Senate Majority Leader Jack Whitver, R-Ankeny, said a law around fentanyl testing kits was worth consideration, but he didn’t commit support for them. He noted that needle exchanges have not received enough support to advance in previous years.
“That process is designed to collect input from all sides of an issue and it will help us identify the correct path forward [to] reduce the impact of fentanyl in Iowa,” he said.
Iowa House Republicans spokesperson Melissa Deatsch said the caucus was using the time between sessions to learn more about what can be done to curb the rising overdose rates in Iowa.
Sen. Joe Bolkcom, D-Iowa City, who sponsored a bill to introduce needle exchanges, said legislators should look at addiction as a public health issue, rather than a criminal issue. He said he hopes measures promoted by harm reduction advocates garner more support in the future.
“If you don't make addicts safer, you're not going to prevent death,” he said. “These press conferences without action will not reduce deaths from fentanyl.”
Gov. Kim Reynolds’ spokesperson, Alex Murphy, didn’t say whether Reynolds would support measures to legalize test strips or set up syringe service programs, but he pointed to her work to raise awareness around the increase in fentanyl-related deaths in the state, as well as her signing of the 2016 law that allowed pharmacists to dispense naloxone without a prescription. Reynolds has directed the Department of Health and Human Services to include information around fentanyl in an awareness ad campaign targeting youth.
Murphy and Whitver also cast blame on the Biden Administration’s policies around the southern border that they said allowed for the influx of drugs brought in from Mexico.
“This is due in large part from failed policies of the Biden Administration to not secure our southern borders,” Murphy said. “The Governor is focused on prevention, intervention and interdiction of these potentially lethal drugs and drug traffickers.”
Harm reduction proposals face mixed support from government policy advisors and law enforcement officers. Story County Sheriff Paul Fitzgerald, who heads the Central Iowa Drug Task Force, threw his support behind fentanyl testing strips alongside Miller in a press conference last month.
But that opinion isn’t shared among all narcotics officers. Ryan Moore, the assistant director of the Iowa Department of Public Safety’s Division of Narcotics Enforcement, said he thinks the measures serve to enable drug users.
“I don’t believe in that, and just our standpoint, I don’t think it’s a way to help out, by no means or bring this to a slowdown,” he said.
Dale Woolery, who runs the governor’s Office of Drug Control Policy, said he’s interested in exploring some measures suggested by harm reduction advocates, but he’d like to see them focused on directing people with substance use disorders to treatment.
“If we want true harm reduction, to borrow the term, then I think we need to look at the referral to treatment, to get additional professional help, and not just saving a life today,” he said. “That’s important, but I think we need to aim for more than that.”
Handwritten on back: Northwest corner, 3rd & Perry streets, razed for RiverCenter. On left: Hickey Brothers, Johnny's 130 Grille and Louisiana Bar-B-Q. On right: Windsor Hotel. Photo taken April 17, 1941. (Quad-City Times Archives)
The City Plan and Zoning Commission and the Off-Street Parking Committee of the Davenport City Council are studying the possibility of purchasing this property in the 300 block of West Second Street to provide additional off-street parking facilities. Such an acquisition would tie-in with the lot now being developed at Third and Ripley Streets, providing a rectangular tract. Photo taken Wednesday, June 15, 1960. (Photo by Phil Hutchison/The Daily Times)
LANDMARK'S END -- The Lagomarcino-Grupe building at the foot of Brady street is being torn down to make way for an off-street parking lot. The structure, built in 1863 by James Renwick, a former Davenport mayor, first served as a steamboat warehouse. The red brick building is of massive construction and has three-inch white-pine joists, capable of holding material of almost any weight and proportion. In 1906, the Lagomarcino firm took over and used the structure, one of the last buildings of its kind in the area, as a produce and grocery warehouse. Published Friday, April 17, 1953. (Photo by The Daily Times)
Austin Crabbs Inc., 216 Brady St., Davenport. View between 2nd & 3rd streets. Circa 1955. (Quad-City Times Archives)
Handwritten on back: Nicholas Kuhnen Tobacco Co., 2nd & Perry. Photo taken May 17, 1960. (Photo by Phil Hutchison/The Daily Times)
Raze Area For New Building
Razing operations are under way today at 4th and Brady Streets by workers of the Priester Construction Co., Davenport. The Mel Foster Co., Inc., owners of the property, said a modern one-story office building will be erected on the site with completion scheduled for about 90-days. Photo taken July 29, 1966. (Photo by Don Jones/Times-Democrat)
J's Stop 'N' Eat Lunches Fountain
"I'll sure miss the people," Permantier says. "We always had a nice class of trade. It has always been such a convenient place for people to meet." Photo taken Thursday, June 7, 1974. (Times-Democrat photo)
Moon's Card Shop and J's Stop 'N' Eat Lunches Fountain, Davenport. Photo taken July 16, 1974. (Photo by Brent Hanson/Times-Democrat)
That's the Davenport intersection of 2nd and Brady Streets, looking west, in the old photo at right. Note the trollies. Some of the same buildings remain, but overall its appearance is quite different. Photo taken Wednesday, Aug. 23, 1978. Published Monday, Sept. 4, 1978. (Quad-City Times photo)
First Trust and Savings Bank, left, will raze the adjacent Franklin Building at 3rd and Brady streets in Downtown Davenport to make way for a major expansion project. Photo taken Aug. 25, 1978. (Photo by Harry Boll/Quad-City Times)
Demolition of LaGare Gallery and Lighthouse Antiques buildings along East River Drive began today. The contractor received an unexpected headstart when the Lighthouse canopy collapsed as workers tried to disconnect gas lines. No injuries were reported. Photo published Aug. 13, 1979. (Photo by Harry Boll/Quad-City Times)
This building at 225 Perry St., Davenport, will be inspected Friday to determine whether it should be repaired or demolished. Published Wednesday, March 4, 1981. (Photo by Michael Chritton/Quad-City Times)
George and Mary Pappas, owners of Louisiana Bar-B-Q, were planning to hold a 25th anniversary celebration here next month -- something special for their customers. They've been told by the city of Davenport that the building will be torn down by then. Published Sept. 1, 1981. (Photo by Quad-City Times)
The old bus barn has sat for years along East River Drive, blocking a large section of the riverfront from view. That soon will change. Photo taken June 6, 1984. Published June 10, 1984. (Photo by Ron Bath/Quad-City Times)
This old building at 120 W. 5th St., Davenport, was once a city market, a jail and a rock pile location. Photo taken Friday, Sept. 7, 1984. Published Monday, Sept. 10, 1984. (Photo by Larry Fisher/Quad-City Times)
Bus barn on East River Drive. Photo taken Oct. 24, 1984. (Photo by Quad-City Times)
The old St. Louis House, on the corner, and most of the other buildings in the notorious 400 block on West 2nd Street in Davenport will be torn down and used as a parking lot for nearby college offices and classrooms. Published, Wednesday, May 22, 1985. (Photo by Don Jones/Quad-City Times)
This building next to the parking ramp on Davenport's East River Drive will be demolished over the next month, beginning today. Photo taken Thursday, June 13, 1985. Published Saturday, June 15, 1985. (Photo by Larry Fisher/Quad-City Times)
Handwritten on front 118 E. River Drive, Davenport.
The historic St. Louis House, and other businesses in the 400 block on West 2nd Street, are being knocked down for a parking lot to serve offices for the Eastern Iowa Community College District and classrooms for the Scott Community College urban center that will be located in the Davenport Ground Transportation Center. Published Aug. 2, 1985. (Photo by Don Jones/Quad-City Times)
Old lodge makes way for new parking lot
Demolition has begun on what was the old Elks Lodge 215-217 W. 4th St., in downtown Davenport. The building, which most recently was a restaurant with apartments above, was purchased by Sieg Partners, who developed Executive Square across the street. Once the building is down, the lot will be used for parking for Executive Square and may also be used for parking for the old Davenport Hotel next door, which is being renovated into apartments. The building should be down in about 1 1/2 months and about 50 parking spaces will be created. The building housed the Elks for more than 70 years, from 1906 until the new Elks lodge at 4400 W. Central Park Ave. opened in November 1879. Photo taken Tuesday, Oct. 8, 1985. Published Wednesday, Oct. 9, 1985. (Photo by Don Jones/Quad-City Times)
The city of Davenport has ordered the demolition of these buildings in the 700 block on Harrison Street, just south of the intersection of 8th Street. The building on the corner once housed the Last Chance grocery store. Cost of the demolition will be assessed against the owner of property. The owner declined to comment on what -- if any -- plans he has for the area. Photo published Tuesday, Oct. 15, 1985. (Photo by Don Jones/Quad-City Times)
End of era ... of sorts
Demolition began Friday, Nov. 29, 1985, on Kathy's Silver Moon and other taverns and businesses in the 400 block on Davenport's West 2nd Street, a "skid row" strip notorious as a hangout for prostitutes. The buildings are being razed to make room for a parking lot that will serve the city's new Transit Center. Published, Saturday, Nov. 30, 1985. (Photo by Larry Fisher/Quad-City Times)
Davenport buildings razed. Photo taken Friday, Nov. 29, 1985. (Photo by Larry Fisher/Quad-City Times)
They knock it down to build it up
The wrecking ball's work is nearly completed at the Goldenrod Adult Bookstore in the 400 block on West 3rd Street in Davenport. The demolition of the buildings is part of an effort by Project Rejuvenate Davenport to make the site available for new downtown development. The location has been mentioned as a possible site for a new Lend-a-Hand Club which would serve as an apartment complex for the handicapped and elderly. Photo taken Friday, Sept. 25, 1987. Published Saturday, Sept. 26, 1987. (Photo by Larry Fisher/Quad-City Times)
SHOPPING CENTER SITE -- The southwest corner of Bridge Avenue and Locust Street in Davenport soon will have a 7,300-square-foot retail center. Four residential properties will be cleared. Published Aug. 30, 1989. (Photo by Harry Boll/Quad-City Times)
The Fischer's Shoes building in downtown Davenport may be demolished soon as a result of an agreement between the owner and developers of a parking lot. Published Aug. 16, 1990. (Photo by Larry Fisher/Quad-City Times).
The wrecking ball sends debris flying at the demolition site of the old Folwell's and Arnolds stores in downtown Davenport. The site will be, at least temporarily, turned into a parking lot. Photo taken Friday, Oct. 12, 1990. Published Sunday, Oct. 14, 1990. (Photo by John Schultz/Quad-City Times)
Then: A portion of Davenport's riverfront is being cleared in 1990 with the demolition of some grain storage silos along River Drive and Federal Street. The silos were the last remnants of a 1975 grain elevator explosion at the former Robin Hood flour mill.
The image of jazz great Bix Beiderbecke looks concerned as Mike McManus of Andalusia, Ill., clear the River Drive site Monday, Feb. 11, 1991, for riverboat gambling-related construction. Plans call for demolition of the Davenport mural. Published, Tuesday, Feb. 12, 1991. (Photo by Jeff Cook/Quad-City Times)
French & Hecht, Davenport, Circa 1955. (Quad-City Times Archives)
French & Hecht, East River Drive, Davenport. (Photo by Phil Hutchison/The Daily Times)
Downtown Davenport. (Quad-City Times photo)
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FILE - In this June 6, 2017 file photo, a reporter holds up an example of the amount of fentanyl that can be deadly after a news conference about deaths from fentanyl exposure, at DEA Headquarters in Arlington Va. Some large law enforcement agencies have recently abandoned the routine chemical field tests out of concern that officers could be exposed to opioids that can be absorbed through the skin or inhaled. Even a minute amount of the most potent drugs, such as fentanyl, can cause violent illness or death. (AP Photo/Jacquelyn Martin, File)
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