As Ohio overdose deaths continue to climb steeply, harm reduction workers around the state are putting naloxone and fentanyl test strips (FTS) in critical drug consumption spaces: bars and nightclubs. Whether people accept that characterization of these spaces depends on who you ask.
In November 2020, Ohio State University Students launched the Safety Outreach Autonomy Respect (SOAR) Initiative, creating a “bad batch” alert app and connecting people to Columbus-area harm reduction resources. These days, SOAR members are meeting with nightlife business owners to talk about training their staff to use naloxone and providing FTS they can offer to their customers.
“Definitely stigma is a big challenge to doing any harm reduction outreach in any space—even in places where drugs are being consumed,” SOAR Director of Community Relations Dennis Pales told Filter. “In the case of nightclubs and bars, many may deny that other drug use [besides alcohol] is happening.”
Pales also observed that some business owners are worried about potential liability involved in employees using naloxone. Ohio has a “Good Samaritan” law for people seeking immunity at the scene of an overdose, but it has a lot more fine print than those in many other states.
Another barrier is making customers understand that they’re at risk of overdose if they use any unregulated drug, not just an opioid. That can be a challenge in places more associated with drugs like cocaine or MDMA.
“People who use [opioids] may have their own communities,” Pales said, “and to keep each other safe they talk about their drug supply. So they are more knowledgeable and aware of what’s going on than people who [more often] use legal substances like alcohol.”
Fentanyl test strips are still considered drug paraphernalia under Ohio law.
Meanwhile in Cincinnati, some harm reductionists doing similar work are finding that the nightlife industry has been open to education about overdose risk. The members of Harm Reduction Ohio (HRO) have their eye on summer festivals and county fairs as potential training sites. By fall, HRO will have expanded its training into Columbus, with a goal of reaching Cleveland or Toledo by winter. After that, the focus will be on expanding to more rural areas.
“A lot of people are harm reduction-minded,” AmandaLynn Reese, HRO director of outreach and engagement, told Filter. “A lot of people in the industry use drugs, or there’s liability that people who are doing a key bump in the bathroom might have some adulterated [cocaine].” About 80 percent of cocaine- and meth-involved overdose deaths in Ohio last year also involved fentanyl.
In March, the community was shaken when a well-known figure in the Columbus nightlife scene died of overdose. Reese said they were not known to use opioids, and likely took another drug cut with fentanyl.
“Having the fentanyl test strips and naloxone in these places and making them community access points not only protects the staff but it protects their patrons, and it’s the reasonable thing to do,” Reese said.
FTS are still considered drug paraphernalia under Ohio law. A bill introduced in February, SB 296, would both provide immunity from criminal prosecution for people using FTS as well as make naloxone more widely available. The bill is currently awaiting its vote in the House.
“The risk of being prosecuted for a fentanyl test strip is fairly low,” Pales said. “[But] I have heard stories of fentanyl test strips being confiscated or being used as reason to do another search. So definitely taking some of the legal burdens off of them is a very good thing.”
To date, HRO and its partners have held several small trainings at local bars, focused on naloxone and FTS. On April 25, the group will partner with the Coalition for Community Safety to host a much larger training at a local bar, welcoming around 150 people from the nightlife industry. Reese said that to make it easier and more inviting for people to participate in these trainings, sometimes the employer will pay their staff as if they were on the clock—or offer an open tab.