Wentworth County is expanding its fentanyl test strip program from six sites to twenty, county health officials said, and switching to combination strips capable of detecting xylazine as the local drug supply shifts.
The Wentworth County Department of Health will more than triple the number of locations distributing free fentanyl test strips over the next two months, from six sites to twenty, after county lab data showed a growing share of the local drug supply contaminated with xylazine, a veterinary sedative that does not respond to naloxone.
“The drug supply we’re seeing today is not the drug supply we were responding to three years ago,” said Dr. Kwame Asare, director of the county health department. “Test strips that only check for fentanyl are still useful, but we’re now distributing combination strips that can also flag xylazine, because naloxone alone won’t reverse an overdose involving that combination.”
Contamination found in local samples
County lab testing of drug samples collected anonymously through the outreach van program found xylazine present in roughly one in four fentanyl samples tested over the past six months, up from near zero three years ago, according to figures the department released alongside the expansion announcement. Asare said the shift mirrors a broader regional trend but that Wentworth County’s numbers have climbed faster than some neighboring counties’.
“We don’t fully know why our numbers moved faster,” Asare said. “It could be supply routes, it could be reporting differences between counties. What we do know is that our test strip guidance from even eighteen months ago is already out of date, which is why we’re changing what we hand out.”
New sites, familiar partners
The expanded distribution network will run through Wayfinder Recovery Services, the Riverside Free Clinic and, for the first time, several Vale Avenue pharmacies that have agreed to keep strips available at the counter without a prescription requirement.
- Wayfinder Recovery Services’ Lowertown office and its outreach van routes
- Riverside Free Clinic’s Cedar Hollow location and its new mobile care unit
- Six independent pharmacies along Vale Avenue and in West Bellwater
- A rotating table at the county health department’s downtown office
Marisol Ferran, a nurse practitioner who oversees medication-assisted treatment at the Riverside Free Clinic, said patients have started asking about xylazine by name in the past year, something she said almost never happened when the clinic first began stocking test strips. “People are scared, and they should be, because the wound care for a xylazine exposure is a lot harder than reversing a fentanyl overdose,” Ferran said. “Giving someone a way to check what they have before they use it is one of the few tools we have that doesn’t require them to be ready to quit yet.”
Donna Wysocki, executive director of Wayfinder Recovery Services, said her organization’s outreach van volunteers have been trained to distribute the new combination strips as part of their standard kit, alongside naloxone and clean supplies. “We’re not asking anybody to prove they’re trying to get clean before we hand them something that might keep them alive long enough to get there eventually,” Wysocki said.
Funding and pushback
The expansion is funded through a combination of a state harm-reduction grant and money freed up in the county’s current budget, according to Asare, who said the program cost roughly $85,000 for the first year, mostly for the strips themselves and staff time. Not everyone on the county board has embraced the approach. Some members have questioned in budget hearings whether distributing test strips sends the wrong message about drug use, though Asare said no board member has moved to block the funding.
“I understand the discomfort,” Asare said. “But the choice isn’t between somebody using drugs and somebody not using drugs. It’s between somebody using drugs with information about what’s actually in their supply, or without it. I’d rather they have the information.”
Wentworth County reported 61 overdose deaths over the past year, down from a peak of 118 three years ago, though Asare cautioned that the emergence of xylazine in the local supply could complicate that trend going forward. “A declining death count doesn’t mean the supply is getting safer,” he said. “In some ways it’s getting more dangerous, just differently. We have to keep adjusting to what’s actually out there instead of what used to be out there.”
The health department plans to publish updated overdose data, including any changes tied to the new contamination trend, in its next full annual report.
Training pharmacists and outreach staff alike
Several of the participating pharmacists said they had to complete a short county-run training before agreeing to stock the strips, covering how to explain their use to customers who might be hesitant to ask questions in person. Marisol Ferran, who helped design part of the training as a clinical advisor to the county, said pharmacy involvement matters because it reaches people who would never walk into a clinic or approach an outreach van.
“Some people are comfortable with an outreach worker,” Ferran said. “Other people would rather quietly pick something up at a counter where nobody knows why they’re there. If we only offer this through clinics and vans, we’re missing a whole group of people who are more private about it, and they deserve access too.”
Asare said the county is also distributing informational cards alongside the strips explaining how xylazine wounds differ from typical injection-site injuries and when to seek emergency care, material the department developed after several regional hospitals reported treating xylazine-related wounds without initially recognizing what caused them. “We had to catch our own emergency rooms up on this before we could expect the public to understand it,” he said. “That education piece is arguably as important as the strips themselves.”