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Reducing Harm, Saving Lives · Talking FACS

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  Welcome to Talking FACS, what you need to know about family,
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  food, finance, and fitness.
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  This nationally recognized, award-winning podcast is hosted by the University
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  of Kentucky Family and Consumer Sciences Extension Program.
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  Our educators share research knowledge with individuals, families,
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  and communities to improve quality of life.
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  Welcome to Talking FACS, where we share research-based information to help
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  improve the quality of life for Kentuckians. I'm Alex Elswick.
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  I'm an assistant professor and extension specialist for substance use prevention and recovery.
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  I'm a frequent guest on the Talking FACs podcast, but today I'm excited to
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  serve as a guest host and have a guest expert with me.
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  Speaking of our expertise, we're speaking today from our personal areas of expertise
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  and our views do not represent the official views of the University of Kentucky.
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  Speaking of experts, I'm excited to have with me today Alex Johansson.
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  Alex is an intern with the UK Harm Reduction Hub, a community service that brings
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  together a team of researchers, healthcare providers, and harm reductionists
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  to provide early insights into Kentucky's street drug supply by analyzing the
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  residue in used syringes.
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  Alex, good morning. Thanks for being here.
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  Good morning. Thank you so much for having me. I'm really excited to talk with you today. Absolutely.
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  So we're talking about harm reduction and a somewhat newer strategy called syringe residue testing.
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  So to start us off, what do we mean when we say harm reduction?
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  So the term harm reduction is exactly what it sounds like.
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  Its main goal is really to reduce any harms or consequences associated with
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  so-called risky behaviors. So in our case, using drugs.
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  But harm reduction really is just focusing on increasing access to services
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  and resources and serving the community with that.
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  Okay. And so harm reduction is something that, as you kind of implied,
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  is a concept that applies both to substance use, but also to other kinds of risky behaviors.
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  Can you give us a few examples of harm reduction, kind of just in real world
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  examples of harm reduction?
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  Yeah, exactly. So it's something that's all in the world around us.
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  We just don't think about it too much because it's kind of common practice.
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  So one thing would be seatbelts, right? If you're driving, it's actually required
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  by law to wear a seatbelt, and that's just to reduce any potential harms associated
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  with driving or getting in an accident.
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  The same is true for wearing a helmet if you're riding a bike or putting on
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  sunscreen before you go to the beach.
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  So it's really just trying to protect people at the end of the day.
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  I love the example of seatbelts, and sometimes I like to give the example of
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  speed limits. And I tell people that I mostly observe those as a way to engage
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  in harm reduction. Great, great examples.
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  So what would harm reduction look like as a practice applied to substance use
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  and substance use disorders?
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  So for substance use, it typically takes the form of maybe distributing overdose
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  reversal medications, things like naloxone, also called Narcan.
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  Another example would be syringe exchanges where people can go and get unused syringes.
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  And another would be syringe residue testing, which is what we're here to talk about today.
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  Yeah. And I think when most people think of harm reduction, if they're familiar
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  with it, they most immediately think of some of those harm reduction practices
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  you mentioned, overdose reversal medications or.
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  You know, syringe service programs, things like that. But harm reduction is
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  also kind of a philosophy.
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  Can you share what that looks like, what that means?
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  Absolutely. So we kind of talked about what harm reduction looks like in practice,
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  but as a philosophy, it's really just grounded in respect, dignity,
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  and the belief that people deserve care and support at any or all stages of their life.
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  So it's really about making informed decisions and just helping people promote
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  well-being, both at the personal and the community level.
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  Yes. And I think one of the things I've always appreciated about harm reduction
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  as a philosophy is that it accepts drug use as a reality.
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  And so rather than deny it or condemn it, it accepts that drug use is a part
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  of our world. It always has been. It always will be.
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  And so rather than deny it, we acknowledge the reality and we try to work within
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  that frame to try to reduce harm. Exactly.
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  So, okay. So syringe residue testing, let's get to the topic of the day.
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  So this is one example of a harm reduction practice in action.
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  What is syringe residue testing and how does it work?
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  Yeah, in its simplest form, syringe residue testing uses what we call kind of
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  a trash to treasure approach.
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  So these services collect these syringes from the community and they test the
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  residue in those syringes to get information about what's in the drug supply
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  at any given point in time for a specific geographic area.
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  And what exactly is being tested? So we specifically test the trace amounts
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  of the drug that are left in the syringe, we swab it, and then we put it through
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  a bunch of chemical analyses, and it tells us what the syringe contained.
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  Okay. And this is a form of drug checking. Are there other forms of drug checking in Kentucky?
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  Yes, there are other forms of drug checking. A really common example is single-use
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  drug test strips. It's kind of like a pregnancy test or a COVID test strip.
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  So you can get them from health departments and similar harm reduction agencies.
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  But for different drugs or additives, which we'll talk about shortly,
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  you basically just take a little bit of the drug, put it in some water,
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  and then dip the strip in there and it'll tell you if the drug of interest is
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  present or absent in your kids.
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  This is really interesting. We hear quite a bit in the media and the news about
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  adulterants and additives.
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  We've certainly seen a lot about the opioid epidemic and the overdose epidemic more specifically.
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  So, I mean, I think on some level it's immediately clear why this is valuable
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  information, but what are some of the substances that you're finding in Kentucky communities?
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  Yeah, so like you said, it's really interesting because this allows us to track
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  patterns of drug use, you know, across Kentucky.
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  It also, in addition to just drugs that you would traditionally expect to see
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  in the supply, it allows us to detect additives.
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  And additives are really just other substances that have been introduced to
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  the supply. Some of them are contaminants, and they can increase the risk for serious health harms.
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  So in Kentucky specifically, we're testing in five counties right now.
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  So we have partnerships with local harm reduction agencies in Fayette,
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  Jefferson, Jessamine, Perry, and Rowan counties.
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  So in February of 2026, this past month, the two most common substances that
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  we found across Kentucky were fentanyl and methamphetamine.
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  About 50% of all the syringes that we tested contained fentanyl and methamphetamine,
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  or not combined, but they had fentanyl and methamphetamine.
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  So those are kind of the regional trends. This can vary county to county.
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  So in Rowan County this past month, about 91% of the syringes contained meth,
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  whereas only 36% in Jefferson County had meth.
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  And similarly, about 60% of syringes from Fayette or Jefferson counties had
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  fentanyl, but only 19% in Perry County had fentanyl. So again,
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  there's some variance geographically, but those are the two most common things that we saw.
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  And then in terms of additives, there's been a lot of metatomidine in the supply right now.
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  For those of you who aren't familiar, metatomidine is a veterinary anesthetic
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  or tranquilizer that's been getting a lot more media attention recently due
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  to its harmful side effects.
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  And in Jefferson County specifically, we saw the most, so there were about 24% of the syringes.
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  So I think to underscore, these additives in many cases, or in most cases perhaps,
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  are substances that people don't realize that they're taking. Exactly, it's right.
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  It's very hard to detect them. You can't really smell them or taste them or
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  see them, so you need to have some sort of test, whether that's a single-use
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  test strip or something like syringe residue testing to determine what's present.
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  And without syringe residue testing, we tend to rely on things like either overdose
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  toxicologies, which clearly by their very nature come too late,
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  or self-report surveys, which have sort of their own problems.
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  So I find this, I'm not familiar with the phrase trash to treasure,
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  but I find this concept really interesting. And I can see where it also provides
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  rapid and timely information.
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  So how does the Harm Reduction Hub go about sharing this information to the people who need it most?
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  Exactly. So we like to think of ourselves as kind of a bridge.
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  So we connect harm reduction agencies, scientists, and healthcare workers,
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  and just community members more generally.
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  So within that, I'd say the main
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  way that we communicate is by sharing newsletters and alerts by email.
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  But I think another big component of this is word of mouth. So if we are sharing
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  our recent findings with a partner site,
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  then they may just have the ability to tell folks what's going on and if they
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  should be aware of potential additives in the supply and that sort of thing.
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  Syringe residue testing has a clear relevance and importance for people who
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  use drugs and for their families as a way to ensure that they're aware of what
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  they're using and able to use more safely to prevent overdose and prevent related harms.
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  But why might syringe residue testing be important, not just for those individuals,
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  but for the broader community?
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  Yeah, exactly. I think it's an important point to kind of highlight.
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  Syringe residue testing, as we've talked about, is really good at giving us
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  information that we can leverage for prevention of harm.
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  And that's immediately obvious for people who are using drugs or distributing drugs.
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  But services like ours also provide really important information for friends
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  or family of people who use drugs,
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  community members, and especially healthcare practitioners or providers who
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  are working in the substance use treatment and recovery spaces,
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  so specifically treatment providers and social workers.
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  So by detecting these emerging threats and identifying them quickly,
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  we can rapidly share public health alerts and different harm reduction agencies
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  like syringe residue testing sites can help communities kind of target naloxone distribution,
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  adjust their outreach strategies, and also just inform like funding proposals
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  and policy decisions based on this time of local data.
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  So essentially, at the end of the day, if we know what's in the supply,
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  we can really tailor our prevention efforts using this information.
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  So really the benefits of syringe residue testing are no small thing.
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  The ripple effects really extend to so many of the factors that we're trying
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  to impact in reducing harm.
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  I love that some of my harm reduction friends like to say, we meet people where
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  they are and maybe we don't leave them there, you know? And that's fantastic.
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  So I'll leave a link in an email contact for the Harm Reduction Hub in the show notes.
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  And if you're just tuning in, you're listening to Talking FACS,
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  presented by Family and Consumer Sciences Extension in the Martin-Gatton College
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  of Agriculture, Food, and Environment at the University of Kentucky.
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  And Talking Facs is available wherever you find your favorite podcast.
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  Alex, thank you so much for being our guest today.
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  Thank you so much for having me. Have a great day. Thank you for listening to Talking FACS.
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