“It’s a blessing — it is a blessing that these are now legal,” said Rafael Mercado.

“What I do is we come out and I have packages similar to this and we hand them out,” said the community outreach worker who distributes fentanyl test strips in Milwaukee, including to people in his own neighborhood on the south side of the city.

“Take it out. If you use the drug, test it. Drop it in the urine. Just like a pregnancy test, it’ll give you one line, two lines and then one that will be higher,” he explained.

Mercado lives in the hot spot for overdose deaths in Milwaukee County. The county saw more than 7,000 ODs in 2021, more than 600 of them fatal.

Some 80% of deaths are caused by fentanyl, a powerful opioid mixed into other drugs by dealers to increase potency, and that in even trace amounts can be deadly.

“They’re not trying to kill themselves,” said Mercado about people who OD from fentanyl. “They’re trying to mask a pain.”

Rafael Mercado is a community outreach worker in Milwaukee who is helping distribute fentanyl testing strips in an effort to reduce overdoses in the city. (Credit: PBS Wisconsin)

The problem is so commonplace that even as Mercado discussed the crisis outside the 16th St. Clinic location on National Ave. in Milwaukee – a person overdosed down the block. Paramedics revived them.

“The overdose deaths have increased for several years in a row where we’ve had a new record. So we are just at unprecedented numbers,” said Michael Lappen, administrator for the Milwaukee County Behavioral Health Division who partners with Mercado, who hits the streets.

“It’s good to walk,” said Mercado.

“You dip it in, just wait about five minutes. So if you get two lines, it’s a negative. One, the high is positive,” he explained.

“They just got me handing out more fentanyl strips,” Mercado told a passerby. “I’m handing out more of them fentanyl testing strips.”

Mercado said the idea is for people to use very small amounts of their heroin, test, and have the emergency OD reviving spray Narcan at the ready.

Michael Lappen, administrator for the Milwaukee County Behavioral Health Division, points to fentanyl testing strips as one approach to help reduce an unprecedented number of drug overdoses and related deaths. (Credit: PBS Wisconsin)

How important is the legalization of these fentanyl test strips?

“Well, it’s very important, because it allows people to make informed decisions about what they’re ingesting. So, if someone tests their drugs and they identify fentanyl, they know perhaps I should have naloxone or Narcan available,” Lappen said. “Maybe they use with a partner so they can keep each other safe. Maybe they reduce their dosage and maybe they don’t use it at all.”

As an ambulance tears away carrying an OD victim, what about the question of whether handing out packages of test strips and Narcan encourages drug use?

“Well, people say that. Folks have said that all these harm reduction initiatives just enable drug use,” said Lappen. “I completely disagree. I believe that what we’re doing is we’re maintaining safety, keeping people alive long enough for them to get into recovery.”

Wisconsin legalized fentanyl test strips in mid-March. Before the law changed, they were illegal — considered drug paraphernalia.

Milwaukee County started distributing 1,600 of them – with more to come.

“The theme is whatever we can do to keep people alive, we want to do that in our community,” said Lappen.

“You know what it’s like for a mom to have to bury her son or daughter or their loved one? You know, their husband?” asked Mercado. “I’m not enabling nobody. I’m saving their life.”