Texas policy updates; fentanyl abuse prevention passed, decriminalization of fentanyl strips failed

The 88th regular session of the Texas legislature concluded on May 29, 2023. Over a thousand bills related to substance use were filed during the session, concerning topics ranging from fentanyl test strips to recovery housing, fentanyl education, and Medicaid reimbursements. While not all of these bills made it to the Governor, there’s a lot to learn from the ideas and enthusiasm that we saw this year. Here’s a review of some of the passed bills that will go into effect in 2023, as well as others with ideas that could be revisited in future sessions.

Some notable bills did not become law this session, including those that aimed to decriminalize fentanyl test strips. A large number of bills proposed decriminalizing fentanyl test strips this year, and were filed by Senators and Representatives from both major parties. The most successful contender – HB 362 – passed the House with almost unanimous support, but ultimately did not advance in the Senate. However, the bipartisan interest in decriminalizing these supplies was encouraging and suggests that similar bills could be filed in the future. Fentanyl test strips may very well be discussed in and leading up to the 89th legislative session.

Other interesting bills that did not become law concerned creating Medicaid coverage for peer-to-peer services, regulating sober living homes, and conducting overdose mapping and response through the Department of State Health Services, as described by HB 1397, HB 1987, and HB 4173, respectively. These bills were also introduced by legislators from both major parties, but also did not advance to the Governor. A few bills, such as HB 4667, took a more conservative approach to the opioid epidemic. According to HB 4667, anyone knowingly involved in operating a supervised consumption site would be subject to a 2nd degree felony charge. However, HB 4667, too, did not advance to the Governor. 

With that said, several substance use-related bills from the 88th legislative session were not only successful, but became effective immediately. This included HB 3908, which requires schools to provide fentanyl abuse prevention and drug poisoning awareness education to students in grades 6 through 12. Similarly successful was SB 867, which amended the Health and Safety Code to allow institutions of higher education to receive opioid antagonists from the executive commissioner of the Health and Human Services Commission. Finally, HB 1357 made Medicaid coverage of medication-assisted treatments for opioid or substance use disorders permanent.

September 1st, 2023 will see several more bills from the 88th session go into effect. These bills take varying approaches to addressing the opioid crisis. For example, SB 2173 will create a pilot program for the safe disposal of controlled substance prescription drugs, while HB 299 will create a voluntary accreditation for recovery housing. SB 1319 is particularly noteworthy for mandating reports of controlled substance overdoses for public safety purposes. The bill maintains confidentiality and provides protections for people who make reports, while aiming to connect data from health care practitioners, local health authorities, and law enforcement agencies to identify patterns and trends in overdoses.

The 88th regular legislative session made it clear that there is bipartisan acknowledgement of the stakes involved in the opioid epidemic. Important conversations were had with a newfound level of support – even if said support was not always enough to pass a bill. The debate on topics such as decriminalizing fentanyl test strips or regulating sober living homes remains ongoing, and may be revisited in and leading up to the 89th session. We hope that this overview provided some useful highlights for you and your organization, as well as areas for advocacy and research in the year and a half until our next regular session begins.