Toward policy punctuation: a content analysis of harm reduction framing in fentanyl test strip policy in texas

Escalating fentanyl-related overdose deaths have intensified calls for harm reduction strategies, including legalization of fentanyl test strips (FTS), which remain criminalized in Texas despite strong empirical support. This study applied Punctuated Equilibrium Theory to examine FTS policy discourse through the lens of policy image, venue dynamics, and feedback mechanisms. A structured qualitative content analysis examined media, legislative, advocacy, and testimony documents (N = 29) published between 2021 and 2025. Harm reduction framing was dominant across the analytic period—marked by bipartisan support, public health messaging, and moral reframing of overdose prevention—while criminalization persisted as a co-present, contested frame. Yet legislative change has not occurred, largely reflecting institutional friction and venue constraints within the Texas Senate. Texas thus represents a pre-punctuational phase: conditions for policy change are emerging but remain constrained. Implications highlight strategic framing, venue access, and institutional navigation for advancing harm reduction within restrictive policy environments.