Fentanyl test strips could cut overdoses, says pilot study

A simple test for the opioid fentanyl, given to known drug users, could help curb fatal overdoses, according to a pilot study.

Researchers in the US asked female sex workers who had used illicit opioid drugs within the last month to use the test strips, which are designed to show whether they contained the highly-potent opioid, which was responsible for almost half of the 67,000 drug overdose deaths in the US in 2018.

Fentanyl and related synthetic drugs are many times more potent than heroin, and are appearing in a growing number of illicit drugs, including heroin, cocaine, and counterfeit opioid pills.

Haphazard manufacturing means that products based on them have unpredictable purity and dosing, raising the risk of an accidental overdose.

In the Fentanyl Innovative Testing (FIT) study, researchers from the Johns Hopkins Bloomberg School of Public Health and Brown University tested the strips among 103 active sex workers in Baltimore.

They were given advice on reducing overdose risk, for example to avoid mixing alcohol with opioids, issued with five strips and trained how to use them, and also given a naloxone kit to treat an overdose.

Among 68 who completed follow-up over the next four weeks, 84 per cent had used at least one strip to test drugs, and 86 per cent having at least one result indicating the presence of the synthetic opioid.

57 per cent reported a surprising result – in other words the presence or absence of fentanyl – and more than two-thirds (69 per cent) engaged in harm reduction behaviours as a result, such as asking someone to check on them or using a smaller amount.

Some of the women said they were surprised at how widespread fentanyl had become after positive test results, while others with negative results were also surprised, saying they assumed fentanyl was present in all drugs.

Overall, the researchers say they were impressed with the willingness of thew women to use the strips, and there was some evidence of reductions in drug use overall, as well as less risky, solitary use.

“This pilot was conducted against a backdrop of high fentanyl-related concern and mortality rates,” they write. “Our data suggest that the FIT intervention…could be a promising model for reducing overdose risk among high-risk populations.”

The pilot is reported in the journal Addictive Behaviours.

The following video shows how fentanyl strips can be used: