As the opioid crisis continues to cause concerns throughout the United States, opinions are divided concerning the use of fentanyl test strips to combat the mounting number of overdose deaths nationwide.
Several programs are distributing fentanyl test strips, along with clean syringes to people who use street drugs. The test strips help users detect if any street drugs, like heroin or cocaine, are laced with fentanyl, which is increasingly being added to illicit drugs, posing an even greater threat of lethal overdose to users.
The test, originally developed by the Canadian biotech company BTNX, allows users to dip the test strip in a mixture of the drug and a small amount of water to test if fentanyl is present. The strip will reveal one line to indicate fentanyl is present. Two lines indicates no fentanyl.
This gives users the opportunity to choose whether or not to use illicit drugs laced with fentanyl, which is often the cause of many unintentional drug overdose deaths.
Fentanyl is a synthetic opioid painkiller that is 50 to 100 times more potent than morphine. It was first developed for patients with the most severe pain, such as cancer pain. In recent years, synthetic fentanyl has become widely popular and many drug dealers lace other illicit drugs with fentanyl, putting many unwitting users at risk.
A recent U.S. Centers for Disease Control and Prevention (CDC) report indicates fentanyl is linked to more overdose deaths than any other drug in the U.S. It accounts for one-third of all fatal overdoses in the country. Fatal overdoses involving fentanyl have doubled each year since 2013. However, some critics staunchly oppose the use of test strips, including the Trump administration’s assistant secretary of Health and Human Services Dr. Elinore McCance-Katz.
McCance-Katz told the Wall Street Journal on Wednesday that many drug users will still use drugs laced with fentanyl even if the test strips show positive, ignoring the danger. Offering test strips to drug users who may not be thinking logically and rationally to begin with will prove ineffective, she claims.
She also speculated that some drug users will use the test strips to search for drugs with fentanyl to find a more potent high and the test strips allow drug users to continue their lifestyle.
However, a survey (PDF) of drug users who used the test strips indicated 75% of users changed their behavior after their drug tested positive for fentanyl. In some cases the users didn’t use the drug at all. In other cases, the users made sure someone with naloxone, the opioid overdose reversal drug, was present during use. In other cases, users used less of the chosen drug so as not to overdose on fentanyl. The survey was published in February 2018 by researchers with the Johns Hopkins Bloomberg School of Public Health.
The test strips can provide a false negative and be difficult to read at times, since the strips are inexpensive and made from cardboard. However, advocates say the inexpensive, controversial tool can save countless lives if widely implemented.
“We are at a pivotal moment in the overdose epidemic, and we need to embrace the full range of interventions that can save lives,” Dr. Susan Sherman, professor in the Bloomberg School’s Department of Health, Behavior and Society and study co-author said in a press release issued at the time of the study’s publication. “Our findings bring to the table evidence that can inform a public health approach to the fentanyl crisis. Smart strategies that reduce harm can save lives.”