Fentanyl Test Strips

"Fentanyl test strips (FTS) are a low-barrier drug-checking tool that can detect multiple fentanyl analogs in a range of substances at the point of consumption [10,11,12,13,14]. While investigation of FTS practices has grown rapidly since 2016 [15], evidence derives primarily from single-instrument feasibility and acceptability studies using qualitative or quantitative designs and small sample sizes (n = 11–93) of people who use drugs (PWUD) [10,11,12,13, 16,17,18,19,20,21,22,23], which limit generalizability. Most FTS studies have been conducted at a single site, typically a syringe service program or other harm reduction service provision sites. At the time of this writing and confirmed by a recent scoping review [15], just four out of 26 FTS studies have sample sizes of PWUD > 100 (n = 105–426) [10, 14, 24], and all but two [14, 24] were conducted in a single state or province. Two studies tested an FTS intervention [22, 25], and another FTS study used a urinalysis test to investigate concordance of self-reported fentanyl consumption with biomarker results [26].

"Findings are mixed on whether PWUD who obtain a positive FTS result modify their drug use behaviors [10, 11], suggesting the need to look more closely at the impact of FTS use, risk perception, and behavior change [27]. A single study using a cross-sectional, mixed-methods design compared substance use behaviors of PWUD who do and do not use FTS [16]. Researchers leading this study found that FTS use by PWUD is associated with both safer behaviors (e.g., using less drug supply than normal) and riskier behaviors (e.g., using more drug supply than normal)."