Fentanyl Test Strips

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How the Opioid Crisis Has Created a Need for Fentanyl Test Strips

In recent years, opioid overdose deaths have been on the rise as potent illicit synthetics like fentanyl have become common on the black market. In the United States, deaths from synthetic opioids (excluding methadone) increased by over 22% between 2020 and 2021. Today, more than 150 people die from synthetic opioid overdoses every day. Because non-prescription fentanyl is criminalized and frequently mixed in with other illicit drugs, users may be unaware of the amount of fentanyl they are consuming, leading to an accidental overdose. Since many people will continue to use drugs under dangerous circumstances, more states are turning to tools like fentanyl test strips in an effort to reduce harm.

Fentanyl test strips can be used to identify fentanyl in liquids, powders, and pills. When people become aware that their drugs contain fentanyl, they have a better chance of making choices that reduce their risk of overdosing.

What Are Fentanyl Test Strips?

Fentanyl test strips are a simple-to-use, inexpensive screening tool that indicate the presence of fentanyl. These small strips of paper can detect fentanyl when it is isolated or mixed with other street drugs that are diluted in water.

Understanding Fentanyl

Fentanyl is a synthetic opioid that doctors sometimes administer to manage pain after surgery. It’s about 50 times stronger than heroin and 100 times stronger than morphine. Unfortunately, its potency makes it extremely dangerous when it is used outside of a hospital setting. Two milligrams of fentanyl, which is equivalent to about 10 to 15 grains of table salt, can be a lethal dose.

On the street, fentanyl is sold in powder form that can be smoked, snorted, dissolved, injected, or mixed with other drugs. Drug traffickers push fentanyl because it is highly addictive and cheap to manufacture. Many former users of prescription opioid painkillers such as oxycodone have turned to fentanyl to manage their addictions, while users of other drugs often encounter it unintentionally because it is undetectable by sight, taste, or scent.

The Rise of Fentanyl in Illicit Drugs

It has become more common for drug traffickers to mix fentanyl with other illicit drugs, including heroin, methamphetamine, cocaine, and pressed pills that are made to look like prescription opioids, to increase their overall potency. Counterfeit Oxycontin, Percocet, Vicodin, Xanax, and Adderall can all potentially contain fentanyl and be riskier to use than prescription opioids. Manufacturing fentanyl for street use is not subject to any particular standards or quality control, and it is relatively easy to take a fatal dose. As a result, many people unintentionally poison themselves by injecting, inhaling, or ingesting too much fentanyl.

Fentanyl Test Strips: How They Work

Fentanyl test strips are small strips of paper that can detect the presence of fentanyl in any pill, powder, or injectable drug. They can be used to screen stimulants, opiates, and benzodiazepines. The strips are easy to use and can be kept in a purse or wallet.

To detect the presence of fentanyl in a drug sample, a user can dilute the drug in water and then dip the strip into the solution. If a single line appears after a few minutes, then the drugs test positive for fentanyl.

How to Use Fentanyl Test Strips

Typically, screening drugs with fentanyl test strips is a five-step process. Make sure to read the instructions on the package to ensure that you are following the right steps for the particular drug you are testing.

• Step 1: Put at least 10mg of your drugs in a dry, clean container.
  
• Step 2: Add the appropriate amount of water and mix. Most drugs require ½ teaspoon of water, but methamphetamines usually require one full teaspoon.
  
• Step 3: Dip the wavy end of the test strip in the water and keep it there for about 15 seconds.
  
• Step 4: Remove the strip from the water and lay it on a clean, flat surface for two to five minutes.
  
• Step 5: Read the results.

How to Interpret Test Results

• Positive test results: A single pink line on the left-hand side of the strip indicates that fentanyl or a fentanyl analog has been detected. If your drugs test positive, it is much safer to discard them; using them could kill you.
  
• Negative test results: Two pink lines indicate that no fentanyl or a fentanyl analog has been detected in your drugs. Since no test is guaranteed to be 100% accurate, you should still use caution. Even if the test result is negative, your drugs could still contain fentanyl or fentanyl analogs like carfentanyl.
  
• Invalid test results: If you see a single pink line on the right-hand side of your strip or you don’t see any lines, your test is invalid, and you should repeat the test with a new strip.

Fentanyl Test Strip Accuracy and Limitations

Fentanyl test strips are 96% to nearly 100% accurate and reliable in detecting fentanyl and several of its synthetic opioid analogs when used correctly. Unfortunately, these tools do have some limitations. User errors can result in inaccurate or invalid results that can’t be definitively interpreted. There is also evidence to suggest that fentanyl test strips may return false positives by cross-reacting with too-high concentrations of methamphetamine in a sample.

Fentanyl test strips cannot measure the quantity or potency of fentanyl or fentanyl analogs present in a drug sample. It’s possible to falsely interpret a negative test result and believe that contaminated drugs do not contain fentanyl. In some cases, one portion of a drug batch may contain fentanyl while another may not, so a sample portion that tests negative for fentanyl may not accurately reflect the purity of the entire batch.

How Fentanyl Test Strips Reduce Harm

Testing drugs with fentanyl test strips can provide users with valuable information that can help them choose to discard a potentially contaminated and dangerous batch of drugs, use less of the batch, use the drugs while others are present, or make sure to have naloxone, an opioid reversal agent, on hand before using the drugs.

Test results can also help reveal if a new dealer is untrustworthy so that users can spread the word to others. They can also influence users to be cautious and avoid future risks. Greater knowledge can give users enough time, space, and information to make more rational choices before they become desperate. Having a greater sense of agency can help a person feel empowered to care for their health.

Fentanyl test strips help users think about how to protect themselves from overdosing. Instead of blindly trusting their dealer, users can test drugs themselves to get firsthand information that can promote better decision-making. Studies show that people who use test strips are more likely to reduce the amount or frequency of their drug use, keep naloxone on hand, or throw away drugs that test positive for fentanyl.

The Positive Impact of Fentanyl Test Strips

In November 2018, the state of Delaware launched a pilot program to see if distributing fentanyl test strips could help people who inject drugs reduce harmful behaviors. The syringe services program gave away over 2,000 fentanyl test strips and worked to increase awareness of the risks of exposure to fentanyl and fentanyl analogues like carfentanyl. They surveyed and found that 47% of the drug users who received the strips adopted harm reduction behaviors such as reducing their use or doing a test shot after seeing a positive result to lower the risk of overdosing. Most users were satisfied with the program and wanted it to continue.

Critics and Controversies

While the use of fentanyl test strips is becoming more commonly accepted in the United States, there has been disagreement about the merits of fentanyl test strips. Some law-enforcement officials and conservative interest groups argue that giving users tools to test drugs is the same as condoning and encouraging drug use if the supply is free of fentanyl. These people consider fentanyl test strips to be a kind of drug paraphanalia, and as a result, they are illegal in some states.

There are also concerns that fentanyl test strips give users a false sense of security since they don’t measure the amount of fentanyl in a sample, can’t detect all forms of fentanyl, aren’t always completely accurate, and sometimes produce false negatives. There is a chance that people will still use drugs that contain fentanyl, despite the risks, or deliberately seek out fentanyl-laced drugs to get high.

Legal Status and Accessibility

Even though fentanyl test strips are illlegal in some states, an increasing number of public policy experts are advocating for their use as a harm-reduction strategy. In 2021, the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Center for Disease Control (CDC) began allowing nonprofit harm-reduction and drug-treatment centers to receive and use federal grant money to buy the test strips.

Fentanyl test strips cost about a dollar each, but many local health departments, syringe and needle exchange programs, and other community overdose prevention programs distribute them at no cost. Some people order test strips online at sites including dancesafe.org, bunkpolice.com, mattersnetwork.org, and amazon.com.

Under United States federal law, it is legal to possess fentanyl test strips, but some states enforce countermeasures that criminalize and limit access to these tools. Iowa has blocked fentanyl test strips and is using harsh penalties to deter people from possessing and distributing fentanyl, but many people believe these measures are unlikely to reduce overdoses. The proliferation of contaminated drugs and the severity of the opioid crisis have caused many states to rethink their policies. Since January 2022, governors in 16 states have signed legislation that legalizes fentanyl test strips. According to the Network for Public Health Law’s tracker, fentanyl test strips were legal in 36 states plus the District of Columbia as of April 2023. Mississippi, Kentucky, Utah, and New Hampshire recently changed their state laws to decriminalize fentanyl testing tools. In New Hampshire, House Bill 287, signed on August 4, 2023, will allow anyone to possess fentanyl test strips.

Harm Reduction Strategies Are Critical to Addressing the Opioid Crisis

The opioid epidemic is a worsening crisis, and fentanyl contributes to hundreds of thousands of drug-involved overdose deaths each year. When harm reduction tools like fentanyl test strips are available and accessible, they can help prevent and reduce drug-related fatalities and promote public health. Programs that distribute fentanyl test strips can also connect users to other treatment services and help them make positive changes. Harm reduction programs can incorporate community-driven prevention, risk reduction, and health promotion strategies to help drug users live healthier, self-directed lives through incremental change. By meeting users on their own terms, harm reduction programs may eventually provide a pathway to treatment and recovery.

If you want to learn more about the risks of fentanyl or need access to tools like fentanyl test strips, Live Free Recovery Services can help. Our team in Keene and Manchester, New Hampshire, can help you navigate your journey and offer other services when you are ready to live your best life. To get the evidence-based tools and treatments you require, call us at (888) 705-3759.

How to Access Fentanyl Test Strips in New Hampshire

The Doorway-NH provides free fentanyl test strips and naloxone to all. To find a location in your area, call 211 or visit thedoorway.nh.gov.