For young people who use drugs, rapid fentanyl test strips may represent an acceptable way to detect illicitly manufactured fentanyl, according to a study published in International Journal of Drug Policy.

The study included young adults in Rhode Island who reported injecting drugs or using heroin, cocaine, or illicitly obtained prescription pills in the previous 30 days (n=93). Participants tested either their urine after drug use or a drug sample prior to use with rapid fentanyl test strips. Each participant took a questionnaire and underwent brief training to learn how to use the strips. Each participant was given 10 strips and asked to return for a 1-month follow-up visit. At follow-up, uptake and acceptability of the rapid strips test as well as the behavioral outcomes associated with positive tests were evaluated.

Of 93 participants, 81 (87%) returned for the 1-month follow-up visit and had complete data. The mean age was 27; 56% (n=45) were men and 46% (n=37) were nonwhite. Of these participants, 77% (n=62) reported using at least 1 test strip. Of these, 50% (n=31) reported at least 1 positive result. A positive result was associated with older age, homelessness, heroin use, injection drug use, ever witnessing an overdose, and concern about overdose or drugs being laced with fentanyl (P <.05 for all). 

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A positive test result was associated with reporting a positive change in overdose risk behavior between baseline and follow-up (P ≤.01). Of all participants, 98% (n=79) reported confidence in their ability to use the test strip, with 95% (n=77) reporting that they wanted to use the strips again in the future.

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“Further research is needed to test the efficacy of the use of these test strips in combination with a behavioral intervention to increase use of established harm reduction practices, increase risk reduction behaviors, and prevent opioid overdose,” the researchers wrote.

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Krieger MS, Goedel WC, Buxton JA, et al. Use of rapid fentanyl test strips among young adults who use drugs. [published online October 18, 2018]. Int J Drug Policy. doi:10.1016/j.drugpo.2018.09.009