PROVIDENCE — Brown University’s School of Public Health researchers report fentanyl test strips are effective in preventing opioid overdoses and that community-based organizations would be the best distribution venues for the low-cost street drug testing method.
Fentanyl test strips work like an over-the-counter pregnancy test, said Max Krieger, research assistant and the lead author of the $50,000 study, published today in the International Journal of Drug Policy. Each single-use strip is dipped into water containing a bit of drug residue, and after a minute, either one or two red lines appear – one line means the liquid contains fentanyl, and two lines means the test did not detect the drug. Brown University has posted a video showing the fentanyl test strips in action on YouTube.
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Krieger was among a team of researchers led by Brandon Marshall, associate professor of epidemiology at Brown University’s School of Public Health, that provided the rapid-acting fentanyl test strips to young adults at risk of overdose in the state.
“We found that fentanyl test strips are an effective harm-reduction tool to prevent overdose,” Marshall said. “Harm reduction is important because everyone deserves to be able to take care of themselves and make informed decisions about their health, whether they use drugs or not. These tests strips could be a life-saving intervention for many young adults who use drugs.”
The team recruited 93 young adults, with an average age of 27, who use drugs in Rhode Island, through bus advertisements, online advertisements, fliers, and through word of mouth from May to September 2017, said Mollie Rappe, life sciences writer at Brown University. As the participants came in individually, they completed a survey, then researchers trained them to use the strips and gave them general overdose prevention education, 10 strips and a naloxone kit. The strips cost about $1 each, but aren’t commercially available.
A month after each participant got the strips, they were asked to return to share their experiences with the strips in, with 87 percent of the participants making a second visit for the follow-up interview, Rappe said.
Half of the participants who used the strips detected fentanyl in their drug supply. Of those, 45 percent reported using smaller amounts, 42 percent proceeded more slowly when using, and 39 percent used with someone else present, who could call 911 or administer naloxone in the case of overdose. Some participants used multiple overdose-reducing strategies, and a few reported discarding fentanyl-laced drugs, Marshall said.
“Our study shows that the fentanyl test strips are effective at preventing overdoses,” Krieger said. “A majority of our participants who received a positive result changed their drug-using behavior. The harm reduction concept behind these test strips, adding a cheap but effective layer of protection against known overdose risks, is similar to other health precautions such as using condoms to prevent sexually transmitted diseases.”
Almost all, 98 percent, including those who didn’t use a single strip, said they were confident in their ability to use the strips, and 95 percent wanted to continue using them.
The study also found that participants would feel most comfortable obtaining rapid-acting fentanyl test strips at health clinics and other community-based organizations. The authors suggest that “community-based organizations that conduct overdose prevention education and outreach efforts may be ideal venues for rapid fentanyl test strip training and distribution, as these organizations also distribute other harm reduction supplies.”
Marshall cautioned that the findings might not apply to older drug users.
Funding for the study came from a seed pilot grant through Brown’s Office of the Vice President of Research.
Rob Borkowski is a PBN staff writer. Email him at Borkowski@PBN.com.
