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New study finds that using fentanyl test strips can lead to safer drug use behaviors

RESEARCH TRIANGLE PARK, NC, October 3, 2018 People who use illicitly-made street opioids and test them for fentanyl by using fentanyl test strips (FTS) are five times more likely to engage in safer drug use behaviors when the test comes back positive, according to a new study by RTI International, a leading non-profit research institute, published today in the International Journal of Drug Policy. Most people who consume street opioids—including many drug sellers—are unaware their drugs contain fentanyl, increasing the likelihood of accidental overdose and death.

In the first-of-its-kind study, RTI examined the use of fentanyl test strips (FTS) among a group of people who inject street opioids in Greensboro, North Carolina. The study documents the influence drug checking with FTS can have on drug use behavior.

“Our study shows that people who test their drugs with fentanyl test strips and receive a positive test result are willing to perform safer drug use behaviors to prevent overdose,” explains Jon Zibbell, a public health researcher at RTI and the study’s senior author. 

In 2016, the number of overdose deaths involving illicitly-made fentanyl surpassed heroin and prescription opioids for the first time. Fentanyl is a synthetic opioid 50 times more potent by weight than heroin. Illicitly-manufactured fentanyl (IMF) is responsible for the majority of opioid overdose deaths in the U.S.—not prescription fentanyl.  IMF is manufactured in clandestine labs outside the U.S. and enters illicit drug markets where it is sold as heroin or used to adulterate heroin. IMF supply has been growing steadily since 2013 and now saturates most of the country’s heroin markets, particularly in states east of the Mississippi River.

The study surveyed 125 people at a community-based syringe services program in Greensboro, NC over a 2-month period in 2017. Respondents were asked about their most recent fentanyl test strip use and subsequent drug use behaviors. Indicators for safer drug use included: used less drug than usual; administered a tester shot; pushed syringe plunger slower than usual; and snorted drug instead of injected.

“An important insight from the study is that people who inject drugs can and will change their behavior when they have information about the risks involved,” Zibbell said. “The bottom line is that fentanyl test strips may represent a new technique to prevent opioid overdose by allowing people to check street drugs for fentanyl and modify consumption behavior accordingly,” Zibbell emphasized. 

The study was self-funded by RTI International. RTI explores multidisciplinary approaches to addressing the scope of the opioid epidemic, from treatment and prevention to pain management and public health communication. For more information, visit https://www.rti.org/emerging-issue/opioid-research.