jurisdictions (45 states + D.C.) support access to fentanyl test strips (FTS) via jurisdiction-wide laws that do not subject the possession or use of FTS to drug paraphernalia penalties, as of September 2023.
Increasing concerns over fentanyl-related overdoses, as well as overdoses caused by other unknown adulterants within substances, alerted many policymakers to the concept of “drug checking.” Drug checking is the process of identifying, analyzing, or detecting the composition of drugs or adulterants within a sampled substance.An oft-publicized type of drug checking equipment is a fentanyl test strip (FTS), which discloses the presence, or absence, of fentanyl in a tested substance.
Fentanyl test strips are accurate, easy-to-use, and low cost
FTS are simple to use for harm reduction service workers or people who use drugs (PWUD). Results are available in a couple minutes and are highly accurate.An individual FTS costs approximately one dollar. Low cost, ease of use, and utility both in and out of healthcare settings make FTS a useful tool—especially given PWUD’s reported reluctance to engage with harm reduction services at distribution sites of points of care due to a fear of legal repercussions and experiences of stigma. In 2021, the Centers for Disease Control and Prevention and Substance Abuse and Mental Health Services Administration announced that federal funds may be used to purchase FTS.
Using fentanyl test strips is associated with safer or reduced drug use
Several studies demonstrate the effectiveness of FTS in promoting actual behavioral change through safer or reduced drug use.In one study, 43% of individuals reported safer drug use behavior following the use of FTS, with the odds of behavior change being five times more likely after receipt of a positive (for fentanyl) test result. A 2020 study showed similar results, with 26.5% of individuals receiving a positive FTS result abstaining from using the drug and 30.1% using a lower dose. Other examples of behavior changes include disposing of the fentanyl-positive drug, using it with other people around, having naloxone on hand, and taking a small (“tester”) dose of the drug to observe potency.
Drug checking programs promote outreach and engagement
Drug checking programs successfully facilitate outreach to PWUD.Through FTS distribution, community partners provide information and linkages to treatment services. Although there is a lack of research examining long-term recovery engagement outcomes associated with FTS programming, stakeholder attitudes surrounding the use of FTS programs for service referrals is positive.