High willingness to use rapid fentanyl test strips among young adults who use drugs

Abstract

BackgroundSynthetic opioid overdose mortality among young adults has risen more than 300% in the USA since 2013, primarily due to the contamination of heroin and other drugs with illicitly manufactured fentanyl. Rapid test strips, which can be used to detect the presence of fentanyl in drug samples (before use) or urine (after use), may help inform people about their exposure risk. The purpose of this study was to determine whether young adults who use drugs were willing to use rapid test strips as a harm reduction intervention to prevent overdose. We hypothesized that those who had ever overdosed would be more willing to use the test strips.MethodsWe recruited a convenience sample of young adults who use drugs in Rhode Island from May to September 2017. Eligible participants (aged 18 to 35 with past 30-day drug use) completed an interviewer-administered survey. The survey assessed participant’s socio-demographic and behavioral characteristics, overdose risk, as well as suspected fentanyl exposure, and willingness to use take-home rapid test strips to detect fentanyl contamination in drugs or urine. Participants were then trained to use the test strips and were given ten to take home.ResultsAmong 93 eligible participants, the mean age was 27 years (SD = 4.8), 56% (n = 52) of participants were male, and 56% (n = 52) were white. Over one third (n = 34, 37%) had a prior overdose. The vast majority (n = 86, 92%) of participants wanted to know if there was fentanyl in their drug supply prior to their use. Sixty-five (70%) participants reported concern that their drugs were contaminated with fentanyl. After the brief training, nearly all participants (n = 88, 95%) reported that they planned to use the test strips.ConclusionsMore than 90% of participants reported willingness to use rapid test strips regardless of having ever overdosed, suggesting that rapid fentanyl testing is an acceptable harm reduction intervention among young people who use drugs in Rhode Island. Study follow-up is ongoing to determine whether, how, and under what circumstances participants used the rapid test strips and if a positive result contributed to changes in overdose risk behavior.

Toots, tastes and tester shots: user accounts of drug sampling methods for gauging heroin potency

“…Other interventions that may be effective aids in assessing overdose risk include point-of-use testing, also known as drug checking, and qualitative user discernment of street heroin. Recent research has shown a high willingness among younger, US-based injection drug users to utilize fentanyl test strips [ 83 ], but the hypersensitivity of on-the-market fentanyl test strips raises questions about their efficacy in helping injectors to quantify risk. Harm reduction interventions focusing on “universal precautions,” i.e., consistent use of drug sampling, may be more effective than point-of-use fentanyl testing.…”

Drug checking at an electronic dance music festival during the public health overdose emergency in British Columbia

“…This information empowers individuals who use drugs to make better-informed decisions about whether, where, how, or with whom to consume the tested substance, which is hoped to trigger behaviour change towards safer drug use practices and reduced overdose risk. In light of the opioid overdose public health emergency and emerging promising results with point-of-care fentanyl drug checking in different settings (Tupper et al 2018;Krieger et al 2018), fentanyl-specific drug checking was added by ANKORS as an optional test for festival attendees in 2017.…”

A Randomised Clinical Trial of a Theory-Based Fentanyl Overdose Education and Fentanyl Test Strip Distribution Intervention to Reduce Rates of Opioid Overdose: Study Protocol for A Randomized Controlled Trial

“…To date, no randomised clinical trials have examined the e cacy of rapid fentanyl test strips in combination with behaviour change intervention for the prevention of opioid overdose events. Our pilot study of young people at risk of fentanyl exposure demonstrated high willingness to use fentanyl test strips as a harm reduction tool, and the feasibility of a brief training module for non-expert use (14,16). Furthermore, positive test strip results were associated with drug risk behaviour changes (16).…”

“…Sample size/power calculations are based on ndings from our pilot intervention study (14). In this study, 37% of participants reported a lifetime history of overdose, and 10% reported a suspected fentanyl-related overdose in the past six months.…”

“…Rapid Response™ fentanyl test strip, BTNX Corporation, Canada) provide similar sensitivity and speci city compared to portable mass spectrometers, with low technical requirements and results within ve minutes (13). People who use drugs report interest in knowing if fentanyl is in their drugs prior to use, with high willingness and acceptability to use fentanyl test strips in the future (14,15).…”