A qualitative exploration of unintentional versus intentional exposure to fentanyl among people who use drugs in Austin, TX

Cance, Jessica D.; Bingaman, Amanda; Kane, Heather; Hairgrove, Sara; Torrez, Sorina B.; Buck, Austin; Zagorski, Claire M.; Loera, Lindsey J.; Hill, Lucas G.

doi:10.1016/j.japh.2022.10.005

Cited by 6 publications

(8 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[39][40][41][42] Acceptability of FTS may be limited by comfort with preexisting methods for detecting fentanyl, such as the use of color, texture, smell, taste, and tester shots. 32,33,[43][44][45][46][47] Purchasing drugs from a known and trusted dealer is often thought of as a sufficient method of protection from fentanyl and may limit acceptability. 41,42…”

Section: Acceptability Of Fts Use By Communitymentioning

confidence: 99%

“…Among people without an opioid tolerance or for whom a nonopioid is their drug of choice, knowledge about the evolving drug supply limits acceptability. Individuals who do not perceive their drugs as at-risk of fentanyl contamination have less interest in FTS use, 32,55 whereas those with knowledge of fentanyl contamination and without an opioid tolerance are highly interested in FTS use, 2,47,56,57 as are individuals who experienced atypical symptoms when using their drug of choice. 58 FTS acceptability is also impaired by their inability to provide information on contaminants with nonfentanyl substances, including fentanyl analogs, 2 xylazine, 21 synthetic cannabinoids, 59 phenacetin, 23 levamisole, 23 and etizolam.…”

Section: Limitations Of Fts In An Evolving Drug Supplymentioning

confidence: 99%

“…30,53 Timing of FTS Use With Relation to Drug Use Individuals using FTS as a harm reduction tool usually perform direct drug checking prior to consumption, but 7 studies show rates of postconsumption testing from either testing urine or drug paraphernalia ranging from 13% to 58% of participants. 38,47,58,66,68,69 Behavior change was noted with both preconsumption and postconsumption FTS use, with 2 studies showing PWUD having a preference for preconsumption testing 28,38,70 and 2 studies providing data in favor of postconsumption testing. 64,71 Barriers and Facilitators to Use…”

Section: Feasibility Of Fts Usementioning

confidence: 99%

See 2 more Smart Citations

Fentanyl Test Strips for Harm Reduction: A Scoping Review

Kutscher,

Barber Grossi,

LaPolla

et al. 2024

J Addict Med

View full text Add to dashboard Cite

Background High potency synthetic opioids like fentanyl have continued to replace or contaminate the supply of illicit drugs in North America, with fentanyl test strips (FTSs) often used as a harm reduction tool for overdose prevention. The available evidence to support FTS for harm reduction has yet to be summarized. Methods A search of PubMed, Ovid Embase, and Web of Science was conducted in March 2023. A 2-stage review was conducted to screen by title and abstract and then by full text by 2 reviewers. Data were extracted from each study using a standardized template. Results A total of 91 articles were included, mostly from North America, predominantly reporting on FTS along with other harm reduction tools, and all conducted after 2016. No randomized controlled trials are reported. Robust evidence exists supporting the sensitivity and specificity of FTS, along with their acceptability and feasibility of use for people who use drugs and as a public health intervention. However, limited research is available on the efficacy of FTS as a harm reduction tool for behavior change, engagement in care, or overdose prevention. Conclusions Though FTSs are highly sensitive and specific for point of care testing, further research is needed to assess the association of FTS use with overdose prevention. Differences in FTS efficacy likely exist between people who use opioids and nonopioid drugs, with additional investigation strongly needed. As drug testing with point-of-care immunoassays is embraced for nonfentanyl contaminants such as xylazine and benzodiazepines, increased investment in examining overdose prevention is necessary.

show abstract

Section: Acceptability Of Fts Use By Communitymentioning

confidence: 99%

Section: Limitations Of Fts In An Evolving Drug Supplymentioning

confidence: 99%

Section: Feasibility Of Fts Usementioning

confidence: 99%

See 1 more Smart Citation

Fentanyl Test Strips for Harm Reduction: A Scoping Review

Kutscher,

Barber Grossi,

LaPolla

et al. 2024

J Addict Med

View full text Add to dashboard Cite

show abstract

“… 11 Drug checking can include testing for the type and quantity of substances; but, more often, and especially given the ability to use federal funding, it includes the distribution of FTS which are small strips of paper that detect the presence of fentanyl with similar strips developed for xylazine. 12 Finally, SSPs are also playing a role in expanding access to evidence-based medications for opioid use disorder; while national experts continue calling for easier access to methadone, it remains highly regulated, making buprenorphine the primary medication for SSPs aiming to provide immediate low-barrier pathways to treatment. 13 …”

Section: Introductionmentioning

confidence: 99%

Comparing harm reduction and overdose response services between community-based and public health department syringe service programmes using a national cross-sectional survey

Ray,

Humphrey,

Patel

et al. 2024

The Lancet Regional Health - Americas

View full text Add to dashboard Cite

“…cocaine and methamphetamine) also attributed to fentanyl have become increasingly common nationwide [ 5 ]. Although exposure among people who use opioids to fentanyl-mixed or substituted heroin is well-documented [ 6 , 7 ], less is known about unintentional fentanyl use among people who primarily use non-opioid substances. Even rare fentanyl exposure in individuals without opioid tolerance could meaningfully contribute to overdose mortality.…”

Section: Introductionmentioning

confidence: 99%

Overdose from Unintentional Fentanyl Use when Intending to Use a Non-opioid Substance: An Analysis of Medically Attended Opioid Overdose Events

Bazazi,

Low,

Gomez

et al. 2024

J Urban Health

View full text Add to dashboard Cite

Fentanyl-mixed and substituted heroin is well-documented, but less is known about unintentional fentanyl use among people using stimulants. To determine the prevalence of and racial and ethnic disparities in unintentional fentanyl use among people experiencing a medically attended opioid overdose, we reviewed 448 suspected non-fatal overdose cases attended by a community paramedic overdose response team in San Francisco from June to September 2022. We applied a case definition for opioid overdose to paramedic records and abstracted data on intended substance use prior to overdose. Among events meeting case criteria with data on intended substance use, intentional opioid use was reported by 57.3%, 98.0% of whom intended to use fentanyl. No intentional opioid use was reported by 42.7%, with most intending to use stimulants (72.6%), including methamphetamine and cocaine. No intentional opioid use was reported by 58.5% of Black, 52.4% of Latinx, and 28.8% of White individuals (p = 0.021), and by 57.6% of women and 39.5% of men (p = 0.061). These findings suggest that unintentional fentanyl use among people without opioid tolerance may cause a significant proportion of opioid overdoses in San Francisco. While intentional fentanyl use might be underreported, the magnitude of self-reported unintentional use merits further investigation to confirm this phenomenon, explore mechanisms of use and disparities by race and ethnicity, and deploy targeted overdose prevention interventions.

show abstract

A qualitative exploration of unintentional versus intentional exposure to fentanyl among people who use drugs in Austin, TX

Cited by 6 publications

References 20 publications

Fentanyl Test Strips for Harm Reduction: A Scoping Review

Fentanyl Test Strips for Harm Reduction: A Scoping Review

Comparing harm reduction and overdose response services between community-based and public health department syringe service programmes using a national cross-sectional survey

Overdose from Unintentional Fentanyl Use when Intending to Use a Non-opioid Substance: An Analysis of Medically Attended Opioid Overdose Events

Contact Info

Product

Resources

About