Selectivity and sensitivity of urine fentanyl test strips to detect fentanyl analogues in illicit drugs

Bergh, Marianne Skov-Skov; Øiestad, Åse Marit Leere; Baumann, Michael H.; Bogen, Inger Lise

doi:10.1016/j.drugpo.2020.103065

Cited by 48 publications

(38 citation statements)

References 9 publications

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“…In addition, 60% reported using FTS to look for fentanyl analogs. However, while FTS can detect a large number of analogs, it is possible for an FTS test to produce false negatives [ 52 , 53 ]. As such, a negative test result cannot guarantee the absence of analogs.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and context of fentanyl test strip use among syringe service clients in southern Wisconsin

Tilhou

Birstler

Baltes³

et al. 2022

Harm Reduct J

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Background Fentanyl adulteration of illicit drugs is a major driver of opioid-involved overdose in the USA. Fentanyl test strips are increasingly used by people who use drugs to check for fentanyl. However, little is known about factors that influence test strip use in this population. Methods In this mixed-methods study employing semi-structured open-ended interviews (n = 29) and a structured survey (n = 341), we examined characteristics associated with test strip use, characteristics of test strip use, and situational, logistical and psychosocial factors influencing test strip use. Respondents were recruited from a syringe service program in southern Wisconsin. Bivariate tests of association and multivariable logistic regression examined the relationship between respondent characteristics and test strip use. Summary statistics were used to describe how situational, logistical and psychosocial factors impact test strip use. Results Most respondents were male (59.6%), non-Hispanic white (77.4%), young (mean 35.7 years), reported heroin as their primary drug (70.7%), injection as their primary route (87.9%), and use ≥ 3 times daily (78.6%). In multivariable models, site, race and ethnicity, drug of choice, and seeking fentanyl were associated with test strip use. Among test strip users, 36.5% use them most of the time or more and 80.6% get positive results half the time or more. Among individuals reporting heroin, fentanyl, methamphetamine, or cocaine or crack cocaine at least once per month, 99.1%, 56.8%, 42.2%, and 55.7% reported testing these drugs, respectively. Test strip use is supported by information from suppliers, regular transportation, diverse distribution locations, recommendations from harm reduction staff, and having a safe or private place to use. Conclusions We found that individuals who use fentanyl test strips are more often non-Hispanic white, use heroin, and seek drugs with fentanyl relative to individuals without test strip use. Findings confirm high fentanyl penetration in the Wisconsin drug supply. Low rates of stimulant testing suggest inadequate awareness of fentanyl penetration. Findings support outreach to key populations, increased diversity of distributing locations, efforts to correct misperceptions about drug wasting, emphasis on pre-consumption testing, and the importance of adjunct behaviors to prevent overdose given high rates of intentional fentanyl use.

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Section: Discussionmentioning

confidence: 99%

Characteristics and context of fentanyl test strip use among syringe service clients in southern Wisconsin

Tilhou

Birstler

Baltes³

et al. 2022

Harm Reduct J

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“…We define community drug checking as a model of drug checking that is implemented within communities to provide an ongoing service to the whole population which may be unique from event or festival site models. Fentanyl test strips are often integrated within harm reduction services at supervised consumption sites and overdose prevention services and are used off-label to provide a simple positive/negative result of the presence of fentanyl in a sample (Bergh et al , 2021; Park et al , 2021; Peiper et al , 2019; Weicker et al , 2020; Zibbell et al , 2021). At the same time, more sophisticated methods, typically optical-based technologies such as spectrometers, are being pursued for their potential to detect and report on the full composition of a sample including the active (psychoactive) ingredients and cuts and, whenever possible, to determine and report on the concentration of ingredients (Borden et al , 2021; Green et al , 2020; Maghsoudi et al , 2020; Scarfone et al , 2022).…”

Section: Introductionmentioning

confidence: 99%

A distributed model to expand the reach of drug checking

Wallace

Gozdzialski

Qbaich

et al. 2022

DHS

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Purpose While there is increasing interest in implementing drug checking within overdose prevention, we must also consider how to scale-up these responses so that they have significant reach and impact for people navigating the unpredictable and increasingly complex drug supplies linked to overdose. The purpose of this paper is to present a distributed model of community drug checking that addresses multiple barriers to increasing the reach of drug checking as a response to the illicit drug overdose crisis. Design/methodology/approach A detailed description of the key components of a distributed model of community drug checking is provided. This includes an integrated software platform that links a multi-instrument, multi-site service design with online service options, a foundational database that provides storage and reporting functions and a community of practice to facilitate engagement and capacity building. Findings The distributed model diminishes the need for technicians at multiple sites while still providing point-of-care results with local harm reduction engagement and access to confirmatory testing online and in localized reporting. It also reduces the need for training in the technical components of drug checking (e.g. interpreting spectra) for harm reduction workers. Moreover, its real-time reporting capability keeps communities informed about the crisis. Sites are additionally supported by a community of practice. Originality/value This paper presents innovations in drug checking technologies and service design that attempt to overcome current financial and technical barriers towards scaling-up services to a more equitable and impactful level and effectively linking multiple urban and rural communities to report concentration levels for substances most linked to overdose.

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“…The limit of detection (LOD) was 0.23 ng ml −1 , which was calculated by extrapolating the fentanyl concentration that produced bubble area ratio signal of 3 times the standard deviation of the zero-analyte signal below the zero-analyte signal. This analytical sensitivity is comparable with current central clinical laboratory gas chromatography-mass spectrometry or LC-MS/MS-based methods and over 20 times more sensitive than commercially available fentanyl lateral flow assays (LFAs), 29 as shown in Fig. S5 †.…”

Section: Resultsmentioning

confidence: 61%

Deep learning-assisted sensitive detection of fentanyl using a bubbling-microchip

et al. 2022

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Selectivity and sensitivity of urine fentanyl test strips to detect fentanyl analogues in illicit drugs

Cited by 48 publications

References 9 publications

Characteristics and context of fentanyl test strip use among syringe service clients in southern Wisconsin

Characteristics and context of fentanyl test strip use among syringe service clients in southern Wisconsin

A distributed model to expand the reach of drug checking

Deep learning-assisted sensitive detection of fentanyl using a bubbling-microchip

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