Advances in Harm Reduction: Fentanyl Test Strips Might Prevent Heroin Overdoses

written forĀ Inspire Malibu


As the nation comes to recognize drug abuse and addiction as a public health issue rather than a moral failing or lack of character that far too many people are incarcerated for, harm reduction strategies have leapt to the forefront. These tactics are taking on new forms and making advances that save lives.

For instance, test strips that detect fentanyl-laced heroin are now available. This practical approach to recreational drug use could potentially save thousands of lives.

These are devices similar to the kind used by diabetics to measure glucose levels or strips that test for pregnancy. Harm reduction test strips, distributed by companies like DanceSafe, or Drink Safe strips, which tests for date-rape drugs in beverages, are the latest in harm reduction technologies and techniques.

The principle behind this approach, according to the Harm Reduction Coalition, is “…a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use.”

The director of the addiction medicine fellowship program at Boston Medical Center, Dr. Alexander Walley, began tracking the fentanyl test strips since Insite, a needle exchange program based in Vancouver, developed the idea in 2016.

“At the end of the day,” Walley said on NPR’s “All Things Considered, “I think giving people knowledge about what they’re putting in their body is a good thing more than a bad thing.”

Organizations, such as DanceSafe, don’t advocate drug use or abuse. All of their messaging, in fact, focuses on the argument that no drug is 100 percent safe. Yet, harm-reduction supporters are realistic about drug abuse, which is why some musical festival promoters have teamed up with activists in attempt to give concertgoers a place to test the purity of drugs like ecstasy and MDMA.

Fentanyl is a particularly pernicious synthetic opioid that’s a hundred times more powerful than morphine. Dealers will cut heroin with fentanyl or carfentanil, a fentanyl derivative used to anesthetize animals the size of elephants, because these drugs are cheaper and stretch their heroin supply, resulting in greater profits. Obviously, there is no regard for the safety of customers.

The crisis of opioid related deaths shows no signs of slowing. A staggering first estimate by the government puts the number of drug overdoses in 2016 at 64,000, an increase of 540 percent in just three years. Fatal drug overdoses are now the leading cause of preventable death for Americans under 50 years old.

A vast number of these fatalities are caused by fentanyl-laced heroin. The White House called the opioid crisis a national emergency on August 6, though the administrations taken no further action to make the declaration official. This means state and local administrators are unable to apply for federal relief and aid to solve the skyrocketing number of opioid related deaths.

DanceSafe offers step-by-step instructions on how to use the test-strip for heroin and other injected drugs, suggesting that the best method is to test drug residue from the spoon or other types of cookers. These instructions include some of the following:

  1. Set the needle aside and wait to inject after preparing the dose
  2. Add tiny amount of water, preferably distilled water, to the spoon or cooker
  3. Take a clean needle and use bottom end to stir the water and residue
  4. Taking the blue end of the test-strip, insert into the test area for no less than 15 seconds
  5. Wait two minutes for results

The guidelines for interpreting the results are listed right below the instruction. DanceSafe, though, makes it clear in their disclaimer that “…fentanyl test strips are provided for harm reduction only. They cannot detect every fentanyl analog, nor can they detect other synthetic opiates. A negative test result does not mean a sample is to consume. No drug use is 100% [sic] safe. All drugs contain inherent risks.”

Healthcare professionals and harm reduction advocates realize that testing-strip technology is not a fix for the thousands of people dying from opioid overdoses. It is, however, one small step in saving the lives of people struggling with addiction who have friends and family that hold out hope that their loved one will not end up a statistic.

Dr. Walley, the Boston Medical Center addiction specialist, put the fentanyl testing-strips into perspective when he considered the overall public opioid health crisis for NPR:

“…even when [heroin users] know they’re going to be positive for fentanyl, the experience of somebody testing their drugs and seeing that it’s fentanyl has an impact. It encourages them to use more safely.”

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