New Tool To Combat Overdose Deaths: Fentanyl Test Strips

Feb 6, 2018

Credit The Bloomberg American Health Initiative

A new study co-led by a Rhode Island epidemiologist found that a simple drug testing strip -- similar to a home pregnancy test --  accurately detected the potentially deadly opioid fentanyl in street drug samples.

The test strips, made by a Canadian company, recently began being used by public health officials in California and New York in an effort to curb the rising death toll from opioid overdoses.

A synthetic opioid 50 to 100 times more potent than morphine, fentanyl and its analogs have been linked with more than half of all fatal opioid overdoses nationwide, including nearly 60 percent of overdose deaths in Rhode Island.

In the study released Tuesday, researchers found that the testing strips accurately detected the presence or absence of fentanyl in 96 percent of the samples from the Rhode Island State Public Health Laboratory. Test results on samples from a Baltimore laboratory were 100 percent accurate, according to a summary of the study, which has not been published.

Traci C. Green, senior research scientist at Rhode Island Hospital and associate professor Brown University’s Warren Alpert Medical School, co-lead the study with Susan Sherman, of the Johns Hopkins Bloomberg School of Public Health.

Green said the test strips offer promise as part of a harm-reduction strategy similar to needle-exchanges to prevent HIV-AIDS infection.

“If you provide people with safe materials and safety messaging they act in their own interest and the (interest of) others that they care about to keep safe,’’ Green said. “And this has been how we’ve actually succeeded as a country, and especially as a state, to bring down HIV transmission in people who inject drugs.’’

The study -- funded by the Bloomberg American Health Initiative -- examined three different technologies for testing fentanyl on drug samples provided by police departments in Providence, Boston and Baltimore. They researchers also interviewed 355 people who use drugs in those three cities.

The vast majority of drug users interviewed - 84 percent -- expressed concern about drugs containing fentanyl. About 26 percent stated a preference for drugs with fentanyl, the report said.

The report’s recommendations include social service agencies being “able to distribute or deploy fentanyl testing, using them in a supervised setting or providing access to these materials for people who use drugs in an outreach context.”

The Canadian company that makes the strips, told WBUR last spring that the tests strips can result in a false negative for fentanyl -- or fail to detect some new variety of fentanyl -- and therefore should only be used in a medical facility where someone who overdoses could be revived.

“Nothing is perfect,’’ Green said. “It’s really part of our counseling and part of our interventions in public health is to talk with people about the fact that nothing is for sure and to take precautions and alter behavior in ways to keep people safe and keep the community safe.”

(The Rhode Island Medical Society recently met with public health officials to discuss  the possibility of opening staffed safe injection facilities in Rhode Island.)

Rhode Island health officials say no state laws or regulations currently prevent distribution of the test strips.

The state of New York makes public money available for needle exchanges to buy the test strips, according to Kaiser Health News. California state health officials last May began supplying needle exchanges with rapid-response test strips.