Fentanyl Test Strips for Harm Reduction and Overdose Prevention: Research and Legislative Update

Fentanyl is increasingly being found in the illicit drug supply across the United States, where it is often added to or sometimes replaces other substances. The unintended use of fentanyl, especially by people who have not built up a tolerance for opioids, has led to a spike in drug overdose deaths around the country. Fentanyl Test Strips (FTS) can be a useful tool in the fight against overdoses and can lead to changes in an individual’s drug use. They can also provide an opportunity to engage individuals in recovery, extend life-saving interventions, and offer social service supports. On April 7, 2021, the Centers for Disease Control and Prevention and the Substance Abuse and Mental Health Services Administration announced that federal funding can be used to purchase FTS. In this session, two presentations will provide the latest research and legislative activity related to FTS.

The first presentation will explain the importance of FTS availability within communities to prevent overdose. Participants will learn the recent trends in fatal and nonfatal overdoses related to all opioids and synthetic opioids across population groups based on the most up-to-date available data on fatal and nonfatal opioid-related overdoses using the Centers for Disease Control and Prevention’s National Vital Statistics System (NVSS, 2016-2020) and morbidity data from National Hospital Ambulatory Medical Care Survey (NHAMCS, 2016-2019). This framing will be used to discuss the epidemiology of fentanyl and evidence and policies that impact use of FTS. Practitioners will share expertise, best practices, and lessons learned.

The second presentation will address practical and legal implications for FTS use, providing a legislative update on their classification as “drug paraphernalia” and other legal challenges to their use. One of the main obstacles to getting FTS into the hands of those who need them most are state laws concerning the use and possession of drug paraphernalia. Currently, more than 30 states have drug paraphernalia laws that include controlled substances testing equipment. Nonetheless, simply because a jurisdiction includes testing equipment in its definition of “drug paraphernalia” does not necessarily mean that harm reduction organizations and others are prohibited from distributing or using FTS.