Primary Submission Category: Substance Use
“It depends on the population”: Harm reduction service provider and community member perspectives on utilization of fentanyl test strips
Authors: Kaylin Sweeney Danielle Russell Madeline Hooten Elizabeth Palmer Haley Coles Raminta Daniulaityte
Presenting Author: Kaylin Sweeney*
Continuing increases in opioid-related overdose deaths have been linked to the growing contamination of the illicit opioid and other drug supply with illicitly manufactured fentanyl (IMF).1,2 Fentanyl test strips (FTS) provide a low-cost form of drug checking that can be implemented at the point of consumption by the user to indicate if their drugs contain IMF.3-5 This qualitative study conducted with harm reduction service providers and people who use illicit opioids (PWUO) in Arizona aims to explore their views and experiences with FTS use.
Qualitative, semi-structured interviews were conducted between 10/2021 and 08/2022 with PWUO (N=26) and harm reduction service providers (N=7). All interviews were audio recorded, transcribed, and qualitatively coded with NVivo. The study was approved by ASU IRB.
Harm reduction providers indicated FTS utility in empowering people who use drugs but noted reduced interest in FTS among PWUO due to most knowingly using IMF. Greater interest in FTS use was noted in people who use stimulants like methamphetamine or MDMA. Some harm reduction providers noted limitations of FTS including their inability to provide information on IMF concentration and IMF analogs. Most PWUO interviewed had little knowledge about FTS, and only 40% reported ever using them. The majority indicated choosing to use IMF due to easier access, giving FTS limited utility in those situations. Among those who used FTS, all reported having used them to test heroin, and some also tested methamphetamine and cocaine. Most who had used FTS reported modifying their behaviors on those occasions, including smoking instead of injecting, going slower, lowering their dose, or seeking another drug source.
There is a need for more advanced drug checking technologies to help PWUO have more information about the composition and risks of street opioids and other drugs. Expanded drug checking education and FTS access is needed for people who use stimulants and other non-opioid drugs.
References
1. Prevention CFDCa. COVID Data Tracker. Website. US Department of Health and Human Services. 04 March 2022, 2022. Updated 04 March 2022. Accessed 04 March 2022, 2022. https://covid.cdc.gov/covid-data-tracker/#cases_totalcases
2. Ciccarone D. The rise of illicit fentanyls, stimulants and the fourth wave of the opioid overdose crisis. Current opinion in psychiatry. 2021;34(4):344.
3. Peiper NC, Clarke SD, Vincent LB, Ciccarone D, Kral AH, Zibbell JE. Fentanyl test strips as an opioid overdose prevention strategy: Findings from a syringe services program in the Southeastern United States. Int J Drug Policy. Jan 2019;63:122-128. doi:10.1016/j.drugpo.2018.08.007
4. Zibbell JE, Peiper NC, Duhart Clarke SE, et al. Consumer discernment of fentanyl in illicit opioids confirmed by fentanyl test strips: Lessons from a syringe services program in North Carolina. Int J Drug Policy. Jul 2021;93:103128. doi:10.1016/j.drugpo.2021.103128
5. Reed MK, Roth AM, Tabb LP, Groves AK, Lankenau SE. “I probably got a minute”: Perceptions of fentanyl test strip use among people who use stimulants. Int J Drug Policy. Jun 2021;92:103147. doi:10.1016/j.drugpo.2021.103147