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Harm Reduction Programs: Why Test for Fentanyl?

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AlcoPro will soon introduce a new “drug residue surface test” product that can detect and identify the presence of several drugs, including fentanyl, from the residue on various surfaces and in powder and liquid form. Fentanyl is a very dangerous drug; a lethal dose is 2 mg. While researching best practices for law enforcement and first responder personnel relating to being in the presence of fentanyl (we’ll have more about that in another blog article), we learned about using similar fentanyl testing products in what is called “harm reduction” programs.

Why Test for Fentanyl?

Drug dealers add fentanyl to other drugs – heroin, for example – to make the heroin more potent. There is no truth in labeling to which heroin users can refer to know if the heroin they buy and inject contains fentanyl. And some heroin addicts want to know. For the past several years some agencies have been making fentanyl test strips available to addicts to test their drugs prior to use. The thought behind harm reduction is that addicts will use drugs – it’s a fact of life. Harm reduction embraces the goal of saving lives – saving an addict from unintentionally overdosing on fentanyl-laced drugs.

Harm Reduction Programs

Agencies and programs that advocate fentanyl testing have very clear and specific instructions and suggestions on how to test. For example, the recommended best practice is to test every bit of the drug the user intends to consume. Instructions describe the procedure to test drugs that are injected, and how to test drugs in tablet and powder form. Although the test process for using the fentanyl strips is somewhat crude, the strips detect the presence of fentanyl frequently enough that harm reduction programs still encourage their use.

Does the fentanyl harm reduction program work? There is evidence that some drug users change their drug use when they identify fentanyl in their drug. They might use less of the drug, they might use it only if another person is present, and/or if naloxone is available. Other users say they use the drug regardless. There is a small but growing body of research on the effectiveness of fentanyl test strips, and several cities and agencies have endorsed the practice by providing the test strips for free. But as with other harm reductions programs such as needle exchange and safe injection houses, harm reduction programs are controversial because they appear to encourage drug use, rather than discourage it.

Harm reduction is not new. An organization called Dancesafe has been in the harm reduction business for 20 years. Dancesafe promotes health and safety within the electronic dance community. The organization began at a time when MDMA began to be popular, and educating festival-goers about MDMA was the first item on the agenda for that organization. Today they include information and testing kits for other drugs as well, including fentanyl.

Drug Test Strips Used as Surfact Tests

What about the fentanyl drug test strips mentioned earlier? The fentanyl test strips described above are designed to detect the presence of fentanyl and fentanyl metabolites in urine. Just because a fentanyl test strip can detect fentanyl in urine does not mean that it can detect and identify fentanyl in powder or liquid form. It happens that the fentanyl test strips from a Canadian manufacturer also seem to work quite well at detecting and identifying the drug itself. That is not necessarily the case with the strips from other manufacturers. A study by Dancesafe and the University of California at San Francisco found that of five strips tested, four did not detect carfentanyl, and one did not detect fentanyl at all.

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