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What are fentanyl testing strips?

Originally intended for urine drug tests, fentanyl testing strips are being used as an off-label harm reduction approach to test the presence or absence of fentanyl and many fentanyl analogs (very closely related drugs) in the unregulated drug supply.

How are fentanyl testing strips used?

Fentanyl testing strips are mostly being used by people who inject opioids. Based on the results of the testing strips, people can choose to implement measures to reduce the risk of an opioid overdose. These reduced risk measures can include using less of the substance, giving slow or test shots, not using alone, using with a naloxone rescue kit nearby, or not using the substances at all.  Other unregulated drugs in pill or powder form can also be tested (i.e. cocaine, MDMA, ketamine, and other non-injectable drugs) but must be mixed with water prior to testing.  Since fake pills may have fentanyl very unevenly mixed into them, the entire pill should be crushed to be sure none is missed.  Testing at the Insite Safe Injection Facility in Vancouver, where drug checking with fentanyl test strips was pioneered, showed that during one month in 2016 86% of ALL DRUGS tested were positive for fentanyl, whether pills or powder.

What about Methamphetamine and MDMA?

The molecular composition of methamphetamine and MDMA are such that they can trigger a positive on the strips if too high of a concentration of the drug is tested. To get an accurate result, you will need to dilute a sample of methamphetamine residue with about a half a cup of water. Do not test whole shards, or even pieces of shards, dissolved in only a cooker or small amount of water.  If there is fentanyl in the sample, then even in a half a cup of water, the strip will still test positive. If there is no fentanyl in the sample, then that dilution will give you an accurate negative result.

Because fentanyl test strips are very sensitive, it is important that drug consumption equipment (i.e. cooker, used syringe, cotton, etc.) must cleaned or sterile prior to testing.

Why are fentanyl test strips being used?

Recent research found that the use of a fentanyl testing strip could accurately detect the presence of fentanyl, which has been blamed for increases in overdose deaths across the US starting in 2013. Most surveyed respondents said that knowing that their drugs contained fentanyl would lead them to modify their behavior, such as not using the drugs, using the drugs more slowly, using the drugs with others who have naloxone, or changing their purchasing behaviors.

Useful Resources

People can check with their local syringe access or harm reduction program to see if testing strips are provided. Alternatively, strips can be ordered online directly from BTNX.

Frequently Asked Questions

Do the strips tell you how much fentanyl is present?

No, the strips only yield positive or negative results.

Have fentanyl test strips been submitted to FDA for review?

No, unfortunately they are not FDA approved and BTNX is not planning to seek approval.

Is there any funding available to buy strips?

Syringe Access Programs should contact their contract managers for details.

If a fentanyl test strip is negative, does that mean you can’t overdose?

No, even if a fentanyl test strip reveals a negative result a person can still overdose. There are many risk factors to experiencing an opioid overdose (i.e. mixing drugs, reduced tolerance, using alone, unknown products, physical and mental health, etc.). In addition, fentanyl test strips do have some potential for false negatives and false positives and the drugs being tested may contain a fentanyl analogue that is not detected by the strips. Contact BTNX for their latest list of analogues that the strips will detect (it includes carfentanil).

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