Test strips used to avoid opioid overdoses

Mike Stobbe
Associated Press

New York – The newest tool in the fight against opioid overdoses is an inexpensive test strip that can help heroin users detect a potentially deadly contaminant in their drugs.

Sales of fentanyl test strips have exploded as a growing number of overdose-prevention programs hand them out to people who use illicit drugs.

Though they weren’t designed for it, the test strips can signal the presence of fentanyl in illicit drugs. Some health officials question their accuracy, but they have proven to be so popular that some programs can’t get enough to satisfy demand.

“As soon as I hit the street with them, they’re gone,” said Washington, D.C., needle-exchange outreach worker Maurice Abbey-Bey.

The U.S. is in the midst of the deadliest drug overdose epidemic in its history, and it’s been getting worse. More than 70,000 Americans died of drug overdoses last year, a 10 percent increase from the year before, according to preliminary U.S. government numbers.

Growing numbers of recent deaths have been attributed to the painkiller fentanyl and fentanyl-like drugs. The drugs are far more potent than heroin, but they are relatively cheap and increasingly have been cut by suppliers into street drugs without buyers’ knowledge.

The strips sell for $1 each. Costs can quickly add up for groups distributing them because some people use drugs four or five times a day.

Government agencies have begun paying for the test strips and providing them to needle-exchange programs. The state health department in California started last year, and the health departments in some cities – including Philadelphia and Columbus, Ohio – have started since then.

But some other health agencies have declined, citing uneasiness with the tests’ accuracy or doubt about whether someone would actually throw away contaminated dope.

There’s been little research on whether tests strips are an effective weapon against the overdose epidemic, said Catherine McGowan, an assistant professor at the London School of Hygiene and Tropical Medicine.

“Anything that empowers people who inject drugs to mitigate their own risk is a good thing,” McGowan said. “You just need to be really careful.”

The tests strips are intended for testing the urine of patients who are legally prescribed fentanyl for pain, as a way for doctors to make sure they are taking the drug, said Iqbal Sunderani, the chief executive of BTNX, the Canadian company that is a main producer of the strips.

The strips are licensed for that purpose – and only that purpose – in Canada. They are not licensed for any use in the United States.

A government-sanctioned facility in Vancouver that allows people to use drugs under medical supervision started offering the tests two years ago. Last year, health officials there released results of a study of more than 1,000 drug checks. More than 80 percent of heroin and crystal meth samples tested positive for fentanyl, as did 40 percent of cocaine samples.

Drug users who got a positive result were 10 times more likely to lower their dose, the study found.

A few small studies have shown a high willingness by drug users to use the tests. Perhaps the most important was a study by researchers at Johns Hopkins University and Brown University, which was not published in a peer-reviewed journal but was released to the public in February. It concluded the test strips were highly accurate.

BTNX doesn’t recommend the strips for testing illicit drugs, but Sunderani, the company’s president, knows it has become the main driver of sales.

It sold 117,000 tests in the U.S. last year. So far this year it has already sold more than 410,000, he said.

A growing list of government agencies in Canada and the United States are paying for the strips, but others have been reluctant.

Dr. Elinore McCance-Katz, a point person in the Trump administration’s response to the nation’s opioid epidemic, said she doubts positive test results deter people from shooting up.

“I don’t think they’re going to be using fentanyl test strips and say ‘Oh gee, this is positive for fentanyl? I better go find something else,’” said McCance-Katz, who heads the U.S. Substance Abuse and Mental Health Services Administration.