You may have gotten some fentanyl testing strips from End Overdose, but have you ever wondered how they work? Drug testing strips are a great tool and measure for preventing overdose deaths, by giving more information on the contents of a substance.

Practical Use

Fentanyl test strips work to inform an individual of the presence or absence of fentanyl in a substance. These strips can be used to test drug or non-drug materials, as long as it can be dissolved in water! If someone has a drug they plan to use, fentanyl testing strips give the individual a clearer image about what the substance contains. In just a few minutes, an individual can have the knowledge as to if fentanyl is present in their substance. This information can be critical to someone, especially if they are not planning to use opioids or fentanyl. Due to the high potency of fentanyl, unknowingly consuming fentanyl can lead to an unwanted experience, and even an opioid overdose. This is especially concerning for someone who is “opioid naive”, meaning they do not have a tolerance to opioids, and did not intend to consume opioids.

To use the test strip, dissolve a powdered substance into water. Specific suggestions of the quantity of substance to dissolve varies product-to-product. To test a powdered substance, dissolve the specified amount into around 15mLs of water. To test a pill, scrape off or crush a part of the pill, and dissolve the contents in 15mLs of water. Once the dilution is fully combined, place the end of the test strip into the water, and let it absorb into the strip for 15 seconds. Once the dilution begins to absorb, let the test strip rest for 60 seconds before reading the results. Depending on the contents of the substance, the strip will show lines that either indicate the absence or presence of fentanyl. Typically, each packet of test strips has specific instructions and a guide on how to interpret the results.

Pros of Fentanyl Testing Strips

Fentanyl testing strips allow for a preventative measure for opioid overdoses. It is important to have more information about the substance that is being ingested, since fentanyl is highly potent, and can not be detected by sight, smell, or taste. A study in the state of Rhode Island shows that 77% of people who use drugs are utilizing fentanyl testing strips in the state. Around 50% of people who used testing strips have encountered at least one positive result for fentanyl in their substance. Having access and education surrounding drug testing mechanisms has allowed states, like Rhode Island, to prevent overdose deaths from fentanyl in their community.

Cons of Fentanyl Testing Strips

Just like any other piece of technology, fentanyl testing strips are not correct 100% of the time. False positives and false negatives can occur when using testing strips. A false positive happens when a substance that does not contain fentanyl, shows a positive result for fentanyl on the testing strip. A false negative can occur when a substance does contain fentanyl, but the testing strip shows a negative result. False negatives can be dangerous, and lead individuals to believe that their substance does not contain fentanyl. A few circumstances can lead to a false negative result, such as inadequate testing procedures, testing a small portion of a substance, or testing too little of substance. It is important to note that testing more of a substance, leads to more security surrounding the legitimacy of the result. For example, one portion of a pill that was tested might not have contained fentanyl, so the test strip shows a negative result. Although, in reality, fentanyl is present in the pill but on a portion that was not tested. Make sure to test every pill individually, even if they are purchased together. It is important to note that these tests do not provide information about the quantity of fentanyl in the substance, or the presence or absence of other substances. They only work to detect fentanyl and cannot ensure the contents of the substance otherwise.

Biochemical Mechanisms

Fentanyl testing strips are a type of test called a lateral flow immunoassay. This technology allows for a solution to travel through the test strips using capillary action. Most fentanyl test strips have the ability to detect fentanyl through the use of an antibody. The role of an antibody is to serve as a specific indicator that undergoes a reaction when it comes into contact with a substance, such as fentanyl. Most of these antibodies are embedded into the test strip and can detect their drug of interest and their analogues. These antibodies are highly specific and will typically only bind the drug it has been developed to detect. In the case of fentanyl test strips, the antibody is embedded in a straight, horizontal line on the strip. The strip will show a "control" line to demonstrate that the dilution has successfully traveled up the strip. The control line will show regardless of the presence or absence of fentanyl. In addition to the control, there will be a second horizontal line that will be sensitive to fentanyl and its analogues. This is called the "test line". If fentanyl is present in the dilution, it will bind to the antibody and immobilize the fentanyl molecules in the "test line" of the strip. When this complex is formed, the antibody will react in the form of a colored line. If a colored line appears for both the "control" and "test line" spaces, it is likely that fentanyl is present in the substance being tested.

Now, you have a complete view of the advantages and disadvantages of fentanyl testing strips! For further information on opioid overdose response and prevention, visit endoverdose.net and take the free certification course!

References

Maxwell S. Krieger, William C. Goedel, Jane A. Buxton, Mark Lysyshyn, Edward Bernstein, Susan G. Sherman, Josiah D. Rich, Scott E. Hadland, Traci C. Green, Brandon D.L. Marshall, Use of rapid fentanyl test strips among young adults who use drugs,

International Journal of Drug Policy, https://doi.org/10.1016/j.drugpo.2018.09.009.

Tilhou, A.S., Zaborek, J., Baltes, A. et al. Differences in drug use behaviors that impact overdose risk among individuals who do and do not use fentanyl test strips for drug checking. Harm Reduct J20, 41 (2023). https://doi.org/10.1186/s12954-023-00767-0

Johns Hopkins Bloomberg School of Public Health., Fentanyl Overdose Reduction Checking Analysis Study https://www.naccho.org/uploads/downloadable-resources/MS-fentanyl-overdose-reduction-study-toolkit24.pdf?utm_source=chatgpt.com

West Virginia Department of Health and Human Resources., Fentanyl Test Strips. https://dhhr.wv.gov/office-of-drug-control-policy/news/Documents/FTS%20Fact%20Sheet%20Final.pdf