To avoid overdoses, some test their heroin before taking it

The most recent tool in the fight against opioid overdose is an inexpensive test strip that can help heroin users detect a potentially deadly contaminant in their medications.

Sales of fentanyl test strips have exploded as an increasing number of overdose prevention programs distribute them to people who use illicit drugs.

Although not designed for this purpose, test strips can report the presence of fentanyl in illicit drugs. Some health officials question their accuracy, but they have proved so popular that some programs are not enough to meet demand.

"As soon as I'm on the street with them, they're gone," said Maurice Abbey-Bey, a syringe exchange advocate in Washington.

The United States is at the heart of the deadliest drug overdose epidemic in its history, and the situation is getting worse. Last year, more than 70,000 Americans died from a drug overdose, an increase of 10% over the previous year, according to preliminary US government figures.

PHYSICIANS PUSH BAN ON BABY WALKERS

An increasing number of recent deaths have been attributed to fentanyl and fentanyl analgesics. Drugs are much more powerful than heroin, but they are relatively inexpensive and providers are increasingly using drugs without the knowledge of buyers.

The bands are selling for $ 1 each. Costs can quickly accumulate for the groups that distribute them, as some people consume drugs four or five times a day.

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

But other health organizations have declined, citing the discomfort aroused by the accuracy of testing or the doubt as to whether someone would actually reject a contaminated drug.

Catherine McGowan, assistant professor at the London School of Hygiene and Tropical Medicine, said little research has been done to determine whether test strips are an effective weapon against the overdose epidemic.

"Anything that allows people who inject drugs to reduce their own risk is a good thing," McGowan said. "You just need to be very careful."

L & # 39; ORIGIN

The test strips are meant to test the urine of patients who are legally prescribed for fentanyl, as a way for doctors to make sure that they are taking the drug, said Iqbal Sunderani, general manager. BTNX, Canada's leading company. producer of the bands.

Bands are permitted for this purpose – and only for this purpose – in Canada. They are not allowed to use in the United States.

In 2016, a Canadian doctor developed a new way to apply them: by dipping them into the residues of "cooking cups" that heroin users use to prepare their injections.

A government-approved facility in Vancouver, which allows people to use medically-supervised drugs, began testing two years ago. Last year, health officials released the results of a study involving more than 1,000 drug checks. More than 80% of the heroin and methamphetamine samples were tested positive for fentanyl, as were 40% of the cocaine samples.

Drug users who tested positive were 10 times more likely to lower their dose, according to the study.

GROUP OF INTEREST

Vancouver's results attracted attention. In October 2016, the Corner of Harm Reduction in St. Ann, New York, became one of the first American programs to offer them.

It was important to take further action, said Van Asher, chair of the Bronx Syringe Access Program.

THE ADOLESCENTS LEAVE SUICIDAL BY BULLIES SPEAK

"We are losing people at a faster pace than HIV" in the early 1990s, he said.

Some small studies have shown that drug users are very willing to use the tests. Perhaps the most important was a study by researchers from Johns Hopkins University and Brown University, which was not published in a peer-reviewed journal but was published in February. He concluded that the test strips were very accurate.

BTNX does not recommend test strips for testing illicit drugs, but Sunderani, the company's president, knows that he has become the main engine of sales.

He sold 117,000 tests in the United States last year. Until now, this year, it has already sold more than 410,000 copies.

THE DOUBERS

A growing list of government agencies in Canada and the United States pays for bands, but others are reluctant.

Dr. Elinore McCance-Katz, an important person in Trump's administration's response to the country's opioid epidemic, said she doubts that the positive test results deter people shoot at each other.

"I do not think they're going to use fentanyl test strips and say," Oh, well, is it positive for fentanyl? I better go get something else, "said McCance-Katz. Administration of health services.

Supporters of the band are in agreement: most heroin addicts will not walk away from the drug, no matter the outcome of a test.

"All this time, only three people have thrown away positive samples," said Tino Fuentes, an overdose prevention worker who has become a sort of Johnny Appleseed in the United States for test strips. by promoting them and distributing them in several cities.

But Fuentes and others say that dipsticks can still lead people to reduce their risk of fatal overdose, for example by taking smaller doses or taking medications in the presence of a person with a drug. Reversal of overdose.

Fuentes said he was delighted to learn that two people had recently stopped using the strips because they had decided to treat each dose as contaminated and take precautions every time.

MAMAN STOLE DIE THE MEDAL OF THE GIRL: POLICE

"The ideal is that we no longer need tapes because people use them safely," he said.

NEGATIVE FALSE

Some health officials are concerned that the strips will detect some contaminants. At the end of last year, the National Health Agency of Canada stated that a preliminary analysis of 70 samples determined that three trials failed to detect fentanyl or fentanyl analogues. A follow-up analysis by Health Canada found that BTNX strips produced five false negatives out of 364 samples analyzed.

In Washington, DC, the health department refused to pay for them or approve their use "because of the high probability of false negatives," said department head Michael Kharfen.

Some outreach workers understand caution, noting, for example, that test strips detect the presence of fentanyl, but not how much.

"It could be 2% or 98%, and the difference will kill you," said Reilly Glasgow, who works at the New York Lower East Side Harm Reduction Center, part of an organization called Alliance. for Positive Change.

But he said his program was finally persuaded to offer the bandages because too many people did not believe that fentanyl could be in their medications.

"They needed proof," he said.

"THERE IS NO SECOND LINE"

Fentanyl contamination has become so common that a man in New York jokingly said that his drug habit had become "a bit of heroin but mostly fentanyl."

The man said he had been injecting heroin since 1992 and spoke to the Associated Press on condition of anonymity because he did not want to compromise his ability to find housing, stay in a treatment program or to get a job.

He said test strips are hard to find, but he used them – usually when he buys drugs at a new reseller. All these tests were positive. He said that he had still taken the medication, starting with a smaller dose called "tester".

One day last month, he showed how the test strips worked on a packet of heroin powder stamped with a blue devil on the side, which he bought from his usual dealer.

He called the dealer's product "always mediocre". It's a sales pitch because it means that he knows what he's getting "rather than playing Russian roulette".

Inside a Brooklyn apartment, he shook the powder in a small cup, added water and took the resulting brown liquid into a syringe. Then he put the needle aside, added a few drops of water to what was left in the cup and swayed it.

Then he dipped the end of a test strip to absorb water and drug residues. In a few seconds, a red line appeared. "There must be two, there is no second line, so it contains fentanyl," he said.

Then he emptied the syringe into a vein on the back of his right hand, his eyes shining as the medicine took effect.

A friend, Jessie Kruger, arrived shortly after. Kruger said she was in the habit of injecting heroin, but that she had stopped more than a year after a frightening episode of health.

The test strips "are a godsend," said Kruger. "But it's important not to just do the test strip, but to do a tester test too … You can not test everything."