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Consumers of illicit drugs who are certain that fentanyl is mixed with heroin that they consume are far more likely to take precautions that reduce their risk of overdose, researchers reported Wednesday in a small study.
The survey examined the use of fentanyl test strips by 125 injection drug users in Greensboro, NC, over a two-month period last year. The distribution of small strips has become an increasingly popular "harm reduction" technique in recent years among groups trying to protect drug addicts from the overdose of a powerful narcotic that has swept most of the United States.
Users with fentanyl-positive drugs were five times more likely to change their behavior than people who tested positive for fentanyl, according to the team led by researchers from RTI International, a think-tank located in Research Triangle Park, Caroline. North.
Precautions taken by users included taking a small "test shot", using less drug mix, pushing the plunger of the syringe more slowly and sniffing instead of injecting drugs, the researchers said. None of the interviewees – who were habitual addicts – threw away their drugs.
"The illicit market is fundamentally poisoned" by fentanyl, said Jon E. Zibbell, one of the leaders in research. "These strips allow people to test their product to see if it contains fentanyl. Knowing what's in your product is the first step to being able to adapt to this product. "
The research is to be published Wednesday morning in the International Journal of Drug Policy.
In February, the Harm Reduction Coalition in San Francisco reported in a less formal survey that a pilot strip distribution program had also led to behavioral changes and increased awareness of fentanyl in the city's drug supply. .
Overdoses of opioids have killed more than 49,000 people in 2017, according to preliminary data released in August by the Centers for Disease Control and Prevention. Synthetic opioids such as fentanyl, which traffickers mix with powdered heroin and other drugs, are primarily responsible for the record number of deaths and the worst drug epidemic in US history.
US public health authorities have focused their harm reduction efforts on the ever-expanding distribution of naloxone, a rapid-acting antidote for overdoses, and needle replacement, which reduce infections by providing users with clean syringes.
Canada, Australia and some European countries have also opened "supervised injection sites", where trained personnel monitor users while they take drugs and respond to overdoses. These are illegal under US law, and California Governor Jerry Brown (D) vetoed a bill that would have allowed the cities of his state to open them. But the mayors of some cities where overdoses are commonplace say that the fight is not over.
The test strips were originally developed for physicians, who used them to test patients' urine and make sure they were taking prescription fentanyl., which is used as a pain medication, and not sell it. However, as fentanyl was pouring into North America at widely varying concentrations across resellers, risk-reduction groups began offering them in 2016 to test fentanyl in heroin and other drugs. drug addicts. Users dip the strips into a mixture of drugs and water, usually – but not always – before injecting.
Iqbal Sunderani, General Manager of Canada's leading commercial strip supplier, BTNX, said his company had sold more than 650,000 test strips in the US this year, almost six times the total of 2017. He now sells many more gangs to harm reduction groups and to governments of cities and states than to doctors, he said.
The bands, which sell for one dollar each, can detect even small amounts of nine different fentanyl analogues, said Sunderani, including carfentanil, 10,000 times more powerful than morphine.
The strips offer users something that naloxone and emergency room travel can not: A way to know if they consume fentanyl before doing so, said Zibbell. "Right now, there is no intervention of people before use," he said. A positive test result and time to test helped people change their behavior, he added.
The RTI survey and a survey conducted in February 2018 by the Johns Hopkins Bloomberg School of Public Health showed that while some users are actively looking for fentanyl, most worry about the danger it represents.
The RTI Research Bands were distributed by Greensboro's Urban Survivors Union, which offers clean syringes and other services, in September and October 2017. Drug users participated in an online survey conducted at group.
Overall, 43% of users reported changing their drug use behavior and 77% said that test strips made them feel safer, according to the survey.
The researchers concluded that the use of the strips "can follow the path of needle exchange and distribution of naloxone, interventions initially developed by activists and harm reduction organizations" before their use. adoption by public health agencies.
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