Perspectives on rapid fentanyl test strips as a harm reduction practice among young adults who use drugs: a qualitative study

Jacqueline E Goldman, Katherine M Waye, Kobe A Periera, Maxwell S Krieger, Jesse L Yedinak, Brandon D L Marshall, Jacqueline E Goldman, Katherine M Waye, Kobe A Periera, Maxwell S Krieger, Jesse L Yedinak, Brandon D L Marshall

Abstract

Background: In 2016, drug overdose deaths exceeded 64,000 in the United States, driven by a sixfold increase in deaths attributable to illicitly manufactured fentanyl. Rapid fentanyl test strips (FTS), used to detect fentanyl in illicit drugs, may help inform people who use drugs about their risk of fentanyl exposure prior to consumption. This qualitative study assessed perceptions of FTS among young adults.

Methods: From May to September 2017, we recruited a convenience sample of 93 young adults in Rhode Island (age 18-35 years) with self-reported drug use in the past 30 days to participate in a pilot study aimed at better understanding perspectives of using take-home FTS for personal use. Participants completed a baseline quantitative survey, then completed a training to learn how to use the FTS. Participants then received ten FTS for personal use and were asked to return 2-4 weeks later to complete a brief quantitative and structured qualitative interview. Interviews were transcribed, coded, and double coded in NVivo (Version 11).

Results: Of the 81 (87%) participants who returned for follow-up, the majority (n = 62, 77%) used at least one FTS, and of those, a majority found them to be useful and straightforward to use. Positive FTS results led some participants to alter their drug use behaviors, including discarding their drug supply, using with someone else, and keeping naloxone nearby. Participants also reported giving FTS to friends who they felt were at high risk for fentanyl exposure.

Conclusion: These findings provide important perspectives on the use of FTS among young adults who use drugs. Given the high level of acceptability and behavioral changes reported by study participants, FTS may be a useful harm reduction intervention to reduce fentanyl overdose risk among this population.

Trial registration: The study protocol is registered with the US National Library of Medicine, Identifier NCT03373825, 12/24/2017, registered retrospectively. https://ichgcp.net/clinical-trials-registry/NCT03373825?id=NCT03373825&rank=1.

Keywords: Fentanyl; Harm reduction; Opioids; Overdose; Qualitative; Rapid test.

Conflict of interest statement

Ethics approval and consent to participate

Our research was performed in accordance with the Declaration of Helsinki and received approval from the Brown University Office of Research Protections IRB, #1612001662. All participants provided written consent at the time of the survey.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Fentanyl rapid test strip results label. This is the key that was placed on each of the FTS packages to assist with interpretation of the test results. This key shows that a strip with one red line indicates a positive test and a strip with two red lines indicates that the test is negative, but that the participant should still use caution

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