Fentanyl Testing Strips Usage and Perceptions: A Survey Analysis

Background: Fentanyl testing strips (FTS) were decriminalized in Tennessee in 2022, and since then have become a widely used tool for harm reduction efforts across the state. Considering that fentanyl has almost entirely replaced heroin and other opioids in the drug supply, we sought to explore whether FTS were in fact an impactful harm reduction strategy. This study examines the usage patterns and perceptions related to Fentanyl Testing Strips (FTS) among individuals with a history of drug use in both urban and rural contexts.

Methods: The survey collected data on FTS usage, reasons for usage (of both substances and FTS), perceptions of FTS, and the perceptions of the impact of drug use on the individuals and their communities.

Results: 88.9% of respondents reported a willingness to use FTS, and those reported needing an average of three per day with 83% willing to wait at least five minutes for the result. 87.8% reported that they would take additional precautions to avoid overdose in response to a positive FTS result, with such behaviors including not using or discarding the fentanyl-positive substance, acquiring naloxone, not using alone or calling a friend, or the modification of dose, speed, and/or route of ingestion. 100% of those that used amphetamines daily (including methamphetamine), whether with or without opioids, reported a willingness to take additional precautions.

Conclusion: The results shed light on the importance of harm reduction strategies and the potential role of FTS in reducing the risks associated with drug use, particularly for those that use amphetamines.