Last updated: 21 December 2023 & medically reviewed by Dr. Jenni Jacobsen
Fentanyl has become a well-known drug worldwide due to its heavy involvement in the opioid epidemic sweeping the US and beyond. With fatal overdoses involving fentanyl still on the rise, the CDC and other health organizations are pushing for more awareness and distribution of drug test kits, including fentanyl test strips, to detect the presence of fentanyl in other substances.
Key takeaways:
Fentanyl strips have become the first-line defense for drug users buying illicit substances at the street level. this has become increasingly important as the opioid overdose crisis shows no signs of slowing down.
Fentanyl test strips work much in the same way as any other over-the-counter drug testing product. The strips test substances for fentanyl and fentanyl analogs such as acetyl fentanyl and take as little as five minutes to give an accurate result.
Drug overdose death rates in the United States have risen dramatically in the past two decades, with 107,375 fatalities reported from January 2021 to January 2022 according to the CDC.[2] Of these deaths, 67% were caused by synthetic opioids such as fentanyl.
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What are fentanyl test strips?
Fentanyl test strips (FTS) are a cheap, simple-to-use method of identifying harmful fentanyl in other substances. These strips can be used on most illicit substances (meth, cocaine, heroin, other opioids, etc.) and can test for fentanyl in pills, powder, liquids, and other substance types.[1] They cost as little as $1 per strip and can be found at most needle exchanges or other drug-related charities or organizations.
Fentanyl strips have become the first-line defense for drug users buying illicit substances at the street level. this has become increasingly important as the opioid overdose crisis shows no signs of slowing down. By having fentanyl test strips readily available, the risk of injecting the harmful opioid is drastically reduced, potentially saving thousands of lives. This is because drug users may unknowingly inject fentanyl that has been hidden within other drugs they are buying on the streets. For instance, a drug advertised for sale as heroin may contain fentanyl.
How do fentanyl test strips work?
Fentanyl test strips work much in the same way as any other over-the-counter drug testing product. The strips test substances for fentanyl and fentanyl analogs such as acetyl fentanyl and take as little as five minutes to give an accurate result.
Steps for using fentanyl test strips
Fentanyl test strips are easy to use and shouldn’t vary between different types and brands. The only variation to the below steps will be with what drug type you are testing (e.g. powder, liquid, etc.) but instructions for these will be clearly outlined on the packaging.[1] Most test strips will instruct to follow these four steps:
Put 10mg (approx) of the drugs you want to test into a dry, clean container.
Add water to the container (min ½ tsp, 1 tsp for methamphetamine) and gently mix the drugs until dissolved
Place the test end of the strip (usually indicated by a blue wavy pattern) into the water and wait 15 seconds until sufficiently absorbed
Remove the strip and place it on a flat dry surface and wait a maximum of 5 minutes until results are visible
What do negative and positive results mean?
Negative results: Two pink lines indicate no fentanyl or fentanyl analogue has been detected. While this is the strongest indicator that the drug is “clean”, there is no 100% guarantee that fentanyl isn’t still present. For example, the sample may be from a portion of the drug that doesn’t contain fentanyl. There is also the risk that the drug may contain other harmful substances.
Positive results: A single pink line on the left-hand side of the strip indicates that fentanyl and or fentanyl analogs are present in the substance. There is no way to accurately indicate the amount of fentanyl in the substance so it is strongly advised that any prescription or illicit drugs yielding a positive result are discarded.
How reliable are fentanyl testing strips?
A qualitative study from 2018 conducted by researchers at Brown University and John Hopkins University with the aid of Boston Medical Center and law enforcement agencies looked at the validity of fentanyl test strips in various drug samples. The study showed that fentanyl test strips have a high detection rate and are unlikely to produce a false negative result.[1]
However, the study also enforced the known limitation of FTS low detection threshold. FTS will often detect incidental amounts of fentanyl in a substance, such as if the drug sample had been prepared in the same area as fentanyl which may not confirm a dangerous quantity of fentanyl.
There is also evidence that fentanyl test strips may be cross-reactive with methamphetamine, meaning samples of meth should be diluted in a greater quantity of water.[1]
Though FTS may detect even the smallest amount of fentanyl in a drug sample and there is no way to accurately show the lethality of the contamination, any positive reading of fentanyl detection on an FTS should warrant the immediate disposal of the contaminated drug sample and all substances from the same supplier.
Related: What does fentanyl look, smell, and taste like?
The growing need for FTS availability
Drug overdose death rates in the United States have risen dramatically in the past two decades, with 107,375 fatalities reported from January 2021 to January 2022 according to the CDC.[2] Of these deaths, 67% were caused by synthetic opioids such as fentanyl. According to NPR, the death rate for the end of 2022 had risen again to over 110,000.[4]
The number of opioid overdose deaths has been on the rise in the US since the onset of COVID-19 and access to treatment, safe drug checking services, syringe services programs, fentanyl test strip distribution, and overdose prevention such as Naloxone has remained the same. A CDC survey found that 13% of people questioned about substance abuse had started taking drugs or experimented with new drugs during the pandemic. While the pandemic threat has eased, the increase in substance abuse and addiction has remained as too has the presence of fentanyl in street drugs. The sad death statistics associated with accidental or intentional ingestion of fentanyl clearly call for greater promotion and access to life-saving fentanyl test strips as well as fatal overdose prevention kits.
