Simple fentanyl test strips could save lives as opioid deaths hit record highs

With COVID-19 stealing headlines, opioid overdoses have fallen out of the spotlight these last few years.

But this figure bears reporting: 100,000 people have died of drug overdoses in the U.S. this year, a record high. Health officials point to fentanyl, a powerful synthetic opioid, for many of them.

For drug dealers, fentanyl can be an inexpensive way to boost potency and stretch out the supply. For users — it’s a nightmare.

Now, some public health workers are trying out a new way to test for fentanyl and save lives. Emily Siqveland is among those. She's the opioids program manager for Arlington County, Virginia, which has seen nearly 90 overdoses this year.

The county introduced fentanyl test strips in August. The strips — which are placed in a mixture of water and a tiny amount of the drug, whatever the substance may be — give results in about 60 seconds, she says. The strip then indicates whether fentanyl is detected in the substance.

From 2015 into 2016, Arlington County, similar to many cities across the U.S., started to see an increase in opioid-related incidents, she says. There was a period of hope around 2018 when the county saw a dip in cases, Siqveland says, but the pandemic unfortunately altered that course.

“For some comparison's sake, in 2018, when we started to see that decrease, we had 11 fatal overdoses. In 2019, it went down to six, but then in 2020 it went up to 20. And so far this year, we're already at 26 fatal overdoses with another 62 non-fatal,” she says.

"These test strips are another shot at life for someone."

Emily Siqveland, opioids program manager for Arlington County, Virginia

It’s why efforts were made to launch the program at the end of summer. So far, the county has dispensed about 660 test strips, she says, and they’ve been able to get the word out in multiple ways.

First, the Behavioral Health Division in Arlington County spreads the message to the clients they support. Second, Siqveland says the team hands out test strips to people leaving jail who have used opioids before.

The test strips are heavily advertised through email blasts to the community, and finally, she says test strips are mailed to anyone who could personally use them or share them with friends and family.

Some studies in places such as Baltimore and San Francisco suggest people who utilize test strips tend to modify their behavior in some way, she says. In Arlington, the county has seen folks come back for more strips after using them to test drugs, finding fentanyl contamination and throwing out the substance.

However, fentanyl test strips are not without controversy similar to onsite injection spaces and needle exchanges. Critics claim handing out these strips encourages people to keep using drugs.

While Siqveland says she understands the criticism, she strongly disagrees.

People will use substances anyway, she says, and providing them with a test strip could save their lives.

“We have 26 Arlingtonians who died this year, and with these test strips, they may not have died and they may have been able to access treatment,” she says. “And we can't help anyone who isn't alive.”

These strips could pave the way for an individual to seek treatment or medical assistance to manage their disease, she says.

There are several ways fentanyl is getting into substances: Some individuals lace drugs with fentanyl to make the drug stronger, while other substances are cross-contaminated with fentanyl unknowingly, she says.

Siqveland says her team has been warning the community of all the ways fentanyl can end up in opioids, heroin, press pills, counterfeit pain medications and other illicit substances, and reminding them to use test strips first.

For any city or county looking to implement test strips, Siqveland says “do it.”

It can save lives, she says, as seen in the number of strips passed out in a short period of time in Arlington County alone.

“A lot of the people that are getting strips are coming back and asking for more,” she says, “and this is an opportunity for us to keep folks alive so they can access treatment when they're ready.”

Karyn Miller-Medzon produced and edited this interview for broadcast with Peter O'Dowd. Serena McMahon adapted it for the web.