The opioid epidemic began in the late 1990s, with the prescription of opioids beginning to lead to addiction and rising overdose deaths. Opioid overdose deaths have only continued to increase through the 2000s, due to illicit opioids such as heroin and synthetically produced opioids. The compound fentanyl has had particularly deadly consequences, as opioid-related deaths increased by 6% from 2018 to 2019, while synthetic opioid-related deaths have increased by over 15%. This is especially significant as heroin-involved deaths and prescription opioid-related deaths have decreased in the same timespan.
Fentanyl is a compound prescribed in hospitals as a pain reliever and anesthetic. Being 50 times more potent than heroin and 100 times more potent than morphine, fentanyl is a powerful compound. In the early 2010s, opioid overdose deaths began to rise as fentanyl production increased in addition to the illicit opioids already illegally distributed. The growing presence of fentanyl has been especially concerning as the compound is often incorporated into other illicit drugs without the user’s knowledge. Fentanyl typically appears as a white powder, which makes it easy to be incorporated into other substances, such as heroin, cocaine, and methamphetamine. With fentanyl being such a potent compound, it can take as little as 2 milligrams for a dose to potentially be deadly.
From 1999 to 2019, nearly 500,000 people have died from overdoses involving opioids. Opioid drugs are depressants, meaning that they slow down the body’s normal functions. When opioids are taken in excess, the brain’s signals to the lungs and heart can slow to the point where one cannot breathe enough to support the body. With too little oxygen reaching the brain, permanent neurological damage and death can occur as a result of an overdose.
With the current widespread abuse of opioids and the elusive nature of fentanyl, a harm reduction approach has recently become more popularized, which opts to limit the harm created by opioid use as opposed to criminalizing users. One method is the widespread availability of the medication naloxone, which can reverse opioid overdose when administered. However, naloxone is not a preventative measure but rather a reactive solution once someone displays signs and symptoms of opioid overdose. Therefore, many professionals were searching for a way to prevent people from overdosing due to the presence of fentanyl in their synthetic opioid substances.
One approach that has the potential to prevent opioid overdose is the ability to test substances for the presence of fentanyl. Fentanyl test strips were created by Canadian biotech company BTNX in 2011 for clinicians to detect the presence of fentanyl in urine. The company has since begun producing fentanyl test strips for commercial use, reporting 96 to 100% accuracy. According to the company, mixing a small amount of a substance (20 ng/mL) with water and dipping it in a test strip for 15 seconds will indicate whether or not fentanyl is present in the sample.
Despite the usefulness of preventing opioid overdoses related to fentanyl, fentanyl test strips are still not widely used. In many states such as Colorado, Maryland, and Rhode Island, drug-testing materials are categorized as illegal drug paraphernalia. Despite this, many states such as Alabama and Tennessee are moving toward including fentanyl test strips in their harm reduction approach to opioid overdose. In April 2021, the Biden-Harris administration even moved to allow recipients of federal funding such as local and state health departments to purchase fentanyl test strips.
While fentanyl test strips can aim at reducing opioid-related overdoses, there are still risks to taking illicit drugs. Fentanyl test strips may not be completely accurate, and it is still possible to overdose on opioids or other substances that do not contain fentanyl. However, fentanyl test strips can be an important factor in reducing the deadly outcomes of fentanyl-related opioid overdoses.
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