The epidemic of overdose deaths due to opioid addiction is rising, and it seems as if there is no end in sight. According to the National Center for Health Statistics, there were over 64,000 opioid deaths in the United States in 2016. That represents a 540% increase over a three year period.
The devastating rise of deaths is likely due, at least in part, to a deadly additive that is found in some heroin. Fentanyl, which is a drug used for pain and sometimes for anesthesia, is an opioid but it's estimated to be 50-100 times more powerful than morphine. It's easily absorbed through the skin, and it's fast acting and wears off quickly as well. When added to heroin, however, it can result in almost instant death.
There is almost no way for a drug user to know if the heroin they purchase has fentanyl in it. While no amount of heroin is safe, once fentanyl is mixed in, it's almost always fatal. In Canada, a company that manufactures test strips that can show the presence of fentanyl in a substance is finding their product in high demand. BTNX, a pharmaceutical company, based in the province of Ontario, makes the strips but only sells them to police agencies and labs. Initially, they were used to test human urine for drugs. Off-label, they can be used to test a substance to see if fentanyl is detected; however, they are not approved in Canada for this use.
Currently, the strips are allowed to be used in supervised injection sites in Canada. Many of these sites hand out clean needles, allowing people to inject themselves in an environment where help is available if there is an overdose. BTNX still gets hundreds of calls, for the strips, many from family members of addicts, wanting to at least have some measure of safety for their loved ones in the midst of addiction.
Vancouver Coastal Health, an agency that oversees a supervised injection site was part of a pilot program last year that provided the strips to workers who could check drugs for fentanyl. A few granules of the heroin can be dissolved in water, and the test strip is then dunked to see if it reacts positively. In that trial, about 80% of the drugs tested had fentanyl in them. There are some drawbacks, however. The strips cannot accurately say how much of it is in the test sample. It's hard to control for the environment the test would be conducted in, since users may have fentanyl residue on their hands or household items. The possibility exists for a false negative result as well, and that is a chance the BTNX does not want to take. The liability would be enormous unless the tests were 100% accurate under any conditions, but they are not.
Harm reduction agencies in the United States, like St. Ann's Corner of Harm Reduction in New York City, are also ordering the test strips and will hand them out to their clients. There is some training involved, but the US does not have legal supervised injection sites, so it's hard to tell who uses them and how. The video below has more information on these strips. They are not perfect, but they do offer some hope to families struggling with opioid addiction. Warning: The video does contain some footage of drug use which could be upsetting for some.