Patients at Vermont center receive fentanyl test strips

At the Howard Center, a Burlington, Vt.-based provider offering counseling and medical services for persons with substance use disorders, client deaths from opioid overdose have been rising in the past year. So in addition to expanding treatment with buprenorphine and distributing naloxone to reverse overdoses, the center has started a program to give away fentanyl test strips, purchasing 3,000 of them from Canadian company BTNX Inc.

“We’ve handed out over 19,000 doses of Narcan (naloxone) to clients, and had 1,252 come back and say it’s been used to save a life,” says Grace Keller, program director for Howard Center Safe Recovery. “But in spite of that, in the last year and a half, we’ve lost more clients to fatal overdose than we have in the past 17 years.”

In one year, the percentage of clients who have witnessed an overdose went from 26% to 81%, with 57% having overdosed themselves, Keller says. “There’s been a shift in the clients; they’re afraid of fentanyl and they’re asking for fentanyl testing strips,” she tells Addiction Professional.

If a test strip comes up positive for fentanyl, the hope is that the person “will use a lot less, or make sure they have a friend with them,” Keller says.

The test strips cost $1 each; the Howard Center received donations to cover the costs.

Part of broad strategy

Giving out the fentanyl test strips is one of two innovations being started at the Howard Center. The second is “low barrier buprenorphine,” in which clients who ask for the medication are given a prescription for three days’ worth the first day they come in, instead of having to wait for a few days or even a few weeks, Keller says. “A couple years ago, there was a two-year wait,” she says.

Ultimately, giving out fentanyl test strips, naloxone and even syringes can be very helpful to treatment, says Keller. “Just talking to people about overdose can get them interested.”

Fentanyl testing strips are intended for urine drug tests, and are being used as an “off-label harm reduction approach,” according to the Harm Reduction Coalition's website.

A description on the site states, “Fentanyl testing strips are mostly being used by people who inject opioids. Based on the results of the testing strips, people can choose to implement measures to reduce the risk of an opioid overdose. These reduced risk measures can include using less of the substance, giving slow or test shots, not using alone, using with a naloxone rescue kit nearby, or not using the substances at all.”