This study seeks to assess the feasibility, consumer acceptability and behavioural outcomes associated with take-home fentanyl test strips (FTS), and to inform features of a take-home FTS distribution program that reflect consumer needs and wants.
Dr Monica Barratt
A/Prof Raimondo Bruno
Dr Craig Rodgers
Dr Phillip Read
Dr Robert Page
Fentanyl and fentanyl analogues pose an urgent public health threat. These substances are of higher potency than other opioids and are increasingly being used to adulterate heroin, contributing to tens of thousands of deaths worldwide. To mitigate the risk of unwitting fentanyl consumption, community-based organisations have started to utilize and distribute fentanyl test strips (FTS). These commercially available test strips are able to detect fentanyl, related analogues and their metabolites in urine (post-consumption), and in drug supplies/drug residue (pre-consumption). The results of these studies (predominantly conducted in North America) show high consumer acceptability of such a strategy, as well as the potential to result in behavioural changes that reduce overdose risk.
Although Australia has not yet witnessed the same magnitude of fentanyl-related overdoses, there is some evidence of a threat, and it is of critical importance that we be prepared to respond should similar trends start to emerge. There has been one (published) pilot study conducted in the Australian context, which used FTS to test the urine of clients entering the Medically Supervised Injecting Centre. This study demonstrated that FTS are a low cost and scalable approach to monitoring the public health threat of undetected fentanyl and its analogues in Australia (18). However, given that there are limited supervised consumption rooms in Australia, restricting the availability of FTS to supervised settings would exclude most consumers. In contrast, distributing take-home FTS has the potential to vastly increase the accessibility of this harm reduction initiative. Further, from a harm reduction perspective, testing substances prior to consumption is superior to testing post consumption, enabling consumers to make a more informed choice regarding their use.
The primary aim of this study is to determine the feasibility, consumer acceptability, and behavioural outcomes associated with take-home FTS, providing an evidence base for implementation and expansion across services in Australia.
This study also aims to inform features of a take-home FTS distribution program that reflect consumer needs and wants, and to examine support for other drug checking mechanisms among people who use heroin.
This study will distribute take-home FTS to a convenience sample of people who use heroin. A four-week follow-up survey will be conducted to assess uptake and consumer acceptability of the strips, as well as associated behavioural changes.
Participant recruitment for this project commenced in August 2020 and finished in May 2021.
The results of this study will increase Australia’s preparedness to respond to the public health threat of undetected fentanyl and its analogues. Specifically, it will:
- Provide an evidence base for the implementation of take-home FTS and the expansion of distribution sites.
- Enable the development of a take-home FTS distribution program that reflects consumer needs and wants.
- Address the knowledge gap regarding support among heroin consumers for broader drug-checking initiatives.