Fentanyl Test Strips and Their Use by Drug Dealers: A Growing Concern

Fentanyl test strips, available online and free from many public health departments, are promoted as a harm reduction tool to help drug users detect the presence of fentanyl in pills or powders. However, Sheriff’s Deputy Patrick Craven, the lead detective of the newly formed opioid response team in rural Placer County, California, warns that these strips are now being misused by drug dealers. Dealers are posting photos on social media showing "negative" test results to falsely advertise their drugs as "clean."

Asked if users can trust such information, Craven responded, “Absolutely not.”

Fentanyl Test Strips: Limited Effectiveness

Fentanyl test strips detect the synthetic opioid in illicit pills, which is intended to reduce overdoses. However, they can’t offer accurate results unless an entire pill or batch of powder is tested—something most users are neither equipped nor willing to do. “Most people are not going to go and spend money on drugs only to test them and then find out, ‘I can’t use this,’” Craven explained.

Last year, the Drug Enforcement Administration (DEA) seized more than 77 million fentanyl pills and nearly 12,000 pounds of fentanyl powder, the most fentanyl seized by the DEA in a single year. According to the agency, this amounts to more than 386 million deadly doses of fentanyl—enough to kill every American.

Increasing Potency and Risks

The DEA also reports that fentanyl pills are becoming more potent. In 2023, laboratory tests revealed that 7 out of 10 pills contained a potentially deadly dose of fentanyl, up from 4 out of 10 in 2021 and 6 out of 10 in 2022. Just two milligrams of fentanyl is considered a lethal dose—an amount that fits on the tip of a pencil.

Craven emphasized the danger due to a lack of quality control. Counterfeit versions of Xanax, Oxycontin, and Percocet containing fentanyl have flooded the market, with the level of the synthetic opioid varying widely from pill to pill. “No pill is processed and made in the same way, and therefore they don’t contain even amounts of fentanyl,” he said.

Public Health Measures and Misuse

Fentanyl test strips were intended as a public health measure to address the surge in overdoses, which has started to subside. Health departments nationwide have spent millions of dollars to provide free test strips. In New York, the state health department website guides users on how to test their drugs, while Chicago has vending machines to dispense the strips. “Our hope is that using the fentanyl strip will have prevented people from overdose,” said Chicago Public Health Commissioner Simbo Ige.

However, Craven noted that test strips are not foolproof. If a user cuts up a pill and tests only part of it, the test could come back negative for fentanyl, while the rest of the pill or batch contains a deadly amount. Furthermore, drug dealers are using test strips to falsely assure customers of the safety of their products.

Case Study: Jewels Wolf

In 2022, Craven led the investigation into the fatal fentanyl poisoning of 15-year-old Jewels Wolf. Nathaniel Cabacungan, 20, met Wolf on social media and provided the counterfeit Percocet pill that killed her. Cabacungan, who had assured customers his pills did not contain fentanyl, was the first dealer in California to be convicted of murder for providing fentanyl-laced pills.

Public Awareness and Parental Concerns

Wolf’s mother, Regina Chavez, emphasizes that parents and young people need to understand that test strips can provide a “false sense of security.” She believes her daughter’s death was an accident, noting that Jewels had future plans, including getting her first job and studying for her driving permit.

Chavez wants people to know test strip results can be trusted only if a user is testing the entire pill or batch themselves. She continues to speak about her daughter to keep her memory alive and help others. “The solace that I take from her death is ... my baby is still doing amazing things, even after she’s gone, to help save our communities, to help save our children.”

Widespread Distribution and Potential Misuse

Fentanyl test strips are widely distributed and easily accessible. Public health departments have invested heavily in their distribution as part of a broader strategy to combat the opioid crisis. However, the potential for misuse by drug dealers highlights a significant challenge in ensuring that these tools are used effectively and safely.

The Role of Education and Awareness

Educating users about the limitations and proper use of fentanyl test strips is crucial. Public health campaigns must emphasize that these strips are not foolproof and should not be relied upon as the sole measure of drug safety. Comprehensive education can help mitigate the risks associated with false negatives and the misleading information propagated by dealers.

Future Directions in Harm Reduction

The opioid crisis continues to evolve, and harm reduction strategies must adapt accordingly. While fentanyl test strips are a valuable tool, they represent just one component of a multifaceted approach to preventing overdoses. Enhancing access to treatment, improving drug education, and continuing to combat the distribution of counterfeit drugs are all critical components of an effective response to this public health emergency.

The Need for Stronger Measures

In addition to educational campaigns, there is a need for stronger regulatory measures to ensure that fentanyl test strips are used correctly and effectively. Policies should be developed to monitor the distribution and use of these strips, preventing their exploitation by drug dealers.

Conclusion

The introduction of fentanyl test strips as a harm reduction tool has undoubtedly saved lives by providing a means to detect the presence of a deadly synthetic opioid. However, their misuse by drug dealers to falsely advertise “clean” drugs poses a significant threat. Addressing this issue requires a comprehensive approach involving education, regulation, and continuous adaptation of harm reduction strategies to effectively combat the evolving opioid crisis.