For people with opioid use disorder, staying safe has become harder over recent years due to the dangers of fentanyl and its analogs spreading throughout the illicit drug supply. Many people have turned to using fentanyl test strips (FTS) as part of overdose prevention efforts. This article will go over what fentanyl test strips are, how they work, and what limitations to consider when making choices about staying safe.

What Are Fentanyl Test Strips?

Fentanyl test strips are small strips of paper that can detect fentanyl and some fentanyl analogs. You can use them before injecting, snorting, or taking pills to check if fentanyl is present. They’re an important harm reduction tool that can help people detect what may be in their drug supply.

Fentanyl is a powerful synthetic opioid estimated to be about 50 times stronger than heroin. Pharmaceutical fentanyl, such as fentanyl patches, is approved for medical use to treat severe pain. Illicitly manufactured fentanyl is dangerous because:

• It can contain fentanyl analogs — like carfentanil — which can be more potent than fentanyl.
• It may be mixed with other drugs, like heroin, cocaine, methamphetamine (meth), or MDMA.
• It can be made into counterfeit pills that resemble other prescription opioids without the person knowing they contain fentanyl.

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Why Are Fentanyl Test Strips Important?

You can’t tell if another drug or pill contains fentanyl by looking at it, tasting it, or smelling it. Fentanyl test strips are one way to check for fentanyl. Because fentanyl is so powerful, it’s important to know if it’s present in a drug or pill before you take it, to prevent an overdose.

How Do Fentanyl Test Strips Work?

Fentanyl test strips work by taking a small sample of the drug mixed with water and placing it on the test strip. The strip can detect the presence of fentanyl in many different substances, including heroin, cocaine, and meth.

These are the steps to take when using fentanyl test strips based on the drug form:

• Crystals, pills, and powders — Mix your small crushed drug sample well with at least one-half teaspoon of water, or 1 teaspoon if testing methamphetamine, ecstasy, or MDMA.
• Injections — Prepare your syringe and set it aside. Add 1 teaspoon of water to the drug residue in the bag or tin, and mix well.
• Blotter LSD — Tear off a small corner of LSD paper and soak the corner in 1 teaspoon of water for at least 10 minutes.

Once mixed or soaked, dip the fentanyl test strip into the water up to the strip’s wavy lines. Wait at least 15 seconds, then place the strip on a flat surface for three minutes to allow it to work before reading the results.

Fentanyl Strip Results — What Do They Mean?

After finishing the test, it’s important to read the results correctly. Always follow the instructions provided with the test strips, as different brands may have slightly different directions for reading the results.

After waiting the recommended time, the results are generally:

• Two red/pink lines = negative result (fentanyl was not detected)
• One red/pink line = positive result (fentanyl was detected). Don’t use the substance. Safely dispose of it to reduce the risk of overdose.
• No red/pink lines or unclear results = invalid test (test again with a new strip)

A negative result doesn’t guarantee that a substance is safe or 100 percent free from fentanyl. Test strips are just one harm-reduction tool of many and should be used along with other overdose prevention methods, like naloxone.

It is important to stress that fentanyl test strips cannot detect many other dangerous contaminants, including nitazene opioids, medetomidine, benzodiazepines, or other emerging adulterants. The illicit drug supply continues to change, so a negative fentanyl test should never be interpreted as meaning a drug is safe.

What Are the Drawbacks of Using Fentanyl Test Strips?

Fentanyl test strips can help tell whether fentanyl is likely in a substance, but they can’t guarantee if the substance is safe. A negative test result doesn’t mean a substance is free of fentanyl. It may contain fentanyl analogs that can’t be detected with fentanyl test strips.

Test strips also can’t tell how much fentanyl is present or how strong it may be. In addition, fentanyl test strips do not detect other dangerous substances that may be in the drug supply. For example, some drugs may contain xylazine, sometimes called “tranq,” which is not an opioid but can cause serious health problems.

Because of these limitations, fentanyl test strips should be used along with other harm reduction and overdose prevention tools.

Other Harm Reduction Strategies

Fentanyl test strips are just one of many ways to reduce the risk of overdose. Several other harm reduction tools can help keep people safe and support recovery. Some examples include:

• Needle exchange programs (NEP) — Sometimes called syringe services programs (SSPs), these programs provide clean needles and syringes. This helps lower the risk of HIV, hepatitis, and other bloodborne infections.
• Opioid treatment programs — Help people who are struggling with opioid use disorder by providing treatment, including counseling, to help people overcome opioid use disorder.
• Naloxone (Narcan) — A tool that can save lives by reversing an opioid overdose. Carrying naloxone, such as a nasal spray or injectable form, and knowing how to use it can help prevent a fatal overdose.
• Use safely — Avoid mixing drugs, alcohol, and other substances, as it can increase your overdose risk. Also, it’s safer to never use alone so that someone can call for help or give naloxone in an emergency.

All of these tools can be used together to help reduce harm, prevent overdose, and support opioid use disorder recovery.

Treating Opioid Use Disorder

If you have opioid use disorder, effective medication treatments are available. FDA-approved medications include buprenorphine, methadone, and naltrexone. These medicines can help reduce opioid use, cravings, and withdrawal symptoms. Buprenorphine comes in several forms, including tablets, films, and long-acting injections.

Whether you use fentanyl test strips, carry naloxone, receive medication treatment, or use a combination of these tools, having access to support and resources can help you stay safe.

Join the Conversation

On MyOpioidRecoveryTeam, people share their experiences with opioid use disorder, get advice, and find support from others who understand.

Have you ever used fentanyl test strips? Let others know in the comments below.