A magazine for friends of the Warren Alpert Medical School of Brown University.

$1 Could Save a Life


Low-cost, low-tech test strips effectively detect fentanyl in street drugs.

Fentanyl, a synthetic opioid that’s up to 100 times more potent than morphine, is implicated in the recent spike in overdose deaths in the US. Because it can be mixed with drugs like heroin or pressed into counterfeit prescription pills, people often don’t know they’ve taken fentanyl until it’s too late.

But inexpensive, easy-to-use test strips could save their lives. Traci Green, PhD, an adjunct associate professor of emergency medicine and of epidemiology, was a coprincipal investigator of a study, conducted with the Johns Hopkins Bloomberg School of Public Health, that confirmed the paper-based strips, made by the Canadian company BTNX, can detect the presence of fentanyl in drug samples as accurately as more expensive technologies that require trained specialists.

The researchers pitted the test strips—which were originally intended to detect fentanyl in urine—against two different spectrometers for their ability to detect when fentanyl was present (sensitivity) and when it was not (specificity) in street drug samples. They found the test strips had the lowest detection limit and the highest rates of sensitivity and specificity.

Furthermore, in surveys of people who use drugs in Providence, Baltimore, and Boston, the vast majority said they’d use the test strips, which cost about $1 apiece and deliver results in a few minutes. Most people also said if they knew their drugs contained fentanyl they’d change their behavior, including not using the drugs.

“When people can … see themselves in the solution is where we have greater success,” Green says.


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