Fentanyl: A Key Factor in Soaring Overdose Deaths Increasing Access to Test Strips: A Vital Factor in Harm Reduction


Drug overdose deaths increased 30% in the United States from 2019 to 2020, reaching 91,799.[1] The Centers for Disease Control and Prevention (CDC) estimates that there were 107,622 drug overdose deaths in 2021, an all-time high.[2]

Overdose deaths have been driven largely by synthetic opioids (primarily fentanyl). Fentanyl is up to 50 times stronger than heroin and 100 times stronger than morphine. It is a major contributor to both nonfatal and fatal overdoses in the U.S. Fentanyl is commonly mixed with other illicit drugs, and people may not know that their drugs are laced with fentanyl. Fentanyl test strips can identify illicit drugs that contain fentanyl. CDC and the Substance Abuse and Mental Health Services Administration have approved the use of Federal grant funding to purchase fentanyl test strips, allowing State and local programs to use fentanyl test strips in their efforts to reduce and prevent overdoses.

Several States have laws that classify fentanyl test strips as drug paraphernalia, limiting the availability and use of fentanyl test strips.[3] New Mexico, Wisconsin, Tennessee, Alabama, New Mexico, Colorado, Rhode Island, Maryland, and other states have been passing legislation to decriminalize fentanyl test strips, a critical step in increasing access to this harm-reduction tool for those who might be at risk for overdosing.

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[1] Kariisa M, Davis NL, Kumar S, et al. Vital Signs: Drug overdose deaths, by selected sociodemographic and social determinants of health characteristics — 25 States and the District of Columbia, 2019–2020. MMWR Morb Mortal Wkly Rep 2022;71:940–947. http://dx.doi.org/10.15585/mmwr.mm7129e2

[2] Centers for Disease Control and Prevention. National Center for Health Statistics. U.S. Overdose Deaths In 2021 Increased Half as Much as in 2020 – But Are Still Up 15%. 2022, May 5. Available from: https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/202205.htm

[3] Legislative Analysis and Public Policy Association. Fentanyl Test Strips. 2021. Available from: https://legislativeanalysis.org/wp-content/uploads/2021/05/Fentanyl-Teststrips-FINAL-1.pdf