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This article contains the following information:
- Why would CPP's want this information?
- What is illicit fentanyl?
- What are some myths about illicit fentanyl?
- What are illicit fentanyl testing strips?
- Are illicit fentanyl testing strips legal?
- Where can I get them?
- How do I use them?
Why Would CPP's Want This Information?
- I want to be clear that we at The Doctor Patient Forum do not encourage anyone to obtain pills on the street, from a friend, or from anywhere other than your pharmacy.
- We are aware that some chronic pain patients (CPP's) who have been medically abandoned have been so desperate for pain relief that they've either gone to the street or taken a pill from a friend.
- Since up to 42% of all pills on the street contain illicit fentanyl, we want to provide Harm Reduction information so if you are getting medication from somewhere other than your pharmacy, you know what to do to try to keep yourself safe.
- Please understand that when you take a pill that you obtained from someone other than your pharmacy, even if you use illicit fentanyl testing strips, there is no guarantee that the medication is safe for you to take. Even if you test your medication, we highly recommend you have Naloxone available (I will be adding content on this shortly, and I will link the information here) and that you don't ever take the medication when you're alone. In case you don't have anyone who can be there with you, there is a never use alone hotline 1-800-484-3731.
Illicit Fentanyl is not the same as prescription fentanyl. It is often made in labs in China and then smuggled in the the USA through Mexico. Illicit fentanyl is the leading cause of all drug-related deaths in the USA. Many who end up taking illicit fentanyl don't even realize it's in the medication or drugs they ingest. Due to this fact, we prefer to call it a poisoning instead of an overdose. Those who sell it often use pill presses so it looks identical to prescription medication. It is made to look like hydrocodone, oxycodone, Xanax, and other prescription drugs. It has also been found in other illicit substances such as heroin, meth, or cocaine. One reason drug dealers are using illicit fentanyl is due to its potency. A tiny bit goes a long way, but that is also the reason it kills so many people. The last statistic I read was that 42% of all street pills tested has illicit fentanyl in them.
What Are Some Myths About Illict Fentanyl?
- A very common myth is that prescription grade fentanyl is what's killing so many people. This is absolutely false. Media and even addiction specialists often conflate prescription fentanyl with illicit fentanyl analogues. Illicit fentanyl, not prescription fentanyl, is what's killing so many people.
- A recent toxicology study showed "Out of 18,393 deaths that were confirmed, probable, or suspected heroin deaths (including 2678 with morphine listed as cause of death on the DC) and 404 as probable pharmaceutical morphine deaths, among deaths with fentanyl detected, 89.3% were defined as probable or suspected IMF (illicitly manufactured) and 1.0% as probable pharmaceutical (prescription) fentanyl."
- There is a false narrative that's widely spread in media and repeated often that just touching illicit fentanyl or being in the same room as it can cause an overdose/poisoning. You see images of police in hazmat suits. This doesn't happen. It's important to understand this fact because if you by a pill off the street and test it for illicit fentanyl, and it turns out your pill contains illicit fentanyl, merely touching the substance will not cause an overdose/poisoning.
Ryan Marino MD often addresses the myths surrounding illicit fentanyl. He has shared the following image with permission to share it:
What Are Illicit Fentanyl Testing Strips?
Illicit fentanyl testing strips are part of Harm Reduction that assist in overdose prevention. They are actually FDA approved to detect fentanyl in urine, but are also increasingly being used as a Harm Reduction drug-checking strategy.
- Sadly, they are illegal in some states because they are considered drug paraphernalia. In the states they're illegal, Harm Reduction groups are fighting to change those laws. Josh Bloom wrote about this issue in an article called Fentanyl Test Strips Are Illegal. This Is Obscene
- Please check here To find out if they're legal in your state.
- For individual or small orders, you can get them at Dosetest. They cost about $1.00 each.
- For larger orders (like if you want to order in bulk for yourself or to hand out) you can get them at BTNX. For more information about how to order them in bulk, please e-mail Michael@btnx.com.They sometimes offer a discount for new customers.
- Here is a Brochure from NYC Dept. of Health showing how to use illicit fentanyl testing strips. Here is a PDF of the Brochure.
- One important point to note is the results are opposite from other tests like pregnancy tests.
- One tine = positive (+) result (meaning there is illicit fentanyl present).
- Two Lines = negative (-) result (no illicit fentanyl detected).
- The following graphic explains how to read results:
- Remember, a negative test result is not a guarantee that illicit fentanyl is not in your pill.
- Most how to videos and information are geared toward PWID (people who inject drugs). We know that most CPP's who go to the streets won't inject the medication. When testing a pill that you are not intending to inject you have two options -both are explained in the following video:
- Dissolve the entire pill in water and test it (this is the most reliable method). Once it tests negative for illicit fentanyl, you can still swallow the liquid, or you can put it in a capsule to avoid tasting the dissolved pill.
- Here are two websites to purchase gel caps which are specifically made for liquid such as essential oils:
- How to fill a gel cap with liquid according to these websites:
- Pull apart the capsule. One side is larger than the other, allowing the smaller end to fit inside the larger one
- Draw your liquid supplements into a medicine dropper. Place the end of the dropper over the smaller side of the gel capsule.
- Carefully squeeze the dropper to fill the capsule. Slide the larger end on to enclose the liquid inside the capsule.
- Store in an airtight container in a cool, dry place.
- You can scrape off part of the pill as Amanda shows in the following video. Just know there is no guarantee that the composition of a counterfeit pill is uniform throughout. So, it's possible that the small sample you test will be negative for illicit fentanyl, but other parts of the pill will be positive.
- Dissolve the entire pill in water and test it (this is the most reliable method). Once it tests negative for illicit fentanyl, you can still swallow the liquid, or you can put it in a capsule to avoid tasting the dissolved pill.
- If you bought more than one pill, testing one of the pills does not guarantee that the other pills will have the same composition.
Here is a how to video by an amazing Harm Reduction advocate, Amanda Mazur. Check out her Tik Tok videos for more information about Harm Reduction. In addition to teaching about Harm Reduction, Amanda also fights for the rights of CPP's to have access to prescription opioids.
As always, if you have any questions feel free to contact us through our contact page.
This content was written by Bev Schechtman and Carrie Judy for The Doctor Patient Forum. Updated March 3, 2022
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What Does This Mean?
If someone is going to take a substance that wasn't obtained from a pharmacy, it is important to not be alone when the substance is ingested. Although we never encourage CPP's to obtain their medication from someone other than a doctor, we are aware it is happening. We are working on adding information about Naloxone (Narcan), which can be used to reverse an opioid overdose. We greatly encourage if anyone knows of someone who is getting medication from somewhere other than a pharmacy, please pass along this information and we also ask you to pass along our information about illicit fentanyl testing strips.
What if I Don't Have Someone Who Can Be With Me?
- There is a Never Use Alone hotline 1-800-484-3731
- This website says "If you are going to use by yourself, call us! You will be asked for your first name, location, and the number you are calling from. An operator will stay on the line with you while you use. If you stop responding after using, the operator will notify emergency services of an \"unresponsive person\" at your location."
Amanda Mazur, a Harm Reduction advocate and expert created these cards. Please reach out to her via email amandamazurholly@icloud.com if you'd like to have one of these cards. You can also follow her on TikTok.
What are Good Samaritan Laws?
According to The Network of Public Health Law: Although the majority of drug overdose/poisonings are due to (illicit) opioids, many witness are too scared to call for help due to the following reasons:
- "People who witness an overdose are often afraid to call for help because emergency medical services responders (EMS) are often accompanied by law enforcement officers, and many aspects of the use of controlled substances in the United States remain illegal. Many individuals therefore fear that alerting EMS to an overdose might result in themselves, the person overdosing, or both being arrested or prosecuted for possession of illegal drugs, drug paraphernalia, violation of probation, or other crimes."
- "They may also fear non-criminal consequences such as loss of housing or the involvement of child welfare authorities."
"To encourage bystanders to summon emergency medical assistance in an overdose, most states have enacted overdose Good Samaritan legislation that provides limited immunity to individuals who do so. As of December 31, 2020, 47 states and the District of Columbia have enacted these laws, which are associated with an approximate 15% reduction in overdose deaths. Recent research suggests that overdose Good Samaritan laws that provide protection from arrest are much more effective than those that provide protection only from charge or prosecution."
What States Have Good Samaritan Laws?
- The Network for Public Health Law created a document (pdf version) that listed all of the Good Samaritan laws as of June 2021 broken down by state.
- Next Distro also lists Harm Reduction laws broken down by state.
