# Off-label Use of Rapid Response Fentanyl Test Strips as an Opioid Overdose Prevention Strategy

> **NIH NIH R01** · RESEARCH TRIANGLE INSTITUTE · 2020 · $657,648

## Abstract

PROJECT SUMMARY/ABSTRACT
DESCRIPTION: See instructions. This must contain a summary of the proposed activity suitable for dissemination to the public (no
proprietary/confidential information). It should be a self-contained description of the project and contain a statement of objectives and methods to be
employed. It should be informative to other persons working in the same or related fields. DO NOT EXCEED THE SPACE PROVIDED.
We propose a mixed-methods study to investigate the positive and negative consequences of fentanyl test
strip (FTS) use by people who inject drugs (PWID). Overdose (OD) deaths involving illicitly made fentanyl
(IMF) increased 540% in the United States from 2013–2016 and another 45.2% from 2016–2017, with IMF-
involved deaths outnumbering heroin and prescription opioid deaths for the first time in 2016. The rapid
proliferation of IMF in the illicit drug market has led to a heightened risk environment characterized by
adulterated products of unknown purity and potency. While naloxone is a proven secondary OD prevention
strategy by preventing fatalities among OD victims, in the wake of the IMF flooding the drug markets, we now
need primary OD prevention strategies to prevent ODs from occurring in the first place. Over the past 3
years, community-based organizations in the U.S. and Canada have started to distribute FTS as a primary
OD prevention strategy. FTS are comparable to point-of-care pregnancy tests in that after a drug solution
comes into contact with the test strip, the strip displays one or two red lines, denoting positive or negative
results. FTS cost about $1, making them a reasonable cost to OD prevention programs. Little is known about
the positive and negative consequences of PWID using FTS. This application proposes a rigorous
prospective study of PWID, guided by Zinberg’s Drug, Set, and Setting model. The specific aims are as
follows: Aim 1: To assess positive behavioral health consequences associated with FTS use in a cohort of
PWID in North Carolina (N=350) and West Virginia (N=350). Aim 2: To assess negative behavioral health
consequences associated with FTS use in a cohort of PWID in North Carolina and West Virginia. Aim 3: To
conduct qualitative interviews with PWID (n=100) to learn how Drug, Set, and Setting factors influence the
use of FTS, drug purchasing and drug use behavior, and OD risk. To achieve these aims, we will recruit a
sample of 700 PWID from two syringe service program sites: Greensboro, NC, and Morgantown, WV. West
Virginia had the highest fentanyl OD death rate in the U.S. in 2017, and North Carolina had the second
highest rate increase (2016–2017) in fentanyl OD deaths. For Aims 1 and 2, we will collect quantitative data
pertaining to FTS use and drug, set, and setting factors at baseline, 6 months, and 12 months. For Aim 3, we
will purposively sample a subset of 100 PWID from the quantitative cohort. The study is led by Multiple
Principal Investigators, Jon Zibbell, a National Institute...

## Key facts

- **NIH application ID:** 9884388
- **Project number:** 1R01DA047334-01A1
- **Recipient organization:** RESEARCH TRIANGLE INSTITUTE
- **Principal Investigator:** JUDITH FEINBERG
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $657,648
- **Award type:** 1
- **Project period:** 2020-07-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9884388

## Citation

> US National Institutes of Health, RePORTER application 9884388, Off-label Use of Rapid Response Fentanyl Test Strips as an Opioid Overdose Prevention Strategy (1R01DA047334-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9884388. Licensed CC0.

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