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. 2023 Jun;30(6):626-635.
doi: 10.1111/acem.14624. Epub 2022 Dec 12.

Pilot testing fentanyl test strip distribution in an emergency department setting: Experiences, lessons learned, and suggestions from staff

Megan K Reed  1   2   3 , Venise J Salcedo  2 , TingAnn Hsiao  2 , Tracy Esteves Camacho  2 , Amanda Salvatore  2 , Anne Siegler  4 , Kristin L Rising  1   2   5
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Free article

Pilot testing fentanyl test strip distribution in an emergency department setting: Experiences, lessons learned, and suggestions from staff

Megan K Reed et al. Acad Emerg Med. 2023 Jun.
Free article

Abstract

Objectives: Fentanyl test strips (FTSs) are increasingly used to address fentanyl contamination of the illicit drug supply by testing a drug for the presence of fentanyl, allowing people who use drugs (PWUD) to engage in overdose prevention. While emergency departments (EDs) have implemented various harm reduction strategies for PWUD, to date distribution of FTSs in EDs is limited and not evaluated. Thus, we sought to explore ED staff experiences distributing FTSs.

Methods: Twenty-one staff serving different roles (e.g., physician, nurse, technician, social worker, certified recovery specialist) within two urban EDs in a major metropolitan area were enrolled in a pilot study to distribute FTS to patients who use drugs. Participants were interviewed about their experience at 3 weeks and again at 3 months. Interviews were recorded, transcribed verbatim, and coded using a conventional content analysis approach.

Results: All participants endorsed the utility of FTS distribution in the ED. Across 42 interviews, participants discussed evolving strategies to approach patients about FTS, primarily favorable patient reactions to FTSs, improved dynamics between participants and patients, mixed intervention support from other staff, and named challenges of FTS distribution and recommendations to make FTS distribution in the ED widespread. Recommendations included medical records prompts to offer FTS, offering via different types of staff, and offering FTS during triage.

Conclusions: Implementing FTS distribution may improve patient rapport while providing patients with tools to avoid a fentanyl overdose. Participants generally reported positive experiences distributing FTSs within the ED but the barriers they identified limited opportunities to make distribution more integrated into their workflow. EDs considering this intervention should train staff on FTSs and how to identify and train patients and explore mechanisms to routinize distribution in the ED environment.

Keywords: drug-checking; emergency department; fentanyl test strips; harm reduction; people who use drugs.

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References

REFERENCES

    1. Centers for Disease Control. U.S. Overdose Deaths In 2021 Increased Half as Much as in 2020 - But Are Still Up 15%. 2022. Accessed May 24, 2022. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/202205.htm
    1. Centers for disease control and prevention. Understanding the Opioid Overdose Epidemic 2021. Accessed February 15, 2022: https://www.cdc.gov/opioids/basics/epidemic.html
    1. Marshall K. Fact sheet: fentanyl test strip pilot. 2018. Accessed August 17, 2021. https://harmreduction.org/issues/fentanyl/fentanyl-test-strip-pilot/
    1. Krieger MS, Yedinak JL, Buxton JA, et al. High willingness to use rapid fentanyl test strips among young adults who use drugs. Harm Reduct J. 2018;15(1):1-9.
    1. Peiper NC, Clarke SD, Vincent LB, Ciccarone D, Kral AH, Zibbell JE. Fentanyl test strips as an opioid overdose prevention strategy: findings from a syringe services program in the southeastern United States. Int J Drug Policy. 2019;63:122-128.

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