Posts claim there is ‘no need’ for fentanyl test strips

Other conversations criticized overdose prevention centers and discussed the effects of naloxone.

This past week, an Instagram video explaining how to use fentanyl test strips generated debate, with some comments claiming that they are unnecessary. Other posts falsely claimed that overdose prevention centers—a type of harm reduction program—cause deaths and discussed what it feels like to receive naloxone during an overdose.

In response, public health communicators may share how to use fentanyl test strips and why they are needed, highlight the benefits of harm reduction programs, and recirculate information about when and how to administer naloxone, as well as what people should expect after giving it.

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What’s trending nationally in conversations about opioids

On November 1, the nonprofit End Overdose shared a video on Instagram of a musician explaining how to use fentanyl test strips. The post received approximately 15,400 likes and 600 comments as of November 6. Some comments stated that people should not use drugs in the first place, so there is no need for harm reduction tools like fentanyl test strips. Others responded to those comments by sharing support for harm reduction, stating, “That’s like saying ‘people who ride motorcycles are taking a known risk so let’s not waste time making and selling helmets.’”

Recent news articles reported that Las Cruces, New Mexico, is considering establishing an overdose prevention center, which would provide a space where people can use drugs in  a supervised environment with overdose prevention tools on hand and be connected to services for people with substance use disorder. A director of Homeless Health Care Los Angeles proposed the idea to Las Cruces city councilors and department administrators late last month. So far, the city has not taken action, but councilors will consider using opioid settlement funds to establish the center. An X post criticizing the idea received approximately 178,000 views, 1,300 likes, 425 resposts, and 300 comments as of November 6. Many comments falsely claimed that overdose prevention centers “enable addiction” and cause overdose deaths.

On November 2, a Reddit user shared a post describing the unpleasant physical experience of “getting narcaned.” The person explained that they felt angry after receiving a dose of naloxone because they believed they had “wasted” other people’s time and would have accepted dying from an overdose. The post received approximately 1,500 upvotes and 290 comments as of November 6. Many comments from people who identified themselves as first responders expressed compassion for the person who wrote the post, stating, “I’d rather deal with an angry narcanned person over having to say ‘I’m sorry, we’ve done everything we can, your loved one is dead and we are stopping CPR’” and “Don’t worry about ‘wasting our time,’ I tell everyone I treat for an overdose I’d rather narcan you 50 times than work your cardiac arrest once, cause every time I’m able to give you Narcan it means you’re alive and given another chance.”

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Recommendations for public health professionals

Each week, the Infodemiology.com team will provide messaging recommendations in response to some of the trending narratives outlined above. These helpful tips can be used when creating content, updating web and FAQ pages, and developing strategy for messaging about opioids.

Circulating conversations provide an opportunity to explain that fentanyl test strips prevent overdose deaths by helping people determine whether their drugs contain fentanyl, which increases the risk of overdose. Communicators may emphasize that fentanyl test strips can be purchased online and may be available for free through local harm reduction programs. However, they are not legal everywhere, as fentanyl test strips are considered “drug paraphernalia” in some states. Ensuring that messaging is up to date with local drug checking equipment laws is recommended. Additional messaging may outline how to use drug test strips and emphasize that testing the entire batch is the only way to know for sure if a drug contains fentanyl.

In response to false claims about overdose prevention centers, messaging may explain that more than 20 years of research show that no one has ever died of an overdose while at an overdose prevention center. Additional messaging may emphasize that overdose prevention centers do not increase crime and are associated with increased access to treatment. Overdose prevention centers, which provide a space where people can use drugs in a supervised environment, are different from syringe services programs (SSPs), which may provide tools like vaccinations and sterile syringes to reduce the spread of infectious diseases. However, both overdose prevention centers and SSPs are types of harm reduction programs that connect people who use drugs to treatment if and when they are ready.

Sharing how to recognize the signs of an opioid overdose, where people can access naloxone, and how to use naloxone is recommended. Messaging may explain that bystanders witnessing a possible overdose should dial 911, administer naloxone, check for breathing, perform CPR if trained in it or if instructed by a 911 operator, and stay with the person until first responders arrive. If overdose symptoms do not resolve before help arrives, give additional doses of naloxone every two to three minutes until the person begins to breathe normally. Naloxone may cause unpleasant withdrawal symptoms, and people who receive naloxone may be confused, agitated, or angry after they are revived, so bystanders may want to explain what happened in order to help the overdosing person stay calm. Naloxone is safe to administer even if a person isn’t overdosing or isn’t overdosing on opioids.