Rapper’s overdose death prompts conversation about fentanyl test strips

Social media users also discussed fentanyl-related deaths in their communities and illegal online pharmacies.

This past week, news articles reported that rapper Rich Homie Quan, who died in September, had died from a fentanyl-related overdose, inciting online conversation about the benefits and challenges of fentanyl test strips. Other posts discussed recent reports that fentanyl may be decreasing in the U.S. drug supply, as well as the DEA’s recent warning about illegal online pharmacies selling counterfeit pills.

In response, communicators may share where people can access fentanyl test strips and how to use them, reiterate that naloxone prevents opioid overdose deaths, and explain how to check if an online pharmacy is licensed and how to safely dispose of pills that may contain dangerous substances.

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What’s trending nationally in conversations about opioids

On October 2, news articles reported that rapper Rich Homie Quan, who died in Atlanta in September, died from an overdose. The Fulton County medical examiner found several drugs in Quan’s system, including fentanyl. Online speculation that Quan had died of an overdose began last month, and with the recent news, conversation about his death surged. A Reddit post sharing an article about Quan’s cause of death received approximately 2,500 upvotes and 480 comments as of October 9. Many comments discussed how street drugs are often unknowingly mixed with fentanyl, increasing the risk of overdose. One comment questioned why Quan wasn’t testing his drugs for fentanyl, and some discussed how using fentanyl test strips can be challenging since the whole batch must be tested in order to know for sure if fentanyl is present.

On October 1, NPR reported that fentanyl may be decreasing in the U.S. drug supply. According to street drug researchers, less fentanyl is circulating, and there has also been an “unprecedented” drop in the purity of fentanyl that is being sold in some states. Lab tests show that fentanyl is often cut with BTMPS—an industrial chemical that is toxic but does not cause overdoses—or xylazine, a non-opioid tranquilizer not meant for human consumption. While this news is encouraging, harm reduction advocates quoted in the article warned that variability in fentanyl potency may lead some people to use larger amounts of drugs or engage in forms of drug consumption that may increase the risk of overdose. NPR shared the article on Facebook, where the post received approximately 300 reactions, 35 shares, and 200 comments as of October 9. Many comments doubted that the fentanyl supply is declining, noting that many people have died of fentanyl overdoses in their communities. Some also blamed immigrants and the current administration’s immigration policies for fentanyl-related deaths.

On October 4, the DEA issued a warning about illegal online pharmacies selling counterfeit pills. The warning stated that these websites typically look like legitimate pharmacies and claim to offer medications at a discounted price, often without requiring a prescription. The warning came after several people were indicted for advertising and selling counterfeit prescription medications online that contained fentanyl and other substances. The CDC is encouraging people who have purchased medication online to confirm that the online pharmacy is licensed and, if it is not, to dispose of the pills. Few social media posts acknowledged the warning. One comment on an X post claimed, “The government and media want you to only buy the drugs from them.”

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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.

In response to conversation about fentanyl test strips, communicators may explain that fentanyl test strips prevent overdose deaths by helping people determine whether their drugs unknowingly contain fentanyl, a potent opioid that increases the risk of overdose. Messaging may emphasize that fentanyl test strips are available for purchase online and may be available for free through local harm reduction programs. Xylazine test strips, which detect the presence of a non-opioid tranquilizer not meant for human consumption, are also available. However, drug test strips are considered “drug paraphernalia” in some states and are not legal everywhere. Staying up to date on local drug checking equipment laws is recommended. Messaging may also explain how to use drug test strips and emphasize that the only way to know for sure if a drug contains fentanyl or xylazine is to test the entire batch.

Posts about fentanyl overdoses provide an opportunity to recirculate materials outlining the signs of an opioid overdose. Explaining where to access naloxone and how to use it to reverse an overdose is recommended. Messaging may emphasize that multiple doses may be required to fully alleviate overdose symptoms. Communicators may also want to prebunk false claims that harm reduction tools “enable” drug use by explaining that experts attribute the recent decline in overdose deaths to the availability of naloxone.

In light of the DEA’s warning about illegal online pharmacies selling counterfeit medication, communicators may explain how to determine if an online pharmacy is state-licensed. Reiterating the CDC’s guidance to dispose of medication purchased from unlicensed online pharmacies and sharing how people can safely dispose of unused medication is recommended.