Observational studyThe International journal on drug policy2025
Association of fentanyl test strip results and change in drug use behaviors: A multi-state, community-based observational study.
Observational study in The International journal on drug policy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed.
- Interpol review of forensic drug chemistry, 2022-2025.Forensic science international. Synergy · 2026Review
- Review
- A mixed methods examination of organizational approaches to fentanyl test strip distribution and training across multiple states.Harm reduction journal · 2026Article
- Polydrug overdose mortality caused by synthetic opioids and stimulants: current sex- and age-specific trajectories in United States national data for 2018-2024.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Article
- "I wasn't scared of the dope I had anymore because I could test it myself:" A qualitative study among rural Appalachians who use drugs about experiences with a fentanyl test strip intervention.Research square · 2026Article
- Harm reduction approaches for the use of benzodiazepines: a scoping review.Harm reduction journal · 2025Article
- Prospective cohort study of fentanyl test strip use and distribution in three states: the stay safe study protocol and implementation recommendations for researchers.Harm reduction journal · 2025Observational
Corrections and comments
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Authors and funding
20 authors.
Funding
Abstract
backgroundThe Stay Safe Study, conducted between May and December 2023 in the United States, investigated the association between fentanyl test strip (FTS) use and risk reduction behaviors. This paper examines the association between self-reported FTS results and change in drug use behaviors.
methodsWe solicited self-reported drug and FTS use among people who use drugs (PWUD), with a baseline and four weekly surveys over a 28-day observation period in three states (Kentucky, New York and Ohio). For each day participants reported drug use, they were asked types of drugs used, use of FTS, FTS results, and 12 drug use behavior changes because of the result. A generalized estimating equation approach was used to model associations between FTS results and each outcome.
resultsThese analyses included 541 PWUD who used FTS at least once in the observation period. Positive FTS results were associated with participants taking turns, having naloxone nearby, and using less drugs. There was a four-fold reduction in the amount of drugs used following a positive FTS result (odds ratio (OR)=4.37; 95 % CI, 3.45-5.55). This was modified by self-reported types of drugs tested, with a 20-fold reduction when testing illicit benzodiazepines (OR=19.92; 95 % CI, 8.6-46.27), a 10-fold reduction when testing illicit stimulants (OR=10.04; 95 % CI, 6.49-15.53), and 2-fold reduction in drugs used when testing illicit opioids or other drugs tested (OR=2.11; 95 % CI, 1.14-3.92).
conclusionsThese findings suggest that FTS assist PWUD to immediately reduce their risks by changing drug use behaviors, including reducing the amount of drug used.
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