Noelle P Weicker1, Jill Owczarzak2, Glenna Urquhart3, Ju Nyeong Park4, Saba Rouhani5, Rui Ling6, Miles Morris7, Susan G Sherman8. 1. Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, 624N. Broadway, Room 180, Baltimore, MD 21205, USA. Electronic address: npweicker@jhu.edu. 2. Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, 624N. Broadway, Baltimore, MD 21205, USA. Electronic address: jillowczarzak@jhu.edu. 3. Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, 624N. Broadway, Baltimore, MD 21205, USA. Electronic address: gurquhar2@jhu.edu. 4. Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, 624N. Broadway, Baltimore, MD 21205, USA. Electronic address: ju.park@jhu.edu. 5. Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, 624N. Broadway, Baltimore, MD 21205, USA; Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 624N. Broadway, Baltimore, MD 21205, USA. Electronic address: srouhan1@jhu.edu. 6. Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, 624N. Broadway, Baltimore, MD 21205, USA. Electronic address: rling3@jhmi.edu. 7. Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, 624N. Broadway, Baltimore, MD 21205, USA. Electronic address: mmorr100@jhu.edu. 8. Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, 624N. Broadway, Baltimore, MD 21205, USA. Electronic address: ssherman@jhu.edu.
Abstract
BACKGROUND: In Baltimore, the emergence of fentanyl and its analogues exacerbated an existing heroin crisis and increased uncertainty about drug composition and potency. In an effort to reduce overdoses, harm reduction organizations and health departments across the U.S. began distributing fentanyl test strips, a low barrier, inexpensive drug checking strategy. Studies show that people who use drugs (PWUD) frequently suspect that their drugs contain fentanyl and are interested in using fentanyl test strips to check their drugs; however, some people question their usefulness in regions where fentanyl presence is assumed. Understanding the utility of fentanyl test strips in fentanyl-saturated markets is a priority to best tailor interventions. METHODS: In-depth interviews (N = 20) were conducted with individuals who reported recent (past 30 days) opioid use in Baltimore, MD. RESULTS: Fentanyl was viewed as pervasive, dangerous, and difficult to avoid in the local drug supply. This dominant narrative characterized PWUD as disempowered by the heightened unpredictability of the drug market. While several strategies are used to navigate the drug market, respondents wanted more information about their drugs. In this context, fentanyl test strips were used in unique and unexpected ways to empower PWUD to be savvier market consumers, including avoiding fentanyl when there could be negative social or legal consequences, negotiating with dealers, and helping others in their social network navigate the opaque drug market. CONCLUSION: These findings add nuance and place fentanyl preference and use in the context of the drug market. When fentanyl presence is assumed, people used fentanyl test strips in unexpected ways to gain some control over their drug use. Novel uses for fentanyl test strips strengthen existing strategies used to navigate the drug market and mitigate overdose risk, and highlight their potential to quickly disseminate valuable information about the local drug supply.
BACKGROUND: In Baltimore, the emergence of fentanyl and its analogues exacerbated an existing heroin crisis and increased uncertainty about drug composition and potency. In an effort to reduce overdoses, harm reduction organizations and health departments across the U.S. began distributing fentanyl test strips, a low barrier, inexpensive drug checking strategy. Studies show that people who use drugs (PWUD) frequently suspect that their drugs contain fentanyl and are interested in using fentanyl test strips to check their drugs; however, some people question their usefulness in regions where fentanyl presence is assumed. Understanding the utility of fentanyl test strips in fentanyl-saturated markets is a priority to best tailor interventions. METHODS: In-depth interviews (N = 20) were conducted with individuals who reported recent (past 30 days) opioid use in Baltimore, MD. RESULTS: Fentanyl was viewed as pervasive, dangerous, and difficult to avoid in the local drug supply. This dominant narrative characterized PWUD as disempowered by the heightened unpredictability of the drug market. While several strategies are used to navigate the drug market, respondents wanted more information about their drugs. In this context, fentanyl test strips were used in unique and unexpected ways to empower PWUD to be savvier market consumers, including avoiding fentanyl when there could be negative social or legal consequences, negotiating with dealers, and helping others in their social network navigate the opaque drug market. CONCLUSION: These findings add nuance and place fentanyl preference and use in the context of the drug market. When fentanyl presence is assumed, people used fentanyl test strips in unexpected ways to gain some control over their drug use. Novel uses for fentanyl test strips strengthen existing strategies used to navigate the drug market and mitigate overdose risk, and highlight their potential to quickly disseminate valuable information about the local drug supply.
Authors: Madeline C Frost; Elizabeth J Austin; Maria A Corcorran; Elsa S Briggs; Czarina N Behrends; Alexa M Juarez; Noah D Frank; Elise Healy; Stephanie M Prohaska; Paul A LaKosky; Shashi N Kapadia; David C Perlman; Bruce R Schackman; Don C Des Jarlais; Emily C Williams; Sara N Glick Journal: Harm Reduct J Date: 2022-07-19
Authors: Wendy Masterton; Danilo Falzon; Gillian Burton; Hannah Carver; Bruce Wallace; Elizabeth V Aston; Harry Sumnall; Fiona Measham; Rosalind Gittins; Vicki Craik; Joe Schofield; Simon Little; Tessa Parkes Journal: Int J Environ Res Public Health Date: 2022-09-22 Impact factor: 4.614
Authors: Ju Nyeong Park; Jill Owczarzak; Glenna Urquhart; Miles Morris; Noelle P Weicker; Saba Rouhani; Susan G Sherman Journal: AIDS Behav Date: 2021-07-21