Harm Reduction Strategies – Fentanyl Screening
Staying informed about new developments in the war on opioids may save lives in your facility. One recent advancement is the use of fentanyl test strips¹. Although fentanyl test strips are a reliable tool, they are not currently approved for use in jails for medical purposes. These test strips are intended to detect fentanyl in urine or in substances such as unknown powder to protect individuals from accidental exposure or overdose. Fentanyl test strips can also be used to detect fentanyl as a forensic screening tool.
While CLIA-waived fentanyl test strips are available on the market, these are FDA approved for forensic use only (FUO)². FUO fentanyl testing is not approved for use related to medical decision making. Until these tests are approved for medical purposes, consider the following strategies:
Give Narcan FIRST
Treat what you see. If you notice signs of overdose, give Narcan first. This medicine can reverse the effects of opioid overdose and may save a life. Do not wait for a person to become unresponsive or stop breathing to give Narcan, even if you’re not sure what they took. In some cases, multiple doses of Narcan may be needed to keep the person alert until EMS arrives. If overdose is suspected, give Narcan FIRST, and call 911 as soon as possible.
Consider harm reduction strategies
Until fentanyl testing is CLIA-waived for medical purposes, jails should not be using fentanyl test strips to influence medical care or decision making. Instead, consider other harm reduction strategies such as:
· Continue Medication-Assisted Treatment (MAT) for detainees already enrolled in a program and compliant with treatment. If someone is already on a path to recovery, partner with medical to continue treatment in custody. This may help avoid withdrawal symptoms in jail.
· Partner with community MAT programs. Referrals to local resources upon release can support an individual in their recovery as they transition back into their community.
· Stock bulk doses of Narcan in the facility. There is an increasing trend of mass exposure to fentanyl requiring multiple doses to save the lives of those affected. Some cases have referenced needing 10 doses or greater per person to keep the victim awake.
· Consider adding a discharge planner and substance use disorder screener as part of your staffing plan.
If you’re interested in learning more about how a discharge planner or substance use disorder screener can benefit your team, please reach out to training@sparktraining.us for more information!
1. VanRegenmorter, C. (2021, February 26). Fentanyl CLIA waived status: a life-saving FDA fix. Eleanor Health Foundation. Retrieved from www.eleanorhealthfoundation.org/blog/fentanyl-clia-waived-status-a-life-saving-fda-fix.
2. CLIA Waived Inc. (n.d.). 14 panel drug test cards. https://cliawaived.com/14-panel-drug-test-cards.html
All materials have been prepared for general information purposes only. The information presented should be treated as guidelines, not rules. The information presented is not intended to establish a standard of medical care and is not a substitute for common sense. The information presented is not legal advice, is not to be acted on as such, may not be current, and is subject to change without notice. Each situation should be addressed on a case-by-case basis. WHEN IN DOUBT, SEND THEM OUT. ®