Karen Cropsey, Psy.D. and Emma Kay, Ph.D.Researchers at the University of Alabama at Birmingham hope to prevent substance use overdoses and deaths through an affordable solution using the six-year $5.3 million grant from the National Institutes of Health’s National Institute on Drug Abuse.
Emma Kay, Ph.D., associate professor at the School of Nursing, and Karen Cropsey, Psy.D., professor of psychiatry at the Marnix E. Heersink School of Medicine, are combining their expertise to co-lead the first national, fully remote trial to assess whether users testing the drug before ingestion can prevent fentanyl overdose.
Fentanyl and other synthetic opioids are responsible for most drug overdose deaths in the United States. Fentanyl is nearly 50 times stronger than heroin and 100 times stronger than morphine, and a lethal dose can be as small as 2 milligrams.
“People who take opioids or stimulants usually don’t set out to use fentanyl; they buy substances laced with it and often don’t know until it is too late,” Kay said. “Fentanyl test strips are a cheap and easy way to detect whether a drug has this potentially lethal substance in it, but many people don’t know they exist or how to use them effectively.”
The testing process is simple — a very small amount of the drug mixed with water will return a positive or negative result on the test strip. The test strips are more affordable than the overdose recovery drug naloxone and can prevent an overdose before it happens.
“It’s just not widely known what a benefit these test strips could be if they are correctly used and access is an issue,” Kay said.
This project is informed by Cropsey’s work, which demonstrated the successful remote distribution of naloxone to prevent overdose deaths.
Initially, naloxone was only used in emergency departments during suspected cases of opioid overdose. However, through the work of Cropsey and others, naloxone is used effectively by non-medically trained bystanders to reverse an overdose, giving people the opportunity to get to the emergency room and into substance use treatment.
By assessing a fentanyl test strip education and distribution intervention in a national sample of individuals at risk for overdose, Kay and Cropsey hope to demonstrate a low-barrier, sustainable and effective approach to reducing overdose deaths.
Kay says that, while preventing people from using illegal substances would be ideal, it is not the reality due to the stigma attached to substance use disorders. A prevention intervention like this could save lives while reducing overdose-related healthcare costs, which are more than $10 billion yearly for each hospital in the United States.
“Being able to reach people who are not engaged in substance use treatment and who live in rural areas where these types of interventions are not available are additional, novel aspects to this work,” Cropsey said.
Researchers say this can be a transformative advancement in overdose prevention. Follow-up studies will focus on making these test strips widely available.