Do Fentanyl Test Strips reduce deaths from overdose?

• In Event: Innovative Approaches and Evaluations to Improving Health among Justice-involved Persons

Abstract

Almost one million people have died from an overdose of Opioids, mostly Fentanyl, in the US in the last twenty years. The problem is so relevant that a different set of strategies have been taken, increasingly tackling harm reduction rather than eliminating the problem itself. Among those harm-reduction strategies, Fentanyl Test Strips (FTS) have been increasingly being adopted in 39 states in the last decade. FTS allows drug users to test if the cocaine, heroin, or fake pills they consume have been purposely mixed with Fentanyl, a practice drug dealers do to increase economic gains (fentayl is cheap) and hook clients.

I study the effects of the FTS policy on overdose deaths from Fentanyl in the US. I used a county-level panel from 2010 to 2020 to identify causal changes related to the FTS policy. As the FTS policy had a staggered adoption, I compare two Difference-in-Difference estimators (Callaway & Sant’Anna, 2021; Sun & Abrahams, 2021) that better capture the dynamic of treatment effects over time. Unexpectedly, results show that FTS increased overdose deaths which may be related to the “blind spots” of FTS (tests do not capture all fentanyl analogs), user error while using the tests, or moral hazard.

Author

• Wilson Hernandez, University of Pennsylvania