From the Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (RAL, PML, KCA, HSK); Cook County Department of Public Health, Chicago, IL (LBK); and Toxikon Consortium, Chicago, IL (PML).
J Addict Med. 2022;16(6):730-732. doi: 10.1097/ADM.0000000000001008. Epub 2022 Aug 17.
United States drug overdose deaths now overwhelmingly involve fentanyl and fentanyl analogs. The emergency department (ED) is an important setting to provide harm reduction for persons who use drugs, but ED-based fentanyl test strip distribution has not yet been described.
This is an observational study of patients with an opioid-related visit to an ED in downtown Chicago, Illinois. We offered fentanyl test strips alongside an existing take-home naloxone program and report on the number of patients who accepted fentanyl test strips. We assessed patient familiarity with fentanyl and fentanyl test strips during the index ED visit and attempted to contact patients 1 month after the ED visit to determine testing outcomes.
We offered fentanyl test strips to 23 consecutive ED patients (mean age, 39.8 years; male, 73.9%) with an opioid-related ED visit (87.0% for opioid overdose). Sixteen patients (69.5%) had heard of fentanyl, and 2 (8.7%) had prior experience using fentanyl test strips. Eighteen patients (78.2%) accepted the fentanyl test strips, 2 of which left the test strips behind in the ED alongside their take-home naloxone kit. Of the 16 total patients who departed with fentanyl test strips, we were able to reach 3 (18.8%) by phone 1 month after their ED visit; 9 had disconnected or wrong numbers listed. All 3 patients reported a positive fentanyl test strip result; tested substances included heroin, alprazolam, and cocaine.
This report demonstrates the feasibility and acceptability of ED fentanyl test strip distribution among patients with opioid-related ED visits.
美国的药物过量死亡现在绝大多数涉及芬太尼和芬太尼类似物。急诊室（ED）是为使用毒品的人提供减少伤害的重要场所，但尚未描述基于 ED 的芬太尼检测条分发情况。
这是一项对伊利诺伊州芝加哥市中心 ED 因阿片类药物相关就诊的患者进行的观察性研究。我们在现有的带药回家纳洛酮计划之外提供芬太尼检测条，并报告接受芬太尼检测条的患者人数。我们评估了患者在 ED 就诊期间对芬太尼和芬太尼检测条的熟悉程度，并试图在 ED 就诊后 1 个月联系患者以确定检测结果。
我们向 23 名连续的因阿片类药物相关 ED 就诊（平均年龄 39.8 岁；男性占 73.9%）的患者提供了芬太尼检测条（87.0%为阿片类药物过量）。16 名患者（69.5%）听说过芬太尼，2 名患者（8.7%）有过使用芬太尼检测条的经验。18 名患者（78.2%）接受了芬太尼检测条，其中 2 名患者在 ED 留下了他们带回家的纳洛酮试剂盒旁边的芬太尼检测条。在总共携带芬太尼检测条离开的 16 名患者中，我们在 ED 就诊后 1 个月通过电话联系到了 3 名患者（18.8%）；9 名患者列出的电话号码已断开或错误。所有 3 名患者均报告芬太尼检测条结果呈阳性；检测物质包括海洛因、阿普唑仑和可卡因。
本报告表明，在因阿片类药物相关 ED 就诊的患者中，ED 分发芬太尼检测条是可行且可接受的。
