Urine drug screening for early detection of unwitting use of fentanyl and its analogues among people who inject heroin in Sydney, Australia

© 2018 Australasian Professional Society on Alcohol and other Drugs Introduction and Aims: North America has witnessed a dramatic rise in fatal opioid overdoses due to the unwitting consumption of non-pharmaceutical fentanyl and its analogues. While some of the drivers of this crisis—including profi...

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Main Authors: Barratt, Monica, Latimer, J., Jauncey, M., Tay, E., Nielsen, S.
Format: Journal Article
Published: Wiley-Blackwell Publishing Ltd. 2018
Online Access:http://hdl.handle.net/20.500.11937/71755
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author Barratt, Monica
Latimer, J.
Jauncey, M.
Tay, E.
Nielsen, S.
author_facet Barratt, Monica
Latimer, J.
Jauncey, M.
Tay, E.
Nielsen, S.
author_sort Barratt, Monica
building Curtin Institutional Repository
collection Online Access
description © 2018 Australasian Professional Society on Alcohol and other Drugs Introduction and Aims: North America has witnessed a dramatic rise in fatal opioid overdoses due to the unwitting consumption of non-pharmaceutical fentanyl and its analogues. While some of the drivers of this crisis—including profitability and access to high-potency opioids through internet sources—also apply in Australia, to our knowledge, there have been no ongoing surveillance studies of local populations. Therefore, this pilot study aimed to detect unintentional fentanyl consumption among people who inject heroin through instant urine screening, and determine the feasibility and acceptability of voluntary urinalysis of clients at the Medically Supervised Injecting Centre, Kings Cross, Sydney. Design and Methods: Brief surveys and urine drug screens were conducted with 67 participants in Wave 1 (October 2017) and 51 participants in Wave 2 (March 2018). Urine samples were tested with BTNX Rapid Response™ fentanyl urine strip test at a detection level of 20 ng/mL norfentanyl. These strips also cross-react to numerous fentanyl analogues. Results: There were no cases where positive urine tests suggested unwitting fentanyl use detected in this study. Discussion and Conclusions: These negative findings contrast sharply with similar Canadian studies. While no cases of fentanyl-laced heroin use have been detected so far, we have demonstrated that this surveillance design is low-cost, feasible and scalable approach to monitoring the considerable public-health threat of undetected fentanyl and its analogues in Australia. Further validation of cross-reactivity of test strips would strengthen this method.
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spelling curtin-20.500.11937-717552018-12-13T09:33:30Z Urine drug screening for early detection of unwitting use of fentanyl and its analogues among people who inject heroin in Sydney, Australia Barratt, Monica Latimer, J. Jauncey, M. Tay, E. Nielsen, S. © 2018 Australasian Professional Society on Alcohol and other Drugs Introduction and Aims: North America has witnessed a dramatic rise in fatal opioid overdoses due to the unwitting consumption of non-pharmaceutical fentanyl and its analogues. While some of the drivers of this crisis—including profitability and access to high-potency opioids through internet sources—also apply in Australia, to our knowledge, there have been no ongoing surveillance studies of local populations. Therefore, this pilot study aimed to detect unintentional fentanyl consumption among people who inject heroin through instant urine screening, and determine the feasibility and acceptability of voluntary urinalysis of clients at the Medically Supervised Injecting Centre, Kings Cross, Sydney. Design and Methods: Brief surveys and urine drug screens were conducted with 67 participants in Wave 1 (October 2017) and 51 participants in Wave 2 (March 2018). Urine samples were tested with BTNX Rapid Response™ fentanyl urine strip test at a detection level of 20 ng/mL norfentanyl. These strips also cross-react to numerous fentanyl analogues. Results: There were no cases where positive urine tests suggested unwitting fentanyl use detected in this study. Discussion and Conclusions: These negative findings contrast sharply with similar Canadian studies. While no cases of fentanyl-laced heroin use have been detected so far, we have demonstrated that this surveillance design is low-cost, feasible and scalable approach to monitoring the considerable public-health threat of undetected fentanyl and its analogues in Australia. Further validation of cross-reactivity of test strips would strengthen this method. 2018 Journal Article http://hdl.handle.net/20.500.11937/71755 10.1111/dar.12864 Wiley-Blackwell Publishing Ltd. restricted
spellingShingle Barratt, Monica
Latimer, J.
Jauncey, M.
Tay, E.
Nielsen, S.
Urine drug screening for early detection of unwitting use of fentanyl and its analogues among people who inject heroin in Sydney, Australia
title Urine drug screening for early detection of unwitting use of fentanyl and its analogues among people who inject heroin in Sydney, Australia
title_full Urine drug screening for early detection of unwitting use of fentanyl and its analogues among people who inject heroin in Sydney, Australia
title_fullStr Urine drug screening for early detection of unwitting use of fentanyl and its analogues among people who inject heroin in Sydney, Australia
title_full_unstemmed Urine drug screening for early detection of unwitting use of fentanyl and its analogues among people who inject heroin in Sydney, Australia
title_short Urine drug screening for early detection of unwitting use of fentanyl and its analogues among people who inject heroin in Sydney, Australia
title_sort urine drug screening for early detection of unwitting use of fentanyl and its analogues among people who inject heroin in sydney, australia
url http://hdl.handle.net/20.500.11937/71755