The Life Saving Role of Fentanyl & Xylazine Test Strips

PAACA Executive Assistant
5 days ago
3 min read

Updated: 4 days ago

Last year the CDC reported that in 2023, approximately 69% of all overdose deaths involved synthetic opioids (CDC, 2025).

Fentanyl, a synthetic opioid, is responsible for many of these overdose deaths. It is up to 50 times stronger than heroin and 100 times stronger than morphine. The drug has been approved for prescription use to treat severe pain, such as in cancer patients. However the fentanyl that is contributing to the overdose crisis is not the kind prescribed by the doctor, it is being made illegally and added into illicit drugs to, often unknowing, consumers. Fentanyl is cheap and simple to produce and looks like many other drugs. In its powder form, it is commonly mixed with heroin, cocaine, methamphetamine, or pressed into substituted pills made to look like other prescription medications for pain, anxiety, and ADHD. The most common three counterfeit drugs substituted with fentanyl are: oxycodone tablets, Xanax tablets and cocaine. In its liquid form it has been found in nasal sprays, eyedrops, and small candies. Another substance on the rise in overdose deaths is xylazine, a non-opioid sedative that is often found with fentanyl. Xylazine is not approved for human use and is primarily used in veterinarian settings for animals. Unlike fentanyl, it is not an opioid so Naloxone does not reverse its effects. Overdose deaths involving these drugs among adolescents have risen in recent years, despite no reported increase in adolescent drug use.

While they can be taken intentionally, fentanyl and xylazine are taken without the person being aware of its presence. They are added to other substances, and at times completely substitute other substances, to enhance effects or increase street value by increasing their weight. The DEA has seized xylazine and fentanyl mixtures in 48 out of 50 states and reported that approximately 23% of fentanyl powder and 7% of fentanyl pills seized by the DEA in 2022 contained xylazine.

There is no way of knowing if a substance or pill you bought illegally contains Fentanyl or Xylazine without testing. Testing strips are accessible and fast, and are often the difference between life or death. Fentanyl testing strips (FTS) and xylazine testing strips (XTS) are small strips of paper that can detect the presence of their respective substance in pills, powder, and injectables. It is important to note, however, that these strips may not work in all cases. FTS does not differentiate between fentanyl and fentanyl analogs. They also may not work as well in the presence of large amounts of methamphetamine, MDMA, or diphenhydramine. Another important point to note is that test strips can’t tell you how much fentanyl or xylazine is in a sample, just if it is present. One portion of a drug may contain contaminants, while another may not.

How to use FTS or XTS test strips

Place a small amount of the substance, 5-10 milligrams or about the size of a match head, in a clean and dry container.
Pour 1 teaspoon of water into the container and stir to mix.
Dip the strip by placing the wavy end of the test strip in water and holding it there for 15 seconds
Take the strip out of the water and lay it on a flat, non-absorbent surface
When the control line appears and the background is clear, the strip is ready to read (about 1 minute) If no control line appears, repeat the test. Do not read results after 10 minutes.

Two red lines: Negative result

One red line: Positive result of fentanyl on FTS or xylazine on XTS

Remember:

One portion of a drug may contain contaminants, while another may not.
No test is 100% accurate. False negatives can occur.
Caution should be used even in the case of a negative test.
Although Naloxone does not reverse the effects of xylazine, it should still be administered in the case of an overdose as it is often mixed with fentanyl.

The drug landscape is constantly changing. Harm reduction strategies, such as test strips, help to combat the risk that the changing drug landscape poses to our communities. Harm reduction initiatives are often discredited as enabling drug use. In reality, harm reduction is the bridge between addiction and recovery. It is important to meet people where they are at with access to resources so that their lives are not lost to overdose before they have a chance to recover. Addiction and overdose do not discriminate, it can happen to anyone of any age, gender, race, or background.

The Massachusetts state Senate voted unanimously to legalize fentanyl test strips in January of 2024, as they had previously been classified as paraphernalia. You can get free FTS and XTS test strips at PAACA on 360 Coggeshall St, New Bedford, MA.