Winnipeg clinic gives people tool to test drugs for fentanyl
NorWest Co-op Community Health adds fentanyl test strips to harm reduction vending machine
NorWest Co-op Community Health is giving people a way to test their drugs for fentanyl on their own.
Test strips are the newest item in the clinic's Our Healthbox vending machine, which distributes free harm reduction and wellness supplies.
Our Healthbox was started by Reach Nexus as part of a national research project to challenge health inequities. The vending machine at NorWest on Keewatin is one of 12 in the country.
Though the vending machine is just over a year old, the test strips are new to the clinic.
The idea to add them came from a group of primary care workers who noticed the need for the kits in the community.
Kazel Ebora, a primary care nurse at the clinic, said the test strips help promote safe consumption.
"We decided to add the fentanyl test strips to our Healthbox as another harm reduction initiative to help people be informed of what they're using in their drugs and to help prevent an overdose," Ebora said.
The kit comes with three fentanyl test strips, a cup, a spoon for measuring and a pamphlet with instructions.
To do the test, a drug sample the size of the head of a match is stirred into 30 millilitres of water. The user then dips the end of the strip with blue wavy lines into the water for 15 seconds. After two minutes, the results appear.
"There are quite a few limitations despite it being a great harm reduction tool," Ebora said.
"Although it can detect fentanyl, it can't detect some fentanyl analogs such as carfentanyl," she said.
"That's really important, because despite using this, if you do get a negative result, an overdose is still possible."
False negatives and positives are possible too, Ebora said. The tests also have expiry dates and can be affected by improper storage.
Health Canada also cautions those using the test strips about their limitations.
A 2022 report published by Nine Circles, a Winnipeg community clinic that specializes in care for people with HIV, said using the strips to test street drugs is considered "off label as the strips were designed to detect fentanyl in urine for forensic purposes."
The test strips cannot detect the percentage of fentanyl in the sample, the Nine Circles report said. The strips give only a positive or negative result.
Since the kits are not 100 per cent accurate, the test strips can give substance users a false sense of confidence that the drugs they are using are fentanyl free, the report said.
Ebora acknowledged the limits of the test strips but said they can still be useful in promoting safe consumption.
"There have been multiple studies on clients who've used the fentanyl test strips, and those who've had a positive result have actually made some drug use behaviour changes and increased their opioid prevention or overdose prevention strategies," she said.
While some substance users avoided using their drugs when fentanyl was detected, Ebora knows others may use the test hoping for a positive result.
"Some people who use drugs are looking to use an opioid, and so some people use the test to see if there is fentanyl in their drugs," Ebora said.
"One of our strategies to prevent overdose is including a pamphlet that goes over tips on how to be safe, like having naloxone and never using alone."
Other items in the box at NorWest include HIV test kits, clean crack pipes, hygiene kits, sage for smudging and naloxone.
NorWest primary care nurse Jennifer Gourlay said each Healthbox is stocked by nurses based on the needs of the community.
Reach Nexus supplies the clinic with some harm reduction tools. The clinic also relies on donations and uses its own budget to keep the box stocked.
Since the box was introduced to the clinic last March, it has been accessed by more than 2,000 unique users. A recent survey by NorWest found that close to 10,000 harm reduction and wellness supplies had been dispensed, including 339 naloxone kits.
So far, 11 fentanyl test strip kits have been given out since they were added to the box just a few weeks ago.
Gourlay said she hopes the anonymity of the machine will encourage users to access the tools and help they need.
"What I hope is that it will build trust with our clinic, with those who are using substances, so that they can come to us when they need us for something they can't get at the Healthbox," Gourlay said.
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