Implementation of a Police-Led Fentanyl Test Strip Distribution Program in Two US States

The increase of fentanyl in the North American drug supply and lack of a reliable detection method for people who use drugs (PWUDs) warrant the broad distribution of fentanyl test strips (FTS). We evaluated the impact and reach of the One2One project in Massachusetts and Maine communities where it was implemented.

An implementation evaluation occurred from January-November 2021. Through One2One, police officers and non-police program staff received training, technical assistance, logistical support, and FTS to distribute. Local innovation was encouraged, and police were trained to incorporate FTS distribution to support referrals and direct services during non-arrest outreach activities. We parameterized measures of uptake (i.e. referrals or services provided/FTS kit distributed) and kit reach (i.e. kits distributed/overdose mortality rate), respectively. An in-depth case study evaluation involving site observations and interviews with police and program staff, kit recipients, and community representatives was conducted among a subset of 12 communities.

Twenty-one police departments and their collaborators distributed 2,556 FTS kits and reported 3,703 referrals or direct services. Quantitative and qualitative analyses suggest higher uptake and reach occurred in places utilizing varied distribution strategies, co-distributing naloxone, optimizing available local treatment services in referrals, and in departments with preexisting community partnerships, leadership champions, prior awareness of harm reduction practices, and prioritized trainings.

FTS distribution through public safety partners, though a modest complement to community-led distribution, is a flexible strategy potentially applicable to other jurisdictions that amplifies extant community policing, post-overdose outreach, and other collaborative programming already providing referrals and direct services.