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Fentanyl Test Strip Use and Overdose Risk Reduction Behaviors Among People Who Use Drugs
Rachel Vickers‐Smith, Kitty H. Gelberg, Janet E. Childerhose, Denise C. Babineau, Redonna K. Chandler, James L. David, Lauren D’Costa, Megan E. Dzurec et al.. JAMA Network Open, 2025-05-13
Topic: Risk, prevention and care in population studies
The study included 732 participants (median [IQR] age, 41 [34.0-48.0] years; 369 [50.4%] male; 64 [8.9%] Black or African American, 587 [81.3%] White, and 71 [9.8%] other races); 414 reported baseline FTS use and 318 did not. Compared with nonusers, a higher percentage of baseline FTS users were from Ohio and White, while a lower percentage were from New York and Hispanic and/or Black. In adjusted analyses, PWUD who used FTS had a mean daily composite score for overdose risk reduction behaviors that was 0.86 (95% CI, 0.34-1.38) units higher across follow-up compared with nonusers (score for FTS users, 7.37; nonusers, 6.51). There was no difference in self-reported nonfatal overdoses between the 2 groups (mean daily risk for FTS users, 0.02; nonusers, 0.02; risk ratio, 1.20; 95% CI, 0.70-2.06). Conclusions and Relevance: In this cohort study, baseline FTS use was associated with greater engagement in overdose risk reduction behaviors during follow-up, but not with the risk of nonfatal overdose during follow-up, suggesting PWUD who use FTS may also engage in a broader set of harm reduction strategies.
Key findings
- The study included 732 participants (median [IQR] age, 41 [34.0-48.0] years; 369 [50.4%] male; 64 [8.9%] Black or African American, 587 [81.3%] White, and 71 [9.8%] other races); 414 reported baseline FTS use and 318 did not.
- Compared with nonusers, a higher percentage of baseline FTS users were from Ohio and White, while a lower percentage were from New York and Hispanic and/or Black.
- In adjusted analyses, PWUD who used FTS had a mean daily composite score for overdose risk reduction behaviors that was 0.86 (95% CI, 0.34-1.38) units higher across follow-up compared with nonusers (score for FTS users, 7.37; nonusers, 6.51).
- There was no difference in self-reported nonfatal overdoses between the 2 groups (mean daily risk for FTS users, 0.02; nonusers, 0.02; risk ratio, 1.20; 95% CI, 0.70-2.06).
- Conclusions and Relevance: In this cohort study, baseline FTS use was associated with greater engagement in overdose risk reduction behaviors during follow-up, but not with the risk of nonfatal overdose during follow-up, suggesting PWUD who use FTS may also engage in a broader set of harm reduction strategies.
Why it matters
This study is about fentanyl test strip use and overdose risk in people who use drugs, not about Alzheimer's disease. It provides no information relevant to treating, curing, or preventing Alzheimer's disease.
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Study details
- Study designcohort study
- Participants732
- Effect size50.4%; 8.9%; 81.3%
- Evidence strengthModerate
How this study scored 65/100
Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (JAMA Network Open) |
| Journal's citation record | 2 / 4 | JAMA Network Open: journal h-index 235 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 732 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 3 / 7 | Cited 32 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 10.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 4 / 6 | Cited 19.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 2 / 4 | Cited 32 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Bridget Freisthler: h-index 36 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Columbia University: institution h-index 1,824 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 13 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40358945) |
| Free to read | 2 / 2 | Free to read |
| Total | 65 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1001/jamanetworkopen.2025.10077
- PubMed: 40358945
- Original source →
- Free full text: JAMA Network Open →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Vickers‐Smith, R., Gelberg, K. H., Childerhose, J. E., Babineau, D. C., Chandler, R. K., David, J. L., et al. (2025). Fentanyl Test Strip Use and Overdose Risk Reduction Behaviors Among People Who Use Drugs. JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2025.10077
Vancouver
Vickers‐Smith R, Gelberg KH, Childerhose JE, Babineau DC, Chandler RK, David JL, et al. Fentanyl Test Strip Use and Overdose Risk Reduction Behaviors Among People Who Use Drugs. JAMA Network Open. 2025. doi:10.1001/jamanetworkopen.2025.10077. PMID: 40358945.
BibTeX
@article{vickerssmith2025-40358945,
author = {Vickers‐Smith, Rachel and Gelberg, Kitty H. and Childerhose, Janet E. and Babineau, Denise C. and Chandler, Redonna K. and David, James L. and D’Costa, Lauren and Dzurec, Megan E. and others},
title = {{Fentanyl Test Strip Use and Overdose Risk Reduction Behaviors Among People Who Use Drugs}},
journal = {JAMA Network Open},
year = {2025},
doi = {10.1001/jamanetworkopen.2025.10077},
pmid = {40358945},
url = {https://doi.org/10.1001/jamanetworkopen.2025.10077}
}