Could at-home test strips prevent drug deaths? Experts say yes, but it's complicated

CBC

24-04-2025

Canadians are dying alone from toxic drugs and experts say easier access to at-home drug-testing strips could help prevent deaths. But they warn the strips have limitations.
Dr. Nash Denic, Newfoundland and Labrador's chief medical examiner, says that though the strips aren't perfect, they can be useful in detecting if some toxins are present. He would like to see a government-led pilot project to distribute the strips along with naloxone kits, which reverse the effects of opioid overdoses.
"There is a possibility that harm can be reduced. Especially if you're a novice and you're trying a different type of drug, you want to test it first," said Denic, adding that if used properly, test strips "can save your life."
Dr. Alexander Caudarella, chief executive officer of the Canadian Centre on Substance Abuse, also sees a benefit in making test strips more available to people in their homes.
"We know most of the people in this country are not dying on the streets — they're dying behind locked doors in their own apartments or houses," said Caudarella.
The strips can be part of a larger strategy to stay safe, which includes not consuming drugs alone, he said.
But there are caveats. The tests need to be used properly and they won't say how much contaminant is present, only that it's there. The number of toxins they can detect is limited. Fentanyl test strips, for example, won't pick up newer opioids, Caudarella says.
"It's not going to tell people exactly what's in their drugs, but we find these tools can be really important to help people understand just how contaminated the drugs that they're buying are," he said.
This is especially important for people who believe their drugs are safe because they purchased them from a website or a person they trust, he added.
BTNX Inc.'s Rapid Response tests are among the most widely used tests strips in Canada. The Ontario-based company has strips for contaminants including fentanyl, xylazine, benzodiazepine and nitazene. The company's website says clearly that the strips don't test for drug purity or safety — they can only say if the target contaminant is present.
The strips can be purchased in Canada online, or they can be found at safe consumption sites or through other harm reduction services. They are placed in a small amount of the drug, which has been dissolved in water. A line appears on the strip to indicate the presence of contaminants.
For those who need the strips immediately, and who may not use or have access to harm reduction services, options are limited. BTNX is still working to offer them for sale in large retail chains, spokesperson Molly McKay said.
The company is also aware the test strips can miss toxic contaminants.
"We're continuously working with our third-party researchers to determine what those blind spots are, and then we make corrections," said McKay.
Two teenagers died this year in Newfoundland and Labrador after taking pills contaminated with nitazene, a potent synthetic opioid, and bromazolam, a benzodiazepine which can be lethal when taken with opioids, says Denic. Xylazine, a veterinary sedative, is a common contaminant in cocaine. And fentanyl deaths in the province show no signs of abating, though they've recently been overtaken by cocaine.
Test strips could help people stay safer from some of these toxins, Denic says. A positive test result may convince someone not to use the drug or to use much less of it.
Ian Culbert, executive director of the Canadian Public Health Association, says ideally, it would be easier for people to have their drugs checked by more advanced equipment, like the tests available at some safe consumption sites in the country. Their results are more accurate, and they can be used to track contaminants in the local drug supply.
"In most parts of the country, you can walk into any community pharmacy and request a take-home naloxone kit. That is how accessible well-developed drug-checking tests should be," said Culbert.
But still, take-home test strips are "better than nothing," he said.
Some have misguided beliefs that expanding drug-checking services will ultimately encourage more drug use, Culbert says, and worries those ideas turn decision-makers away from making it easier to check and test drugs.
"There is a continuum of public health interventions that all can help reduce the number of deaths associated with the toxic drug crisis. Drug checking is one of them," Culbert said. "We need to be investing across the spectrum, not just ideologically picking the ones that suit the agenda of the government of the day."