Impact of Fentanyl Test Strips as Harm Reduction for Drug-Related Mortality

This study examines the impact of legalizing fentanyl test strips (FTSs) on drug-related mortality in the United States from 2018 to 2022. Using a difference-in-differences approach with state-level data, we find that FTS legalization is associated with a significant reduction in drug-overdose deaths. Across the population, FTS legalization corresponds to a 7% decrease in overdose mortality, with an even more pronounced 13.5% reduction among Black individuals. Our analysis employs two-way fixed effects models and triple differences specifications to isolate the effect of FTS legalization from other factors. The results suggest that FTS legalization is particularly effective in reducing unintentional drug-overdose deaths. These findings underscore the potential of FTS as a critical harm reduction tool in addressing the opioid crisis, especially in mitigating racial disparities in overdose mortality. The study provides evidence to support expanding access to FTS as part of comprehensive public health strategies.