PSHP 2026 Residency Conference

Purpose: 
Harm reduction minimizes negative outcomes associated with substance use. Fentanyl test strips are distributed as a strategy due to its presence in local supply. The primary goal is to assess impact of test strips on high-risk behaviors.
 
Methods:
Retrospective chart reviews were conducted using the Veterans Health Administration (VHA) Computerized Patient Record System (CPRS) to collect data on 129 veterans who received fentanyl test strips from behavioral health teams between 10/02/2024 to 09/08/2025. Veterans receiving outpatient care aged 18 and older with active opioid and/or stimulant use disorder were included in our review. Veterans with significant cognitive impairments or acute psychiatric instability that prevent informed consent were excluded. A prospective component was planned but will not be reported due to insufficient enrollment.  
 
Results:
Among veterans offered fentanyl test strips, the majority accepted, with only a small percentage declining. A subset of veterans accepted additional fentanyl test strip kits when re-offered.  Additionally, many veterans who accepted the fentanyl test strips already had naloxone on hand, or received it concurrently. 
 
Conclusion:
Fentanyl test strip acceptance, including repeated offer acceptances, suggest potential utilization and perceived benefits by veterans. However, further evaluation is warranted to determine whether use leads to reduction in high-risk behaviors. Additionally, ensuring naloxone access alongside fentanyl test strip distribution further supports harm-reduction efforts to protect veterans who are at risk for opioid overdose.