The United States continues to grapple with an opioid crisis that has escalated into a full-blown synthetic drug epidemic, primarily driven by the proliferation of illicitly manufactured fentanyl and its analogs. Despite billions in funding and dozens of harm reduction initiatives, overdose deaths only declined slightly over a five-year period. Central to this failure is the country’s overreliance on outdated, impractical fentanyl test strips—tools that have proven woefully inadequate in the real-world drug use environment.
The logic behind fentanyl test strips is sound: provide users with a simple way to determine whether fentanyl is present in their drugs before use, allowing them to reduce risk or abstain. But in practice, these test strips have failed to fulfill their promise. The most widely distributed strips—which often only detect fentanyl and a limited set of analogs—require users to completely dissolve a portion of their drug in water, essentially wasting their supply to test it. In a street economy where every dollar and dose counts, this method doesn’t work. Furthermore, the process is dangerous: in cases of overdose involving multiple substances, as little as 3 nanograms of fentanyl—about the size of three grains of salt—can be lethal. In addition, most drug users who dilute their drugs in water to stay safe often end up injecting the toxic solution intravenously, which exacerbates their drug problem and can lead to infection and death.
A major blind spot in national harm reduction strategy is the assumption that users will engage with tools that undermine their immediate needs—in this case, preserving the integrity and value of their drugs. While health departments have distributed tens of millions of these strips nationwide, anecdotal and survey-based evidence shows that the majority go unused. Moreover, most strips are not equipped to detect the ever-expanding array of deadly synthetic adulterants like nitazenes, xylazine, or benzodiazepines—substances now commonly found in the illicit drug supply.
Testing only for fentanyl in 2025 is like checking for rain while a hurricane bears down. Fentanyl analogs such as carfentanil (used in anesthesia for large animals like rhinoceroses) are up to 10,000 times stronger than morphine and 100 times stronger than fentanyl. Nitazenes are up to 40 times stronger than fentanyl and not easily detected. Cartels, drug suppliers, and enemies of the United States know this, and are rapidly adapting to these substances to continue business as usual.
Despite knowing these limitations and emerging threats, federal and state agencies have continued to throw money at the same failed model. According to government procurement data and harm reduction budgets, hundreds of millions of dollars have been allocated to distribute these flawed strips, often with little follow-up or data collection on usage or effectiveness. The result? A false sense of progress, while overdose death rates—particularly among younger users and communities of color—drop subtly, remain steady, or, in some states, climb.
Meanwhile, a potential inflection point has emerged: the $7.4 billion settlement reached with Purdue Pharma and the Sackler family, a landmark agreement that all 50 states approved. This windfall represents a rare opportunity to reinvest in more effective, evidence-based, and user-friendly harm reduction tools. The question is, will this money be used to sustain failed models or to pivot toward more effective solutions?
Enter the A47 testing line from The Fentanyl Test—a next-generation drug-checking solution that addresses nearly every flaw of traditional fentanyl strips. The A47 test is a multi-analyte screening tool that requires no dilution of the drug being tested, can test any surface or substance—including drinks, and preserves user trust and the usability of the tested drug. Its sensitivity threshold is unmatched, and it can detect a wide array of opioids beyond fentanyl.
Unlike current tests that require separate strips for each substance—making testing cumbersome, costly, and more likely to be skipped altogether—the A47 line integrates multi-substance detection into a single test. This not only improves the quality of information users receive but also increases the likelihood they will actually use the product. It’s the kind of scalable, user-centered technology that could significantly reduce overdoses and help bring the epidemic to an end.
Allocating even a fraction of the Purdue settlement toward widespread distribution and education around the A47 testing line could drastically improve harm reduction outcomes. For example, if just 5% of the $7.4 billion settlement—roughly $370 million—were used to manufacture and distribute A47 tests through community-based organizations, syringe exchange programs, and mail-distributed harm reduction services, millions of high-risk users could access multiple lifesaving technologies without the barriers imposed by traditional strips.
Moreover, unlike other public health interventions, advanced drug testing technology offers real-time, individual-level protection. A user who knows their dose contains fentanyl, xylazine, or nitazenes can make an informed choice immediately—something that naloxone, supervised use sites, or abstinence-based messaging cannot provide on their own.
But for this shift to occur, public health leadership must acknowledge a difficult truth: we’ve failed by clinging to inadequate tools out of convenience and institutional inertia. The fentanyl crisis is not static; the substances change, the risk increases, and our harm reduction strategies must evolve accordingly. We can no longer afford to measure success by the number of strips distributed. We must measure it by lives saved, and that requires deploying the most effective tools available.
The opioid crisis has always been complex, but the solution doesn’t have to be. The A47 testing line offers a practical, scalable, and scientifically sound advancement in harm reduction. With billions now available through the Purdue settlement, the United States has a rare chance to course-correct—to choose effectiveness over performative action and to finally offer drug users the tools they deserve.
The only question that remains is whether policymakers will seize the moment or let another opportunity slip away.
J.C. Sheppard, Founder and CEO of The Fentanyl Test.