DanceSafe is now 25 years old! To put it into perspective: that’s a quarter century of national drug education, “Consent is sexy” campaigns, free condoms, ear protection, and so much more. We were able to speak with DanceSafe founder Emanuel Sferios about new fentanyl test strips produced by WHPM Inc., and what they mean for the future of harm reduction.
Back in November, DanceSafe released their significantly improved fentanyl test strips to the public. These new test strips have been run through two separate lab studies which have confirmed that the new test strips will not trigger false-positive results when testing for fentanyl in drugs like MDMA, methamphetamine, methadone, and cocaine that has been cut with levamisole/lidocaine.
We’ve learned a lot about the fentanyl test strip market. For example: did you know that just because fentanyl test strips are not FDA-approved, it does not mean that it is illegal to sell them? Getting approved by the FDA just means that the FDA knows that they work for testing urine. There are no regulations in place to see how effective fentanyl test strips are for drug testing.
This is dangerous for the harm reduction community because more distributors are trying to provide them for harm reduction purposes without doing the appropriate lab testing. Explaining this conundrum, Emanuel shared his favorite quote from Upton Sinclair:
“It is difficult to get a man to understand something when his salary depends on his not understanding it.”
Check out the interview below DanceSafe’s 25th birthday post.
DMNW: Why did you personally want to be involved in the production process of new test strips for DanceSafe?
Emanuel: This whole thing started back in 2016 when InSite, a safe injection facility in Vancouver (Canada) got a hold of the AssureTech strips that the Canadian company BTNX were selling and did an informal study on the drugs that people brought into their facility. They published an article that claimed that 83% of the drugs that were brought in tested positive for fentanyl.
This was the first time any of us in the harm reduction movement ever even knew that immunoassay strips could be used for drug checking purposes. This was late 2016. So I called InSite just to say, “Hey, did you do any studies to determine the efficacy of these strips before you started using them?” Because they were originally made for testing urine. And I did not want to start distributing them if they were going to give false positives or false negatives. We needed scientific studies, and they said ,”No, it was just sort of a a pilot study.”
I commissioned a study at [University of California, San Francisco] with Dr. Kara Lynch where we bought some strips from BTNX, and we tested three different brands. We determined at that time that the AssureTech strips worked the best, but they weren’t perfect. They worked best because they were able to detect most of the analogues at practical harm reduction dilutions, and they produced the fewest false positives. But they still did produce false positives with meth and MDMA at the time. We later discovered years later that they produced false positives with levamisole and lidocaine (common cuts inside of cocaine).
About a year ago, I was contacted by WHPM Inc., and they were just making a Fentanyl strip normally like any other manufacturer: for urine testing. Most drug immunoassay test trips are purchased by workplaces, customs agencies, law enforcement, or treatment centers who are all testing urine. WHPM Inc. didn’t even know about the use for drug checking, but when they finished their strip and they had this product, they got online and were just Googling and discovered that, “Oh, look, these strips are being used for drug checking. Maybe that’s a market we can sell to as well.”
So they called me and they also found Harm Reduction Ohio, which has done some great work out there. It’s one of the best local harm reduction groups in the country. Love, love, Harm Reduction Ohio. And so we were near the top of the Google list. WHPM Inc. sent both of us samples and Dennis [Dennis Cauchon – President and Founder of Harm Reduction Ohio] promptly sent his samples to me because he knew that I did the original testing on the BTNX strips.
First we started using them experimentally in our field testing because DanceSafe goes to festivals and we do drug checking. And the first thing we noticed is that it didn’t produce false positives with MDMA. And I mean, we don’t get any people bringing us meth at festivals because of the stigma around it. Same as opioids. So we know people are using meth and opioids at festivals, but nobody is getting it checked.
It just has the stigma. But we do get cocaine and we do get MDMA. And I listed the, you know, the more common drugs that are less stigmatized. People bring them to us for testing. So, we weren’t getting false positives with MDMA and cocaine like we did with the AssureTech strips. So I was like, “Wow, this might, you know, this might be the one.”
What was the most challenging stage in launching the new strips?
The contract negotiations were time-consuming and expensive. There was a lot of back and forth with the lawyers on both sides.
How many analogues of fentanyl do the new DanceSafe Fentanyl Test Strips detect?
We tested the dozen common ones and they could detect 11 out of the 12, which was exactly the same number as the AssureTech strips. The WHPM Inc. strips are slightly better at detecting the analogues than the older strips. The issue here, and this might get a little complicated to explain, but the best way I’ve explained it to people is that these strips were made for fentanyl. But they have a lower sensitivity for the analogues.
The best way to think about it is like COVID. Everyone’s aware how COVID has been mutating to evade our antibodies. And so the newer variants like Omicron and now even never ones escape the antibodies but they don’t escape completely. The antibodies can still detect Omicron, just not as well as it detects the original variant. So a fentanyl analogue is similar to a mutated COVID molecule. It’s like it’s got a few little additional things added and subtracted here.
The strips have lesser binding affinity for the analogues and this is why you need to concentrate more. Our lab study determined that ten milligrams per milliliter is the optimum concentration in order to detect the most of the analogues. But the AssureTech strips will give false positives for many drugs at that concentration. And so you need to dilute more. For meth and MDMA, our study determined that you needed to dilute down to two milligrams per milliliter. It’s five times more dilute than the optimum, which means you’ll still detect fentanyl, but you’ll likely miss some of the analogues.
The AssureTech strips are used by a number of harm reduction organizations and health authorities. How do you plan to market the new DanceSafe fentanyl test strips to them?
We’re sending emails and brochures to all the various needle exchanges and the agencies and other nonprofits that we know are directly distributing them. We have already started negotiations with NASEN, the North American Syringe Exchange Network, which is the second largest distributor of the strips after DanceSafe. BTNX is the main distributor, everyone’s buying from them. But we have been the BTNX’s largest customer since the beginning. And then NASEN has been their second largest customer. So now that we have become the sole distributor of the new and improved strips, NASEN is going to start buying strips from us.
NASEN will continue to sell the old BTNX test strips alongside the new DanceSafe test strips.
The brochure mentions that harm reduction organizations are able to get the strips for the lowest possible price of 45 cents per strip. Are you able to explain how that works?
A social service entity gets a grant for $50,000 that they’re allowed to use for testing. And they will spend it all on test strips. So if you come out with a strip (like we’re about to do) half price, they’re going to buy double the amount of strips. It’s not like they say, “Oh, well, we want 10,000 strips.” It’s “We have this much money to spend on strips.” So this is why lowering the price definitely increases the number of strips that get distributed because the state institutions have a grant to spend all of this money on strips.
Resellers who want to resell our strips get a mid-range price. We’re charging a little bit extra for that. And then, of course, you have online retailers where we sell strips directly to end consumers and that’s a little bit higher. So, we have these three tiers of pricing with the lowest price fairly marked up in order to cover our cost to provide. Anyone giving strips away for free gets the lowest possible price.
Have a look at DanceSafe’s remarkable breadth of knowledge on their website. What harm reduction fact did you learn from this interview that surprised you? Let us know in the comments, on Twitter and Facebook. Hope to see you at a DanceSafe booth at your next event!
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