“I wasn’t scared of the dope I had anymore because I could test it myself:” A qualitative study among rural Appalachians who use drugs about experiences with a fentanyl test strip intervention

Key Points

• The analysis found that fentanyl test strips are crucial due to specific characteristics of the rural Appalachian risk environment.
• Unreliable emergency medical services (EMS) increased local interest in using fentanyl test strips.
• Strong social networks in these communities facilitated unexpected spread of the fentanyl test strip intervention.
• Future research is encouraged to utilize these social connections to enhance the intervention's reach.