Remote Intervention to Prevent Overdose

This Type 1 hybrid effectiveness-implementation randomized controlled trial, Remote Fentanyl Test Strip Distribution and Education to Prevent Drug Overdose, aims to address the United States opioid crisis driven by fentanyl and other synthetic opioids by reducing overdose rates. It is supported by and included in the HEAL Initiative. This study would be the first national, fully remote trial to assess the impact of fentanyl test strips on overdose outcomes, using a novel 2x2 design crossing fentanyl test strip distribution and education to determine which approach most significantly reduces overdose rates while minimizing costs. This research will inform scalability around mail-based fentanyl test strip distribution and education programs to address the nation's opioid overdose crisis.

Inclusion Criteria: * 18 years old * English-speaking and reading * Report using illicit opioids and/or stimulants (including counterfeit pills) within the past 3 months per the ASSIST * Able and willing to provide informed consent * Reside in any of the US states where fentanyl test strips are legal with no plans to move out of state for at least 12 months * Reside in any of the US states where FTS are legal with no plans to move out of state for at least 12 months * Be able and willing to provide the names and contact information of three close contacts to reach if the participant cannot be reached Exclusion Criteria: * Living in a restricted environment (e.g., prison)