JMIR Publications

ABSTRACT

The United States (U.S.) drug supply rapidly fluctuates, distinguished by synthetic substances such as illicitly manufactured fentanyl (IMF). IMF drives overdose risk and frustrates treatment induction and retention, leaving few options for patients with opioid use disorder and motivating adaptations to medications for opioid use disorder (MOUD) such as injectable formulations and dosing changes. A recent innovation that shows promise for addressing drug supply challenges and that is being implemented in state and local jurisdictions is community drug checking. The Community Use and Testing Study (CUTS) will inform how IMF’s presence, form, and potency in the illicit drug supply influence ongoing use, overdose risk, and clinical severity of health consequences; and how the presence of IMF and other novel substances in the drug supply impact MOUD treatment uptake and experiences. This prospective, observational community-based longitudinal study in Rhode Island, USA conducts repeated surveys with 600 people who use drugs , alongside community drug checking programming using both field- and laboratory-based testing. This research was funded by the National Institute on Drug Abuse (UG/UH3DA056881) in 2023 and is projected to end December 2027. Enrollment (N=600) was completed in March 2026 and data collection is scheduled to end in September 2027. Findings from CUTS will help inform prevention and intervention approaches to the drug supply in fentanyl endemic areas, determine engagement in and clinical utility of community drug checking, and help identify factors influencing poor MOUD treatment experience and retention.