Why Pharmacies?
Fentanyl test strips (FTS) and Xylazine test strips (XTS) are often available through local harm reduction programs like syringe service programs at no cost. However, these resources may not be accessible to everyone, especially in rural areas of North Carolina.
As of March 2025 there are approximately 50 syringe service programs registered in North Carolina, while there are over 1900 registered North Carolina community pharmacies.2
Community pharmacists are the most accessible healthcare providers, with extensive medication knowledge and experience engaging in overdose reduction strategies including:
Opioid counseling
Naloxone distribution
Dispensing medications for opioid use disorder – MOUD
Non-prescription syringe sales
Pharmacists are Willing!
In a survey, we asked NC community pharmacists: "How willing would you be to do the following activities with customers who you think would benefit from them?"
The figure above shows the percent of pharmacists surveyed who noted they were somewhat or very willing to engage with each FTS activity. The largest group, 86.2%, were willing to refer to harm reduction organizations for FTS.3
The most common benefits of selling FTS pharmacists reported were reducing overdose deaths and participating in harm reduction efforts in the community. 3
Similar studies of pharmacists in Georgia and Alabama indicate—despite limited awareness of drug test strips—that pharmacists are supportive of selling drug test strips and counseling on drug test strips. 4, 5
Increased Visibility!
Displaying, selling, and distributing FTS and XTS at the pharmacy increases their visibility and accessibility.
People who use drugs recreationally may not be aware of the extent of fentanyl or xylazine in the unregulated drug supply, so increasing the availability of test strips may increase the public’s understanding of contamination with these drugs.
Family members and friends of people who use drugs who may otherwise not search out or be aware of drug test strips may be interested in learning about them and buying them from the pharmacy.”
Below is a video of a patient describing their interest in buying fentanyl test strips.
Legality of Drug Test Strips in NC Pharmacies
The General Assembly updated the Drug Paraphernalia Statute in 2019, making it legal for pharmacists to sell drug test strips, such as FTS.
This video from Jay Campbell, the executive director of the North Carolina Board of Pharmacy, encourages pharmacies to sell and distribute FTS and XTS.