SYRACUSE, N.Y. – Some Syracuse heroin users are now testing their drugs before shooting up to see if they contain a powerful synthetic opioid that could kill them.

ACR Health, a Syracuse agency that operates needle exchanges, is distributing inexpensive test strips drug users can dip into heroin, cocaine and other street drugs to detect fentanyl. That drug, which is 50 times more powerful than heroin, is a leading cause of drug overdoses.

Since January ACR has given out fentanyl test strips to about 150 clients at its syringe exchanges in Syracuse, Utica and Watertown. It got a $2,000 grant from Excellus BlueCross BlueShield to buy the test strips which cost about $1 each.

“We are investing a dollar to save someone’s life,” said Roberto Gonzalez, who manages ACR’s syringe exchange program.

The test strips were originally developed as urine tests for patients legally prescribed fentanyl for pain. The fentanyl mixed with heroin and other street drugs is an illicit version of the painkiller produced in Mexico and China.

A medically supervised safe injection program in Vancouver, Canada started using the strips three years ago to test clients’ drugs. A study based on the results of more than 1,000 tests at that program found the strips detected fentanyl in 80 percent of heroin and crystal meth samples, and 40 percent of cocaine samples. The study also found drug users were 10 times more likely to lower their dose after discovering their drugs contained fentanyl.

Since then a growing number of syringe exchange programs nationwide have been giving out the test strips. Some state health departments pay for the test strips.

New York’s Health Department is in the process of developing guidance on fentanyl test strip use, said Jeffrey Hammond, a department spokesman. “Governor Cuomo has led an aggressive, comprehensive response to the opioid epidemic and is committed to exploring all options to reduce opioid deaths,” he said.

If injection drug users don’t know the heroin they buy from dealers is spiked with fentanyl they are at increased risk of overdosing, Gonzalez said.

The two vertical lines in the center of this test strip show fentanyl is not present in powdered vitamin C residue tested during a demonstration at ACR Health.James T. Mulder

If a test strip shows the presence of fentanyl, most drug users will inject it anyway, but use a lower dose, he said.

“If they know fentanyl is in the substance, maybe they will do a test shot or cut back to using a bag and a half a day instead of their usual two to three bags,” he said.

ACR teaches clients most at risk of overdosing how to use the test strips. Users dip the strips for 15 seconds into containers, known as “cookers,” used to mix heroin or other drugs with water prior to injection. The results show up in five minutes or less. Fentanyl is present if one line appears on the test strip. Two lines means there is no fentanyl.

A top Trump administration official opposes the use of fentanyl test strips to fight the opioid overdose epidemic.

“The entire approach is based on the premise that a drug user poised to use a drug is making rationale choices, is weighing pros and cons and is thinking completely logically about his or her drug use,” Dr. Elinore McCance-Katz, assistant secretary for Mental Health and Substance Abuse, wrote in a blog post. “Based on my clinical experience, I know this could not be further from the truth.”

She said the strips may not be 100 percent accurate and could create a false sense of security. “ .., let’s not rationalize putting tools in place to help them continue their lifestyle more ‘safely,’” she wrote.

Gonzalez said ACR distributes fentanyl test strips for the same reason it gives out clean needles and the overdose reversal drug Narcan: to reduce the negative consequences of drug use.

Just because people use drugs “doesn’t mean they deserve to die,” he said.

Dessa Bergen-Cico, a Syracuse University professor and addiction expert, believes giving test trips to drug users is a good strategy.

“If people are picking up drug testing strips at ACR it gives them a point of contact with a professional who can also provide them with other information, build trust and maybe eventually get them into treatment,” she said.

Public health agencies in some European countries routinely test illicit drugs for the public to help prevent overdoses, she said.

It’s very easy for all types of street drugs, including marijuana, produced by clandestine operations to become cross contaminated with fentanyl, she said.

“If people are going to use, it’s important they know what the potential risks are,” Bergen-Cico said.