Deshawn Hendricks, 26, wants to check his drugs for the powerful opioid fentanyl when he can, because as a crack user, he worries it could cause a life-threatening overdose. Matthew Todd, 32, tests for another reason: As an opioid user, he has come to depend on the quick and intense high fentanyl provides, and wants to make sure what he purchased is “real.”

On a sloping sidewalk that runs under the Grand Concourse in the Bronx, both men accepted fentanyl test strips from outreach workers on a recent Thursday, along with sandwiches, water and Narcan, a drug that reverses overdoses. Around them, a few people openly injected dope, as an occasional pedestrian threaded past.

Mr. Hendricks, who has a 1-year-old daughter, said he suspected that fentanyl was being added to his crack to make the drug more addictive and even harder to quit. Using a test strip “would give me piece of mind, to explain what I’ve been feeling,” he said.

As the nation grapples with a deadly overdose crisis, mostly driven by illicit fentanyl, a consensus is developing — from the Biden White House to political leaders in conservative states like Texas, Georgia and Alabama — that widespread distribution of fentanyl test strips can be an effective, if limited, way to reduce the drug’s destructive impact.

Over the past year and a half, as fentanyl, which can be 50 to 100 times more powerful than morphine, has killed tens of thousands of Americans, 16 additional states have passed laws legalizing the strips. Mississippi, Ohio and South Dakota have joined about 20 other states, including New York, where the strips were already legal. And bills to legalize them are pending in almost every remaining state where they are still barred, as they are considered drug paraphernalia.

The strips, which retail for about a dollar, are emerging as a sliver of common ground in a bitter debate over the overdose epidemic, in which one side prioritizes law enforcement as a way to prevent drug use, and the other emphasizes safer use and treatment.

“There is just this sense that fentanyl has really changed the game,” said Corey Davis, the director of the Harm Reduction Legal Project at the Network for Public Health Law, which tracks state laws on testing drugs. “There are not that many specific things you can do to fight it.”

More than 2,100 people died of an accidental fentanyl overdose in 2021 in the city, among more than 67,000 deaths nationwide.

But the strips serve a different function depending on the user. Fentanyl is now present throughout much of the illicit drug supply, in unpredictable quantities. For people who use pills, ketamine, cocaine or MDMA, for example, fentanyl strips can be particularly important because people without an opioid tolerance are at a higher risk of a fentanyl overdose.

Fentanyl Overdoses: What to Know

Devastating losses. Drug overdose deaths, largely caused by the synthetic opioid drug fentanyl, reached record highs in the United States in 2021. Here’s what you should know to keep your loved ones safe:

Understand fentanyl’s effects. Fentanyl is a potent and fast-acting drug, two qualities that also make it highly addictive. A small quantity goes a long way, so it’s easy to suffer an overdose. With fentanyl, there is only a short window of time to intervene and save a person’s life during an overdose.

Stick to licensed pharmacies. Prescription drugs sold online or by unlicensed dealers marketed as OxyContin, Vicodin and Xanax are often laced with fentanyl. Only take pills that were prescribed by your doctor and came from a licensed pharmacy.

Talk to your loved ones. The best way to prevent fentanyl use is to educate your loved ones, including teens, about it. Explain what fentanyl is and that it can be found in pills bought online or from friends. Aim to establish an ongoing dialogue in short spurts rather than one long, formal conversation.

Learn how to spot an overdose. When someone overdoses from fentanyl, breathing slows and their skin often turns a bluish hue. If you think someone is overdosing, call 911 right away.

Buy naloxone. If you’re concerned that a loved one could be exposed to fentanyl, you may want to buy naloxone. The medicine can rapidly reverse an opioid overdose and is often available at local pharmacies without a prescription.

Other users, including many who previously used heroin, have become dependent on fentanyl, and a positive result is unlikely to stop them from using. But it can act as a reminder to use more cautiously.

“The whole thing is, know your drug,” said Jose Martinez, who participates in street outreach with the National Harm Reduction Coalition in the Bronx.

For people who now seek out fentanyl, a new kind of strip may be more useful: one that tests for xylazine, a veterinary tranquilizer that can cause horrific skin wounds. Known on the street as tranq, xylazine extends a fentanyl high and is already found in more than 90 percent of the fentanyl supply in Philadelphia. It has also started to turn up in New York and elsewhere.

At the Bronx underpass, most people knew about tranq, and no one wanted to mess with it.

“I want to stay away from that,” Mr. Todd said. “I don’t need another problem in my life.” When he heard that xylazine strips might soon be available, he said, “Definitely that I would use, hell yeah.”

Sales of the fentanyl test strips have soared since the start of the pandemic, as knowledge of them has grown, said Iqbal Sunderani, the chief executive of BTNX, a Canadian company that created the xylazine test strips and is also the main maker of fentanyl strips. The company sold eight million tests in 2022, up from about 1.5 million in 2020, almost all of them to harm reduction organizations. A flood of Chinese-made strips is also entering the market.

Opioid users “are very interested in having them, even though there is fentanyl in the entire heroin supply,” said Dr. Andrea Littleton of BronxWorks, the group that was handing out strips at the Bronx underpass, adding, “But I think actually seeing the test turn positive changes their behavior. They’re still going to use it, but usually they’ll do a test batch or they’ll make sure that somebody checks on them.”

Still, the strips can be hard to find for many New Yorkers.

Darryl Phillips, 48, is a film producer and a test strip evangelist trying to change that reality. He is the executive director of the ASAP Foundation, an acronym for Always Strive and Prosper. It was founded in honor of his friend A$AP Yams, born Steven Rodriguez, a hip-hop influencer who died of an accidental overdose in 2015.

At about 60 bars, restaurants and galleries around the city, a small clear box marked with ASAP’s logo now sits behind the bar or out on a table. The boxes contain dozens of fentanyl test kits and are regularly refreshed by Mr. Phillips and his band of volunteers. Each kit contains a test strip, a vial of clean water, a small tin container in which to dissolve a drug sample and an easy-to-follow instruction card that he designed.

Taking inspiration from the fishbowls full of condoms that began to appear in bars in the 1980s during the AIDS crisis, the group’s goal is to make the test strips visible and accessible where people go to party.

While some business owners refuse to carry the kits, Mr. Phillips said, others have changed their minds.

The Opioid Crisis

Opioids, whether in the form of powerful pharmaceuticals or illegally made synthetics, are fueling a deadly drug crisis in America.

“A few bars that were like, ‘Nah, we don’t really need that,’ or ‘We don’t have that crowd,’ were experiencing either an overdose in their bar, or with someone close to them,” he said. “And then they were like, ‘Hey, actually we’re going to take those.’”

The city government also distributes test strips; it gave out 48,000 in 2022, most of them through nonprofit organizations that target chronic opioid drug users.

One evening this month, Nneka Enerji, a Brooklyn-based D.J., took two ASAP kits from the bartender at Scarr’s, a pizza place on Orchard Street in Manhattan, and put them in her bag, saying she planned to leave them on her D.J. stand for anyone who needed one. She said she knew two people who recently overdosed.

“I really do feel like these should be planted,” she said. “Just leave them in bathrooms, or on a train. Because people are going to see it as a sign.”

New York City is also piloting a small program, with four locations, where a technician can give people a more detailed description of what their drugs contain in about 30 minutes.

But among cocaine and other party drug users in New York City, bars are the perfect place to normalize the strips because “there’s the least amount of stigma here,” said Charlotte Foley, a bartender at Treasure Club, a speakeasy-style bar on Orchard Street that has an ASAP box on a side table.

BTNX says its strips are 98 percent accurate in detecting the presence of fentanyl, if used correctly. However, they have limitations. The strips cannot detect how much fentanyl is present, and there may be some fentanyl analogues that the strips do not pick up. Testing fake pills, such as those meant to mimic Xanax or Adderall, is particularly tricky, as fentanyl can cluster in some parts of the pill but not others. The best approach is to dissolve the entire pill in water and test that.

At St. Ann’s Corner for Harm Reduction in the South Bronx — where drug users and those in recovery can get free meals, syringes and medical care — Joseph Dudnik, 58, credits fentanyl test strips with both saving his life and helping him to get clean.

Mr. Dudnik said that as a “high-volume” crystal meth addict, he had still used his drugs even when they tested positive for fentanyl. But he would use less.

“A couple of times, if I would have used what I wanted to without testing it, I wouldn’t be here right now,” he said.

Knowing that fentanyl was in his drugs “more often than not” eventually helped him stop using, he said, because he hated how the fentanyl made him feel. As of March 16, he was 12 days clean.

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