Effect of positive urine fentanyl screen on attitudes toward heroin use.

Background: It is unknown if targeted risk reduction counseling in the health care setting, after documented exposure to fentanyl, can affect behavior change to reduce risks and increase utilization of evidence-based overdose prevention strategies.

Methods: We conducted a retrospective analysis of results (7/2018-6/2019) from questionnaire-facilitated counseling by recovery coaches in the emergency department (ED) and primary care settings following disclosure of a urine toxicology positive for fentanyl.

Results: Seventy-five percent of N = 101 respondents were neither aware of nor expecting fentanyl in their substances of use.