Rapid Analysis of Drugs: A Pilot Surveillance System To Detect Changes in the Illicit Drug Supply To Guide Timely Harm Reduction Responses — Eight Syringe Services Programs, Maryland, November 2021–August 2022

Among 364 samples from drug paraphernalia collected at eight syringe services programs during November 2021–August 2022 that tested positive for fentanyl or fentanyl analogs, 80% also contained xylazine (an animal sedative). Heroin was rarely detected. Results were available within 48 hours. Sample test results did not always differ from participant expectations and were used to enhance harm reduction efforts. Rapid analysis of drug paraphernalia can provide timely data on changing illicit drug markets that can be used to mitigate the harms of drug use more effectively.