Study finds increases in fentanyl and stimulants from SUD patients

A new report published in JAMA Network Open found striking increases in the amounts of illicit fentanyl, methamphetamine and cocaine detected in urine drug test (UDT) specimens. The study, led by Andrew Huhn, Ph.D., associate professor of psychiatry and behavioral sciences and Kelly Dunn, Ph.D., professor of psychiatry and behavioral sciences, both at Johns Hopkins University School of Medicine, and co-authored by Millennium Health researchers, showed that concentrations of fentanyl and methamphetamine were 8.3 and 5.2 times higher in these specimens, respectively, in 2023 when compared with 2013 levels. Cocaine concentrations also doubled during this time, while levels for heroin fell by more than half. “Fentanyl, methamphetamine and cocaine concentrations are higher now relative to any time in the past decade, suggesting that the people who are using these drugs are doing so in larger quantities and/or with greater frequency now,” said Huhn. “The findings also demonstrate that aggregated, quantitative UDT data offer a scalable surveillance method that can provide swift and nimble feedback on real-time changes in drug exposure levels as well as emerging threats, like xylazine, that are not routinely captured by other methods,” he added. The analysis, which included 921,931 unique patient UDT specimens collected in SUD treatment settings across the U.S., also evaluated how these concentrations have changed in different parts of the country. With a few exceptions (eg, greater methamphetamine concentrations in the West and part of the South, largely stable heroin concentrations in the West), changes in drug exposure concentrations have been relatively similar across the U.S. over time. “These findings reveal that the drug use epidemic is evolving not only in terms of what drugs are being used but how much drug is being used,” said Angela Huskey, Pharm.D., chief clinical officer at Millennium Health. “This is the most granular assessment of drug use patterns in the U.S. to date and highlights an important, underappreciated nuance about drug use that may effect overdose risk and other clinically relevant phenomena.”