Urine drug test concentrations up for fentanyl, methamphetamine, cocaine

Absolute concentrations of fentanyl, methamphetamine, and cocaine in urine specimens increased from 2013 to 2023, according to a study published online Oct. 24 in JAMA Network Open.

Andrew S. Huhn, Ph.D., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues analyzed urine drug testing (UDT) results to quantify changes in absolute drug exposure concentrations from 2013 to 2023. The analysis included 921,931 unique UDT samples.

The researchers found that the adjusted fentanyl concentration in urine specimens was 38.23 ng/mg creatinine in 2023, up from 4.61 ng/mg in 2013. The adjusted methamphetamine concentration was 3,461.59 ng/mg creatinine in 2023, up from 665.27 ng/mg in 2013. The adjusted cocaine concentration was 1,122.23 ng/mg creatinine in 2023, up from 559.71 ng/mg in 2013. The adjusted heroin concentration was 58.36 ng/mg creatinine in 2023, down from 146.59 ng/mg in 2013. There was variation in drug concentrations across U.S. Census divisions.

“The findings suggest that exposure to these substances, as well as the illicit drug supply, has fundamentally changed in many parts of the United States, highlighting the need to reinforce surveillance initiatives and accelerate efforts to treat individuals with illicitly manufactured fentanyl and/or stimulant exposure,” the authors write.

Two authors disclosed ties to the pharmaceutical industry.

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