SECAUCUS, N.J., Oct. 15, 2020 /PRNewswire/ -- A new Quest
Diagnostics Health Trends study indicates that misuse of fentanyl,
heroin and nonprescribed opioids are on the rise, potentially due
to the COVID-19 pandemic's impact on healthcare access and support
for individuals most at-risk for substance use disorder. The full
study, from researchers at Quest Diagnostics (NYSE: DGX) and
published online in the peer reviewed journal Population Health
Management, can be found here.
Based on analysis of more than 872,000 de-identified lab results
representative of all 50 states and the District of Columbia, the study is believed to
be the largest to examine drug positivity rates before and during
the first several months of the pandemic, and the first to examine
drug combining patterns based on lab data on a national scale.
Key Findings:
Misuse of nonprescribed opioids and drug mixing
surges
The researchers compared testing positivity rates for
January 1, 2019-March 14, 2020 and March
15-May 16, 2020 (during the onset of the COVID-19 outbreak).
Among individuals tested, the drug positivity rate increased 35%
for non-prescribed fentanyl and 44% for heroin during the pandemic
compared to the period prior to the pandemic. Nonprescribed opioids
also increased, by 10%.
The study also found a massive surge in the positivity rate of
drug combining with non-prescribed fentanyl during the pandemic
compared to prior to the pandemic. Positivity for non-prescribed
fentanyl increased substantially among specimens that were
also positive for amphetamines (by 89%), benzodiazepines (48%),
cocaine (34%), and opiates (39%; P <0.01 for all
comparisons).
These findings suggest fentanyl is increasingly likely to be
found in, or taken with, other drugs, resulting in dangerous drug
combinations. Drug mixing often occurs without a user's
knowledge.
Fentanyl is a synthetic opioid that is 50 to 100 times more
potent than morphine, a Schedule II prescription drug used to treat
severe pain, but also a drug of abuse. Most overdose deaths
involving opioids such as fentanyl involve concurrent use of
benzodiazepines, cocaine, or methamphetamine.
"The COVID-19 pandemic has created the perfect storm for a rise
in substance use disorders and other forms of prescription and
illicit drug misuse. Stress, job losses and depression compounded
with isolation and a lack of access to health services can trigger
prescription medication overuse, illicit drug use, or relapses,"
said co-author Harvey W. Kaufman,
M.D., Senior Medical Director, Head of Health Trends Research
Program, Quest Diagnostics.
Stay-at-home orders and reduced access to routine testing may
hide true breadth of crisis
From March to mid-May 2020 rates
of drug testing declined significantly compared to prior to the
pandemic, including both for patients on medication assisted
treatment and those receiving in-person care. The rate of orders
for clinical lab tests from Quest Diagnostics dropped by as much as
70% weekly, indicating fewer patients were being screened for drug
misuse during the early months of the pandemic.
Yet, the rate of overall misuse held steady, with one in two
patients showing signs of misuse of prescription or illicit drugs,
specifically 49.4% at the height of the pandemic compared to
49.9% prior to the pandemic – similar to rates observed
annually over the past four years. However, rates of drug testing
in patients on medication assisted treatment or receiving care in
substance use disorder care settings declined. The investigators
theorize that these declines may be due to high-risk patients
failing to continue to access healthcare services, possibly due to
relapse, during the pandemic.
"Our Health Trends data demonstrate the consequences of the
pandemic, with dramatic increases of misuse of nonprescribed drugs
at a time when fentanyl is also on the rise. Our nation is
grappling with a drug epidemic inside a pandemic. Patients and
providers need increased access to support services, clinical care
and drug testing to stop drug misuse from claiming more lives," Dr.
Kaufman said.
Men at greatest risk for illicit fentanyl use
Use of illicit fentanyl in men increased 51%, from 5.7% in 2019
to 8.6% from mid-March to mid-May
2020. Women's positivity rate increased 16%, from 3% to
3.7%.
"COVID-19 interrupted non-essential patient care, but it hasn't
stopped drug misuse, We observe in the Quest data a striking
increase in misuse of fentanyl in men compared to women during
the initial phase of the pandemic," said study co-author
Jeffrey Gudin, M.D., Senior Medical
Advisor, Drug Monitoring, Quest Diagnostics. "Given the
psychological, social, and financial impacts of the COVID-19
crisis, more efforts are needed to ensure that patients are taking
medications as prescribed. While the nation focuses on the
pandemic, we must not lose sight of the ongoing drug misuse
epidemic, which continues to kill upwards of 70,000 Americans each
year."
Gabapentin misuse declined 21%
Nonprescribed gabapentin positivity declined 21% during the
pandemic – although the rate of misuse remained relatively high, at
10.9%.
"A possible factor for the decline in non-prescribed use of
gabapentin is a decline in physician visits resulting in fewer
prescriptions," Dr. Kaufman said.
For the complete study methodology, including strengths and
limitations, refer to:
https://www.liebertpub.com/doi/10.1089/pop.2020.0230
About Quest Diagnostics Health Trends™
Quest
Diagnostics Health Trends™ is a series of scientific reports that
provide insights into health topics, based on analysis of objective
clinical laboratory data, to empower better patient care,
population health management and public health policy. The reports
are based on the Quest Diagnostics database of 48 billion
de-identified laboratory test results, believed to be the largest
of its kind in healthcare. Health Trends has yielded novel insights
to aid the management of allergies and asthma, prescription drug
monitoring, diabetes, Lyme disease, heart disease, influenza and
workplace wellness. Quest Diagnostics also produces the Drug
Testing Index (DTI)™, a series of reports on national workplace
drug positivity trends based on the company's employer workplace
drug testing data.
www.QuestDiagnostics.com/HealthTrends
About Quest Diagnostics
Quest Diagnostics empowers
people to take action to improve health outcomes. Derived from the
world's largest database of clinical lab results, our diagnostic
insights reveal new avenues to identify and treat disease, inspire
healthy behaviors and improve health care management. Quest
annually serves one in three adult Americans and half the
physicians and hospitals in the United States, and our 47,000
employees understand that, in the right hands and with the right
context, our diagnostic insights can inspire actions that transform
lives. www.QuestDiagnostics.com
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