Positive Test Rates for Four Illicit Substances Spike During Pandemic

An analysis of more than 500,000 urine drug test results for non-prescribed fentanyl, cocaine, heroin and methamphetamine before and after COVID-19 was declared a national emergency on March 13 found that all four drugs have had double-digit percentage increases in positivity, according to a report published by the specialty laboratory Millennium Health.

Specifically, Millennium found:

• 32.0% increase for non-prescribed fentanyl
• 20.0% increase for methamphetamine
• 10.1% increase for cocaine
• 12.5% increase for heroin

“This data can help us identify specific substances that are likely contributing to the reported increases in drug-related overdose deaths nationwide, which can then be used to inform tailored, geographically-targeted mitigation strategies to help save lives,” Kevin L. Zacharoff, MD, FACIP, FACPE, FAAP, faculty and clinical instructor at SUNY Stony Brook School of Medicine in Stony Brook, New York, said in a news release. “As we focus on what happens with the COVID-19 pandemic in both the long and short-term, it is critically important for us to not lose sight of the epidemic of drug- related overdoses that continues to coexist.”

The particularly sizable spike in positive tests for non-prescribed fentanyl is in line with data from an American Medical Association report published earlier this month, which noted an increase in opioid-related fatalities in 35 states, largely linked to illicit fentanyl and fentanyl analogs.

In Millennium’s research, the Mid-Atlantic region saw a 135.9% increase in positive tests for fentanyl, while New England had a 96.4% spike. In state-by-state results, Iowa had the sharpest increase in positive fentanyl tests, up 561.7%. Overall, 19 states had statistically significant increases or decreases in adjusted positivity rates for at least one of the drugs evaluated.

While some states had increases for multiple drugs, Minnesota was the only state in the nation to see decreases across all four substances evaluated.