Analysis of Urine Drug Test Results From Substance Use Disorder Treatment Practices and Overdose Mortality Rates,...

Area of Science:

• Public Health
• Toxicology
• Epidemiology

Background:

• Drug overdose deaths in the US have reached unprecedented levels.
• Timely data on emerging drug use patterns is crucial for effective surveillance and intervention.
• Urine drug testing (UDT) offers a potentially underutilized source for real-time data collection.

Purpose of the Study:

• To evaluate the correlation between real-time UDT results and overdose mortality data.
• To assess the utility of UDT in augmenting public health surveillance efforts.

Main Methods:

• Retrospective cross-sectional study of 500,000 urine specimens from 2013-2020.
• UDT data from a proprietary national database compared with National Vital Statistics System overdose mortality data.
• Analysis of drug categories including cocaine, heroin, methamphetamine, synthetic opioids, and other opioids using liquid chromatography-tandem mass spectrometry.

Main Results:

• High national-level correlations were found between synthetic opioids and methamphetamine positivity rates and overdose mortality (Spearman ρ = 0.96).
• Synthetic opioids and methamphetamine showed the strongest state-level correlations over time.
• Multivariate analysis indicated significant associations between UDT positivity rates and increased monthly overdose deaths at state and county levels.

Conclusions:

• Real-time UDT results demonstrate a strong correlation with overdose mortality rates across multiple geographic levels.
• UDT surveillance can rapidly identify shifts in drug use patterns.
• These findings support the use of UDT for informing targeted harm reduction strategies to mitigate overdose deaths.