The pandemic impacted many aspects of society and business, including the publication of the Let’s Talk Tox newsletter; but we are excited to be back to update customers with important post-pandemic news.
Illicit drug supply and synthetic opioids like fentanyls at root cause
It is postulated that social isolation, healthcare service closures and disrupted drug trafficking fueled the increase in overdose deaths in adults and adolescents. The increasing illicit drugs contaminated highly potent synthetics opioids like fentanyl, fentanyl analogs, and tramadol.
- A recent analysis of drug overdose deaths conducted by Friedman et al. (1) noted that prior to the pandemic (2010) there were 518 deaths among adolescents, 2.40 per 100,000. Death rates remaining stable through 2019 with 419 deaths (2.36 per 100,000). During the pandemic overdose deaths increased to 954 (4.57 per 100,000) in 2020 and 1146 (5.49 per 100,000) in 2021. Between 2019 and 2020 overdose mortality increased by more than 94%.
- Among adolescents, when looking at the subcategorization of fentanyl-involved fatalities, the overdose deaths increased from 253 (1.21 per 100,000) in 2019 to 680 (3.26 per 100,000) in 2020 and to 884 (4.23 per 100,000) in 2021. Fentanyls were identified in 77.14% of adolescent overdose deaths, compared with 13.26% for benzodiazepines, 9.77% for methamphetamine, 7.33% for cocaine, 5.76% for prescription opioids, and 2.27% for heroin.
- Although the major driver of overdose deaths is still illicit fentanyls, a ‘fourth wave’ of high mortality involving stimulant-related deaths appears entwined with the ongoing opioid epidemic. Stimulant-related overdose is also increasing nationwide driven by methamphetamine and cocaine. Polysubstance use, e.g. the use of a stimulant along with an opioid is driving stimulant-related overdose.(2)
(1) Friedman, et al; JAMA. 2022;327(14):1398-1400. doi:10.1001/jama.2022.2847
(2) Ciccarone, Daniel Current Opinion in Psychiatry: July 2021 - Volume 34 - Issue 4 - p 344-350 doi: 10.1097/YCO.0000000000000717
For Provisional Drug Overdose Death Counts by state and class of drug, please refer to the state-specific database CDC Provisional Data Nov2021.
Curbing the Opioid Crisis: The Role of the Clinical Laboratory for Pain Management
Understand the important advantages of using urine drug-screening technology to eliminate cross-reactivity with other drugs, the benefits of oral fluid testing, and the role of LC-MS for confirmation testing of urine and oral fluids.
Delta Dawn: The rise of alternatives to Delta 9 THC
Cannabis is one of the most widely used illicit drugs in the world and is associated with a variety of mental health problems, especially in youths. New analogs and commercially sold forms of marijuana are flooding the market, making it challenging to conduct drug screening.
Thermo Fisher Scientific drugs of abuse testing professionals will be at the AACC in Chicago, this summer, July 26-28 at booth # 1413 and at the NADCP in Nashville, July 25-28 at booth # 103-107.
Why are my QC results different from the ones published in the values?
The combinations of different lots of reagents, calibrators, instrument-to-instrument variability, and different methods from which the results were generated (i.e. LC/MS vs Immunoassay) can shift target means. Please keep in mind that published values are provided as a guide, and each laboratory should establish their own control ranges per regulatory guidelines.
If you need further assistance, please contact Technical Support at:
Phone: +1 800-232-3342, opt 2, opt 3.
In addition to receiving this newsletter, you will be subscribed to receive marketing and promotional email messages about Thermo Fisher Scientific drugs of abuse testing products and services.