Fentanyl-Positive Drug Screenings Surge in Western States

Drug tests positive for fentanyl across the US increased by 146% from 2019 to 2022, fueled largely by the western half of the nation, according to data from the Millennium Health Signals Report, which was released on Tuesday.

An accredited specialty drug testing services lab, Millennium Health processes more than 1 million specimens per year, allowing the organization to provide analytics regarding emerging drug use trends. In its report released on Tuesday, Millennium Health found that positive tests in the Mountain region of the US were up 875% in the 3-year period studied, and in Pacific states, the increase was 900%. Meanwhile, fentanyl-positive tests in the New England region increased by just 0.8% from 2019 to 2022.

In addition to the increase in the detection of fentanyl in urine drug test specimens, the Millennium Health report also showed 2 other trends: a rise in the combination of fentanyl and illicit substances, and a proliferation of fentanyl analogs.

More than 83% of fentanyl-positive specimens also contained additional drugs. About 30% were positive for 1 additional drug, more than 43% were positive for an additional 2-3 drugs, and nearly 10% were positive for 4 or more other drugs.

Among fentanyl-positive specimens, co-positivity for heroin increased by 62% from 2019 to 2022, while co-positivity for methamphetamine increased by 180%, prescription opioids by 92%, and cocaine by 71%.

Fentanyl analogs, which can present complications in treatment options, have proliferated, with positivity for 4-ANPP, the most common analog, doubling from 30% to 60% from 2019 to 2022. The analogs acetylfentanyl and parafluorofentanyl have also seen increased positivity rates.

“Due to the fact that these fentanyl analogs differ from one another in potency and effect, knowing which ones have penetrated a local geography can be very important information for both caregivers and policymakers working to mitigate the overdose epidemic,” Angela Huskey, PharmD, Millennium Health senior vice president and chief clinical officer, said in a news release. “These findings suggest that America doesn’t just face one fentanyl problem—it faces several.”

In addition to increasing rates for fentanyl-positive specimens, Millennium Health also shared the following findings:

• Methamphetamine use has risen by 42%;
• Cocaine use has increased by 28%; and
• Heroin- and prescription opioid-positive tests, however, are down by 36% and 21%.

Reference

Fentanyl Is widening grip on the nation as western presence and detection with other drugs increase to record highs, Millennium Health Signals Report™ shows. News release. Millennium Health. February 21, 2023. Accessed February 21, 2023.