The Cyclical and Evolving Nature of Methamphetamine Use: An Evaluation of Near Real-time Urine Drug Test Results

Abstract

Objective: To determine methamphetamine positivity and copositivity with other drugs in urine drug test (UDT) results geographically through time. Methods: This cross-sectional study of UDT results from January 1, 2014, through December 31, 2019, included patient specimens submitted by health care professionals across the United States. The analysis used LC-MS/MS to detect cocaine, heroin, alcohol, marijuana and nonprescribed methamphetamine, fentanyl, methadone, buprenorphine, benzodiazepines, and other opioids. Logistic regression was used to evaluate association of demographic features and model yearly methamphetamine detection patterns across US census divisions. Odds ratios (OR) from logistic modeling were used to evaluate the impact of methamphetamine positivity on the spatio-temporal detection patterns of additional nonprescribed or illicit drugs. Results: The probability of being positive for methamphetamine increased nationally from 0.010 [0.010–0.011] in 2014 to 0.044 [0.042–0.046] in 2019, a 340% increase after correction for demographic covariates. The highest predicted positivity rate was in male patients, 25- to 34-years-old, from the West North Central division and from substance use disorder treatment centers. Nationally, copositivity ORs for fentanyl, heroin, and other opioids with methamphetamine were highest in 2019. Increases in ORs from 2014 through 2019 were statistically significant for heroin ( P = 0.024) and fentanyl ( P = 0.0085). Copositivity ORs for methamphetamine and other substances varied by census division. Conclusions: The probability of being positive for methamphetamine in UDT increased nationwide between 2014 and 2019. Not all census divisions are increasing at the same rate. Copositivity with additional substances is increasing in some census divisions, which further increases the risk of overdose and poor treatment outcomes.

Polysubstance Use Among Patients Treated With Buprenorphine From a National Urine Drug Test Database

“…UDT has been used to examine trends in substance use (not specific to patients treated for OUD). 6,[13][14][15] Furthermore, prior studies have examined UDT findings among OUD patients treated at single sites or hospital health systems. 9,16,17 We are not aware of any studies that specifically examine national trends in definitive UDT findings among OUD patients.…”

“…UDT can provide an important window into the changing substance use issues among patients treated with medications for OUD. UDT has been used to examine trends in substance use (not specific to patients treated for OUD) . Furthermore, prior studies have examined UDT findings among OUD patients treated at single sites or hospital health systems .…”

Analysis of the Effectiveness and Detection Rate of Urine Occult Blood Test in the Diagnosis of Urinary System Diseases

“…This study also compared the turnaround time of the two testing methods and found that the urine sediment occult blood test had a longer turnaround time than urinalysis. The more efficient urinalysis is recommended for emergency cases to avoid delaying the diagnosis and treatment [13,14] .…”