U.S. Saw Big Rise in Meth, Fentanyl Use in 2019

A study of over 1 million urine drug tests from across the United States shows soaring rates of use of methamphetamines and fentanyl, often used together in potentially lethal ways.

The drug test results came primarily from clinics dealing with primary care, pain management or substance abuse disorders.

The results showed that between 2013 and 2019, urine samples testing positive for methamphetamine ("meth") have skyrocketed sixfold, from about 1.4% of samples testing positive in 2013 to about 8.4% in 2019.

Similarly, the percentage of drug urine tests coming back positive for the highly potent -- and sometimes fatal -- opioid fentanyl have more than quadrupled since 2013, the study found. In 2013, just over 1% of the urine samples tested positive for fentanyl, but by 2019 that number was nearing 5%, said a team led by Dr. Eric Dawson, of Millennium Health in San Diego.

And, too often, fentanyl is being taken in combination with meth or other illicit drugs.

Between 2013 and 2019, the rate at which urine samples testing positive for fentanyl also tested positive for meth rose almost 14-fold, Dawson's group found, and by more than sixfold for cocaine and heroin.

All of this suggests that "methamphetamine-related overdose deaths [especially] may continue to increase," according to the study published online Jan. 3 in JAMA Network Open.

One doctor on the front lines of the epidemic of drug abuse and overdose said the statistics are cause for alarm.

"We are talking about serious and deadly risks -- patients who may stop breathing and suffer heart attacks, strokes or develop bleeding in the brain," said Dr. Robert Glatter, an emergency medicine physician at Lenox Hill Hospital in New York City.

Even when meth doesn't kill, it can easily ruin lives, he noted.

"Methamphetamine abuse can result in anxiety, insomnia, addiction, mood disturbances, psychosis and violent behavior," Glatter explained. The drug "may also trigger psychotic symptoms including hallucinations, paranoia and delusions. In some cases, psychotic symptoms can persist for months or even years after people have stopped using," he said.

Right now, data from the U.S. National Institute on Drug Abuse shows that "methamphetamine abuse is most prevalent in the western and midwestern regions of the U.S.," according to Glatter. "Nearly 70% of local law enforcement agencies from those areas of the U.S. indicate that methamphetamine is the drug that poses the greatest danger to its citizens."

Add fentanyl to the mix, and risks run even higher.

"Fentanyl is 50 to 100 times more potent than morphine, and consequently may lead to respiratory depression and death," Glatter said, and often "rescue" medications like naloxone won't help.

"Standard doses of naloxone to reverse the respiratory effects of fentanyl are typically ineffective," Glatter said, so "[only] intubation and mechanical ventilation may be lifesaving in the setting of fentanyl overdose."

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