Table 5.
Clinical Studies on Fentanyl/Stimulant Exposure, United States
| First Author, Year (Reference No.) |
Design | Population | Primary Outcome | Key Findings |
|---|---|---|---|---|
| Amlani, 2015 (16) | Cross-sectional analysis of surveys of demographics and substance usage and UDTs | Clients at harm reduction sites in British Columbia, Canada (n = 242) | Correlation of demographics and substance use with positive fentanyl UDTs | Crystal methamphetamine was most significantly correlated with positive fentanyl UDTs. Odds ratio = 3.50, 95% confidence interval = (1.77, 6.86). No other variables were significantly correlated. |
| Karamouzian, 2020 (37) | Cross sectional analysis of UDTs | Clients of harm reduction sites in British Columbia, Canada (n = 303) | Compare reports of known or unknown fentanyl use with UDT results | Of 303 clients, 117 (38.7%) reported known fentanyl use, 66 (21.7%) had unknown fentanyl use, and 120 (39.6%) had no recent fentanyl use. |
| LaRue, 2019 (49) | Serial cross-sectional analysis of UDTs, 2013–2018 | Convenience sample of tests from US health-care practices (20% substance use treatment, 33.5% pain management, 23.7% primary care, 10% behavioral health, 6% ob/gyn, 6% other) (n = 1,000,000) | Nonprescribed fentanyl among cocaine- or methamphetamine-positive urinalysis results | Nonprescribed fentanyl increased from 0.9% to 17.6% among cocaine-positive results and from 0.9% to 7.9% among methamphetamine-positive results. |
| Twillman, 2020 (50) | Serial cross-sectional analysis of UDTs, 2013–2019 | Convenience sample of tests from US health-care practices (22.67% substance use treatment, 33.25% pain management, 22.8% primary care, 13.25% behavioral health, 1.76% ob/gyn, 6.27% other) (n = 1,050,000). | Nonprescribed fentanyl among cocaine- or methamphetamine-positive urinalysis results | Nonprescribed fentanyl increased from 5.3% to 33.5% among cocaine-positive results and from 2.2% to 30.4% among methamphetamine-positive results. Fentanyl among methamphetamine-positive results and among cocaine-positive increased significantly from 2016–2019 (P < 0.001). |
Abbreviations: ob/gyn, obstetrics/gynecology; UDT, urinary drug test.