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Use of laboratory data for illicit drug use surveillance and identification of socioeconomic risk factors.
Azimi, Vahid; Jackups, Ronald; Farnsworth, Christopher W; Budelier, Melissa M.
  • Azimi V; Department of Pathology & Immunology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
  • Jackups R; Department of Pathology & Immunology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
  • Farnsworth CW; Department of Pathology & Immunology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
  • Budelier MM; Department of Pathology & Immunology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA. Electronic address: Melissa.budelier@tricore.org.
Drug Alcohol Depend ; 236: 109499, 2022 07 01.
Article in English | MEDLINE | ID: covidwho-1850940
ABSTRACT

BACKGROUND:

Drug overdose is the leading cause of death among people 25-44 years of age in the United States. Existing drug surveillance methods are important for prevention and directing treatment, but are limited by delayed reporting and lack of geographic granularity.

METHODS:

Laboratory urine drug screen and complete metabolic panel data from patients presenting to the emergency department was used to observe long-term and short-term temporal and geospatial changes at the zip code-level in St. Louis. Multivariate linear regression was performed to investigate associations between zip code-level socioeconomic factors and drug screening positivity rates.

RESULTS:

An increase in the fentanyl positive drug screens was seen during the initial COVID-19 shutdown period in the spring of 2020. A decrease in cocaine positivity was seen in the fall and winter of 2020, with a return to baseline coinciding with the second major COVID-19 shutdown in the summer of 2021. These changes appeared to be independent of changes in emergency department utilization as measured by complete metabolic panels ordered. Significant short-term changes in fentanyl and cocaine positivity rates between specific time periods were able to be localized to individual zip codes. Zip code-level multivariate analysis demonstrated independent associations between socioeconomic/demographic factors and fentanyl/cocaine positivity rates as determined by laboratory drug screening data.

CONCLUSIONS:

Analyzing clinical laboratory drug screening data can enable a more temporally and geographically granular view of population-level drug use surveillance. Additionally, laboratory data can be utilized to find population-level socioeconomic associations with illicit drug use, presenting a potential avenue for the use of this data to guide public health and healthcare policy decisions.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Illicit Drugs / Cocaine / Substance-Related Disorders / Drug Overdose / COVID-19 Type of study: Observational study / Prognostic study Limits: Humans Country/Region as subject: North America Language: English Journal: Drug Alcohol Depend Year: 2022 Document Type: Article Affiliation country: J.drugalcdep.2022.109499

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Illicit Drugs / Cocaine / Substance-Related Disorders / Drug Overdose / COVID-19 Type of study: Observational study / Prognostic study Limits: Humans Country/Region as subject: North America Language: English Journal: Drug Alcohol Depend Year: 2022 Document Type: Article Affiliation country: J.drugalcdep.2022.109499