Toxicology Associates of North Georgia

While the drug epidemic has focused on opioid use, two-thirds of patients who ended up at two University of Maryland Medical System emergency rooms in 2016 had multiple drugs in their systems — up to six were found in some urine samples. Emergency rooms tend to use a basic urine test that, like a pregnancy test, turns colors when it detects certain chemicals in drugs. The test is quick and inexpensive, but detects fewer than a dozen drugs, including opioids. The tests don’t detect drugs such as fentanyl and oxycodone, both of which have contributed to record overdoses across the country. Knowing what drugs a patients has taken can help doctors better decide a course of immediate treatment, as well as follow- up treatment such as rehabilitation, said doctors from the two emergency rooms and researchers from the Center for Substance Abuse Research at the University of Maryland, College Park. “We need to know the drug trends to know how to help people,” said Dr. Zachary D.W. Dezman, an attending physician in the emergency room at Midtown. Urine samples were tested from 106 patients at Prince George’s and 69 from the Midtown campus. Patients in Baltimore tested positive mostly for marijuana and fentanyl, a highly potent synthetic often added to heroin without users knowing.

The results highlight the complexities that exist in the current epidemic, said principal investigator Eric Wish, director of the Center for Substance Abuse Research. In some cases, dealers are mixing drugs without the knowledge of users. Many of the patients whose urine was tested misinformed doctors about what they had taken. “It used to be [drug users] didn’t want to admit what they were taking,” Wish said. “In this age they don’t know what they are taking.” Maryland’s drug-related deaths increase for seventh straight year, reach all-time high in 2017. “People are like walking drug stores now, there are so many drugs in their system,” Wish said. “A lot of the treatment now is focused on opioids. The important thing for the medical and treatment community to know is they are using far more than opioids.” Lawmakers and public health officials need to know the extent of fentanyl use to help reduce it, he said. “The emergency room is a place from which you can launch those public health efforts,” he said.

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