{"id":3021,"date":"2023-11-17T12:07:17","date_gmt":"2023-11-17T12:07:17","guid":{"rendered":"https:\/\/springerhealthcare.nl\/france\/?p=3021"},"modified":"2023-11-17T14:48:49","modified_gmt":"2023-11-17T14:48:49","slug":"to-treat-overdose-patients-now-hospitals-must-test-for-more-kinds-of-drugs","status":"publish","type":"post","link":"https:\/\/springerhealthplus.nl\/shmigrate\/to-treat-overdose-patients-now-hospitals-must-test-for-more-kinds-of-drugs\/","title":{"rendered":"To Treat Overdose Patients Now, Hospitals Must Test for More Kinds of Drugs"},"content":{"rendered":"

[vc_row full_width=”stretch_row” content_placement=”middle” css=”.vc_custom_1663187695627{padding-bottom: 37px !important;background-image: url(http:\/\/springerhealthcare.nl\/wp-content\/uploads\/sites\/24\/2022\/09\/science_connect_back.png?id=2486) !important;background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}” el_class=”sciencetitle”][vc_column][vc_custom_heading text=”Science Connect” font_container=”tag:h2|text_align:left|color:%23ffffff” use_theme_fonts=”yes” link=”url:https%3A%2F%2Fspringerhealthcare.nl%2Ffrance%2Fscience-connect-november-2023%2F”][vc_column_text css=”.vc_custom_1663186747780{margin-bottom: 40px !important;}”]A Springer Healthcare Initiative For Pharma Professionals<\/span>[\/vc_column_text][vc_column_text]NOVEMBER 2023
\n<\/span>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=”.vc_custom_1538651642953{padding-top: 75px !important;}”][vc_column width=”3\/4″ css=”.vc_custom_1538657061395{border-right-width: 1px !important;padding-top: 0px !important;border-right-color: #8faec1 !important;border-right-style: solid !important;}”][vc_custom_heading source=”post_title” font_container=”tag:h1|font_size:40px|text_align:left|line_height:60px” google_fonts=”font_family:Merriweather%3Aregular%2Citalic|font_style:700%20regular%3A700%3Anormal” el_class=”title” css=”.vc_custom_1664358136969{margin-bottom: 30px !important;}”][vc_column_text css=”.vc_custom_1686833173052{padding-bottom: 0px !important;}”]Most hospitals typically test people for drugs that drove overdoses 15 to 20 years ago. We need a national system for expanded testing to help patients get the treatment they need today<\/strong><\/span>[\/vc_column_text][vc_column_text el_class=”intro-box”]By ERIN ARTIGIANI, AMY BILLING & ERIC D. WISH<\/span>[\/vc_column_text]

\"to-treat-overdose-patients-now-hospitals-must-test-for-more-kinds-of-drugs\" <\/div> <\/div>[vc_column_text css=”.vc_custom_1689357004274{margin-bottom: 30px !important;}” el_class=”sc-img-caption”]Urine test strips. Credit: Lothar Drechsel\/Getty Images[\/vc_column_text][vc_column_text]

Hospitals link people to treatment in their time of greatest need. That includes drug overdoses, which now\u00a0kill more than 100,000 people<\/a>\u00a0in the U.S. every year.<\/p>\n

However, the standard hospital urine drug tests often do not detect fentanyl, which today is\u00a0the leading cause<\/a>\u00a0of fatal overdoses, or other \u201csynthetic\u201d substances. Expanded urinalyses that could detect them can be time-consuming and cost-prohibitive.<\/p>\n

But if hospital drug screens fail to detect these drugs, people will likely not be fully diagnosed. Without an opioid-positive urine test, they may not be accepted into an opioid treatment program. Or their treatment may not be\u00a0covered by insurance<\/a>. Without clear identification of all the substances involved in their visit, patients may be less likely to remain in treatment, even if they are accepted.<\/p>\n

Most hospitals, however, are still testing for the drugs driving previous drug crises, such as heroin and cocaine, and have little concrete data about the drugs to which their patients are now being exposed. In fact, in the second quarter of 2022,\u00a0only 5 percent of hospitals<\/a>\u00a0included fentanyl in their standard drug screen. One year later, this percentage had only increased to\u00a0approximately 14 percent<\/a>, while testing for opiates (natural opioids like heroin<\/a>) remained at about 50 percent. That\u2019s a decade into an overdose crisis driven by fentanyl that has claimed\u00a0more than a million American lives<\/a>.<\/p>\n

The overdose crisis is in constant flux, and users are often unaware of the drugs to which they have been exposed. Changes in drug composition can alter the symptoms seen in emergency departments and can change patients\u2019 treatment needs. Drug use and overdose are often very individualized. Therefore, America\u2019s hospitals must have access to expanded urinalyses to understand all the drugs to which their patients have been exposed.<\/p>\n

The University of Maryland\u2019s Center for Substance Use, Addiction, and Health Research (CESAR), where we work, has been piloting a new approach, the\u00a0Emergency Department Drug Surveillance (EDDS)<\/a>\u00a0system, with federal and state funding. We currently offer 50 hospitals across the U.S. the opportunity to submit anonymous urine specimens at no cost to the hospitals for expanded urinalyses. We look for many more substances than local hospitals can routinely test for; we use the results to identify patient exposure to specific drugs and to track new patterns of drug use that may be emerging in the population.<\/p>\n

Our program could serve as the first phase of a national system to inform hospitals about the drugs to which their patients have been exposed, as well as the role of multiple drugs, or\u00a0polysubstance use<\/a>, in overdoses. Hospitals have already used our findings to update their urine drug test panels. For example, EDDS has documented patient exposure to drugs such as fentanyl and xylazine across the U.S. Two hospitals in Baltimore\u00a0added fentanyl<\/a>\u00a0to their standard drug screens in 2019 after participating in EDDS and have since found fentanyl to be the most frequently detected drug in\u00a070 percent or more of specimens<\/a>\u00a0tested each year.<\/p>\n

In addition, California and Maryland have passed legislation requiring all of their hospitals to include fentanyl in urine drug screens to diagnose patient drug exposure. This is an important step, but as we stressed earlier, illicit drugs are constantly changing. EDDS was able, for example, to detect\u00a0the animal tranquilizer xylazine<\/a>\u00a0in urine specimens from hospitals in Florida, Georgia, South Carolina, Tennessee and Maryland. The drug most likely to be found in addition to xylazine was fentanyl, detected in\u00a085 percent of the xylazine<\/a>-positive specimens. Xylazine can worsen the life-threatening effects of opioids by causing dangerously slowed breathing and low blood pressure.<\/p>\n

EDDS researchers believe that it is essential to launch a true nationwide system to provide hospitals with expanded urine testing at regular intervals and support physicians interested in conducting more in-depth research. We now have a proven method for doing this. More states should follow the lead taken by California and Maryland and require every hospital to include fentanyl in diagnostic drug screens. New drugs such as xylazine should also be added to urine drug screens in states where they are an identified part of the illicit drug market.<\/p>\n

Most specimens positive for drugs such as fentanyl and xylazine are also positive for at least one other drug on standard hospital urine screens. While these results may provide adequate information for physicians to treat the immediate medical condition, they don\u2019t ensure that hospitals can link patients to\u00a0the substance use treatment they need<\/a>\u00a0to start a successful recovery. The EDDS system has laid the foundation for a nationwide system, but more work still needs to be done.<\/p>\n

With\u00a0nearly 300 Americans a day<\/a>\u00a0dying of overdoses and a\u00a0nonfatal opioid overdose<\/a>\u00a0occurring approximately every three minutes,it is imperative that a system for collaborating with hospitals to conduct expanded urinalyses be fully funded by the federal government. A centralized system like this can regularly collect drug use information that can then be disseminated in a practical and useful manner, and support work with local physicians to conduct more in-depth research, as well as inform health policy. Other tools, such as urine test strips for xylazine and fentanyl, could also support a cost-effective approach to expanding hospital testing abilities and monitoring drug use trends.<\/p>\n

Without these kinds of resources, we will forever play catch-up, striving to identify emerging drugs and keep up with the illicit drug market. And patients will continue to miss opportunities for treatment and recovery.<\/p>\n

This is an opinion and analysis article, and the views expressed by the author or authors are not necessarily those of\u00a0<\/em>Scientific American.<\/p>\n

The views presented here are those of the authors and do not necessarily represent the official views of the CESAR funding agencies, any other federal or state of Maryland agencies, or the participating hospitals.<\/em><\/p>\n[\/vc_column_text][vc_column_text]\u00a9 2023 SCIENTIFIC AMERICAN, A DIVISION OF SPRINGER NATURE AMERICA, INC.[\/vc_column_text][vc_column_text]<\/p>\n

About the Author(s)<\/h3>\n

ERIN ARTIGIANI is deputy director for policy at CESAR at the University of Maryland and co-investigator on the EDDS system. She received an MA in Sociology from UCLA in 1991.<\/p>\n

AMY BILLING is the project manager for the EDDS system at CESAR. She received an MSSA from Case Western Reserve University in 2001.<\/p>\n

ERIC D. WISH is the founding director of CESAR and is currently the principal investigator of the EDDS system. He received his Ph.D. in psychology from Washington University in St. Louis in 1977.<\/p>\n[\/vc_column_text][\/vc_column][vc_column width=”1\/4″ css=”.vc_custom_1538657003956{padding-top: 0px !important;padding-bottom: 0px !important;}”][vc_custom_heading text=”ISSUES” font_container=”tag:h3|font_size:12px|text_align:left|color:%23333333|line_height:18px” use_theme_fonts=”yes” el_class=”titlewidget”][vc_column_text el_class=”columnflex” css=”.vc_custom_1664404002021{margin-bottom: 40px !important;}”]

October 2023<\/a><\/p>\r\n

September 2023<\/a><\/p>\r\n

August 2023<\/a><\/p>[\/vc_column_text][vc_custom_heading text=”OTHER ARTICLES IN THIS ISSUE” font_container=”tag:h3|font_size:12px|text_align:left|color:%23333333|line_height:18px” use_theme_fonts=”yes” el_class=”titlewidget” css=”.vc_custom_1674576179369{margin-bottom: 15px !important;}”][vc_basic_grid post_type=”post” max_items=”-1″ style=”load-more” items_per_page=”4″ element_width=”12″ orderby=”rand” item=”538″ grid_id=”vc_gid:1700225216890-9dec8bc4-bc98-9″ taxonomies=”33″][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"Most hospitals typically test people for drugs that drove overdoses 15 to 20 years ago. We need a national system for expanded testing to help patients get the treatment they need today ...more<\/a>","protected":false},"author":29,"featured_media":3037,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[7],"tags":[33,30],"class_list":{"0":"post-3021","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-science-connect","8":"tag-november-2023","9":"tag-scientific-american"},"acf":[],"yoast_head":"\nTo Treat Overdose Patients Now, Hospitals Must Test for More Kinds of Drugs - SH migration<\/title>\n<meta name=\"robots\" content=\"noindex, nofollow\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"To Treat Overdose Patients Now, Hospitals Must Test for More Kinds of Drugs - SH migration\" \/>\n<meta property=\"og:description\" content=\"Most hospitals typically test people for drugs that drove overdoses 15 to 20 years ago. 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