The MD-EDDS research project has collected information critical to the discussion regarding HB0811/SB0914. Fentanyl is the leading cause of fatal opioid overdoses (MDH, June 2021), but most Maryland hospitals do not regularly test patients for exposure to fentanyl. MD-EDDS provided rapid urine fentanyl dipstick tests to eight Maryland hospitals that do not routinely test patients for the drug.
Maryland EDDS Pilot Study
Maryland Emergency Department Drug Surveillance (EDDS) publications detailing urine drug testing trends in ED populations: EDDS pilot study, brief bulletins for the Baltimore area and Prince George's County, and MMWR Notes from the Field showing Fentanyl was detected in 73 to 87% of specimens in two hospitals.
Prince George’s Hospital Center: Emergency Department Drug Surveillance (EDDS) hospital’s urinalysis results compared with expanded re-testing by an independent laboratory, a pilot study (January 2022)
- Re-testing urine specimens using an expanded toxicology panel can help to identify drugs that hospitals may want to consider adding to a routine screen.
- Cocaine (37% vs. 20%, p<.01) and benzodiazepines (21% vs. 11%, p<.05) were significantly more likely to be detected by the expanded re-testing than the hospital screen, likely due to differences in test sensitivity.
- Fentanyl was detected in 4-14% of the samples re-tested using the expanded toxicology panel.
MMWR Notes from the Field: High Prevalence of Fentanyl Detected by the Maryland Emergency Department Drug Surveillance System — Baltimore, Maryland, 2019; (June 12, 2020)
- After analysis of EDDS data, two hospitals introduced fentanyl testing as part of their routine urinalysis screen.
- Fentanyl was detected in 73 to 87% of specimens.
- 61% of the fentanyl positive specimens contained two or more drugs/drug classes in addition to fentanyl.
- Hospitals and medical systems throughout the United States might consider adding fentanyl to their routine drug testing panels.
Baltimore Area / Full Report: A Pilot Study Using Electronic Health Records from Hospital Emergency Departments to Monitor Drug Use Trends in Overdose Patients in the Baltimore Area, January 2016-December 2018 (May 1, 2019, Revised)
- EDDS data from four Baltimore hospitals shows that opiates were found in 43% of tested specimens, followed by cocaine (37%), benzodiazepines (30%), and marijuana (22%).
- 47% of the specimens tested positive for multiple drugs.
- An unexpected decline was found in the percentage of specimens testing positive for opiates (43% vs. 36%, p<.05).
- Subsequent studies found high rates of fentanyl in patients at these hospitals and led to their implementing routine fentanyl testing.
Baltimore Area | Bulletin (2-pages): Using Hospital Electronic Health Records to Monitor Drug Use Trends in Overdose Patients (February 2019)
- EDDS data from four Baltimore hospitals show an unexpected decline in opiates.
- The decline in opiate positives likely does not reflect patterns of use of synthetic opioids, such as fentanyl, which are not detected by the hospital screen.
Prince George's County | Bulletin (2-pages): Cocaine Positives at New High, Marijuana Most Detected, Opiates Remain Low (November 2019)
Prince George’s County: University of Maryland Prince George’s Hospital Center (UM PGHC), June 2013 to June 2019
- Marijuana remains the drug most often detected, found in 59% of specimens from April-June 2019 only slightly below its peak of 62% reached in October-December 2018.
- Cocaine was found in 25% of the specimens from April-June 2019, the highest percentage of any quarter.
- Opiate positives remain low, declining to 20% in April-June 2019, just above the low of 19% in April-June 2018.
Funding for the Maryland EDDS pilot studies was provided by the University of Maryland Strategic Partnership: MPowering the State (MPower) Opioid Use Disorders Research Collaboration.