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.