Identifying and treating the numerous patients who overdose on new mixtures of illicit drugs proves complex for emergency department physicians in Maryland, according to a study conducted by researchers at the University of Maryland's Center for Substance Abuse Research in College Park.
Here are four things to know:
1. For the study, which was supported by the U.S. Office of National Drug Control Policy, CESAR researchers collected urine samples from patients at two Maryland hospitals in 2016. They analyzed 106 urine samples from
2. The urine samples were sent to Dover, Del.-based Armed Forces Medical Examiner System laboratory, which tested the samples for the presence of 26 synthetic cannabinoids and 59 designer drugs, along with 84 other illicit and prescription drugs. Once researchers received the results, they realized the drugs taken by the overdose patients were more complex than anticipated.
"We were thoroughly amazed that in a study where we thought everyone was having a synthetic cannabinoid-related problem, only one specimen tested positive for synthetic cannabinoids," CESAR Director Eric Wish, PhD, said in a
3. The results showed the illicit drugs had been tweaked into new combinations that often went undetected. Still a year later after the initial sampling, only 25 percent of the urine samples tested positive for synthetic cannabinoids.
4. One-fifth to one-third of the specimens at each hospital tested positive for a new psychoactive substance alternative to synthetic cannabinoids. About two-thirds of patients between both hospitals tested positive for multiple substances, with some urine samples containing at least six different substances. About 47 percent of the urine specimens contained PCP, which makes patients three-to-four times more likely to exhibit bizarre or aggressive behavior.
"The results from this study clearly demonstrate the complexity of both detecting and treating patients reporting to the ED for an adverse drug-related event," the researchers concluded. "Most hospitals and other public health settings lack the testing capacity we had to identify the drugs that had been recently used by their patients. … Physician knowledge of local drug use patterns may therefore help them to anticipate the drugs that are most likely to be involved in their ED patients, even though patients have not specifically reported using them."