TY - JOUR PY - 2022// TI - Use of laboratory data for illicit drug use surveillance and identification of socioeconomic risk factors JO - Drug and alcohol dependence A1 - Azimi, Vahid A1 - Jackups, Ronald Jr A1 - Farnsworth, Christopher W. A1 - Budelier, Melissa M. SP - e109499 EP - e109499 VL - 236 IS - N2 - BACKGROUND: Drug overdose is the leading cause of death among people 25-44 years of age in the United States. Existing drug surveillance methods are important for prevention and directing treatment, but are limited by delayed reporting and lack of geographic granularity.

METHODS: Laboratory urine drug screen and complete metabolic panel data from patients presenting to the emergency department was used to observe long-term and short-term temporal and geospatial changes at the zip code-level in St. Louis. Multivariate linear regression was performed to investigate associations between zip code-level socioeconomic factors and drug screening positivity rates.

RESULTS: An increase in the fentanyl positive drug screens was seen during the initial COVID-19 shutdown period in the spring of 2020. A decrease in cocaine positivity was seen in the fall and winter of 2020, with a return to baseline coinciding with the second major COVID-19 shutdown in the summer of 2021. These changes appeared to be independent of changes in emergency department utilization as measured by complete metabolic panels ordered. Significant short-term changes in fentanyl and cocaine positivity rates between specific time periods were able to be localized to individual zip codes. Zip code-level multivariate analysis demonstrated independent associations between socioeconomic/demographic factors and fentanyl/cocaine positivity rates as determined by laboratory drug screening data.

CONCLUSIONS: Analyzing clinical laboratory drug screening data can enable a more temporally and geographically granular view of population-level drug use surveillance. Additionally, laboratory data can be utilized to find population-level socioeconomic associations with illicit drug use, presenting a potential avenue for the use of this data to guide public health and healthcare policy decisions.

Language: en

LA - en SN - 0376-8716 UR - http://dx.doi.org/10.1016/j.drugalcdep.2022.109499 ID - ref1 ER -