Study: Fentanyl Analog Positivity

Millennium Health Identifies National Fentanyl Analog Positivity Which May Increase Risk of Overdose Death

SAN DIEGO, Calif. – October 7, 2020 – A study conducted by Millennium Health and published in Drug and Alcohol Dependence highlights the role real-time urine drug test results can play in identifying dangerous drug abuse trends including fentanyl analog positivity nationwide.

Up to 10,000-fold more potent than morphine,1 fentanyl analogs can pose a serious risk for overdose. Synthetic opioids, including illicit fentanyl and its analogs, contribute to over 40% of all drug overdose deaths.2

The study was conducted to provide timely information regarding fentanyl analog positivity and geographic distribution that can be critical in reducing harm and saving lives. The analysis included 300,000 urine specimens collected between July 15, 2019 and March 12, 2020 from health care practices in all 50 states. The results included:

  • In the population of patients testing positive for fentanyl without a fentanyl prescription, the fentanyl analog positivity rate was 40.55% with 12.78% of those having more than one fentanyl analog present
    • The combination of fentanyl with fentanyl analogs may increase the risk of overdose
    • Fentanyl analog positivity varied by geographic location
  • In the fentanyl-prescribed population, the fentanyl analog positivity rate was 8.93%; however, the majority of the analogs detected were likely consistent with the prescribed fentanyl

“This is the first study of its kind that analyzes rates of fentanyl analog positivity in urine drug testing across two distinct fentanyl-positive populations. Having awareness and understanding of fentanyl analog positivity in these populations gives clinicians an opportunity to make more informed clinical decisions, which may ultimately lead to better patient care,” said Eric Dawson, Pharm.D., Vice President, Clinical Affairs, Millennium Health.

The Drug and Alcohol Dependence study can be accessed here.

 About Millennium Health

Millennium Health is an accredited specialty laboratory with over a decade of experience delivering timely, accurate, clinically-actionable information through our nationwide medication monitoring and drug testing services. Clinical drug testing is used in various healthcare settings to obtain objective information about patients’ recent use of prescription medications and illicit drugs. Processing over a million specimens each year allows us to provide real-time analytics regarding emerging drug use trends, such as our studies published in JAMA Network Open and our most recent Millennium Health Signals Report™.

Media Contact

Jody Schneider
Millennium Health
(619) 917-6810


1. Suzuki J, El-Haddad S. A review: Fentanyl and non-pharmaceutical fentanyls. Drug Alcohol Depend. 2017; 171: 107-116.

2. Chester KL. The Countdown: Fentanyl Analogues and the Expiring Emergency Scheduling Order. Committee on the Judiciary United States Senate. Office of National Drug Control Policy. June 4, 2019.