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New Study Finds Heroin-Positive Patients Have Increasing Co-Occurrence of Non-Prescribed Fentanyl

The study demonstrates evidence of an escalating national epidemic

SAN DIEGO Sept. 20, 2017 – A new study examined urine drug test (UDT) results to measure the co-occurrence of non-prescribed fentanyl in populations of heroin-positive healthcare patients across the United States. The study revealed a 3,000 percent increase of non-prescribed fentanyl in heroin-positive patients between January 2013 and January 2017. Regionally, 5 of the 9 U.S. Census regions exhibited a dramatic increase in the co-occurrence of fentanyl use in the heroin-positive population, with New England exhibiting the greatest jump climbing from 3 percent to 76 percent.

In 2016, both the Centers for Disease Control and the Drug Enforcement Administration issued nationwide warnings on the increased prevalence of fentanyl in the illicit market[1]. Up to 50 times more potent than heroin and up to 100 times more potent than morphine, fentanyl is often spiked into heroin or sold as heroin without knowledge to the consumer.

“To date, the epidemiology of fentanyl-spiked heroin has relied largely on reports of seizures by law enforcement agencies and accounts of fatal and non-fatal overdoses by emergency healthcare professionals, first responders, medical examiners and coroners,” said Dr. Angela Huskey, chief clinical officer, Millennium Health. “The results from the study are alarming. We hope this timely data raises awareness about the issue and helps clinicians and those responsible for public health to leverage life-saving tools in an effort to help save more lives.”

According to the results, in January 2013, heroin-positive rates were less than 1 percent, with less than 2 percent of those also testing positive for non-prescribed fentanyl. Between January 2013 and January 2017, heroin-positive rates rose to 1.3 percent, but the co-occurrence of non-prescribed fentanyl rose to 35.6 percent. Regionally, there was a 44 percent increase in the Mid Atlantic, 52 percent increase in the South Atlantic, 50 percent increase in East North Central, and 34 percent increase in West North Central, respectively. Ten individual states: DE, FL, IN, KY, MI, WI, MD, MO, OH, and PA, were impacted at the highest level. While growth patterns differ between these states, each exhibited greater than 33 percent of their heroin-positive UDT’s tested in January 2011 also testing positive for fentanyl without a reported prescription.

The data used in the study is limited to patient samples submitted for testing to Millennium Health, a leading health solutions company, by healthcare providers as part of their normal course of treatment, wherein the test requisition included (but was not limited to) definitive drug testing by LC-MS/MS for both heroin and fentanyl.

The study was presented in a poster presentation at PAINWeek on Sept. 7.



Jody Schneider
Millennium Health
(858) 217-1159



[1] NDEWS Special Report on Fentanyl and Fentanyl Analogs, http://pub.lucidpress.com/NDEWSFentanyl/#6hDoOtJbsqOJ (accessed 6.28.17); Reported Law Enforcement Encounters Testing Positive for Fentanyl Increase Across US, https://www.cdc.gov/drugoverdose/data/fentanyl-le-reports.html (accessed 6.28.17); As Fentanyl Deaths Spike, States and CDC Respond, http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2016/04/01/as-fentanyl-deaths-spike-states-and-cdc-respond, (accessed 6.28.17); Fentanyl Law Enforcement Submissions and Increases in Synthetic Opioid–Involved Overdose Deaths — 27 States, 2013–2014, https://www.cdc.gov/mmwr/volumes/65/wr/mm6533a2.htm, (accessed 6.28.17).