{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T20:17:51Z","timestamp":1785442671478,"version":"3.56.0"},"reference-count":16,"publisher":"SAGE Publications","issue":"1_suppl","license":[{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Population Health Management"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:p>\n                    The convergence of the opioid epidemic and the coronavirus disease 2019 (COVID-19) pandemic has created new health care challenges. The authors analyzed changes in clinical drug testing patterns and results at a national clinical laboratory, comparing data obtained before and during the pandemic. Testing for prescription and illicit drugs declined rapidly during the pandemic, with weekly test volumes falling by approximately 70% from the baseline period to the trough (the week beginning March 29) before rising in subsequent weeks. Among individuals tested, positivity increased by 35% for non-prescribed fentanyl and 44% for heroin during the pandemic. Positivity for non-prescribed fentanyl increased significantly among patients positive for other drugs: by 89% for specimens positive for amphetamines; 48% for benzodiazepines; 34% for cocaine; and 39% for opiates (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u20090.01 for all comparisons). These findings suggest significant increases in dangerous drug combinations. Positivity for non-prescribed use of many other drugs remained consistent or declined for some drugs, relative to pre-pandemic patterns. Models adjusting for potential confounding variables, including medication-assisted treatment and treatment at a substance use disorder facility indicated that the risk for non-prescribed fentanyl positivity rose by more than 50% during the pandemic. In summary, these findings demonstrate decreased drug testing overall, with increased positivity for high-risk drugs and dangerous drug combinations. The convergence of the drug abuse epidemic and COVID-19 pandemic has led to an increased need for health care and public health resources dedicated to supporting vulnerable patients and addressing the underlying causes of these disturbing trends.\n                  <\/jats:p>","DOI":"10.1089\/pop.2020.0230","type":"journal-article","created":{"date-parts":[[2020,10,8]],"date-time":"2020-10-08T14:34:57Z","timestamp":1602167697000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":126,"title":["The Opioid Epidemic Within the COVID-19 Pandemic: Drug Testing in 2020"],"prefix":"10.1177","volume":"24","author":[{"given":"Justin K.","family":"Niles","sequence":"first","affiliation":[{"name":"Quest Diagnostics, Secaucus, New Jersey, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Gudin","sequence":"additional","affiliation":[{"name":"Quest Diagnostics, Secaucus, New Jersey, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Radcliff","sequence":"additional","affiliation":[{"name":"Quest Diagnostics, Secaucus, New Jersey, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harvey W.","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Quest Diagnostics, Secaucus, New Jersey, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,2,5]]},"reference":[{"key":"e_1_3_4_2_2","unstructured":"Centers for Disease Control and Prevention. Opioid overdose. https:\/\/www.cdc.gov\/drugoverdose\/data\/index.html Accessed July28 2020."},{"key":"e_1_3_4_3_2","unstructured":"Centers for Disease Control and Prevention . National Center for Health Statistics . Data Brief . Overdose death in the United States 1999\u20132018. https:\/\/www.cdc.gov\/nchs\/data\/databriefs\/db356_tables-508.pdf#1 Accessed July28 2020."},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6911a4"},{"key":"e_1_3_4_5_2","unstructured":"Centers for Disease Control and Prevention . National Center for Health Statistics. Vital statistics rapid release provisional drug overdose death counts. https:\/\/www.cdc.gov\/nchs\/nvss\/vsrr\/drug-overdose-data.htm Accessed July28 2020."},{"key":"e_1_3_4_6_2","unstructured":"Centers for Disease Control and Prevention. Framework for healthcare systems providing non-COVID-19 clinical care during the COVID-19 pandemic. https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/framework-non-COVID-care.html Accessed July28 2020."},{"key":"e_1_3_4_7_2","unstructured":"Johns Hopkins University and Medicine. COVID19 dashboard by the center for systems science and engineering at JHU. https:\/\/coronavirus.jhu.edu\/data\/cumulative-cases Accessed July29 2020."},{"key":"e_1_3_4_8_2","unstructured":"The Washington Post. \u2018Cries for help\u2019: Drug overdoses are soaring during the coronavirus pandemic. 2020. https:\/\/www.washingtonpost.com\/health\/2020\/07\/01\/coronavirus-drug-overdose\/ Accessed July28 2020."},{"key":"e_1_3_4_9_2","unstructured":"Overdose Detection Mapping Application Program. The consequences of COVID-19 on the overdose epidemic: overdoses are increasing. 2020. www.odmap.org\/Content\/docs\/news\/2020\/ODMAP-Report-May-2020.pdf Accessed July28 2020."},{"key":"e_1_3_4_10_2","unstructured":"Petterson S Westfall JM Miller BF. \u201cProjected Deaths of Despair During the Coronavirus Recession. \u201d Well Being Trust. 2020. https:\/\/wellbeingtrust.org\/wp-content\/uploads\/2020\/05\/WBT_Deaths-of-Despair_COVID-19-FINAL-FINAL.pdf Accessed July28 2020."},{"key":"e_1_3_4_11_2","unstructured":"Quest Diagnostics Health Trends\u2122 2019 Report: Prescription Drug Misuse in America. www.questdiagnostics.com\/home\/physicians\/health-trends\/prescription-drug-misuse\/ Accessed July28 2020"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1441.030"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002130100917"},{"key":"e_1_3_4_14_2","unstructured":"NIH Director's Blog. Coping with the collision of public health crises: COVID-19 and substance use disorders. 2020. https:\/\/directorsblog.nih.gov\/2020\/04\/21\/coping-with-the-collision-of-public-health-crises-covid-19-and-substance-use-disorders\/ Accessed July28 2020."},{"key":"e_1_3_4_15_2","unstructured":"Los Angeles Times. Coronavirus crisis disrupts treatment for another epidemic: Addiction. 2020. https:\/\/www.latimes.com\/science\/story\/2020-07-06\/coronavirus-crisis-disrupts-addiction-treatment Accessed July28 2020."},{"key":"e_1_3_4_16_2","unstructured":"Centers for Disease Control and Prevention. Opioid Overdose. Fentanyl. https:\/\/www.cdc.gov\/drugoverdose\/opioids\/fentanyl.html Accessed July28 2020."},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6834a2"}],"container-title":["Population Health Management"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/pop.2020.0230","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/pop.2020.0230","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/pop.2020.0230","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T01:24:52Z","timestamp":1777685092000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/pop.2020.0230"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2]]},"references-count":16,"journal-issue":{"issue":"1_suppl","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1089\/pop.2020.0230"],"URL":"https:\/\/doi.org\/10.1089\/pop.2020.0230","relation":{},"ISSN":["1942-7891","1942-7905"],"issn-type":[{"value":"1942-7891","type":"print"},{"value":"1942-7905","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2]]}}}