Precision Diagnostics, University of California San Diego, San Diego, CA, USA
Department of Pathology and Laboratory Medicine, University of California San Diego, San Diego, CA, USA.
Ann Clin Lab Sci. 2021 Sep;51(5):694-697.
The conjunction of the coronavirus disease lockdown and the use of illicit drugs suggests the potential increase in drug usage and opioid deaths. Because of other studies, we felt the need to examine if the lockdown has caused a change in the drug intake of our population of substance abuse and pain management patients.
Urine drug testing is a strategy to reduce harm to patients in pain management and substance abuse treatment programs. We analyzed trends in the clinical drug testing patterns of urine specimens sent by substance abuse and pain clinics to monitor their patients. These specimens were tested by a national clinical laboratory using LC-MS/MS definitive methods. The time frame of these comparative observations was the past five years, including the time of the pandemic.
The only decrease was a 30% reduction in test requests during the second quarter of 2020. Among the patients tested, positivity decreased greatly for the illicit drugs heroin and cocaine but increased for methamphetamine and fentanyl. Use of the antidepressant and anxiolytic drugs remained consistent or declined for some drugs, relative to pre-pandemic patterns. The percent of patients prescribed the opiates morphine and oxycodone decreased, while the use of hydrocodone increased. Positivity for the drug gabapentin increased greatly. The use of alcohol did not increase significantly during the lockdown period.
In summary, these findings demonstrate relatively consistent drug use, with decreased positivity for high-risk drugs and dangerous drug combinations. We speculate that monitoring of these patients mitigates the possibility of drug misuse and potential overdose and is in concordance with the goals of these monitoring programs.
冠状病毒病封锁期间非法药物的使用表明，药物使用和阿片类药物死亡人数可能会增加。由于其他研究，我们认为有必要检查封锁是否导致我们的滥用药物和疼痛管理患者群体的药物摄入发生变化。
尿液药物检测是减少疼痛管理和药物滥用治疗计划中患者伤害的一种策略。我们分析了滥用药物和疼痛诊所发送的尿液样本的临床药物检测模式趋势，以监测其患者。这些标本由国家临床实验室使用 LC-MS/MS 确证方法进行检测。这些对比观察的时间框架是过去五年，包括大流行时期。
唯一的下降是 2020 年第二季度测试请求减少了 30%。在接受测试的患者中，非法药物海洛因和可卡因的阳性率大大降低，但冰毒和芬太尼的阳性率却有所增加。与大流行前模式相比，一些药物的抗抑郁药和抗焦虑药的使用保持不变或下降。开处阿片类药物吗啡和羟考酮的患者比例下降，而氢可酮的使用增加。加巴喷丁的阳性率大大增加。封锁期间，酒精的使用并未显著增加。
总之，这些发现表明药物使用相对稳定，高危药物和危险药物组合的阳性率降低。我们推测，对这些患者的监测减轻了药物滥用和潜在过量的可能性，与这些监测计划的目标一致。
