SUDx, which provides specialized diagnostics and comprehensive, customizable toxicology testing for addiction treatment providers, has officially published the results from a recently-conducted analysis, which focused on unpacking the relative usage of both illicit and non-illicit substances among substance use disorder (SUD) patients throughout Maryland.
Going by the available details, this particular analysis will tread up a long distance to help providers, payers and public health officials in making informed decisions as they try and combat the public health emergency stemming from drug overdose deaths.
More on SUDx’s 2024 State of Addiction Treatment in Maryland Analysis would reveal that it packs together well over 2 million toxicology compound tests, performed by SUDx during 2024. The testing was also performed on more than 50,000 individual samples, quantifying the usage of drugs, including fentanyl, heroin, amphetamines, and cocaine.
Talk about the published results on a slightly deeper level, we begin from how cocaine (24%) was the most detected illicit substance, followed by opioids (17%).
Next up, fentanyl emerged as a relevant component for nearly half (47%) of all opioid-positive tests, whereas on the other hand, morphine (16%), and oxycodone (15%) were also deemed as significant contributors.
Heroin positivity, on the other hand, was comparatively low (5%), relaying the shift to fentanyl and other synthetic opioids from poppy-derived opioids.
Moving on, SUD’s survey also discovered that Xylazine was evident in 47% of all fentanyl-positive samples. This comes after, back in March of 2023, the U.S. Drug Enforcement Administration (DEA) issued a Public Safety Alert warning about the widespread threat of fentanyl mixed with Xylazine, which is understood to be a powerful sedative that the U.S. Food and Drug Administration has only approved for veterinary use.
Apart from that, gabapentin was also found in 22% of all samples. In case you weren’t aware, gabapentin is prescribed for the treatment of neuropathic pain and epileptic disorders whose increased illicit use was again noted by the DEA in January 2023.
“The prevalence of both Fentanyl and xylazine, underscores the public health crisis confronting Maryland and the need for targeted interventions,” said Felix Dawson, CEO of SUDx. “Xylazine is among the most prevalent and problematic substances to emerge locally in recent years. Medetomidine, another powerful animal sedative, is gaining a foothold. Providers and public health officials should be particularly mindful of these trends given that both compounds pose lethal risks to patients, while undermining medication assisted treatment.”
Another detail worth a mention here is rooted in how SUD’s analysis also provides a unique perspective on patients with an opioid use disorder (OUD) who don’t improve, despite exposure to standard interventions like buprenorphine and other medication assisted treatments.
These patients were tracked over time with SUDx’s OUD Stability Score, which takes into account patient’s likely medication adherence and opioid use at a future visit. The stated scores serve as a straightforward indicator to use standardized outcome measure for providers.
Here, an estimated 78% of OUD patients would show immediate and sustained improvements, including limited opioid use, when receiving conventional medication treatments.
However, 13% of OUD patients were largely treatment-resistant, displaying continuously high rates of opioid use and infrequent buprenorphine use from treatment initiation. Unpacking it further would have 9% displaying treatment non-response from the beginning of treatment.
The published data would even show 4% experiencing initial improvements in opioid use and medication adherence that subside over time.
“The Stability Score distills a patient’s opioid use and medication adherence into a single score,” said Albert Burgess-Hull, PhD, SUDx Scientific Director. “This enables a clinician to quickly see the historical recovery path of a patient and the risk of opioid use and non-adherence at their next appointment.”
