SAN DIEGO – A new study shows that a change in policy placing more restrictions on all hydrocodone-containing drugs has successfully decreased the use of certain opioids such as Vicodin. This research and a second study illuminating regional drug use trends in Canada were announced today at the 69th AACC Annual Scientific Meeting in San Diego, and could help to guide future strategies for combatting addiction.
From 2007–2014 in the U.S., more prescriptions were written for hydrocodone-acetaminophen—which is best known as Vicodin—than for any other medication. In late 2014, the U.S. Drug Enforcement Agency reclassified hydrocodone-containing products as schedule II controlled substances in order to place tighter restrictions on prescriptions for these drugs and in the hopes of deterring abuse. An analysis found that hydrocodone prescriptions subsequently declined, but this did not answer the question of whether overall hydrocodone use changed, or whether addicts had simply shifted to using the drug illicitly.
Joshua Akin, a clinical laboratory scientist at University of California (UC) San Diego Health, set out to answer this question by investigating the impact of the hydrocodone rescheduling on laboratory urine drug testing results, which capture both prescription and non-prescription hydrocodone use.
“We wanted to see how the legislation has impacted laboratory drug testing,” said Akin. “It’s hard to make conclusions based on prescription data alone—sometimes patients aren’t taking their medication as prescribed or are using drugs illicitly. The beauty of laboratory data is that you can’t really deny the test results.”
Akin compared a total of 253,773 urine drug test results from UC San Diego Health for 18 months prior to and 18 months after the rescheduling event. He found that positive results for hydrocodone significantly dropped by 2.9% and positive opioid screening results decreased overall by 0.09%. This suggests that the rescheduling successfully reduced hydrocodone use by decreasing prescriptions for this drug, and that policies and guidelines targeting prescription practices for other opioids could help to end the current epidemic.
The opioid crisis is also dominating headlines in Canada, but as a result, alarming trends for other drugs of abuse are potentially being overlooked. For example, data from one supervised injection center in Vancouver show that from 2004–2015, methamphetamine injections rose from 6,500 to 39,400 per year—a 17-fold increase. If trends such as this are widespread, health agencies need to know so that they can take appropriate action, but statistics on substance use across Canada are sorely limited.
Researchers from the reference lab Dynacare in London, Ontario (a subsidiary of LabCorp) have filled a critical gap in Canadian drug use data by performing the first comprehensive study of urine drug test results throughout Ontario. Led by toxicologist Adam Ptolemy, PhD, the researchers reviewed 396,880 of Dynacare’s urine drug test results from 2014–2016. During this time period, they observed a climb in illicit drug use, with significant annual increases in positive results for methamphetamine and cocaine. Positive results related to heroin use and the opioid dependence treatment Suboxone also increased, but surprisingly, no significant changes in prescription opioid or fentanyl positive results occurred. This information is vital for medical providers and healthcare agencies so that they can allocate the necessary resources to help meth and cocaine users in addition to opioid addicts.
“There’s a need in Canada to further establish a network that identifies drug trends and makes them widely available,” said Ptolemy. “Since we’re a reference lab and we do such a high volume of testing, we’re uniquely positioned to look at what drugs people are actually using in the province. Most physicians here don’t have access to this information. Toxicology laboratories should consider publishing their drug testing data in peer reviewed articles to increase awareness of drug use in their catchment areas.”
AACC Annual Scientific Meeting registration is free for members of the media. Reporters can register online here: https://www.xpressreg.net/register/aacc0717/media/start.asp
Abstract A-231: The Effects of Hydrocodone Rescheduling on Laboratory Urine Drug Testing will be presented during:
Scientific Poster Session
Tuesday, August 1
9:30 a.m. – 5 p.m. (presenting authors in attendance from 12:30 – 1:30 p.m.)
Sails Pavilion, Upper Level
Abstract B-408: Use of Urine Drug Screening Positivity Rates from Qualitative Liquid Chromatography Tandem Mass Spectrometry Definitive Testing to Identify Annual Trends in Drug Use will be presented during:
Session 34218 Invited Oral Abstracts: Global Health
Wednesday, August 2
2:30 – 4 p.m.
All sessions will be held at the San Diego Convention Center in San Diego, California.
About the 69th AACC Annual Scientific Meeting & Clinical Lab Expo
The AACC Annual Scientific Meeting offers 5 days packed with opportunities to learn about exciting science from July 30–August 3. Plenary sessions feature the latest research on CRISPR and the future of genome engineering, the public health crisis of antibiotic resistance, treating substance abuse and addiction, preserving fertility in cancer patients, and new frontiers in genomic sequencing.
At the AACC Clinical Lab Expo, more than 750 exhibitors will fill the show floor of the San Diego Convention Center with displays of the latest diagnostic technology, including but not limited to mobile health, molecular diagnostics, mass spectrometry, point-of-care, and automation.
Dedicated to achieving better health through laboratory medicine, AACC brings together more than 50,000 clinical laboratory professionals, physicians, research scientists, and business leaders from around the world focused on clinical chemistry, molecular diagnostics, mass spectrometry, translational medicine, lab management, and other areas of progressing laboratory science. Since 1948, AACC has worked to advance the common interests of the field, providing programs that advance scientific collaboration, knowledge, expertise, and innovation. For more information, visit www.myadlm.org.