Researchers from the University of Maryland School of Medicine (UMSOM) have found that fentanyl, a potent synthetic opioid, has topped the list of drugs detected in overdose patients at two Baltimore hospital ERs.

Considering this finding, hospitals and medical systems across the United States said fentanyl is linked to most fatal overdoses in Maryland.

The researcher conducted a study based on de-identified urinalysis results along with other data collected through the new Maryland Emergency Department Drug Surveillance (EDDS) system, from January 2016 to December 2019.

Lead author Dr. Zachary Dezman said, “The overdose cases we see in our emergency departments stem from a wide variety of substances that may not be known and present increasingly complex treatment challenges.”

“In the case of fentanyl, without knowing its true role in these overdoses, public health officials and policymakers will find it difficult to implement the correct measures to improve patient care and help prevent substance abuse,” he added.

Fentanyl was found to be the most prevalent drug in the study. It was detected in 73 to 87 percent of samples that were tested for the drug in each of the four calendar quarters in 2019. More than 60 percent of the fentanyl positive samples contained other drugs along with fentanyl, while nearly 13 percent had fentanyl only.

The researchers published these results in the current issue of the Morbidity and Mortality Weekly Report (MMWR), from the CDC.

Dr. Dezman said hospital laboratory testing is routine for several substances, including cocaine, opiates, and methadone, but not fentanyl.

“Fentanyl was rarely a cause of overdoses, so routine fentanyl testing was not typically performed,” he explained.

“However, through our regular fentanyl testing and EDDS collaboration, we have addressed a gap in our patient care, allowing us to better inform our patients of the risks associated with continued use, assist with buprenorphine induction in the emergency department, and help us connect patients to substance use treatment programs.”

UMSOM Dean E. Albert Reece said, “This study finding makes an important case for including fentanyl in routine drug overdose testing.” “It highlights the important role and function of the newly created Maryland EDDS system, which helps to better guide patient treatment and more effective overdose prevention programs,” he added.