2024 National Drug Threat Assessment and Gravity Diagnostics’ Trending Data

Authors:  Nicholas Lyktey, Chief of Laboratory Operations, and Jordan Kelsey, Clinical Product Specialist

The Drug Enforcement Administration (DEA) released the 2024 National Drug Threat Assessment, which contains a comprehensive assessment of illicit drug threats and traffic trends in the United States. Gravity Diagnostics’ Team continues to be proactively educated on new drug trends and add them to our testing menu as they gain heightened, long-term popularity among the patient populations. This assessment provides insight on illicit drug supply trends affecting the patients served.

Drug Related Deaths:

Fentanyl, methamphetamine, cocaine, other opioids, and heroin are responsible for nearly 100% of the deaths that occurred in the United States, as reported in the 2024 National Drug Threat Assessment. Gravity Diagnostics offers testing for these deadly drugs as well as their metabolites in urine and oral fluid, which include the following analytes with their cutoff concentrations:

• Fentanyl
• Norfentanyl
• Tramadol
• O-desmethyltramadol
• Methadone
• EDDP
• Methamphetamine
• Amphetamine
• 6-MAM

“Drug-related deaths claimed 107,941 American lives in 2022, according to the Centers for Disease Control and Prevention (CDC). Fentanyl and other synthetic opioids are responsible for approximately 70% of lives lost, while methamphetamine and other synthetic stimulants are responsible for approximately 30% of deaths.” (Drug Enforcement Administration National Drug Threat Assessment, page 8).

Fentanyl/Xylazine:

Gravity Diagnostics has added Xylazine testing to their urine toxicology test offerings. Xylazine use continues to trend up and its detection can be lifesaving. Xylazine is a veterinary medication used to sedate animals for surgery or pain relief. It is not approved for human consumption but is most often found in the illicit drug supply when mixed with fentanyl. NARCAN is not effective for Xylazine overdose which leads to drowsiness, amnesia, slowed breathing, and decreased blood pressure to potentially fatal levels. Gravity Diagnostics offers Xylazine as part of their urine confirmation testing.

“Seizures of fentanyl, in both powder and pill form, are at record levels. Over the past two years seizures of fentanyl powder nearly doubled. DEA seized 13,176 kilograms (29,048 pounds) in 2023. Meanwhile, the more than 79 million fentanyl pills seized by DEA in 2023 is almost triple what was seized in 2021. Last year, 30% of the fentanyl powder seized by DEA contained xylazine. That is up from 25% in 2022.” (Drug Enforcement Administration National Drug Threat Assessment, page 8).

As reported in Time Magazine, Philadelphia, PA has been deemed by some as “ground zero for xylazine in the U.S.” due to the drug’s rampant permeation through the city in 2019. The pandemic, combined with xylazine being a cheap alternative to cut dope for a longer-lasting high, only exacerbated the issue. As seen in the DEA figure below, which details states with reported seizures of xylazine, the Appalachian region is particularly vulnerable to the pervasive usage of xylazine. Gravity Diagnostics offers clients a GravReport™, which shows a geographically targeted analysis of drug use and trends from clients. This type of analysis is another tool Gravity offers the clinicians served to better understand and monitor drug activity and how it impacts the patients they work with.

Continued Monitoring:

Gravity Diagnostics is constantly monitoring the moving landscape of drug trends and how it impacts those with substance use disorders. Fentanyl and methamphetamine continue to be larger and larger issues, resulting in a continuously worsening drug crisis in the United States. Plant-based drugs like heroin and cocaine continue to be less prevalent than the chemical-based drugs like fentanyl and methamphetamine. Gravity is committed to continue monitoring other synthetic opioids like nitazenes to see if there are any upward trends in this drug’s usage in the U.S. For now, xylazine remains one of the most well-discussed national threats to these vulnerable patient populations due to xylazine almost exclusively being co-detected with fentanyl. More xylazine in fentanyl products lowers the cost of fentanyl to be produced, which allows for fentanyl to be accessible to more populations of people. Gravity Diagnostics will continuously expand operations to provide accurate and timely results to clients, which in turn, allows for clinicians to treat patients as quickly as possible while providing them the regional data on emergent drug trends.

Resources:

(2024) Drug Enforcement Administration National Drug Threat Assessment. Available at: https://www.dea.gov/sites/default/files/2024-05/NDTA_2024.pdf (Accessed: 01 June 2024).