Less than 5% of overdose patients tested for fentanyl

According to a study created by the Center for Substance Abuse Research (CESAR) at the University of Maryland and released by Epic Research, less than 5% of overdose patients are tested for fentanyl, the No. 1 killer of Americans aged 18–44. Since 2017, patients visiting the emergency department for an overdose have been tested for opiates in 45–50% of cases, and the positivity rate of these tests has gradually decreased to less than 14%. 

However, opiate screenings do not detect fentanyl. Despite more than 56,000 overdose deaths involving synthetic opioids like fentanyl, testing for the substance remains at 5%. When testing does occur, however, positivity rates for fentanyl are near 50%, more than three times the positivity rate of opiates. Testing and identification of fentanyl can appropriately identify treatment needs and inform public health interventions for illicit drug use. In the analysis, the study looked at lab test results for 15 drug categories from 2017 to the present day and found that opiates are consistently tested nearly half the time, with 152,845 tests done during 315,467 overdose visits. The positivity rate has decreased dramatically from 25.2% in 2018 to 13.5% in 2022. The declining trend of opiate positives may reflect a transition in drug composition from heroin to fentanyl.