Background

• Public health officials across the country are reporting spikes in drug overdose deaths that appear to be associated with the COVID-19 pandemic, with over 30 states reporting increases in opioid-involved overdose deaths primarily related to illicit fentanyl1

• Public health emergencies typically affect communities and individuals in a variety of ways, including economic loss and instability, emotional or physical isolation, additional stressors from mass at-home confinement, and anxiety from fear of contracting disease.2 The impact on mental health may be contributing to increased substance use in general

• Additionally, several experts have published op-eds or letters to the editors of medical journals warning of increased risks to patients with substance use disorders3,4 In this analysis, we evaluate the urine drug testing (UDT) positivity rates of non-prescribed fentanyl, cocaine, heroin, and methamphetamine in the periods before and after COVID-19 was declared a national emergency.