Drug Early Warning Signals from High Risk Populations

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The Office of National Drug Control Policy (ONDCP), Executive Office of the President, is seeking applications from public nonprofit institutions/organizations (includes institutions of higher education and hospitals) to perform research and analysis of data to inform drug policy. This project seeks to further refine a methodology for obtaining drug early warning indicators from expanded testing of urine samples that were previously collected and tested as part of an existing drug test protocol. This method was initially developed using local criminal justice populations – including persons in pre-trial or lock-up, parolees or probationers, and drug court participants. In addition, this method was also tested in two trauma units, with promising results. This project will use similar methodology in criminal justice, health care, and other venues, to include opioid treatment admissions, trauma units or emergency departments, and criminal justice programs such as parole or probation, where biological samples are often collected from clients. Before the specimens are discarded, the project will re-test them for an expanded panel of drugs, including synthetic cannabinoids and opioids, to determine what old and new illicit drugs are detected or missed by conventional testing protocols, and how the drug patterns might vary by subpopulation and geography. Bypassing the expense of collecting the original urine specimens and re-using those that have already been tested with known results yields a relatively inexpensive and timely picture of emerging drugs in a given subpopulation and locality. The proposed cooperative agreement will use the same methodology from the Community Drug Early Warning System (CDEWS). Existing urine specimens are sampled and retested for over 150 substances using a government laboratory at no cost. The proposed study will provide resources to analyze the drug re-test results and provide a relatively inexpensive but a rapid and comprehensive picture of what specific drugs are being used or abused in the local population. While users may report what drug(s) they think they took, in many instances, the actual drugs ingested may include substances - such as fentanyl and its analogues - that the drug user may not be aware of. More recently, this method was tested in the health care area with emergency department populations. Other venues, such as drug treatment facilities where biological samples are often collected from patients, are also promising. The recipient will work with ONDCP to determine specific metabolites to include in the expanded test panel beyond the NIDA-5 drugs, including synthetic cannabinoids and synthetic opioids. The recipient will also establish working relationships with organizations that can provide the specimens to be re-tested in this project. Analysis of the expanded drug test results will provide essential information on what old and new illicit drugs are detected or missed by conventional testing protocols, and how the drug patterns might vary by subpopulation and geography. Bypassing the expense of collecting the original specimens and re-using those that have already been tested with known results yields a relatively inexpensive and timely picture of emerging drugs in a given subpopulation and locality. ONDCP expects to continue to engage the laboratory testing services of the Armed Forces Medical Examiner System at no charge to further minimize project costs.

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