Emergency Department Substance Use Surveillance System

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The Office of National Drug Control Policy (ONDCP) 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 and geographically expand a methodology for obtaining drug early warning indicators through broader 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. Similar methodology is promising for use in other venues, such as in trauma units and emergency departments, where biological samples are often collected from patients. Before the specimens are discarded, the project will re-test them for an expanded panel of drugs, including fentanyl and methamphetamine, 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 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. Supplemental validation of testing gaps, needs, and positivity trends against other data sources, such as de-identified electronic health records from patients treated in the hospital care setting is also desired. ONDCP is seeking to apply this testing methodology and insight from supplemental analyses to Emergency Department populations in locations throughout the United States to reinforce best practice guidelines, testing standardization, and build local and national surveillance capacity. A. Program Description Overview This project seeks to refine and geographically expand 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. Similar methodology is promising for use in other venues, such as in trauma units and emergency departments, where biological samples are often collected from patients. ONDCP seeks to apply this methodology to emergency department populations. (See Dezman et al., 2020, High Prevalence of Fentanyl Detected by the Maryland Emergency Department Drug Surveillance System — Baltimore, Maryland, 2019, Mortality and Morbidity Weekly Report , June 12, 69:20 724-26, available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315791/ ). ONDCP seeks to expand this methodology beyond Maryland to a purposive sample of emergency department populations throughout the United States to determine the extent of geographic variability in the outcome of testing for an expanded panel of illicit drugs. Before the specimens are discarded, this project will re-test them for an expanded panel of drugs. The awardee will work with ONDCP to determine specific metabolites to include in the expanded test panel beyond the NIDA-5 drugs, including fentanyl, methamphetamine, and other new emerging synthetic drugs of concern. The awardee will also establish working relationships with hospitals systems and emergency departments 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. Authorizing Statutes and Governing Regulations Applicable to this Funding Opportunity: The authority for this opportunity is the SUPPORT for Patients and Communities Act, (Pub. L. No. 115-271), 21 U.S.C. §§ 1701 et seq . and applicable appropriations statutes providing funding to ONDCP for this purpose. The Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards are applicable to the government and applicants, grant applications, and grant awards to non-Federal entities. See 2 C.F.R. Part 200 et seq ., as adopted in full by ONDCP via 2 C.F.R. Part 3603, et seq . B. F ederal Award Information ONDCP expects to award one Federal cooperative agreement under the Emergency Department Substance Use Surveillance System , for a one-year period, beginning in September 2022. All applications and awards are subject to such additional requirements expressed in governing law. See 2 C.F.R. Part 200 et seq. ONDCP expects that it will make an award of financial assistance from this announcement in the form of a cooperative agreement. Substantial involvement of ONDCP is anticipated in the form of regular project consultation – at minimum on a monthly basis; review of draft reports, and coordination of activities that involve other government agencies. Estimated Amount and Length of Award Cooperative Agreement Amount:     Up to $200,000 Project Period:                                  12 months (September 2022 through September 2023)

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