The SUDx 2024 State of Addiction Treatment in Maryland Analysis Details Illicit Substances Detected in SUD Patients

The 2024 State of Addiction Treatment in Maryland Analysis consists of more than 2 million toxicology compound tests performed by SUDx in 2024 on behalf of substance use disorder patients treated by providers across Maryland. The testing was performed on more than 50,000 individual samples. The report quantifies the usage of drugs, including fentanyl, heroin, amphetamines and cocaine.

The findings include the following:

• Cocaine (24%) was the most detected illicit substance, followed by opioids (17%).
• Fentanyl accounted for nearly half (47%) of all opioid-positive tests, while morphine (16%) and oxycodone (15%) were also significant contributors. Heroin positivity was relatively low (5%), reflecting the shift to fentanyl and other synthetic opioids from poppy-derived opioids.
• Xylazine was found in 47% of all fentanyl-positive samples. In March 2023, the U.S. Drug Enforcement Administration (DEA) issued a Public Safety Alert warning about the widespread threat of fentanyl mixed with xylazine – a powerful sedative that the U.S. Food and Drug Administration has approved for veterinary use only. "Xylazine and fentanyl drug mixtures place users at a higher risk of suffering a fatal drug poisoning," according to the agency. According to treatment providers, Xylazine seriously complicates the process of introducing a patient to treatment medications.
• Gabapentin was found in 22% of all samples. Gabapentin is prescribed for the treatment of neuropathic pain and epileptic disorders whose increased illicit use was noted by the DEA in January 2023.

"The prevalence of both Fentanyl and xylazine, underscores the public health crisis confronting Maryland and the need for targeted interventions," said Felix Dawson, SUDx CEO. "Xylazine is among the most prevalent and problematic substances to emerge locally in recent years. Medetomidine, another powerful animal sedative, is gaining a foothold. Providers and public health officials should be particularly mindful of these trends given that both compounds pose lethal risks to patients, while undermining medication assisted treatment."

Treatment-Resistant OUD Patients
The analysis also provides a unique perspective on patients with an opioid use disorder (OUD) who don't improve, despite exposure to standard interventions, including buprenorphine and other medication assisted treatments. These patients, who are also known as treatment-refractory patients, can be tracked over time with SUDx's OUD Stability Score, which is based on a patient's likely medication adherence and opioid use at a future visit. These scores serve as an easy to use standardized outcome measure for providers.

As documented in the Journal of Addiction Medicine, the Stability Score is based on proprietary, clinically validated algorithms developed by SUDx in collaboration with scientists at the National Institute of Drug Abuse and addiction psychiatrists at the University of Maryland.

The findings for 2024 include the following.

• 78% of OUD patients showed immediate and sustained improvements, including limited opioid use, when receiving conventional medication treatments.
• 13% of OUD patients were treatment-resistant, displaying continuously high rates of opioid use and infrequent buprenorphine use from treatment initiation.
  • 9% display treatment non-response from the beginning of treatment.
  • 4% show initial improvements in opioid use and medication adherence that subside over time.

"The Stability Score distills a patient's opioid use and medication adherence into a single score," said Albert Burgess-Hull, PhD, SUDx Scientific Director. "This enables a clinician to quickly see the historical recovery path of a patient and the risk of opioid use and non-adherence at their next appointment."

SUDx also uses the Stability Score, along with a patent-pending proprietary algorithm, the Treatment Twin, to predict the recovery path a patient is most likely to take in treatment with 92% accuracy. The Treatment Twin framework allows providers and support staff to personalize the care of patients and to allocate resources based on their unique needs. 

"This is the first forecasting tool capable of predicting which OUD patients will be non-responsive to treatment, eliminating potentially life-threatening delays in care," Burgess-Hull added.

About SUDx
Albemarle Laboratories, LLC (dba SUDx) provides specialized diagnostics and comprehensive, customizable toxicology testing substance use treatment providers can use to enhance the confidence and efficacy of their care, as well as operational efficiency of their practices. SUDx is COLA-accredited, licensed by the State of Maryland and Certified by CLIA. For more information visit www.sudx.com. 

SOURCE SUDx