Millennium Health Signals Report™ Volume 5: Fentanyl in Focus

The 5^th volume of our Signals Report analyzed urine drug test results from more than 4.5 million specimens collected between 2015-2022 from all 50 states to bring Fentanyl in Focus and explore polysubstance use from several vantage points. Our goal is to provide valuable insights into current drug use trends to provide value to clinicians and other partners, including public health officials, and government and academic collaborators as they develop, refine, and implement harm reduction strategies and interventions across the continuum of care and recovery.

Section 1: A Snapshot of Recent Trends in Urine Drug Test Positivity and Fentanyl Co‑Positivity in Substance Use Disorder Treatment Settings. In this section we:

Show trends in use for drugs driving overdose deaths (fentanyl, methamphetamine, cocaine, heroin, prescription opioids)
Assess fentanyl co-use in people who test positive for methamphetamine, cocaine, heroin, or prescription opioids.

Section 2: Gaining Perspective on Fentanyl Analogues: Current Landscape and New Frontiers to Explore - This section reveals a) that fentanyl may often represent a mixture of fentanyl and various fentanyl analogues, b) a clear difference in fentanyl analogue prevalence exists geographically, and c) geographical differences have potentially significant clinical implications.

Section 3: Polysubstance Use in the Fentanyl-Positive Population: The Bigger Picture - Because fentanyl is so prevalent and primary for so many, in this section, we focus on those who use fentanyl to give a better view of polysubstance use in this group.

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