Decreasing fentanyl concentrations in urinalysis results for methadone treatment admissions: Evidence of changing fentanyl exposure in street drugs.
- 1Jane Addams College of Social Work, University of Illinois Chicago, Chicago, IL, USA.
Abstract
Background
Recent declines in opioid-related overdose fatalities (OROF) in Chicago and nationally in the U.S. have prompted questions about whether changes in fentanyl exposure may be occurring in the illicit opioid supply.Objective
This study examined temporal trends in fentanyl exposure among individuals entering opioid treatment, using admission urinalysis as a biological indicator of recent opioid exposure.Methods
We conducted a secondary analysis of clinical admission data collected between 2023 and 2025 from a community-based opioid treatment program (OTP) on Chicago's West Side (N = 339). Multivariable ordinary least squares regression models were used to examine changes in log-transformed urine concentrations of fentanyl, norfentanyl, and morphine across admission years, adjusting for sociodemographic and clinical characteristics. Concentration analyses were restricted to participants with confirmed positive tests.Results
Relative to 2023, fentanyl concentrations were significantly lower in 2024 (b = -0.77, p < 0.001) and 2025 (b = -1.29, p < 0.001), corresponding to approximately 54% and 72% reductions, respectively. Norfentanyl concentrations also declined over time, while morphine concentrations remained stable. Participant characteristics and the prevalence of opioid detection at admission were largely stable across years.Conclusions
Declining concentrations of fentanyl and norfentanyl, alongside stable morphine levels, suggest reduced fentanyl exposure among treatment-seeking individuals over the study period. While urinalysis provides an indirect indicator and cannot establish causality, these findings are consistent with broader reports of declining fentanyl-related overdose mortality and highlight the potential value of treatment-entry toxicology data as a sentinel indicator of changes in illicit opioid markets.
Related
- Comparative health outcomes of buprenorphine versus methadone treatment for opioid use disorder: a retrospective propensity score-matched cohort study in the global federated electronic health record network
- Total-body [11C]carfentanil PET: Liver-brain axis in methadone vs. buprenorphine treatment
- Effect of kidney function on drug concentrations of first-line anti-tubercular treatment
- Automated urinalysis for predicting urine culture positivity and presumptive Gram classification: a retrospective study at a cancer hospital
- Methadone: Historical success, modern challenges and lessons for opioid drug discovery
BibTeX
@article{giangrande2026decreasing,
title = {{Decreasing fentanyl concentrations in urinalysis results for methadone treatment admissions: Evidence of changing fentanyl exposure in street drugs.}},
author = {Emily Giangrande and James A Swartz},
journal = {AIMS public health},
year = {2026},
month = aug,
doi = {10.3934/publichealth.2026045},
url = {https://europepmc.org/article/MED/42909204},
note = {CC BY},
}
RIS
TY - JOUR
TI - Decreasing fentanyl concentrations in urinalysis results for methadone treatment admissions: Evidence of changing fentanyl exposure in street drugs.
AU - Emily Giangrande
AU - James A Swartz
PY - 2026
DA - 2026/08/07
JO - AIMS public health
DO - 10.3934/publichealth.2026045
UR - https://europepmc.org/article/MED/42909204
AB - Background Recent declines in opioid-related overdose fatalities (OROF) in Chicago and nationally in the U.S. have prompted questions about whether changes in fentanyl exposure may be occurring in the illicit opioid supply.Objective This study examined temporal trends in fentanyl exposure among individuals entering opioid treatment, using admission urinalysis as a biological indicator of recent opioid exposure.Methods We conducted a secondary analysis of clinical admission data collected between 2023 and 2025 from a community-based opioid treatment program (OTP) on Chicago's West Side (N = 339). Multivariable ordinary least squares regression models were used to examine changes in log-transformed urine concentrations of fentanyl, norfentanyl, and morphine across admission years, adjusting for sociodemographic and clinical characteristics. Concentration analyses were restricted to participants with confirmed positive tests.Results Relative to 2023, fentanyl concentrations were significantly lower in 2024 (b = -0.77, p < 0.001) and 2025 (b = -1.29, p < 0.001), corresponding to approximately 54% and 72% reductions, respectively. Norfentanyl concentrations also declined over time, while morphine concentrations remained stable. Participant characteristics and the prevalence of opioid detection at admission were largely stable across years.Conclusions Declining concentrations of fentanyl and norfentanyl, alongside stable morphine levels, suggest reduced fentanyl exposure among treatment-seeking individuals over the study period. While urinalysis provides an indirect indicator and cannot establish causality, these findings are consistent with broader reports of declining fentanyl-related overdose mortality and highlight the potential value of treatment-entry toxicology data as a sentinel indicator of changes in illicit opioid markets.
SN - 2327-8994
ER -