Sessions

Synthetic opioids, primarily illicitly manufactured fentanyl (IMF), remain the driving force behind the overdose epidemic in the U.S.—contributing to more than 68% of the nearly 108,000 drug overdose deaths reported in 2022. Although IMF continues to dominate the national conversation, a substantial and growing number of synthetic opioid overdose deaths now co-involve stimulants (i.e., methamphetamine and cocaine). Thus, the analysis of individual drugs fails to capture the complex patterns of substance use that are more common in real-world settings and the concurrent use of other illicit or non-prescribed substances increases overdose risk and negatively affects treatment outcomes. Urine drug testing (UDT) provides clinically actionable, objective information about drug use to support clinical decision making and aggregated UDT data have shown to significantly and strongly correlate with overdose mortality data reported by the CDC. UDT data complement data from public health and law enforcement agencies to provide more complete and timely information on current drug use trends to help inform clinical practice and community response efforts to reduce overdose deaths. This presentation will provide insight into current drug use trends (i.e., 2023 and 2024), with an emphasis on shifting trends in polysubstance use among people who use fentanyl, from a national database of millions of definitive UDT results derived from patient specimens collected in health care settings, including substance use disorder treatment. It will also describe peer-reviewed research on non-prescribed and illicit drug use among patients prescribed buprenorphine or methadone and how their drug use varies based on MOUD adherence.

Presentation Objectives

1. Participants will gain an understanding of the relationship between aggregated UDT data and overdose mortality data reported by the CDC
2. Participants will be able to describe the “fourth wave” of the overdose crisis and current drug and polysubstance use trends among people who use fentanyl at the national, regional, and state levels
3. Participants will be able to articulate key issues related to continued drug use among individuals receiving medications for opioid use disorder (MOUD)

Due to the trend of legalizing cannabis, it's important attendees increase their knowledge of cannabis and potential products produced from it. During this training, you will learn about the different types of cannabis plants and how they are identified, how cannabis extracts are made and used, and how cannabis is broken down in the body. This session helps attendees learn about the intricate world of legal cannabis. Current field sobriety research that is available in detecting a driver that is impaired on cannabis as well as ongoing studies and resources that are available, are included, as well.

Recently we have seen troubling trends in both highway safety, and impaired driving.  25% of fatal crash-involved drivers tested positive for multiple impairing substances, compared with 18% prior to the pandemic. The number of DWI arrests has plummeted while impaired driving fatalities increased by 14% in 2020, an additional 14% in 2021, and continue to trend in the wrong direction.  The impact of the COVID pandemic, the increase in states legalizing recreational marijuana and the prevalence of polysubstance use have forced practitioners to reevaluate our current approaches in addressing this serious issue. This interactive presentation will provide research that explains the changes we are seeing with the DWI population as well as approaches to address this growing crisis.  Participants will learn best practices in supervision strategies, available countermeasures, issues surrounding polysubstance use and testing to help criminal justice and treatment professionals maximize their effectiveness in reducing risk to the community.

Objectives

• Participants will identify 3 factors that have influenced the increase in impaired driving fatalities
• Participants will identify two research-based strategies that are effective in the supervision of impaired drivers
• Participants will identify drug/alcohol testing strategies to maximize client accountability
• Participants will identify the characteristics and profiles of impaired drivers and the criminogenic risk factors that increase their likelihood of recidivating

This fast paced presentation will discuss polydrug use based on toxicology data from impaired driving cases. Possible sources of these substances are based on results of seized drug analysis concentrating on illicitly made counterfeit pharmaceuticals. Ms. Chiasson uses humor and audience interaction to deliver this important message. 

Learning objectives:

Evaluate polydrug use trends based on toxicological data

Review several case studies with polydrugs detected

Identify possible sources of polydrug use based on counterfeit pharmaceutical drug trends