2021 AM Posters-Designer drugs or renal clearance, a case of positive fentanyl drug

Designer drugs or renal clearance, a case of positive fentanyl drug

Pdf Summary

This case report discusses the persistence of fentanyl in a 52-year-old female patient with opioid use disorder who received fentanyl during a medical procedure. The patient tested positive for fentanyl on urine toxicology and confirmatory tests for up to four weeks after the administration, despite not actively using the drug during that time. The prolonged presence of fentanyl in the urine suggests delayed renal clearance, possibly due to the drug's high lipophilicity.<br /><br />The upsurge in fentanyl contamination, overdose, and use has become a significant issue, with limited clinical data available on fentanyl metabolism and clearance in patients with substance use disorders. Increased fentanyl lacing of drugs like heroin and cocaine has contributed to a rise in overdose deaths.<br /><br />Frequent drug monitoring through urine toxicology is standard in medication-assisted treatment and rehabilitation programs. Therefore, understanding the metabolism and clearance of fentanyl is crucial for effective monitoring and patient care.<br /><br />The case report presented here includes details of the patient's medical history and drug testing results throughout her inpatient rehabilitation treatment. Despite not actively using fentanyl, the patient consistently tested positive for benzodiazepines and fentanyl on urine toxicology and confirmatory tests.<br /><br />It is essential to rule out organic causes such as liver and kidney damage and protracted release from adipose tissue before questioning the patient's reliability in cases like this.<br /><br />This case report, along with limited existing data, suggests that fentanyl can appear positive in urine toxicology and confirmatory tests for longer than expected, potentially impacting treatment decisions and the therapeutic alliance with patients.<br /><br />Understanding the prolonged clearance of fentanyl has significant clinical implications, including drug screening, therapeutic alliance, and treatment monitoring for substance use disorders. Further research on this topic is necessary to develop appropriate monitoring guidelines and improve patient care.

Keywords

fentanyl persistence

opioid use disorder

urine toxicology

confirmatory tests

renal clearance

lipophilicity

fentanyl contamination

overdose deaths

medication-assisted treatment

rehabilitation programs

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