TABLE 2

Summary of Drugs Detected in At-Risk (Clinical Testing Indicated) Versus No-Risk-Identified Cohort

Drug or MetaboliteCutoff Concentration, ng/gCurrent Study (August 18, 2017–February 2, 2018)Previous Study (August 27, 2013–August 2, 2015)b
At-Risk Cohort (n = 257),an (%)No-Risk-Identified Cohort (n = 600), n (%)Overall Prevalence (n = 857), %Positive at National Reference Laboratory (All Clients), %Umbilical Cord Positives (n = 1035), %
Amphetamines
 Methamphetamine53 (1.2)*0 (0.0)0.13.51.0
 Amphetamine54 (1.6)*0 (0.0)0.54.21.4
 Amphetamine only51 (0.4)**0 (0.0)0.10.70.8
Barbiturates
 Butalbital252 (0.8)5 (0.8)0.81.50.7
Benzodiazepines
 Alprazolam and/or metabolite3 (1.2)*0 (0.0)0.41.10.2
  Alprazolam (parent)0.53 (1.2)*0 (0.0)0.41.1
  α-hydroxyalprazolam0.50 (0.0)0 (0.0)0.00.1
 Clonazepam and/or metabolite1 (0.4)0 (0.0)0.10.60.3
  Clonazepam (parent)11 (0.4)0 (0.0)0.10.6
  7-aminoclonazepam11 (0.4)0 (0.0)0.10.5
 Diazepam11 (0.4)0 (0.0)0.10.60.1
 Lorazepam50 (0.0)1 (0.2)0.10.10.3
 Midazolam10 (0.0)2 (0.3)0.20.70.0
 Zolpidem (benzodiazepinelike)0.515 (5.8)21 (3.5)4.22.16.5
Cocaine
 Cocaine and/or metabolites1 (0.4)0 (0.0)0.13.50.1
  Cocaine (parent)0.50 (0.0)0 (0.0)0.02.7
  Benzoylecgonine0.51 (0.4)0 (0.0)0.13.5
  m-hydroxybenzoylecgonine10 (0.0)0 (0.0)0.01.8
  Cocaethylene10 (0.0)0 (0.0)0.00.2
Opioids
 Codeine0.51 (0.4)0 (0.0)0.11.30.7
 Fentanyl0.51 (0.4)4 (0.7)0.52.06.4
 Hydrocodone0.54 (1.6)*1 (0.2)0.51.70.7
 Norhydrocodone0.54 (1.6)*1 (0.2)0.51.8N/Ab
 Hydromorphone0.50 (0.0)2 (0.3)0.20.81.1
 Methadone and/or metabolite)1 (0.4)0 (0.0)0.13.10.4
  Methadone (parent drug)21 (0.4)0 (0.0)0.13.1
  EDDP (metabolite)11 (0.4)0 (0.0)0.13.1
 Morphine0.510 (3.9)13 (2.2)2.73.83.7
 Oxycodone and/or metabolites14 (5.4)*12 (2.0)3.04.74.1
  Oxycodone (parent drug)0.59 (3.5)9 (2.0)1.52.1
  Oxymorphone0.50 (0.0)0 (0.0)0.00.4
  Noroxycodone19 (3.5)8 (1.3)2.02.2
  Noroxymorphone0.55 (1.9)5 (0.8)1.21.9
THC
 ELISA117 (6.6)***6 (1.0)2.718.39.0
 LC/MS/MS0.27 (7.4)c20 (4.2)c21.5N/A
Ethyl glucuronide53 (3.5)c,*3 (0.6)c4.6N/A
  • EDDP, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine; N/A, not available; —, not applicable.

  • a Statistically significant compared with no-risk-identified cohort by Fisher’s exact test. Compounds that were not detected in the Iowa cohorts but were detected at the national reference laboratory included buprenorphine (frequency 1.4%), buprenorphine glucuronide (frequency 1.8%), norbuprenorphine (frequency 5.3%), dihydrocodeine (frequency 0.4%), meperidine (frequency 0.4%), 6-acetylmorphine (heroin metabolite; frequency 0.5%), naloxone (frequency 0.1%), propoxyphene (frequency <0.1%), tapentadol (frequency <0.1%), tramadol (frequency 0.8%), N-desmethyltramadol (frequency 0.7%), O-desmethyltramadol (frequency 0.7%), 3-4 methylenedioxymethamphetamine or ecstasy (frequency 0.0%), phentermine (frequency <0.1%), midazolam α-hydroxy metabolite (frequency <0.1%), nordiazepam (frequency 0.8%), oxazepam (frequency <0.1%), phencyclidine (frequency <0.1%), phenobarbital (frequency <0.1%), and temazepam (frequency 0.2%).

  • b Testing unavailable in the previous published study time period.

  • c THC metabolite analysis by LC/MS/MS and ethyl glucuronide could not be performed on all specimens.

  • * P < .05; ** P < .01; *** P < .0001.