An investigation of fentanyl and methamphetamine use among first-time arrestees from 25 county jails across the U.S. in 2023
Joseph E. Schumacher, Abdullah Ahsan, Amber H. Simpler, Adam P. Natoli, Bradley J. Cain, Peter S. Chindavong, Aren Yarcan

TL;DR
This study finds that many first-time arrestees in U.S. jails use fentanyl and methamphetamine, highlighting the need for better treatment and support.
Contribution
The study provides new insights into the prevalence and patterns of fentanyl and methamphetamine use among first-time arrestees in U.S. jails.
Findings
74.8% of first-time arrestees tested positive for any drug, with 44.3% testing positive for fentanyl and/or methamphetamine.
Co-occurrence of fentanyl and methamphetamine was most common in western and large jails.
97.5% of arrestees tested positive for two or more drugs, with higher likelihood of fentanyl and methamphetamine co-occurrence among those testing positive for five or more drugs.
Abstract
Widespread use of fentanyl in combination with methamphetamine in carceral settings presents unique health risks and public health challenges. To contribute to continued efforts to understand drug use among first-time arrestees, this study characterizes the nature and extent of urine drug screenings (UDS) positive for fentanyl and/or methamphetamine among first-time arrestees receiving healthcare in 25 jails across the U.S. This study used the same data source, data extraction, sample selection, and UDS variables as those reported by Schumacher et al. (2025) and a similar data analytic strategy which included 81,842 arrestees with a UDS or 28.8% of total arrestees (283,884). Among first-time arrestees with complete results (43,553), 32,561 or 74.8% of arrestees tested positive for any drug and among those, 14,426 (44.3%) were positive for fentanyl and/or methamphetamine. Of those, 59.8%…
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Taxonomy
TopicsOpioid Use Disorder Treatment · Substance Abuse Treatment and Outcomes · Forensic Toxicology and Drug Analysis
