Shifting Substance Use Patterns: Insights from the National Rehabilitation Center, Abu Dhabi

Abstract

Background: Monitoring trends in substance use is critical for informing public health policy and clinical practice. This study analyzes the temporal patterns of drug positivity in urine samples at the National Rehabilitation Center in Abu Dhabi from 2021 to 2024. Methods: A retrospective analysis was conducted on de-identified urine toxicology data. Screening was performed primarily via immunoassay (DOA), with confirmation and quantitative analysis by Gas Chromatography-Mass Spectrometry (GC/MS) and Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS). The total number of tests processed increased significantly over the study period, from 17,257 in 2021 to 29,672 in 2024, with LC-MS/MS becoming the dominant confirmatory method (from 2,877 tests in 2021 to 13,607 in 2024). Results:  Amphetamine-type stimulants remained dominant: total positives rose from 1,771 to 2,991 (2024), driven largely by methamphetamine (1,535 cases in 2024). Concurrently, pregabalin detections more than doubled (650 to 1,575)[3]. Novel psychoactive substances (NPS) emerged sharply: synthetic cannabinoids (e.g. MDMB-4en-PINACA) were first detected in 2023 (223 cases) and reached 440 positives in 2024. In contrast, “classic” drugs declined – for example, morphine and codeine positives fell compared to earlier years. The patient cohort (n≈3,700) was 94.2% male, largely under 40 years, mostly single (60.1%), with secondary-level education common. Primary drugs of abuse were amphetamine-type stimulants (35.9%) and heroin (16.3%). These findings document a rapid transition in Abu Dhabi’s drug landscape: a shift away from traditional opioids and sedatives toward potent stimulants, prescription drugs, and synthetic compounds, underscoring the importance of LC-MS/MS in modern toxicology and the need for dynamic intervention strategies. Conclusion: The data reveals a rapid transition in the substance use landscape in Abu Dhabi, characterized by a decline in some classic drugs and a surge in prescription medications (e.g., Pregabalin, Carisoprodol) and potent synthetic compounds (e.g., Methamphetamine, synthetic cannabinoids). These findings underscore the need for dynamic, evidence-based prevention and treatment strategies that address the evolving nature of substance use disorders. The increased reliance on advanced LC-MS/MS technology highlights its essential role in detecting these emerging substances.