A comparison of trends in wastewater-based data and traditional epidemiological indicators of stimulant consumption in three locations.

To compare long-term trends in wastewater data with other indicators of stimulant use in three locations and to test the reliability of estimates based on 1 week of sampling. Comparison of trends in quantities ('loads') of stimulants or their metabolites in wastewater with trends in other indicators of stimulant use (e.g. treatment, police, population survey data). Populations in Oslo (Norway), South-East Queensland (Australia) and Eindhoven (the Netherlands). Wastewater data were modelled for MDMA (3,4-methyl​enedioxy​methamphetamine), benzoylecgonine (a metabolite of cocaine), amphetamine and methamphetamine in Oslo; benzoylecgonine in Eindhoven; and methamphetamine in South-East Queensland. Choice of stimulants modelled in each region was primarily determined by availability of useable data. In Oslo, wastewater data, driving under the influence of drugs statistics and seizure data all suggested increasing MDMA use between 2009 and 2017. In South-East Queensland, there was an estimated 31.1% [95% confidence interval (CI) = 29.4-32.9%] annual increase in daily loads of methamphetamine in wastewater between 2009 and 2016, compared with a 14.1% (95% CI = 10.9-17.3%) annual increase in seizures. Some of the increase in wastewater can be explained by increased purity. In Eindhoven, there was no evidence of a change in cocaine consumption from wastewater, but a reduction was observed in numbers in treatment for cocaine use from 2012 to 2017. In approximately half the cases examined in Oslo, credible intervals around estimates of annual average loads from a regression model versus estimates based on a single week of sampling did not overlap. Long-term trends in loads of stimulants in wastewater appear to be broadly consistent with trends in other indicators of stimulant use in three locations. Wastewater data should be interpreted alongside epidemiological indicators and purity data. One week of wastewater sampling may not be sufficient for valid inference about drug consumption.

Goulding N ，Hickman M ，Reid M ，Amundsen EJ ，Baz-Lomba JA ，O'Brien JW ，Tscharke BJ ，de Voogt P ，Emke E ，Kuijpers W ，Hall W ，Jones HE ... -  《-》

Spatio-temporal assessment of illicit drug use at large scale: evidence from 7 years of international wastewater monitoring.

Wastewater-based epidemiology is an additional indicator of drug use that is gaining reliability to complement the current established panel of indicators. The aims of this study were to: (i) assess spatial and temporal trends of population-normalized mass loads of benzoylecgonine, amphetamine, methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA) in raw wastewater over 7 years (2011-17); (ii) address overall drug use by estimating the average number of combined doses consumed per day in each city; and (iii) compare these with existing prevalence and seizure data. Analysis of daily raw wastewater composite samples collected over 1 week per year from 2011 to 2017. Catchment areas of 143 wastewater treatment plants in 120 cities in 37 countries. Parent substances (amphetamine, methamphetamine and MDMA) and the metabolites of cocaine (benzoylecgonine) and of Δ9 -tetrahydrocannabinol (11-nor-9-carboxy-Δ9 -tetrahydrocannabinol) were measured in wastewater using liquid chromatography-tandem mass spectrometry. Daily mass loads (mg/day) were normalized to catchment population (mg/1000 people/day) and converted to the number of combined doses consumed per day. Spatial differences were assessed world-wide, and temporal trends were discerned at European level by comparing 2011-13 drug loads versus 2014-17 loads. Benzoylecgonine was the stimulant metabolite detected at higher loads in southern and western Europe, and amphetamine, MDMA and methamphetamine in East and North-Central Europe. In other continents, methamphetamine showed the highest levels in the United States and Australia and benzoylecgonine in South America. During the reporting period, benzoylecgonine loads increased in general across Europe, amphetamine and methamphetamine levels fluctuated and MDMA underwent an intermittent upsurge. The analysis of wastewater to quantify drug loads provides near real-time drug use estimates that globally correspond to prevalence and seizure data.

González-Mariño I ，Baz-Lomba JA ，Alygizakis NA ，Andrés-Costa MJ ，Bade R ，Bannwarth A ，Barron LP ，Been F ，Benaglia L ，Berset JD ，Bijlsma L ，Bodík I ，Brenner A ，Brock AL ，Burgard DA ，Castrignanò E ，Celma A ，Christophoridis CE ，Covaci A ，Delémont O ，de Voogt P ，Devault DA ，Dias MJ ，Emke E ，Esseiva P ，Fatta-Kassinos D ，Fedorova G ，Fytianos K ，Gerber C ，Grabic R ，Gracia-Lor E ，Grüner S ，Gunnar T ，Hapeshi E ，Heath E ，Helm B ，Hernández F ，Kankaanpaa A ，Karolak S ，Kasprzyk-Hordern B ，Krizman-Matasic I ，Lai FY ，Lechowicz W ，Lopes A ，López de Alda M ，López-García E ，Löve ASC ，Mastroianni N ，McEneff GL ，Montes R ，Munro K ，Nefau T ，Oberacher H ，O'Brien JW ，Oertel R ，Olafsdottir K ，Picó Y ，Plósz BG ，Polesel F ，Postigo C ，Quintana JB ，Ramin P ，Reid MJ ，Rice J ，Rodil R ，Salgueiro-González N ，Schubert S ，Senta I ，Simões SM ，Sremacki MM ，Styszko K ，Terzic S ，Thomaidis NS ，Thomas KV ，Tscharke BJ ，Udrisard R ，van Nuijs ALN ，Yargeau V ，Zuccato E ，Castiglioni S ，Ort C ... -  《-》

Cocaine, MDMA and methamphetamine residues in wastewater: Consumption trends (2009-2015) in South East Queensland, Australia.

Wastewater analysis, or wastewater-based epidemiology, has become a common tool to monitor trends of illicit drug consumption around the world. In this study, we examined trends in cocaine, 3,4-methylenedioxymethamphetamine (MDMA) and methamphetamine consumption by measuring their residues in wastewater from two wastewater treatment plants in Australia (specifically, an urban and a rural catchment, both in South East Queensland) between 2009 and 2015. With direct injection of the samples, target analytes were identified and quantified using liquid chromatography-mass spectrometry. Cocaine and MDMA residues and metabolites were mainly quantifiable in the urban catchment while methamphetamine residues were consistently detected in both urban and rural catchments. There was no consistent trend in the population normalised mass loads observed for cocaine and MDMA at the urban site between 2009 and 2015. In contrast, there was a five-fold increase in methamphetamine consumption over this period in this catchment. For methamphetamine consumption, the rural area showed a very similar trend as the urban catchment starting at a lower baseline. The observed increase in per capita loads of methamphetamine via wastewater analysis over the past six years in South East Queensland provides objective evidence for increased methamphetamine consumption in the Australian population while the use of other illicit stimulants remained relatively stable.

Lai FY ，O'Brien JW ，Thai PK ，Hall W ，Chan G ，Bruno R ，Ort C ，Prichard J ，Carter S ，Anuj S ，Kirkbride KP ，Gartner C ，Humphries M ，Mueller JF ... -  《-》

Triangulating Amsterdam's illicit stimulant use trends by wastewater analysis and recreational drug use monitoring.

Drug consumption estimates are of relevance because of public health effects as well as associated criminal activities. Wastewater analysis of drug residues enables the estimation of drug consumption and drug markets. Short-term and long-term trends of cocaine, MDMA (ecstasy), amphetamine (speed) and methamphetamine (crystal meth), were studied for the city of Amsterdam. MDMA (+41%) and cocaine (+26%) showed significantly higher weekend vs. week consumption, while no differences were observed for the other drugs. The consumption of MDMA, cocaine, amphetamine and methamphetamine significantly increased between 2011 and 2019. Weekly trends emerging from wastewater analyses were supported by qualitative and quantitative data from a recreational drug use monitoring scheme. However, information collected in panel interviews within nightlife networks and surveys among visitors of pubs, clubs and festivals only partially reflected the long term increase in consumption as registered from wastewater analysis. Furthermore, methamphetamine use was not well presented in survey data, panel studies and test service samples, but could be monitored trough wastewater analysis. This illustrates that wastewater analysis can function as an early warning if use and user groups are small or difficult to reach trough other forms of research. All in all, this study illustrates that wastewater-based epidemiology is complementary to research among user groups, and vice versa. These different types of information enable to connect observed trends in total drug consumption to behaviour of users and the social context in which the use takes place as well as validate qualitative signals about (increased) consumption of psychoactive substances. Such a multi angular approach to map the illicit drug situation on local or regional scale can provide valuable information for public health.

Ter Laak TL ，Emke E ，Benschop A ，Nabben T ，Béen F ... -  《-》

The spatial epidemiology of cocaine, methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA) use: a demonstration using a population measure of community drug load derived from municipal wastewater.

Banta-Green CJ ，Field JA ，Chiaia AC ，Sudakin DL ，Power L ，de Montigny L ... -  《-》