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

Abstract

Aims 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. Design 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). Setting and Participants Populations in Oslo (Norway), South‐East Queensland (Australia) and Eindhoven (the Netherlands). Measurements 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. Findings 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. Conclusions 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.

Highly predictive regression model of active cases of COVID-19 in a population by screening wastewater viral load

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Developing Unique Nontarget High-Resolution Mass Spectrometry Signatures to Track Contaminant Sources in Urban Waters

“…Tetraethylene glycol is used in a wide variety of applications (e.g., personal care products, vehicle antifreeze, dispersants) and has been widely detected in the environment . However, co-occurrence of methamphetamine, a compound previously suggested as a wastewater indicator compound, in all targeted urban waters indicated that simple assessments of presence or absence of typical representative chemical indicator(s) ,, may lack sufficient resolution for tracking wastewater contributions. This observation reflected previous reports that contaminants traditionally considered “wastewater derived”, such as prescription/recreational drugs, have been frequently detected in urban receiving waters that are disconnected from known sewage sources, with elevated levels especially evident during storm events. , …”

Key Interpretation Challenges for Wastewater-Based Epidemiology of Illicit Drugs: A Norwegian Three-City Case Study

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“…In this context, additional data sources will be needed for further interpretation of the findings. Observed trends may additionally be influenced by timevarying and unobserved factors, such as changes in drug purity over the observation period [2,18,[30][31][32][33]. In this respect, an observed increase in daily loads may have a negligible association with street volume/weight units, but rather the increased purity of the product on the market.…”