Long-term monitoring of drug consumption patterns in a large-sized European city using wastewater-based epidemiology: Comparison of two sampling schemes for the assessment of multiannual trends

Abstract

A comprehensive study aimed at monitoring of temporal variability of illicit drugs (heroin, cocaine, amphetamine, MDMA, methamphetamine and cannabis) and therapeutic opiate methadone in a large-sized European city using wastewater-based epidemiology (WBE) was conducted in the city of Zagreb, Croatia, during an 8-year period (2009-2016). The study addressed the impact of different sampling schemes on the assessment of temporal drug consumption patterns, in particular multiannual consumption trends and documented the possible errors associated with the one-week sampling scheme. The highest drug consumption prevalence was determined for cannabis (from 59 ± 18 to 156 ± 37 doses/day/1000 inhabitants 15-64 years), followed by heroin (from 11 ± 10 to 71 ± 19 doses/day/1000 inhabitants 15-64 years), cocaine (from 8.3 ± 0.9 to 23 ± 4.0 doses/day/1000 inhabitants 15-64 years) and amphetamine (from 1.3 ± 0.9 to 21 ± 6.1 doses/day/1000 inhabitants 15-64 years) whereas the consumption of MDMA was comparatively lower (from 0.18 ± 0.08 to 2.7 doses ±0.7 doses/day/1000 inhabitants 15-64 years). The drug consumption patterns were characterized by clearly enhanced weekend and Christmas season consumption of stimulating drugs (cocaine, MDMA and amphetamine) and somewhat lower summer consumption of almost all drugs. Pronounced multiannual consumption trends were determined for most of the illicit drugs. The investigated 8-year period was characterized by a marked increase of the consumption of pure cocaine (1.6-fold), THC (2.7-fold), amphetamine (16-fold) and MDMA (15-fold) and a concomitant decrease (2.3-fold) of the consumption of pure heroin. The heroin consumption decrease was associated with an increase of methadone consumption (1.4-fold), which can be linked to its use in the heroin substitution therapy. The estimated number of average methadone doses consumed in the city of Zagreb was in a good agreement with the prescription data on treated opioid addicts in Croatia.

Long-term monitoring of drug consumption patterns during the COVID-19 pandemic in a small-sized community in Brazil through wastewater-based epidemiology

“…In this study, a sampling campaing of almost a whole year was applied. Long-term WBE studies can provide a valuable outline of the drug consumption profile of a locality and are less affected by point variabilities ( Krizman-Matasic et al, 2019 ).…”

Wastewater-Based Epidemiology as an Early Warning System for the Spreading of SARS-CoV-2 and Its Mutations in the Population

“…However, it should be noted that monitoring of the status and trends of the spread of COVID-19 will require some adjustments or changes compared to existing well-established practices and methods used to monitor, for example, drug use [ 64 ]. On the positive side, there is already an established network of scientific institutions and workplaces in several European countries for monitoring illicit drugs (transnational studies describing in particular the issue of drug use and consumption are regularly published) [ 66 , 67 , 68 ], which could also be used to create an early warning system for an upcoming pandemic.…”

Detection of Eight Cannabinoids and One Tracer in Wastewater and River Water by SPE-UPLC–ESI-MS/MS

“…The presence of an HM in detectable concentrations at the inlet of sewage catchment areas such as a wastewater treatment plant (WWTP) and a sewage treatment plant is an indicator of significant drug use. These sewage epidemiology approaches are more often used to observe consumption trends and loads by directly measuring a specific drug of abuse or a related HM, thus estimating the consumption via back-calculations [51,52]. When a particular drug HM is found in effluent water (EWW), river water (RW), and surface water (SW), it represents a clear symptom of wide use across the general population or in a specific context [53,54].…”