Abstract
BackgroundMonitoring the scale of pharmaceuticals, illicit and licit drugs consumption is important to assess the needs of law enforcement and public health, and provides more information about the different trends within different countries. Community drug use patterns are usually described by national surveys, sales and seizure data. Wastewater-based epidemiology (WBE) has been shown to be a reliable approach complementing such surveys.MethodThis study aims to compare and correlate the consumption estimates of pharmaceuticals, illicit drugs, alcohol, nicotine and caffeine from wastewater analysis and other sources of information. Wastewater samples were collected in 2015 from 8 different European cities over a one week period, representing a population of approximately 5 million people. Published pharmaceutical sale, illicit drug seizure and alcohol, tobacco and caffeine use data were used for the comparison.ResultsHigh agreement was found between wastewater and other data sources for pharmaceuticals and cocaine, whereas amphetamines, alcohol and caffeine showed a moderate correlation. methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA) and nicotine did not correlate with other sources of data. Most of the poor correlations were explained as part of the uncertainties related with the use estimates and were improved with other complementary sources of data.ConclusionsThis work confirms the promising future of WBE as a complementary approach to obtain a more accurate picture of substance use situation within different communities. Our findings suggest further improvements to reduce the uncertainties associated with both sources of information in order to make the data more comparable.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3686-5) contains supplementary material, which is available to authorized users.
Highlights
Monitoring the scale of pharmaceuticals, illicit and licit drugs consumption is important to assess the needs of law enforcement and public health, and provides more information about the different trends within different countries
High agreement was found between wastewater and other data sources for pharmaceuticals and cocaine, whereas amphetamines, alcohol and caffeine showed a moderate correlation. methamphetamine and 3,4methylenedioxymethamphetamine (MDMA) and nicotine did not correlate with other sources of data
The day-to-day variability for each of the compounds over 7 days was relatively low with some exceptions (mean relative standard deviation (RSD) = 24 %, excluding methadone, morphine and methylphenidate)
Summary
Monitoring the scale of pharmaceuticals, illicit and licit drugs consumption is important to assess the needs of law enforcement and public health, and provides more information about the different trends within different countries. Community drug use patterns are usually described by national surveys, sales and seizure data. Wastewater-based epidemiology (WBE) has been shown to be a reliable approach complementing such surveys. The chemical analysis of the exogenous biomarkers of drug consumption in wastewater has been shown to be an interesting approach for studying drug use within a defined population [1]. The approach, termed wastewaterbased epidemiology (WBE), was first applied in 2008 to study illicit drug use in three Italian cities [2] and it has since been extended to a wider range of exogenous biomarkers specific to the use of alcohol [3,4,5], tobacco [6], caffeine [7] and selected pharmaceuticals [8, 9]. An alternative could be to quantitatively measure pharmaceuticals in wastewater as an indicator of use [14,15,16]
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