EU - EMCDDA: Wastewater analysis, a promising prospect for drug monitoring

[Alfa]

IN aqua veritas? assessing illicit drugs in wastewater

Wastewater analysis, a promising prospect for drug monitoring, says EMCDDA

(3.12.2008, LISBON) A novel approach to monitoring illicit drug use in the community is showcased by the EU drugs agency (EMCDDA) today in the latest edition of its Insights series. Entitled Assessing illicit drugs in wastewater: potential and limitations of a new monitoring approach, the report looks at how analysing communal wastewater (e.g. from treatment plants) for residues of illicit drugs can provide real-time insights into local drug consumption levels and changing trends.

The report explains how technological advances and more sensitive detection techniques (mass spectrometry; high-performance liquid chromatography) have enabled scientists to identify drug residues in liquids, even at very low concentrations. The method involves analysing wastewater in order to measure levels of illicit drug by-products excreted in urine. These levels are then used to calculate the consumption levels of specific substances in a particular community.

‘While work in this area is still in its infancy and considerable uncertainties remain, the approach appears increasingly promising’, says EMCDDA Director Wolfgang Götz. ‘It is becoming clear that new developments in our ability to detect drugs and their metabolites in wastewater are likely to have important implications for the approaches we adopt to monitoring drug consumption trends over time’.

The methodology was originally used by scientists in the 1990s to monitor the environmental impact of liquid household waste. Its potential in the area of illicit drug monitoring was quickly understood, with work focusing on cocaine launched in 2005. Since then, the procedure has been extended to other drugs including opioids, amphetamine-type stimulants and cannabis. Although it is possible to sample both wastewater (e.g. untreated fluid waste in treatment plants) and surface water (e.g. rivers, lakes), the report focuses on the former.

Scientific research in this newly emerging field is developing quickly and in a multidisciplinary fashion, involving analytical chemistry, physiology and biochemistry, spatial epidemiology and statistics, sewage engineering and conventional drug epidemiology.
Today’s report explores how the approach can be applied to estimating drug use in the community, looking at: how drugs are broken down in the body; how drugs are transported in urban drainage systems; and how maps and geographical information systems (GIS) can be used to understand the complex inter-relationships between humans, disease and the environment. Experts also look at the ethical and legal aspects of wastewater sampling and how data from wastewater studies can complement drug use estimates gained from more conventional approaches.

‘Illicit drug use is, by its nature, a covert and hidden activity, and traditional survey methods (such as population or household surveys) can be inefficient and sometimes ineffective ways of estimating levels of at least some types of illicit drug use’, states the report. ‘The possibility that a new technique for estimating illicit drug use might be added to the existing repertoire of research methods is, therefore, an exciting prospect’.

Notes: Assessing illicit drugs in wastewater: potential and limitations of a new monitoring approach, EMCDDA Insights No 9, December 2008 — http://www.emcdda.europa.eu/publications/insights

Reputation Comments on this post:

Thank ye for posting. I had heard about this, but I had not read up on it until now. Amusing to say the least.

[Alfa]

SUMMARY — INSIGHTS No 9

Assessing illicit drugs in wastewater: potential and limitations of a new monitoring approach



Introduction
This report presents a number of contributions that relate to analysing communal wastewaters for drugs and their metabolic products in order to estimate their consumption in the community. This area of work is developing in a multidisciplinary fashion, involving scientists working in different research areas. For this reason, the contributions to this publication come from a variety of different perspectives including: analytical chemistry, physiology and biochemistry, sewage engineering, spatial epidemiology and statistics, and conventional drug epidemiology.

Estimating community drug use
Ettore Zuccato and colleagues provide an overview of the procedures used to estimate drug consumption rates in communities by analysis of wastewater. The method is based on the measurement of the breakdown products of illicit substances collectively excreted with the urine by consumers and conveyed by the sewage system to wastewater treatment plants. When pharmacokinetic and metabolic factors and the fate of excretion products are taken into account, the amounts of a drug and its metabolites entering the system can be used as indicators of consumption.

This approach investigates mass flows of the urinary breakdown products of drugs to estimate epidemiological data, i.e. drug consumption rates in the population. While the method may be able to provide objective data of drug consumption in real time, from an epidemiological point of view, there are several sources of uncertainty that may compromise the accuracy of estimates of quantities consumed among drug-using subpopulations.

Drug metabolism
The metabolic pathways of cocaine and methadone and the breakdown of these substances in the human body, before reaching the wastewater system, are reviewed by Teresa Summavielle. The chapter considers some of the factors that may occur at the individual level prior to the excretion of drug residues into the wastewater system. For example, different routes of drug administration produce different blood levels of the drug and different peak times. Attention is also drawn to uncertainties surrounding individual variations in the response to a set dose of drugs. Sources of uncertainty may include age, sex, body mass, kidney and liver function, interactions with other drugs, previous drug use history and genetic variability.

Illicit substances in sewer systems
Jörg Rieckermann discusses current knowledge on the transport and fate of illicit drugs in urban drainage systems. Typically, a drainage system includes house connections, manholes, main sewers and retention tanks, and the system itself is normally complemented with a wastewater treatment plant. Sewer systems are themselves complex: mostly they have evolved over time, and few of them have been planned from scratch. The chapter considers the discharge patterns of drugs to sewers, and a description is provided of in-sewer processes. The relevance of these processes to making accurate back-calculations of usage figures is discussed. Finally, the chapter looks at issues regarding the monitoring of drug loads over time. As in other chapters, these issues are considered mostly in relation to cocaine, since this is the substance for which most information is available.

Georeferenced wastewater sampling and applied spatial statistics
The use of maps by health scientists as a valuable tool to understand the complex interrelationships that exist between humans, diseases and the environment is considered by Fátima Pina. Maps can be used to complement other information and tools of spatial statistical analysis, epidemiology and public health in order to increase our understanding of the occurrence and localisation of health events. Geographical information systems provide options for spatial analysis by allowing the overlay of different maps to determine topological relationships of connectivity, proximity and adjacency. This has particular relevance to sewage epidemiology.

Integrating wastewater analysis with conventional approaches to measuring drug use
Lucas Wiessing and colleagues consider how data from wastewater studies might be integrated with estimates of illicit drug use from conventional approaches. The chapter briefly reviews current methods for monitoring and estimating illicit drug use and discusses issues that arise with regard to future work linking wastewater measurements with prevalence estimates.

Legal and ethical issues
The legal and ethical issues raised by this new approach are reviewed as part of a final chapter by Roberto Fanelli and Norbert Frost.

• Where the aim of wastewater analysis is to establish an area-level profile of drug use, conflict with data protection issues is unlikely.
• At present, other than the normal operating procedures regarding restricted access, there is little or no legal safeguard against private or state agencies obtaining access to household waste.
• Taking samples directly at the level of house connections goes beyond the scope of system monitoring and, from an ethical perspective, cannot be recommended.
• A clear distinction should be made about the purposes and extent of investigations involving wastewater sampling: in particular, clarity is needed about whether the findings are to be used in the interests of public health or as a part of law enforcement or political control measures.
• While a monitoring programme of main wastewater streams or wastewater treatment plant influents seeks to establish community-wide average values, the specific sampling of public institutions or private households will not provide public health relevant information and, therefore, cannot be recommended from this point of view.
• From an ethical and legal perspective, many of the apparent difficulties arise if this new approach is applied for purposes other than scientific inquiry. Standard research procedures are generally required to provide guarantees of anonymity. The same ethical understanding should apply to sampling in wastewater systems. However, a crucial difference is that wastewater sampling can take place without informed consent and users may not be given the option of not 'participating'.
• Greater clarity is needed regarding current and required legislation concerning sampling procedures. It is recommended that all involved stakeholders should contribute to a full and open discussion of the ethical and legal issues that are involved in the application of wastewater analysis.

Overall conclusion
Although the prospect of estimating drug loads from wastewater measurements presents an attractive proposition, this approach is accompanied by a number of uncertainties. There are various factors that may have important, but currently, poorly understood effects upon the findings and their interpretation. These issues are themselves interesting and further research will undoubtedly be required to enable a better understanding of the utility of this approach and of the best interpretation of the results.

[Alfa]

Access the file here: Assessing illicit drugs in wastewater. EMCDDA

[gmeziscool2354]

The quote that one guest lecturer at my college was "there are things in any body of water that would make your blood boil if i told you about them, but they are in such minute qualities that even the most complex devices in this college may not be able to detect"

believe it or not there are bodies of water so full of estradiols and other hormone mimicking compounds that females drinking from this water are not able to conceive.

believe this is the case in many nations where pharmaceuticals can be produced with less regulations but may be a problem in isolated parts of any nation.

Reputation Comments on this post:

funny, good points