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Sewage epidemiology is a cost-effective, comprehensive, and non-invasive technique capable of determining semi-real-time community usage of drugs utilizing the concentration of drug residues in wastewater, wastewater inflow, and the population size served by a wastewater treatment plant. In this study, semi-real-time consumption rates of ten illicit drugs were determined using sewage epidemiology during special events including Independence Day, the solar eclipse, and the first week of an academic semester in the Midwestern United States.
This study is the first to compare community use of drugs during special events in the USA using sewage epidemiology. Drug abuse is a global burden for public health as well as for social and economic welfare. In the USA, drug abuse has been a major public concern over a half a century, and the recent opioid epidemic has been declared as a national public health emergency Johnson and Wagner, In , approximately 7.
In that year, the total drug-related deaths increased by Midwestern and Southeastern United States, as transshipment and distribution hubs for drug trafficking organizations, are facing an epidemic level of diversion and abuse of drugs including cocaine, opioids, methamphetamine, marijuana, and heroin KODCP, ; USDJ, Self-reported surveys suffer from high cost, time delays for the prompt need of intervention, low coverage, and biases including nonresponse bias and bias in the selection of sample populations with higher use of drugs Keshaviah et al.
Sewage epidemiology can provide a more comprehensive, real-time, and cost-effective measure of drug abuse in a community as a complement to other conventional methods Subedi, ; Subedi and Kannan, The usefulness and limitations of the sewage epidemiology approaches have been reviewed in detail elsewhere van Nuijs et al. Contrary to conventional methods of drug use estimation, sewage epidemiology operates on a rapid timescale, such that day to day variations in drug use can be measured.
