title: Spatial differences and temporal changes in illicit drug use in Europe quantified by wastewater analysis.
abstract: OBJECTIVE
  To perform wastewater analyses to assess spatial differences and temporal changes of illicit drug use in a large European population.
  
  
  METHODS
  Analyses of raw wastewater over a 1-week period in 2012 and 2013.
  
  
  METHODS
  Catchment areas of wastewater treatment plants (WWTPs) across Europe, as follows: 2012: 25 WWTPs in 11 countries (23 cities, total population 11.50 million); 2013: 47 WWTPs in 21 countries (42 cities, total population 24.74 million).
  
  
  METHODS
  Excretion products of five illicit drugs (cocaine, amphetamine, ecstasy, methamphetamine, cannabis) were quantified in wastewater samples using methods based on liquid chromatography coupled to mass spectrometry.
  
  
  RESULTS
  Spatial differences were assessed and confirmed to vary greatly across European metropolitan areas. In general, results were in agreement with traditional surveillance data, where available. While temporal changes were substantial in individual cities and years (P ranging from insignificant to <10(-3) ), overall means were relatively stable. The overall mean of methamphetamine was an exception (apparent decline in 2012), as it was influenced mainly by four cities.
  
  
  CONCLUSIONS
  Wastewater analysis performed across Europe provides complementary evidence on illicit drug consumption and generally concurs with traditional surveillance data. Wastewater analysis can measure total illicit drug use more quickly and regularly than is the current norm for national surveys, and creates estimates where such data does not exist.
authors.affiliation: Swiss Federal Institute of Aquatic Science and Technology (Eawag), Dübendorf, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Ort
authors.forename: Alexander L N
authors.initials: AL
authors.lastname: van Nuijs
authors.forename: Jean-Daniel
authors.initials: JD
authors.lastname: Berset
authors.forename: Lubertus
authors.initials: L
authors.lastname: Bijlsma
authors.forename: Sara
authors.initials: S
authors.lastname: Castiglioni
authors.forename: Adrian
authors.initials: A
authors.lastname: Covaci
authors.forename: Pim
authors.initials: P
authors.lastname: de Voogt
authors.forename: Erik
authors.initials: E
authors.lastname: Emke
authors.forename: Despo
authors.initials: D
authors.lastname: Fatta-Kassinos
authors.forename: Paul
authors.initials: P
authors.lastname: Griffiths
authors.forename: Félix
authors.initials: F
authors.lastname: Hernández
authors.forename: Iria
authors.initials: I
authors.lastname: González-Mariño
authors.forename: Roman
authors.initials: R
authors.lastname: Grabic
authors.forename: Barbara
authors.initials: B
authors.lastname: Kasprzyk-Hordern
authors.forename: Nicola
authors.initials: N
authors.lastname: Mastroianni
authors.forename: Axel
authors.initials: A
authors.lastname: Meierjohann
authors.forename: Thomas
authors.initials: T
authors.lastname: Nefau
authors.forename: Marcus
authors.initials: M
authors.lastname: Ostman
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Pico
authors.forename: Ines
authors.initials: I
authors.lastname: Racamonde
authors.forename: Malcolm
authors.initials: M
authors.lastname: Reid
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Slobodnik
authors.forename: Senka
authors.initials: S
authors.lastname: Terzic
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Thomaidis
authors.forename: Kevin V
authors.initials: KV
authors.lastname: Thomas
mesh_terms: D000662:Amphetamines / Q000032:analysis / Q000378:metabolism; D002186:Cannabinoids / Q000032:analysis / Q000378:metabolism; D002853:Chromatography, Liquid; D003042:Cocaine / Q000032:analysis / Q000378:metabolism; D004784:Environmental Monitoring / Q000379:methods* / Q000706:statistics & numerical data; D005060:Europe / Q000453:epidemiology; D006801:Humans; D013287:Illicit Drugs / Q000032:analysis* / Q000378:metabolism; D013058:Mass Spectrometry; D008694:Methamphetamine / Q000032:analysis / Q000378:metabolism; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000032:analysis / Q000378:metabolism; D011159:Population Surveillance; D012722:Sewage / Q000032:analysis* / Q000737:chemistry; D015813:Substance Abuse Detection / Q000379:methods* / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000378:metabolism; D013997:Time Factors; D014865:Waste Disposal, Fluid / Q000379:methods / Q000706:statistics & numerical data; D014874:Water Pollutants, Chemical / Q000032:analysis / Q000737:chemistry
chemical_list: D000662:Amphetamines; D002186:Cannabinoids; D013287:Illicit Drugs; D012722:Sewage; D014874:Water Pollutants, Chemical; D008694:Methamphetamine; D003042:Cocaine; D018817:N-Methyl-3,4-methylenedioxyamphetamine
keywords: Amphetamine; cannabis; cocaine; drugs of abuse; ecstasy; methamphetamine; sewage