title: Challenges and opportunities in using wastewater analysis to measure drug use in a small prison facility.
abstract: OBJECTIVE
  Wastewater analysis (WWA) is intended to be a direct and objective method of measuring substance use in large urban populations. It has also been used to measure prison substance use in two previous studies. The application of WWA in this context has raised questions as to how best it might be used to measure illicit drug use in prisons, and whether it can also be used to measure prescription misuse. We applied WWA to a small regional prison to measure the use of 12 licit and illicit substances. We attempted to measure the non-medical use of methadone and buprenorphine and to compare our findings with the results of the prison's mandatory drug testing (MDT).
  
  
  METHODS
  Representative daily composite samples were collected for two periods of 12 consecutive days in May to July 2013 and analysed for 18 drug metabolites. Prescription data and MDT results were obtained from the prison and compared with the substance use estimates calculated from WWA data.
  
  
  RESULTS
  Daily use of methamphetamine, methadone, buprenorphine and codeine was detected, while sporadic detection of ketamine and methylone was also observed. Overall buprenorphine misuse appeared to be greater than methadone misuse.
  
  
  CONCLUSIONS
  Compared with MDT, WWA provides a more comprehensive picture of prison substance use. WWA also has the potential to measure the misuse of medically prescribed substances. However, a great deal of care must be exercised in quantifying the usage of any substance in small populations, such as in prisons.
authors.affiliation: Law Faculty, The University of Tasmania, Hobart, Australia.
authors.forename: Emma
authors.initials: E
authors.lastname: van Dyken
authors.affiliation: National Research Centre for Environmental Toxicology, The University of Queensland, Brisbane, Australia.
authors.forename: Foon Yin
authors.initials: FY
authors.lastname: Lai
authors.affiliation: National Research Centre for Environmental Toxicology, The University of Queensland, Brisbane, Australia.
authors.forename: Phong K
authors.initials: PK
authors.lastname: Thai
authors.affiliation: Advanced Water Management Centre, The University of Queensland, Brisbane, Australia.|Swiss Federal Institute of Aquatic Science and Technology, Eawag, Zurich, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Ort
authors.affiliation: School of Psychology, The University of Tasmania, Hobart, Australia.
authors.forename: Raimondo
authors.identifier: http://orcid.org/0000-0001-6673-833X
authors.initials: R
authors.lastname: Bruno
authors.affiliation: Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, Australia.
authors.forename: Wayne
authors.initials: W
authors.lastname: Hall
authors.affiliation: School of Chemical and Physical Sciences, Flinders University, Adelaide, Australia.
authors.forename: K Paul
authors.initials: KP
authors.lastname: Kirkbride
authors.affiliation: National Research Centre for Environmental Toxicology, The University of Queensland, Brisbane, Australia.
authors.forename: Jochen F
authors.initials: JF
authors.lastname: Mueller
authors.affiliation: Law Faculty, The University of Tasmania, Hobart, Australia.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Prichard
mesh_terms: D002047:Buprenorphine / Q000008:administration & dosage / Q000032:analysis; D006801:Humans; D013287:Illicit Drugs / Q000032:analysis; D008297:Male; D008691:Methadone / Q000008:administration & dosage / Q000032:analysis; D063487:Prescription Drug Misuse; D011329:Prisoners; D011330:Prisons; D015813:Substance Abuse Detection / Q000379:methods*; D019966:Substance-Related Disorders / Q000175:diagnosis*; D062065:Wastewater / Q000032:analysis*
chemical_list: D002047:Buprenorphine; D013287:Illicit Drugs; D008691:Methadone; D062065:Wastewater
keywords: Australia; prescription misuse; prison; sewage epidemiology; urinalysis