title: Wastewater-based assessment of regional and temporal consumption patterns of illicit drugs and therapeutic opioids in Croatia.
abstract: A comprehensive study of spatial and temporal consumption patterns of the selected illicit drugs (heroin, cocaine, amphetamine, MDMA, methamphetamine, cannabis) and therapeutic opioids (codeine, methadone) has been performed in six Croatian cities by applying wastewater-based epidemiology. The investigated cities (Bjelovar, Vinkovci, Varazdin, Karlovac, Zadar and Zagreb) varied widely in the population size (27,000-688,000 inhabitants) as well as in the number of registered drug consumers included in compulsory and voluntary medical treatment and rehabilitation programs (30-513 persons/100,000 inhabitants of age 15-64). The most consumed illicit drugs were cannabis (10-70doses/day/1000 inhabitants), heroin (<0.2-10doses/day/1000 inhabitants) and cocaine (0.2-8.7doses/day/1000 inhabitants), while the consumption of amphetamine-type drugs was much lower (<0.01-4.4doses/day/1000 inhabitants). Enhanced consumption of illegal drugs was generally associated with larger urban centers (Zagreb and Zadar) however comparatively high consumption rate of cocaine, MDMA and methadone was determined in some smaller cities as well. The overall average dose number of 3 major illegal stimulants (cocaine, MDMA, amphetamine) was rather similar to the number of corresponding heroin doses, which is in disagreement with a comparatively much higher proportion of heroin users in the total number of registered drug users in Croatia. Furthermore, the illicit drug consumption pattern in the large continental city (Zagreb) was characterized by a significant enhancement of the consumption of all stimulants during the weekend, which could not be confirmed neither for the coastal city of Zadar nor for the remaining small continental cities. On the other hand, the city of Zadar exhibited a significant increase of stimulant drug usage during summer vacation period, as a result of pronounced seasonal changes of the population composition and lifestyle in coastal tourist centers. The obtained results represent a valuable complementary data source for the optimisation and implementation of strategies to combat drug abuse in Croatia.
authors.affiliation: Division for Marine and Environmental Research, Rudjer Boskovic Institute, Bijenicka c. 54, 10000, Zagreb, Croatia.
authors.forename: Ivona
authors.initials: I
authors.lastname: Krizman
authors.affiliation: Division for Marine and Environmental Research, Rudjer Boskovic Institute, Bijenicka c. 54, 10000, Zagreb, Croatia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Senta
authors.affiliation: Division for Marine and Environmental Research, Rudjer Boskovic Institute, Bijenicka c. 54, 10000, Zagreb, Croatia.
authors.forename: Marijan
authors.initials: M
authors.lastname: Ahel
authors.affiliation: Division for Marine and Environmental Research, Rudjer Boskovic Institute, Bijenicka c. 54, 10000, Zagreb, Croatia. Electronic address: terzic@irb.hr.
authors.forename: Senka
authors.initials: S
authors.lastname: Terzic
mesh_terms: D000701:Analgesics, Opioid / Q000032:analysis*; D002947:Cities; D017523:Croatia; D004784:Environmental Monitoring; D006801:Humans; D013287:Illicit Drugs / Q000032:analysis*; D012621:Seasons; D015813:Substance Abuse Detection; D013997:Time Factors; D062065:Wastewater / Q000032:analysis*; D014874:Water Pollutants, Chemical / Q000032:analysis*
chemical_list: D000701:Analgesics, Opioid; D013287:Illicit Drugs; D062065:Wastewater; D014874:Water Pollutants, Chemical
keywords: Croatia; Illicit drug consumption; LC-MS/MS; Municipal wastewater; Opioids; Wastewater-based epidemiology