1
|
McGrane IR, Ramsbacher NC, Rook WC, Omar FA. Effects of 3,4-methylenedioxymethamphetamine and methamphetamine on motor vehicle driving performance: A systematic review of experimental and observational studies. J Forensic Sci 2023; 68:22-34. [PMID: 36411495 DOI: 10.1111/1556-4029.15179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/29/2022] [Accepted: 11/15/2022] [Indexed: 11/23/2022]
Abstract
Methamphetamine (METH) and 3,4-methylenedioxymethamphetamine (MDMA) are common drugs of abuse and driving under their influence may occur in 1 million people yearly in the United States. This systematic review fills the currently unmet need in understanding the effects of METH and MDMA on motor vehicle driving performance (MVP) and provides insight into the forensic community. A PubMed search on September 24, 2020, for experimental and observational studies, which evaluated the impact of METH and MDMA on MVP was performed. After a review of 208 abstracts, 103 were considered potentially interesting and full texts were obtained. After the exclusion of non-English articles, review articles, single case reports, and articles which did not evaluate METH or MDMA on MVP, a total of nine experimental studies, 10 traditional observational studies, and 35 case series were included. The clinical rigor of experimental studies was evaluated using the Jadad scale. Experimental studies often demonstrated no significant MVP safety signals for METH or MDMA use, which was contrary to the overwhelming MVP safety risks found in observational studies. Common driving behaviors while using METH or MDMA include: errors in judgment, traveling at high speeds, failure to stop, merging inappropriately, lane weaving, and crashes. Limitations of experimental studies that led to dissimilar MVP outcomes from observational studies include: the common use of driving simulators, as opposed to actual driving examinations, and doses of METH or MDMA administered may not be representative of blood concentrations seen in observational studies. This systematic review has no funding source and was not registered.
Collapse
Affiliation(s)
- Ian R McGrane
- Skaggs School of Pharmacy, College of Health, University of Montana, Missoula, Montana, USA.,Department of Pharmacy, Providence St. Patrick Hospital, Missoula, Montana, USA
| | - Nathan C Ramsbacher
- Department of Pharmacy, Providence St. Patrick Hospital, Missoula, Montana, USA
| | - William C Rook
- Department of Pharmacy, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Faddy A Omar
- Department of Pharmacy, Holy Rosary Healthcare, Miles City, Montana, USA
| |
Collapse
|
2
|
Cumming C, Armstrong G, Borschmann R, Foulds JA, Newton-Howes G, McKetin R, Vallesi S, Preen D, Young J. Amphetamine-type stimulant use and self-harm: protocol for a systematic review of observational studies. BMJ Open 2022; 12:e057029. [PMID: 35074824 PMCID: PMC8788311 DOI: 10.1136/bmjopen-2021-057029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Amphetamine type stimulant (ATS) use and self-harm are both major public health concerns globally. Use of ATS is associated with a range of health and social problems, and has been increasing internationally in the last decade. Self-harm and ATS use share a number of underlying risk factors and occur at elevated rates in marginalised groups with high rates of exposure to trauma. The relationship between self-harm and ATS use is likely complex, and the causal pathway may run in either direction. A comprehensive review, synthesis and analysis of the evidence are warranted to investigate this relationship and inform policy and practice. METHODS AND ANALYSIS We will search the Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycINFO and Scopus databases for relevant observational studies published in peer-reviewed journals. The initial search was conducted on 5 February 2021, with a final search expected on 1 February 2022. All studies will be independently screened by two reviewers, first on title and abstract, and then on full-text to determine inclusion in the review. We place no restriction on the population that studies investigate, our exposure of interest is both prescription and illicit ATS use, comparators will be those not currently using ATS, and our primary outcome of interest is the prevalence of self-harm. Data will be extracted using a predesigned template, and pooled prevalence and pooled measures of effect for the association between ATS use and self-harm. If sufficient data are available, we will perform multiple meta-analyses to produce pooled measures of effect for each measure of ATS exposure, as well as different population sub-groups. The Methodological Standard for Epidemiological Research scale will be used to assess study quality, and Egger's test and I2 values will be used to assess publication bias and heterogeneity, respectively. ETHICS AND DISSEMINATION No ethical approval is required for this review. We will only synthesise information from published studies that were conducted with ethical approval, so no individual participant data will be used. We will disseminate our findings via publication in a peer-reviewed journal, national and international conference presentations, and presentations to stakeholders in the community. TRIAL REGISTRATION NUMBER This study has been registered with the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021226562).
Collapse
Affiliation(s)
- Craig Cumming
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Gregory Armstrong
- The University of Melbourne, Melbourne, Victoria, Australia
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, Carlton, Victoria, Australia
| | - Rohan Borschmann
- The University of Melbourne, Melbourne, Victoria, Australia
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, Carlton, Victoria, Australia
| | - James A Foulds
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, Canterbury, New Zealand
| | - Giles Newton-Howes
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Rebecca McKetin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Shannen Vallesi
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - David Preen
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Jesse Young
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, Carlton, Victoria, Australia
| |
Collapse
|
3
|
Methamphetamine-related postmortem cases in Jeddah, Saudi Arabia. Forensic Sci Int 2021; 321:110746. [PMID: 33676238 DOI: 10.1016/j.forsciint.2021.110746] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 01/13/2023]
Abstract
A more than 500% increase in the number of deaths involving methamphetamine occurred between 2016 and 2018 in Jeddah, Saudi Arabia. As such, this report employed a validated liquid chromatography tandem mass spectrometry method to quantify methamphetamine and its metabolites in bodily fluids from 47 postmortem cases in which methamphetamine was involved. The mean age of the deceased was 33 years old (median: 30, range: 16-63), and 94% were male. Methamphetamine was co-ingested with another drug in 32 of the cases (68%); however, the deaths were only due to the combined toxicity of methamphetamine and another drug in 15 of the cases (32%). Of note, 13 of these deaths (28% of all deaths) involved heroin. When methamphetamine was the sole cause of death (32% of the studied cases), the median concentrations of methamphetamine and amphetamine were 527 and 128 ng/mL. When methamphetamine was combined toxicity with another drug, the median concentrations of methamphetamine and amphetamine decreased to 161 and 53 ng/mL. When deaths were unrelated to methamphetamine, the median concentrations of methamphetamine and amphetamine were 130 and 44 ng/mL, respectively. The highest median methamphetamine concentration was found in urine (5281 ng/mL), followed by stomach contents (878 ng/mL), bile (762 ng/mL), vitreous humor (3 ng/mL), and blood (208 ng/mL). Almost 40% of the studied cases involved violence, 61% were accidental, 21% were suicides, 17% were homicides, and 2% were natural deaths. Methamphetamine is highly addictive. Increases in deaths have been seen in various countries. More awareness, education and treatment programs are required to reduce the likelihood of addiction, crimes, suicide, and other fatalities resulting from methamphetamine abuse.
Collapse
|
4
|
Congdon P. Geographical Aspects of Recent Trends in Drug-Related Deaths, with a Focus on Intra-National Contextual Variation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8081. [PMID: 33147847 PMCID: PMC7663441 DOI: 10.3390/ijerph17218081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 10/21/2020] [Accepted: 10/30/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Recent worldwide estimates are of 53 million users of opioids annually, and of 585,000 drug-related deaths, of which two thirds are due to opioids. There are considerable international differences in levels of drug death rates and substance abuse. However, there are also considerable variations within countries in drug misuse, overdose rates, and in drug death rates particularly. Wide intra-national variations characterize countries where drug deaths have risen fastest in recent years, such as the US and UK. Drug deaths are an outcome of drug misuse, which can ideally be studied at a relatively low spatial scale (e.g., US counties). The research literature suggests that small area variations in drug deaths to a considerable degree reflect contextual (place-related) factors as well as individual risk factors. METHODS We consider the role of area social status, social cohesion, segregation, urbanicity, and drug supply in an ecological regression analysis of county differences in drug deaths in the US during 2015-2017. RESULTS The analysis of US small area data highlights a range of factors which are statistically significant in explaining differences in drug deaths, but with no risk factor having a predominant role. Comparisons with other countries where small area drug mortality data have been analyzed show differences between countries in the impact of different contextual factors, but some common themes. CONCLUSIONS Intra-national differences in drug-related deaths are considerable, but there are significant research gaps in the evidence base for small area analysis of such deaths.
Collapse
Affiliation(s)
- Peter Congdon
- School of Geography, Queen Mary University of London, Mile End Rd, Bethnal Green, London E1 4NS, UK
| |
Collapse
|
5
|
Vergiftungen durch Suchtstoffe, Laboruntersuchungen und rechtsmedizinische Todesfallaufklärung bei Vergiftungen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 62:1362-1369. [DOI: 10.1007/s00103-019-03027-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
6
|
Schmidt U, Flössel U, Pietsch J, Dinger J, Engel A, Forberger A, Nitzsche K. Intrauterine und perinatale Todesfälle bei maternalem Methamphetaminkonsum. Rechtsmedizin (Berl) 2018. [DOI: 10.1007/s00194-018-0269-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
7
|
|
8
|
Three fatalities associated with the synthetic cannabinoids 5F-ADB, 5F-PB-22, and AB-CHMINACA. Forensic Sci Int 2017; 281:e9-e15. [PMID: 29133010 DOI: 10.1016/j.forsciint.2017.10.042] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 10/28/2017] [Accepted: 10/30/2017] [Indexed: 11/24/2022]
Abstract
The use of synthetic cannabinoids (SC) has been widespread in certain groups of drug users for many years. In the scientific literature many intoxication cases and a number of fatalities after the use of synthetic cannabinoids were reported. In this paper three death cases are described with involvement of the synthetic cannabinoids 5F-PB-22, AB-CHMINACA, and 5F-ADB. The three cases occurred in the eastern region of Germany, which is known as a region of high methamphetamine abuse. All decedents were male, between 25 and 41 years old, and had a known history of drug use. Femoral blood concentrations of the synthetic cannabinoids were measured using a validated LC-MS/MS method. The concentration of 5F-PB-22 in the first case was 0.37ng/mL, the concentration of AB-CHMINACA in the second case was approximately 4.1ng/mL (extrapolated) and the 5F-ADB concentration in the third case was 0.38ng/mL. Compared to other published cases the concentrations in the here presented cases seem to be in the lower range. However, taking into account the scene of death, the results of the forensic autopsy and the full toxicological analysis, the deaths can be explained as a direct consequence of consumption of synthetic cannabinoids, although in case one and two relevant amounts of ethanol were found, and in case three trimipramine and olanzapine were present in non-toxic concentrations. It has to be noted that concentrations of synthetic cannabinoids in femoral blood cannot directly be judged as toxic or lethal due to the possibility of postmortem redistribution and the development of tolerance after frequent use. Therefore, all available information has to be considered carefully before stating SC use as the cause of death.
Collapse
|
9
|
Gamma A, Schleifer R, Weinmann W, Buadze A, Liebrenz M. Could Google Trends Be Used to Predict Methamphetamine-Related Crime? An Analysis of Search Volume Data in Switzerland, Germany, and Austria. PLoS One 2016; 11:e0166566. [PMID: 27902717 PMCID: PMC5130206 DOI: 10.1371/journal.pone.0166566] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 10/31/2016] [Indexed: 11/28/2022] Open
Abstract
Objective To compare the time trends of Google search interest in methamphetamine and criminal offences related to this drug. Methods Google Trends data for the search term "meth" was compared to methamphetamine-related crime statistics (incl. use, possession, and dealing) in Switzerland, Germany, and Austria for the years 2004–2016. Google data was availably monthly. Crime data was available yearly, and monthly values were imputed. Results On the country level, internet search trends for "meth" roughly paralleled relevant criminal activity. State-level data, which was available for Austria, showed more heterogeneity. Cross-correlations for yearly data almost always peaked at a lag time of 0 and coefficients were mostly between 0.7 and 1.0 on the country level, and between 0.5 to 1.0 on the state level. Monthly cross-correlations based on imputed values were substantially lower, ranging from 0 to 0.6. Conclusions These results encourage the further evaluation by law enforcement authorities of Google search activity as a possible predictor of methamphetamine-related crime. However, several limitations, in particular the crude temporal resolution of available crime data, precluded a detailed assessment of the relationship between internet search trends and the development of methamphetamine-related crime in central Europe.
Collapse
Affiliation(s)
- Alex Gamma
- Department of Forensic Psychiatry, Institute of Forensic Medicine, University of Bern, Bern, Switzerland
- * E-mail:
| | - Roman Schleifer
- Department of Forensic Psychiatry, Institute of Forensic Medicine, University of Bern, Bern, Switzerland
| | - Wolfgang Weinmann
- Department of Forensic Toxicology and Chemistry, Institute of Forensic Medicine, University of Bern, Bern, Switzerland
| | - Anna Buadze
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Zürich, Switzerland
| | - Michael Liebrenz
- Department of Forensic Psychiatry, Institute of Forensic Medicine, University of Bern, Bern, Switzerland
| |
Collapse
|
10
|
Cumming C, Troeung L, Young JT, Kelty E, Preen DB. Barriers to accessing methamphetamine treatment: A systematic review and meta-analysis. Drug Alcohol Depend 2016; 168:263-273. [PMID: 27736680 DOI: 10.1016/j.drugalcdep.2016.10.001] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 09/26/2016] [Accepted: 10/01/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND Methamphetamine use is associated with a range of poor health, social and justice outcomes. In many parts of the world increased methamphetamine use has been identified as a major public health concern. Methamphetamine treatment programmes have been effective in reducing and ceasing use, however a range of barriers have prevented these programmes being widely adopted by methamphetamine users. This review examines the barriers to accessing meth/amphetamine treatment identified in the literature. METHODS Databases were systematically searched using relevant terms for peer-reviewed articles describing original research exploring the barriers to accessing treatment for meth/amphetamine use. Reviews and grey literature were excluded. Eleven studies conducted in 5 countries were included in data synthesis; this involved a systematic review of all 11 studies, and meta-analysis of the prevalence of barriers reported in 6 studies that published sufficient quantitative data. RESULTS Psychosocial/internal barriers to accessing methamphetamine treatment were most prevalent across studies (10/11 studies). Meta-analysis confirmed the four most commonly endorsed barriers to treatment access across studies all psychosocial barriers were embarrassment or stigma (60%, 95% CI: 54-67%); belief that treatment was unnecessary (59%, 95% CI:54-65%); preferring to withdraw alone without assistance (55%, 95% CI:45-65); and privacy concerns (51%, 95% CI:44-59%). CONCLUSIONS The primary barriers to accessing methamphetamine treatment are psychosocial/internal. Services and treatment models that address these barriers are urgently required. There is a growing need for methamphetamine-appropriate treatment services. Further research evaluating treatment engagement and effectiveness for methamphetamine and polysubstance use, including the development of effective pharmacotherapies is warranted.
Collapse
Affiliation(s)
- Craig Cumming
- Centre for Health Service Research, School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia.
| | - Lakkhina Troeung
- Centre for Health Service Research, School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
| | - Jesse T Young
- Centre for Health Service Research, School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia; Melbourne School of Population and Global Health, University of Melbourne, Level 4, 207 Bouverie St, Carlton, Victoria 3053, Australia; National Drug Research Institute, Curtin University, Level 2, 10 Selby Street, Shenton Park, Western Australia 6008, Australia
| | - Erin Kelty
- Centre for Health Service Research, School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
| | - David B Preen
- Centre for Health Service Research, School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
| |
Collapse
|
11
|
|
12
|
Vearrier D, Vearrier L, McKeever R, Okaneku J, LaSala G, Goldberger D, McCloskey K. Issues in driving impairment. Dis Mon 2016; 62:72-116. [DOI: 10.1016/j.disamonth.2016.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
13
|
Paydar P, Sabzghabaee AM, Paydar H, Eizadi-Mood N, Joumaa A. Outcome of treatment in patients with methamphetamine poisoning in an Iranian tertiary care referral center. J Res Pharm Pract 2015; 4:167-72. [PMID: 26312257 PMCID: PMC4548437 DOI: 10.4103/2279-042x.162365] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objective: Methamphetamine is the second most widely abused drug worldwide. We performed a study on the treatment outcome of acute methamphetamine intoxication in a referral tertiary care University hospital in Iran. Methods: In this hospital-based, retrospective study which was carried out from 2012 to 2013, medical records of all patients aged 18 to 65 years who were admitted with a reliable history and clinical diagnosis of acute methamphetamine intoxication were abstracted and analyzed. Patients’ data included gender, age, type and route of poisoning, clinical manifestations, duration of hospitalization, and the treatment outcome. ANOVA, Chi-square, and binary logistic regression statistical tests were used for data analysis. Findings: A total of 129 patients with a mean age of 30.70 ± 0.93 (mean ± standard error), including 111 (86%) males, had been fully evaluated. Most of the patients had intentional poisoning (93.7%). In 42.6% of patients, inhalation was the main route of exposure. Most of the patients had complete improvement without any complication (89.1%). Age (odds ratio [OR], 1.05; 95% confidence interval [95% CI] 1.006–1.099), suicide history (OR, 30.33; 95% CI 3.11–295.24), route of poisoning ([ingestion: OR, 0.21; 95% CI 0.05–0.87], [inhalation: OR, 0.19; 95% CI 0.04–0.78]), and pulmonary system manifestations (OR 1.84; 95% CI 1.15–2.93) were predictive in patients outcome (P < 0.05). Conclusion: Methamphetamine poisoning was more common in males with intentional poisoning. Age, past history of suicide, route of poisoning, and pulmonary manifestations on admission could be considered as important predictive factors in patients’ outcome.
Collapse
Affiliation(s)
- Parva Paydar
- Pharmacy Students' Research Committee, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Mohammad Sabzghabaee
- Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hooman Paydar
- Medical Students' Research Center, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Nastaran Eizadi-Mood
- Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Joumaa
- Pharmacy Students' Research Committee, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
14
|
Ort C, van Nuijs ALN, Berset JD, Bijlsma L, Castiglioni S, Covaci A, de Voogt P, Emke E, Fatta-Kassinos D, Griffiths P, Hernández F, González-Mariño I, Grabic R, Kasprzyk-Hordern B, Mastroianni N, Meierjohann A, Nefau T, Östman M, Pico Y, Racamonde I, Reid M, Slobodnik J, Terzic S, Thomaidis N, Thomas KV. Spatial differences and temporal changes in illicit drug use in Europe quantified by wastewater analysis. Addiction 2014; 109:1338-52. [PMID: 24861844 PMCID: PMC4204159 DOI: 10.1111/add.12570] [Citation(s) in RCA: 286] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 10/09/2013] [Accepted: 04/01/2014] [Indexed: 11/26/2022]
Abstract
AIMS To perform wastewater analyses to assess spatial differences and temporal changes of illicit drug use in a large European population. DESIGN Analyses of raw wastewater over a 1-week period in 2012 and 2013. SETTING AND PARTICIPANTS 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). MEASUREMENTS 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. FINDINGS 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.
Collapse
Affiliation(s)
- Christoph Ort
- Swiss Federal Institute of Aquatic Science and Technology (Eawag)Dübendorf, Switzerland
| | | | | | - Lubertus Bijlsma
- Research Institute for Pesticides and Water, University Jaume ICastellón de la Plana, Spain
| | - Sara Castiglioni
- Department of Environmental Health Sciences, IRCCS—Istituto di Ricerche Farmacologiche Mario NegriMilan, Italy
| | - Adrian Covaci
- Toxicological Center, University of AntwerpAntwerp, Belgium
| | - Pim de Voogt
- KWR Watercycle Research InstituteNieuwegein, the Netherlands
- Institute for Biodiversity and Ecosystem Dynamics, University of AmsterdamAmsterdam, the Netherlands
| | - Erik Emke
- KWR Watercycle Research InstituteNieuwegein, the Netherlands
| | | | - Paul Griffiths
- European Monitoring Centre for Drugs and Drug AddictionLisbon, Portugal
| | - Félix Hernández
- Research Institute for Pesticides and Water, University Jaume ICastellón de la Plana, Spain
| | - Iria González-Mariño
- IIAA—Institute of Food Analysis and Research, University of Santiago de CompostelaSantiago de Compostela, Spain
| | - Roman Grabic
- University of South Bohemia in Ceske Budejovice, Faculty of Fisheries and Protection of Waters, South Bohemian Research Center of Aquaculture and Biodiversity of HydrocenosesVodnany, Czech Republic
| | | | - Nicola Mastroianni
- Water and Soil Quality Research Group, Department of Environmental Chemistry, IDAEA-CSICBarcelona, Spain
| | - Axel Meierjohann
- Laboratory of Organic Chemistry, Åbo Akademi UniversityÅbo, Finland
| | - Thomas Nefau
- Laboratoire Santé Publique Environnement, University of Paris SudChâtenay-Malabry, France
| | - Marcus Östman
- Department of Chemistry, Umeå UniversityUmeå, Sweden
| | - Yolanda Pico
- Food and Environmental Safety Research Group, University of ValenciaValencia, Spain
| | - Ines Racamonde
- IIAA—Institute of Food Analysis and Research, University of Santiago de CompostelaSantiago de Compostela, Spain
| | - Malcolm Reid
- Norwegian Institute for Water Research (NIVA)Oslo, Norway
| | | | - Senka Terzic
- Division for Marine and Environmental Research, Rudjer Boskovic Institute BijenickaZagreb, Croatia
| | - Nikolaos Thomaidis
- Laboratory of Analytical Chemistry, Department of Chemistry, University of AthensAthens, Greece
| | - Kevin V Thomas
- Norwegian Institute for Water Research (NIVA)Oslo, Norway
| |
Collapse
|