Mass loading and removal of select illicit drugs in two wastewater treatment plants in New York State and estimation of illicit drug usage in communities through wastewater analysis

Evaluation of spatial and temporal changes in illicit drug use in the Taipei metropolitan area via wastewater-based epidemiology

Taiwan, identified as pivotal in the Asian drug trafficking chain, has been experiencing a surge in illicit drug-related issues. Wastewater-based epidemiology (WBE) has emerged as a promising approach for comprehensive evaluation of actual illicit drug usage. This study presents the first WBE investigation of illicit drug consumption in Taiwan based on the analysis of wastewater from four wastewater treatment plants (WWTPs) in the Taipei metropolitan area. Additionally, it demonstrates a high correlation between the amounts of illicit drugs seized and influent concentrations over an extended period of time. The reliability of solid-phase extraction and analysis via high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) was validated for 16 illicit drugs (methamphetamine, ketamine, cocaine, codeine, methadone, morphine, meperidine, fentanyl, sufentanil, para-methoxyamphetamine (PMA), para-methoxymethamphetamine (PMMA), 3,4-methylenedioxymethamphetamine (MDMA), cathinone, methcathinone, mephedrone (MEPH), and 4-methylethcathinone (4-MEC)). Methamphetamine, ketamine, and 4-MEC were consistently detected in all wastewater samples, underscoring their prevalence in the Taipei metropolitan area. Biochemical oxygen demand (BOD) and ammonia nitrogen (ammonia N) were employed to reduce uncertainty in estimations of population size during back-calculation of illicit drug consumption. The results indicate that methamphetamine was the most consumed drug (175-740 mg day-1 1000 people-1), followed by ketamine (22-280 mg day-1 1000 people-1). In addition, urban-related WWTPs exhibited higher consumption of methamphetamine and ketamine than did the suburban-related WWTP, indicating distinct illicit drug usage patterns between suburban and urban regions. Moreover, an examination of temporal trends in wastewater from the Dihua WWTP revealed a persistent predominance of ketamine and methamphetamine, consistent with statistical data pertaining to seizure quantities and urine test results. The study provides encouraging insight into spatial and temporal variations in illicit drug usage in the Taipei metropolitan area, emphasizing the complementary role of WBE in understanding trends in illicit drug abuse.

Assessment of restriction measures implemented during COVID pandemics on community lifestyle choices via wastewater-based epidemiology

SARS-CoV-2 pandemic affected lifestyle habits, and the mental health and wellbeing of people around the world. In this manuscript, two towns (Paulton and Radstock) and two cities (Bath and Bristol) in Southwest England (> 1 million people) were monitored for two years using Wastewater-Based Epidemiology to assess impacts of COVID (including management measures such as lockdowns and movement restrictions) on community lifestyle choices: illicit drugs, legal stimulants, abused pharmaceuticals and pain pharma usage. Results were triangulated with key dates captured during the pandemic (national lockdowns, restrictions and social distancing measures, etc.). This highlighted a reduction in cocaine intake (as benzoylecgonine) (community average: -36 %) during the first lockdown and an increase in illicit drugs usage after the 3rd national lockdown (community averages for amphetamine: +8 %, cocaine/benzoylecgonine: +39 %, ketamine:+70 %) when restrictions were removed, and social interaction and recreational activities increased. There was a reduction in the intake of caffeine (as 1,7-dimethylxanthine) (community average:-39 %) after 3rd national lockdown coinciding with pubs reopening while nicotine intake (via cotinine) remained stable indicating lack of impact of COVID on smoking habits. Pain pharma often used in pain management resulting from injuries linked with sport activities (naproxen and diclofenac) showed decrease in usage due to lockdown restrictions in physical exercise and access to gyms/sport facilities.

Occurrence, ecotoxicity and ecological risks of psychoactive substances in surface waters

Psychoactive substances (PSs) represent a subset of emerging contaminants. Their widespread production and utilization contribute to a growing ecological burden and risk on a global scale. Conventional wastewater treatment methods have proven insufficient in adequately removing psychoactive substances, leading to their occurrence in surface water ecosystems worldwide. As of present, however, a thorough understanding of their geographical prevalence and distribution patterns remains elusive. Further, in the existing literature, there is a scarcity of comprehensive overviews that systematically summarize the toxicity of various psychoactive substances towards aquatic organisms. Through summarizing almost 140 articles, the present study provides an overview of the sources, pollution status, and biotoxicity of psychoactive substances in surface waters, as well as an assessment of their ecological risks. Concentrations of several psychoactive substances in surface waters were found to be as high as hundreds or even thousands of ng·L-1. In parallel, accumulation of psychoactive substances in the tissues or organs of aquatic organisms was found to potentially cause certain adverse effects, including behavioral disorders, organ damage, and DNA changes. Oxidative stress was found to be a significant factor in the toxic effects of psychoactive substances on organisms. The application of the risk quotient approach indicated that psychoactive substances posed a medium to high risk in certain surface water bodies, as well as the need for sustained long-term attention and management strategies.

Ephedrine and cocaine cause developmental neurotoxicity and abnormal behavior in zebrafish

Ephedrine (EPH) and cocaine (COC) are illegal stimulant drugs, and have been frequently detected in aquatic environments. EPH and COC have negative effects on the nervous system and cause abnormal behaviors in mammals and fish at high concentrations, but their mechanisms of neurotoxicity remain unclear in larvae fish at low concentrations. To address this issue, zebrafish embryos were exposed to EPH and COC for 14 days post-fertilization (dpf) at 10, 100, and 1000 ng L-1. The bioaccumulation, development, behavior, cell neurotransmitter levels and apoptosis were detected to investigate the developmental neurotoxicity (DNT) of EPH and COC. The results showed that EPH decreased heart rate, while COC increased heart rate. EPH caused cell apoptosis in the brain by AO staining. In addition, behavior analysis indicated that EPH and COC affected spontaneous movement, touch-response, swimming activity and anxiety-like behaviors. EPH and COC altered the levels of the neurotransmitters dopamine (DA) and γ-aminobutyric acid (GABA) with changes of the transcription of genes related to the DA and GABA pathways. These findings indicated that EPH and COC had noticeable DNT in the early stage of zebrafish at environmentally relevant concentrations.

SERS and machine learning based effective feature extraction for detection and identification of amphetamine analogs

Surface-enhanced Raman spectroscopy (SERS) is extensively researched in diverse disciplines due to its sensitivity and non-destructive nature. It is particularly considered a potential and promising technology for rapid on-site screening in drug detection. In this investigation, a technique was developed for fabricating nanocrystals of Ag@Au SNCs. Ag@Au SNCs, as the basic material of SERS, can detect amphetamine at concentrations as low as 1 μg/mL. The Ag@Au SNCs exhibits a strong surface plasmon resonance effect, which amplifies molecular signals. The SERS spectra of ten substances, including amphetamine and its analogs, showed a strong peak signal. To establish a qualitative distinction, we examined the Raman spectra and conducted density functional theory (DFT) calculations on the ten aforementioned species. The DFT calculation enabled us to determine the vibrational frequency and assign normal modes, thereby facilitating the qualitative differentiation of amphetamines and its analogs. Furthermore, the SERS spectrum of the ten mentioned substances was analysed using the support vector machine learning algorithm, which yielded a discrimination accuracy of 98.0 %.

In five wastewater treatment plants in Xinjiang, China: Removal processes for illicit drugs, their occurrence in receiving river waters, and ecological risk assessment

Residues of illicit drugs are frequently detected in wastewater, but data on their removal efficiency by wastewater treatment plants (WWTPs) and the ecological risks to the aquatic environment are lacking in this study. The research evaluates the residues, mass load, drug removal efficiency, and risk assessment of illicit drugs in WWTPs and aquatic environments (lakes) in Xinjiang, China. Initially, the concentration (incidence) and mass load of 10 selected illicit drugs were analyzed through wastewater analysis. The detected substances included methamphetamine (METH), morphine (MOR), 3,4-methylenedioxy methamphetamine (MDMA), methadone (MTD), cocaine (COC), benzoylecgonine (BE), ketamine (KET), and codeine (COD), with concentrations ranging from 0.11 ± 0.01 ng/L (methadone) to 48.26 ± 25.05 ng/L (morphine). Notably, morphine (59.74 ± 5.82 g/day) and methamphetamine (41.81 ± 4.91 g/day) contributed significantly to the WWTPs. Next, the drug removal efficiency by different sewage treatment processes was ranked as follows: Anaerobic-Oxic (A/O) combined Membrane Bio-Reactor (MBR) treatment process > Oxidation ditch treatment process > Anaerobic-Anoxic-Oxic (A2/O) treatment process > Anaerobic-Anoxic-Oxic combined Membrane Bio-Reactor treatment process. Finally, the research reviewed the concentration and toxicity assessments of these substances in the aquatic environment (lakes). The results indicated that Lake1 presented a medium risk level concerning the impact of illicit drugs on the aquatic environment, whereas the other lakes exhibited a low risk level. As a result, it is recommended to conduct long-term monitoring and source analysis of illicit drugs, specifically in Lake1, for further investigation. In conclusion, to enhance the understanding of the effects of illicit drugs on the environment, future research should expand the list of target analytes.

Wastewater surveillance of 105 pharmaceutical drugs and metabolites by means of ultra-high-performance liquid-chromatography-tandem high resolution mass spectrometry

Water pollution from pharmaceutical drugs is becoming an environmental issue of increasing concern, making water quality monitoring a crucial priority to safeguard public health. In particular, the presence of antidepressants, benzodiazepines, antiepileptics, and antipsychotics require specific attention as they are known to be harmful to aquatic biota. In this study, a multi-class comprehensive method for the detection of 105 pharmaceutical residues in small (30 mL) water samples was developed according to fit-for-purpose criteria and then applied to provide wide screening of samples obtained from four Wastewater Treatment Plants (WWTPs) in northern Italy. The filtered samples (0.22 µm filters) were extracted by SPE, and then eluted. 5 µL of the concentrated samples were analyzed by a UHPLC-QTOF-HRMS method validated for screening purposes. Adequate sensitivity was recorded for all target analytes, with limits of detection below 5 ng/L for 76 out of 105 analytes. A total of 23 out of the 105 targeted pharmaceutical drugs was detected in all samples. Several further compounds were detected over wide concentration intervals, ranging from ng/L to µg/L. In addition, the retrospective analysis of full-scan QTOF-HRMS data was exploited to carry out an untargeted screening of some drugs' metabolites. As a proof of concept, it was investigated the presence of the carbamazepine metabolites, which is among the most frequently detected contaminants of emerging concern in wastewater. Thanks to this approach, 10,11-dihydro-10-hydroxycarbamazepine, 10,11-dihydro-10,11-dihydroxycarbamazepine and carbamazepine-10,11-epoxide were identified, the latter requiring particular attention, since it exhibits antiepileptic properties similar to carbamazepine and potential neurotoxic effects in living organism.

Removal of residues of psychoactive substances during wastewater treatment, their occurrence in receiving river waters and environmental risk assessment

Continuous consumption combined with incomplete removal during wastewater treatment means residues of psychoactive substances (licit drugs, medications of abuse and illicit drugs) are constantly introduced into the aquatic environment, where they have the potential to affect non-target organisms. In this study, 17 drug residues of psychoactive substances were determined in wastewater influent, effluent and in receiving rivers of six Slovene municipal wastewater treatment plants employing different treatment technologies. Variations in removal efficiencies (REs) during spring, summer and winter were explored, and ecotoxic effects were evaluated using in silico (Ecological Structure-Activity Relationships software-ECOSAR) and in vivo (algal growth inhibition test) methods. Drug residues were detected in influent and effluent in the ng/L to μg/L range. In receiving rivers, biomarkers were in the ng/L range, and there was good agreement between measured and predicted concentrations. On average, REs were highest for nicotine, 11-nor-9-carboxy-∆9-tetrahydrocannabinol (THC-COOH), cocaine residues, and amphetamine (>90 %) and lowest for methadone residues (<30 %). REs were comparable between treatments involving activated sludge and membrane bioreactors, while the moving biofilm bed reactor (MBBR) removed cotinine, cocaine, and benzoylecgonine to a lesser extent. Accordingly, higher levels of nicotine and cocaine residues were detected in river water receiving MBBR discharge. Although there were seasonal variations in REs and levels of drug residues in receiving rivers, no general pattern could be observed. No significant inhibition of algal growth (Chlamydomonas reinhardtii) was observed for the tested compounds (1 mg/L) during 72 h and 240 h of exposure, although effects on aquatic plants were predicted in silico. In addition, environmental risk assessment revealed that levels of nicotine, methadone, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP), morphine, and 3,4-methylenedioxymethamphetamine (MDMA) pose a risk to aquatic organisms. Since nicotine and EDDP can have acute and chronic effects, the authors support regular monitoring of receiving surface waters, followed up by regulatory actions.

Long-term wastewater-based surveillance and impacts of the COVID-19 pandemic on drug use trends in a U.S. Northeast rural town

Herein we discuss the findings of a two-year wastewater-based drug use surveillance from September 2018 to August 2020 and present objective evidence on the impacts of the COVID-19 pandemic on drug use in a rural community. 24-h composite wastewater samples were collected twice each month from a university town in Northeastern United States and were analyzed for ten priority opioids and stimulants: morphine, codeine, hydrocodone, methadone, fentanyl cocaine, methamphetamine, amphetamine, 3,4-methylenedioxymethamphetamine (MDMA), and 3,4-methylenedioxy-N-ethylamphetamine (MDEA). All target drugs were detected at 100 % frequency in wastewater samples. On a mass basis, the average estimated per capita drug consumption were highest for cocaine, morphine, and amphetamine, and lowest for MDMA, MDEA, and hydrocodone. Furthermore, the estimated per capita consumption of fentanyl was higher than previous reports from rural and university settings in the U.S. Generally, drug consumption was higher during the spring semesters, with year-on-year semester increases also noted over the 2-y study period. Except for methadone and cocaine, the estimated average per capita consumption of drugs increased over the pandemic period, with the highest increase noted for MDMA (286 % increase compared to baseline, p = 0.016). Estimated average consumption of methadone and cocaine decreased slightly by 6 % and 7 %, respectively. These results demonstrate the utility and strength of wastewater-based approaches in capturing long-term and evolving trends in drug use within communities. Our study findings reflect the regionwide problem with opioid-related overdoses and increasing stimulant prescription rates. Our findings also provide objective data and insights for health policymakers on the effects of the pandemic period on community drug use in a rural U.S. town.

Occurrence of contaminants of emerging concern in the Eerste River, South Africa: Towards the optimisation of an urban water profiling approach for public- and ecological health risk characterisation

The study evaluated the presence and fate of various contaminants of emerging concern (CECs) from a South African wastewater treatment works (WWTW) and surface waters located around an urban setting. A total of 45 CECs were quantified from nine sampling locations over an 11-month period. Daily loads (g/day) of the target analytes in the WWTW showed persistence of some CECs, along with population-normalised daily loads (mg/day/1000inh) of pharmaceuticals and drugs of abuse (DOA) that were estimated for the first time in the study area. Multiple chemical markers were recorded in river water located upstream of the WWTW discharge throughout the study period, suggesting a high degree of diffuse pollution from urban communities in the study area that are not connected to sewage networks or where sanitation services are limited. The potential of using defined surface water locations to perform community-wide substance use profiling for non-sewered communities was also explored. Environmental risk characterisation for the WWTW effluent and surface waters throughout the study period provided multiple risk quotients (RQ) for the target list of CECs spanning over various sentinel trophic levels. High risk profiles (RQ > 1.0) with a frequency of exceedance (FoE) larger than 75 % were recorded for several CECs in both WWTW effluent and surface water locations that suggest potential long-term ecological health risk impacts of pollution hotspot areas in the river catchment situated around the urban area. We present challenges in surface water quality within the study area that is relatable, or may even present more challenging, in other low- or middle-income country (LMICs) settings. The study also highlighted some challenges and limitations associated with the much-needed application of wastewater-based epidemiology (WBE) intervention in non-sewered communities that can inform on public health and communal substance use profiles of the entire urban setting.

Occurrence of Z-drugs, benzodiazepines, and ketamine in wastewater in the United States and Mexico during the Covid-19 pandemic

Z-drugs, benzodiazepines and ketamine are classes of psychotropic drugs prescribed for treating anxiety, sleep disorders and depression with known side effects including an elevated risk of addiction and substance misuse. These drugs have a strong potential for misuse, which has escalated over the years and was hypothesized here to have been exacerbated during the COVID-19 pandemic. Wastewater-based epidemiology (WBE) constitutes a fast, easy, and relatively inexpensive approach to epidemiological surveys for understanding the incidence and frequency of uses of these drugs. In this study, we analyzed wastewater (n = 376) from 50 cities across the United States and Mexico from July to October 2020 to estimate drug use rates during a pandemic event. Both time and flow proportional composite and grab samples of untreated municipal wastewater were analyzed using solid-phase extraction followed by liquid chromatography-tandem mass spectrometry to determine loadings of alprazolam, clonazepam, diazepam, ketamine, lorazepam, nordiazepam, temazepam, zolpidem, and zaleplon in raw wastewater. Simultaneously, prescription data of the aforementioned drugs were extracted from the Medicaid database from 2019 to 2021. Results showed high detection frequencies of ketamine (90 %), lorazepam (87 %), clonazepam (76 %) and temazepam (73 %) across both Mexico and United States and comparatively lower detection frequencies for zaleplon (22 %), zolpidem (9 %), nordiazepam (<1 %), diazepam (<1 %), and alprazolam (<1 %) during the pandemic. Average mass consumption rates, estimated using WBE and reported in units of mg/day/1000 persons, ranged between 62 (temazepam) and 1100 (clonazepam) in the United States. Results obtained from the Medicaid database also showed a significant change (p < 0.05) in the prescription volume between the first quarter of 2019 (before the pandemic) and the first quarter of 2021 (pandemic event) for alprazolam, clonazepam and lorazepam. Study results include the first detections of zaleplon and zolpidem in wastewater from North America.

Towards a novel application of wastewater-based epidemiology in population-wide assessment of exposure to volatile organic compounds

In this study, we investigated the feasibility of detecting 35 urinary biomarkers of volatile organic compounds (VOCs) exposure in community wastewater. 24-h composited municipal wastewater samples were collected from two communities (n = 8) in the southeastern US. Using isotope-dilution liquid chromatography-tandem mass spectrometry, results showed 16 metabolites were detected in wastewater samples, including indicators of exposure to acrolein, acrylonitrile, 1,3-butadiene, crotonaldehyde, n,n-dimethylformamide (DMF), ethylbenzene, nicotine, propylene oxide, styrene, tetrachloroethylene, toluene, and xylene. Additional metabolites qualitatively identified exposure to acrylamide and trichloroethylene. Community 1 (closer proximity to manufacturing facilities) had a greater number of detects (n = 36) and higher VOC loadings, 22,000 mg day^-1 per 1000 people, as compared to Community 2 (n = 28), 7100 mg day^-1 per 1000 people. Normalizing to nicotine consumption biomarkers to account for differences in smoking behaviors, Community 1 continued to have higher levels of propylene oxide, crotonaldehyde, DMF, and acrylonitrile exposures, VOCs generally sourced from manufacturing activities and vehicle emissions. This is the first study to utilize wastewater to detect urinary biomarkers of VOCs exposure. These preliminary results suggest the WBE approach as a potentially powerful tool to assess community health exposures to indoor and outdoor air pollutants.

Preparation and application of nano petal-shaped covalent organic frameworks modified polystyrene-divinylbenzene- glycidylmethacrylate microspheres for the extraction of illicit drugs from wastewater

A novel nano petal-shaped covalent organic frameworks modified magnetic polystyrene-divinylbenzene-glycidylmethacrylate (NP-COF@Mag-PS/DVB/GMA) microsphere has been synthesized. It is a perfect combination of high productivity of PS/DVB/GMA microspheres and excellent enrichment efficiency of COF particles, and the excellent properties of NP-COF@Mag-PS/DVB/GMA microspheres are characterized by scanning electron microscopy (SEM), Brunauer-Emmett-Teller (BET) and X-ray photoelectron spectroscopy (XPS). The sorbent can extract illicit drugs via the reverse-phase interactions provided by benzene ring on the polymer backbone and the hydrogen bonding interactions provided by functional group (-NH-) on the COF particles. Based on using NP-COF@Mag-PS/DVB/GMA as sorbents, an easiness-to-handle of magnetic dispersive solid phase extraction (Mag-dSPE) procedure is proposed for the simultaneous preconcentration of 12 illicit drugs from wastewater. The obtained results show high extraction efficiency of NP-COF@Mag-PS/DVB/GMA to illicit drugs with recoveries between 81.6 and 116%. Furthermore, a liquid chromatography-tandem quadrupole mass spectrometry (LC-MS/MS) method for the determination of 12 illicit drugs from wastewater at sub-ppt levels has been proposed and validated with the pretreatment of samples by Mag-dSPE. The limits of quantification (LOQs) for the 12 illicit drugs are between 0.40 and 4.90 ng/L. Validation results on linearity, specificity, trueness and precision, as well as on application to the analysis of 12 illicit drugs in ten real samples demonstrate the applicability to environment monitoring analysis.

Occurrence, distribution, and ecological risk of psychoactive substances in typical lakes and rivers in Qinghai-Tibet Plateau

The occurrence, distribution, and ecological risks of psychoactive substances (PSs) in Qinghai-Tibet Plateau (QTP) was investigated in this study. The surface water samples were collected in July in 2020 from five major water bodies, and 9 PSs were determined by liquid chromatography-mass spectrometry. The mean concentrations of the total PSs were 2.19-96.86 ng/L in lakes and 4.56-34.47 ng/L in rivers. Amphetamine (AMP) was the predominant contaminant both in lakes and rivers with a mean concentration of 12.21 ± 22.76 ng/L and 9.83 ± 6.14 ng/L, respectively. The compositions of PSs in lakes and rivers were significantly different. AMP, methadone (MTD), 3,4-methylenedioxyamphetamine (MDA), and ketamine (KET) were the most detected contaminants in lakes, while in rivers AMP, MDA, heroin (HER), and methamphetamine (METH) were the most detected ones. Concentrations of AMP and MTD, the two predominant drugs, varied spatially, with the decreasing concentration of AMP in the order of Huangshui River > Yamzhog Yumco Lake > Qinghai Lake > Lhasa River > Namco Lake, and of MTD in the order of Qinghai Lake > Namco Lake > Huangshui River > Yamzhog Yumco Lake. The risk quotients (RQs) of PSs ranged from 4.44 × 10^-6 to 4.32 × 10^-2, indicating a low risk of PSs in the aquatic ecosystem in QTP. Compared with other research in the world, the contamination of psychoactive substances in the Qinghai-Tibet Plateau was at relatively low levels with low ecological risks.

Progress on aptamer-based SERS sensors for food safety and quality assessment: methodology, current applications and future trends

It is well known that food safety has aroused extensive attentions from governments to researchers and to food industries. As a versatile technology based on molecular interactions, aptamer sensors which could specifically identify a wide range of food contaminants have been extensively studied in recent years. Surface-enhanced Raman spectroscopy integrated aptamer combines the advantages of both technologies, not only in the ability to specifically identify a wide range of food contaminants, but also in the ultra-high sensitivity, simplicity, portable and speed. To provide beneficial insights into the evaluation techniques in the field of food safety, we offer a comprehensive review on the design strategies for aptamer-SERS sensors in different scenarios, including non-nucleic acid amplification methods ("on/off" mode, sandwich mode, competition model and catalytic model) and nucleic acid amplification methods (hybridization chain reaction, rolling circle amplification, catalytic hairpin assembly). Meanwhile, a special attention is paid to the application of aptamer-SERS sensors in biological (foodborne pathogenic, bacteria and mycotoxins) and chemical contamination (drug residues, metal ions, and food additives) of food matrix. Finally, the challenges and prospects of developing reliable aptamer-SERS sensors for food safety were discussed, which are expected to offer a strong guidance for further development and extended applications.

Wastewater-based monitoring of 2-fluoro-deschloroketamine abuse from 2019 to 2021 in a southern Chinese province

2-fluoro-deschloroketamine (FDCK) is a ketamine (KET) analog and new psychoactive substance that has appeared on the drug market in Europe and China in the past few years. The substance has been recently listed as a controlled drug by the narcotics control authority of China. In this work, FDCK and its metabolite nor-fluoro-deschloroketmaine (N-FDCK) in wastewater were analyzed for the first time to monitor FDCK abuse in a southern Chinese province that used to be a major producer and consumer of ketamine. For comparison, KET and its metabolite, nor-ketamine (N-KET) were monitored simultaneously. The concentration ratios between FDCK and N-FDCK were not statistically different from those of KET and N-KET. The average FDCK loads in the province in 2019 were higher than KET loads in most major cities in China in 2014 (when KET abuse hit its peak in the country). Rough estimation of FDCK and KET consumption revealed that FDCK was the predominant synthetic drug in the province in 2019, indicating rapid spread of the substance since its first appearance on the market. FDCK consumption decreased dramatically in 2020 and 2021, due to proactive actions by the local drug police before its listing as a controlled drug. Despite the dramatic decrease, FDCK was still the drug with greatest consumption by 2021, indicating that this substance persisted on the market even in the presence of forceful law enforcement. This finding also demonstrates that this substance may indeed have similar or even improved psychoactive effects relative to KET. Quick spread and persistence of FDCK demonstrated here indicates the urgent need to conduct wastewater-based monitoring of the abuse of the substance in other Chinese provinces and other countries.

Rapid nanomolar detection of methamphetamine in biofluids via a reagentless electrochemical aptamer-based biosensor

The availability of sensing platforms able to rapidly measure abused drugs directly in biological fluids in a single step would allow performing drugged driving screening on the site. The achievement of this goal is extremely important for preventing and controlling drug abuse and crime incidence. Motived by this, we constructed a simple, cost-effective and reagentless electrochemical aptamer-based (EAB) sensor with methamphetamine (MAMP) as the target molecule. This EAB sensor produced a nanomolar level of detection accuracy in unprocessed or minimally processed bio-samples. Specifically, circular dichroic spectrum was used to confirm that the truncated aptamer from the original sequence would undergo large binding-induced conformational changes. We then engineered the aptamer to work in the EAB platform and the resulting sensor enabled sensitive and specific detection of MAMP with the detection limit of 30 nM in undiluted serum, 50 nM in undiluted urine and 20 nM in 50% saliva. The sensor has good recovery rate, implying this method has good reliability and repeatability. The detection limit is far below the clinical detection threshold, it would be hopefully used for preliminary screening of drugged driving in real world.

Estrogenic activity and ecological risk of steroids, bisphenol A and phthalates after secondary and tertiary sewage treatment processes

Effluents of sewage treatment plants (STPs) are an important source of estrogenic substances to the receiving water bodies affecting their ecological safety. In this study, steroids, bisphenol A (BPA) and phthalates were assessed in the secondary (SE) and tertiary effluent (TE) of three typical urban STPs in Beijing (China). In addition, the overall estrogenic activity in these effluents was assessed by an in-vitro bioassay (ERE-CALUX). Results showed that the concentrations and activities of estrogenic compounds in TE were lower than those in SE. The residual concentration of 17β-estradiol (E2) was the highest among the detected steroids, accounting for 51.6 ± 5.1% in SE and 57.5 ± 24.8% in TE. The residual level (25.2-41.6 ng/L) of BPA in effluents was significantly higher than that of steroids (0.2-28.8 ng/L). The residual concentration of diethyl phthalate was the highest among the detected phthalates accounting for 47.1 ± 5.1% in SE and 37.6 ± 11.5% in TE. Steroids and BPA had a higher removal rate (83.5% and 96.7%) in secondary and tertiary treatment than phthalates (68.8% and 83.1%). The hydrophobic characteristics of these estrogenic compounds determined the removal mechanism. The removal of steroids, BPA, dimethyl phthalate and diethyl phthalate (LogKow= 1.61-4.15) mainly occurred through biodegradation in the water phase, while the removal of dibutyl phthalate, butylbenzyl phthalate and di(2-ethylhexyl) phthalate (LogKow= 4.27-7.50) mainly occurred in the solid phase after adsorption on and sedimentation of the suspended particulate matter. According to ERE-CALUX, the estrogenic activity in the final STP effluents was 3.2-45.6 ng E2-equivalents/L, which is higher than reported levels in the effluents of European STPs. Calculation of estrogenic equivalents by using substance specific chemical analysis indicated that the dominant contributor was E2 (56.4-88.4%), followed by 17α-ethinylestradiol (EE2) (4.1-34.8%), both also exerting a moderate risk to the aquatic ecosystem. While the upgrade of treatment processes in STPs has efficiently reduced the emission of estrogenic substances, their ecological risk was not yet phased out.

Rapid, Multianalyte Detection of Opioid Metabolites in Wastewater

By monitoring opioid metabolites, wastewater-based epidemiology (WBE) could be an excellent tool for real-time information on the consumption of illicit drugs. A key limitation of WBE is the reliance on costly laboratory-based techniques that require substantial infrastructure and trained personnel, resulting in long turnaround times. Here, we present an aptamer-based graphene field effect transistor (AptG-FET) platform for simultaneous detection of three different opioid metabolites. This platform provides a reliable, rapid, and inexpensive method for quantitative analysis of opioid metabolites in wastewater. The platform delivers a limit of detection 2-3 orders of magnitude lower than previous reports, but in line with the concentration range (pg/mL to ng/mL) of these opioid metabolites present in real samples. To enable multianalyte detection, we developed a facile, reproducible, and high-yield fabrication process producing 20 G-FETs with integrated side gate platinum (Pt) electrodes on a single chip. Our devices achieved the selective multianalyte detection of three different metabolites: noroxycodone (NX), 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP), and norfentanyl (NF) in wastewater diluted 20× in buffer.

Wastewater-based epidemiology for illicit drugs: A critical review on global data

Illicit drug use is complex, hidden and often highly stigmatized behaviour, which brings a vast challenge for drug surveillance systems. Drug consumption can be estimated by measuring human excretion products in untreated wastewater, known as wastewater-based epidemiology (WBE). Over the last decade, the application of wastewater-based epidemiology to monitor illicit drug loads increased and WBE is currently applied on a global scale. Studies from over the globe are evaluated with regard to their sampling method, analytical accuracy and consumption calculation, aiming to further reduce relevant uncertainties in order to make reliable comparisons on a global level. Only a limited number is identified as high-quality studies, so further standardization of the WBE approach for illicit drugs is desired especially with regard to the sampling methodology. Only a fraction of the reviewed papers explicitly reports uncertainty ranges for their consumption data. Studies which had the highest reliability are recently published, indicating an improvement in reporting WBE data. Until now, WBE has not been used in large parts of Africa, nor in the Middle East and Russia. An overview of consumption data across the continents on commonly studied drugs (cocaine, MDMA, amphetamine and methamphetamine) is provided. Overall, high consumption rates are confirmed in the US, especially for cocaine and methamphetamine, while relatively low illicit drug consumption is reported in Asia.

Occurrence, removal and mass loads of antiviral drugs in seven wastewater treatment plants with various treatment processes

Antiviral drugs are among the most common and important classes of pharmaceuticals to treat viral infections, however their continuous emission and persistence in the receiving environment has attracted increasing attention about their potential ecological risks. Here we investigated the occurrence, fate and mass load of 9 antiviral drugs for acquired immunodeficiency syndrome and hepatitis B, in 7 wastewater treatment plants (WWTPs) with different treatment processes in Guangdong, China. Totally, 8 target antiviral drugs were detected in the WWTPs influent wastewater, effluent wastewater and sludge, with maximal concentrations up to 7624 ng/L (telbivudine), 568 ng/L (telbivudine), and 2013 ng/g wet weight (telbivudine), respectively. The removal efficiency varied widely between different antiviral drugs, with the mean aqueous removal efficiency and total removal efficiency ranging from -6.2% (nevirapine) to 100% (lamivudine) and -1.2% (nevirapine) to 100% (lamivudine), respectively. Mass balance analysis showed that their elimination was mostly attributed to the biodegradation/biotransformation. The total back-estimated usage and emission of 9 target antiviral drugs were 77.8 t/y and 13.2 t/y in Guangdong province, China, respectively. Based on the sewage epidemiology approach, the consumption and emission of antiviral drugs in seven studied WWTPs were ranged at 2.31 mg/d/1000 people (nevirapine) to 4970 mg/d/1000 people (telbivudine), and 0 (lamivudine) to 900 mg/d/1000 people (telbivudine), respectively. Preliminary risk assessment showed that the antiviral drugs of zidovudine, ritonavir, lopinavir, and telbivudine in the receiving rivers could pose high ecological risks for aquatic environment. The findings from the present study illustrate the persistence of nevirapine in WWTPs, and provide essential evidence for further study into the development of wastewater treatment technologies.

Occurrence, mass loads, and ecological risks of amphetamine-like substances in a rural area of South China

The occurrence and levels of amphetamine like substances (ALSs) in various environments, as a group of illicit psychoactive substances, have attracted great attention due to their potential ecological risks. In this study, three ALSs (i.e., ephedrine (EPH), amphetamine (AMP) and methamphetamine (METH)) in the raw domestic wastewater (RDW) and surface river water (SRW) collected from the rural area in South China were analyzed. METH was identified as the prevalent and dominant ALS in the RDW, which was detected in approximately 99.0% of the samples with a mean concentration of 0.7 μg·L^-1, followed by AMP and EPH. Consistent trend was also found in the SRW collected from the same region. METH concentrations in the SRW were significantly and positively correlated with those in the RDW (p < 0.05), indicating that the discharge of RDW could be the important source of METH in the nearby rivers. The mean mass load of METH in the study rural area was about 65.8 mg·day^-1·1000 inhabitants^-1. Source apportionment showed that the abuse consumption was the main source of METH at most of sampling towns in the investigated rural area, and the mean mass load of METH at these towns (24.5 mg·day^-1·1000 inhabitants^-1) might reflect the abuse level of METH in this region. The disposal and illegal synthesis of METH could be important point sources, which led to the elevated METH level in the RDW. Risk assessment demonstrated that ALSs posed a minimal or medium risk to aquatic organisms. Our results provided valuable insights into the mass loads, source characteristics and ecological risks of ALSs in the rural area.

Environmental risk assessments of multiclass pharmaceutical active compounds: selection of high priority concern pharmaceuticals using entropy-utility functions

This research aimed to identify high-risk pharmaceutically active compounds (PhACs) by analyzing occurrence (O), persistence (P), bioaccumulation (B), and toxicity (T) of 62 drugs which are widely used in Iran. A comprehensive approach was taken in risk assessment of the selected PhACs and in their prioritization using multiple-criteria decision analysis (MCDA) such as utility functions and principal component analysis (PCA). In practice, assigning weight to each criterion (i.e., O, P, B, and T) for risk assessment of PhACs is a challenge. In this research, the impact of giving both equal and unequal weight to each criterion by using a quantitative entropy method was studied. For risk assessment, two exposure approaches (consumption rate and occurrence of PhACs) and three MCDA approaches (PCA and utility functions with and without equal weights for each criterion) were compared. The utility function using equal weights for all O, P, B, and T criteria showed that thioridazine, pimozide, chlorpromazine, sertraline, clomipramine, and aripiprazole were at the highest level of risk, with concern score of 0.75, 0.75, 0.67, 0.58, 0.58, and 0.58, respectively. Unequal weight approach included additional compounds such as fluoxetine, citalopram, and methadone as a priority. All three MCDA approaches showed that sedatives and antidepressants were prevalent PhACs in the risk-based priority lists. However, the exposure-based approaches showed antibiotics and analgesics as the pharmaceutical of the highest priority. Overall, selection of the high priority concern pharmaceuticals depends on the prioritization approach employed. However, the utility function using unequal weights is a more conservative and effective approach for prioritization.

Tissue-specific accumulation, elimination, and toxicokinetics of illicit drugs in adult zebrafish (Danio rerio)

The abuse of illicit drugs has led to their extensive detection worldwide and subsequently exerted adverse effects upon aquatic organisms and ecosystem. However, less attention has been paid to the uptake, biotransformation, internal distribution, and toxicokinetic processes in the exposed organisms. In this study, zebrafish (Danio rerio) was exposed to methamphetamine (METH) and ketamine (KET) at three different concentrations in a semi-static exposure system. METH and KET, together with their metabolites, amphetamine (AMP) and norketamine (NK), were consistently detected in zebrafish. Over 14-day exposure, the relative magnitude of mean concentrations of illicit drugs in zebrafish generally followed the order of brain > liver > intestine > ovary > muscle. The uptake rate constants (K_u) of METH and KET were in the range of 0.590-1.38 × 10³ L/(kg·d), the elimination rate constants (K_e) were in the range of 0.18-6.98 1/d, and the half-lives were in the range of 0.18-6.98 d, respectively. METH and KET demonstrated relatively rapid uptake and elimination kinetics and short half-lives, and concentrations in organs were driven by external concentrations. Illicit drugs were not persistent within zebrafish organs when there were no substantial external contaminant sources. The observed values of bioconcentration factor (BCF_o, L/kg) and kinetically-derived bioconcentration factor (BCF_k, L/kg) were at the similar level. The ability of different zebrafish organs accumulating target chemicals from the aquatic environment was different, and brain was the target organ of the test illicit drugs.

In-sewer stability of selected analgesics and their metabolites

Understanding the in-sewer stability of analgesic biomarkers is important for interpreting wastewater-based epidemiology (WBE) data to estimate community-wide analgesic drugs consumption. The in-sewer stability of a suite of 19 analgesics and their metabolites was assessed using lab-scale sewer reactors. Target biomarkers were spiked into wastewater circulating in simulated gravity, rising main and control (no biofilm) sewer reactors. In-sewer transformation was observed over a hydraulic retention time of 12 h. All investigated biomarkers were stable under control reactor conditions. In gravity sewer conditions, diclofenac, desmetramadol, ibuprofen carboxylic acid, ketoprofen, lidocaine and tapentadol were highly stable (0-20% transformation in 12 h). Valdecoxib, parecoxib, etoricoxib, indomethacin, naltrexone, naloxone, piroxicam, ketoprofen, lidocaine, tapentadol, oxymorphone, hydrocodone, meperidine, hydromorphone were considered as moderately stable biomarkers (20-50% transformation in 12 h). Celecoxib and sulindac were considered unstable biomarkers (>50% transformation in 12 h). Ketoprofen, lidocaine, tapentadol, meperidine, hydromorphone were transformed to 0-20% whereas diclofenac, desmetramadol, ibuprofen carboxylic acid, valdecoxib, parecoxib, etoricoxib, indomethacin, naltrexone, piroxicam were transformed up to 20-50% in 12 h in rising main reactor (RMR). These biomarkers were considered as highly stable and stable biomarkers in RMR, respectively. Sulindac, celecoxib, naloxone, oxymorphone and hydrocodone were transformed more than 50% in 12 h and considered as unstable biomarkers in RMR. This study provides the information for a better understanding of the in-sewer loss of the analgesics before using them in WBE biomarkers for estimating drug loads at the population level.

Evaluation of private well contaminants in an underserved North Carolina community

On-site sewage treatment systems can be an important source of antibiotic resistant bacteria and organic micropollutants into adjacent groundwater. Due to the frequent proximity of private wells to septic systems, this contamination is a concern to communities that do not have access to public municipal services. In both rural and urban environments, low-income communities, indigenous communities and those of color are disproportionately affected by well contamination. The objective of this study was to assess well water quality in an underserved North Carolina community by performing a comprehensive evaluation of microbial and organic micropollutant occurrence and determining possible sources of contamination. Well water, septic tanks, and adjacent municipal water were sampled. Culture- and molecular biology-based microbial analysis and non-targeted, high resolution mass spectrometry chemical analysis were conducted to assess water quality in comparison to nearby municipal water. Three of thirteen homes had between 1 and 6.3 CFUs/100 mL of E. coli and two homes had fecal bacteria resistant to antibiotics in their well water. The water of four homes showed concentrations of the artificial sweetener sucralose, a wastewater tracer, higher than the municipal water (range ~ 60-1500 ng L^-1). The human-specific HF183 fecal marker was detected in 79% of the wells tested. The presence of pharmaceuticals and personal care products in four home wells, along with the presence of pesticides and insecticides in two homes, suggest possible contamination from septic tanks and lawn care runoff. The implications of this work highlight the necessity of wider scale contaminant evaluation of well water.

Occurrence, bioaccumulation and toxicological effect of drugs of abuse in aquatic ecosystem: A review

Drugs of abuse are a group of emerging contaminants. As the prevalence of manufacture and consumption, there is a growing global environmental burden and ecological risk from the continuous release of these contaminants into environment. The widespread occurrence of drugs of abuse in waste wasters and surface waters is due to the incomplete removal through traditional wastewater treatment plants in different regions around the world. Although their environmental concentrations are not very high, they can potentially influence the aquatic organisms and ecosystem function. This paper reviews the occurrence of drugs of abuse and their metabolites in waste waters and surface waters, their bioaccumulation in aquatic plants, fishes and benthic organisms and even top predators, and the toxicological effects such as genotoxic effect, cytotoxic effect and even behavioral effect on aquatic organisms. In summary, drugs of abuse occur widely in aquatic environment, and may exert adverse impact on aquatic organisms at molecular, cellular or individual level, and even on aquatic ecosystem. It necessitates the monitoring and risk assessment of these compounds on diverse aquatic organisms in the further study.

Effectiveness of Advanced Oxidation Processes in Wastewater Treatment: State of the Art

In recent years, many scientific studies have focused their efforts on quantifying the different types of pollutants that are not removed in wastewater treatment plants. Compounds of emerging concern (CECs) have been detected in different natural environments. The presence of these compounds in wastewater is not new, but they may have consequences in the future. These compounds reach the natural environment through various routes, such as wastewater. This review focuses on the study of tertiary treatment with advanced oxidation processes (AOPs) for the degradation of CECs. The main objective of the different existing AOPs applied to the treatment of wastewater is the degradation of pollutants that are not eliminated by means of traditional wastewater treatment.

Tracking the fate of artificial sweeteners within the coastal waters of Shenzhen city, China: From wastewater treatment plants to sea

Artificial sweeteners (ASs), as a new emerging pollutant, the fate from wastewater treatment plants (WWTPs) to sea is growing concerned. In this study, the distribution and polluted loading of six typical ASs were analyzed based on the measurement in influent, primary effluent, secondary effluent, tertiary effluent, suspended particulate matter (SPM), and sludge from four WWTPs and receiving waters near the coast of Shenzhen city, China. Elevated levels of ASs were detected in WWTPs located near a highly populated area (about 14,000 people km^-2). Sucralose was predominant in all water samples (0.1-22.2 μg L^-1), and had a 1.6-704.0 times higher concentration than the means of other ASs detected. Aspartame were mainly distributed in SPM and sludge, and the fractions in offshore water exceeded 45%. Acesulfame, sucralose, cyclamate and saccharin could be effectively removed by secondary biochemical treatment. The average daily loading (4.2 g d^-1 1000people^-1) and discharge loading (0.4 g d^-1 1000people^-1) of sucralose in WWTPs was higher than those of the other ASs. Dissolved organic carbon and UV₂₅₄ can affect the fate of ASs, and SPM mainly affects the distributions of aspartame and neotame. As a potential sewage indicator, neotame deserves further attention.

Wastewater analysis of psychoactive drugs: Non-enantioselective vs enantioselective methods for estimation of consumption

The consumption of licit and illicit psychoactive drugs (PAD) is ubiquitous in all communities and a serious public health problem. Measuring drug consumption is difficult but essential for health-care professionals, risk assessment and policymakers. Different sources of information have been used for a comprehensive analysis of drug consumption. Among them, Wastewater based epidemiology (WBE) emerged as an essential and complementary methodology for estimating licit and illicit drugs consumption. This methodology can be used for quantification of unchanged drugs or their human-specific metabolites in wastewater for estimation of consumption or screening of new PAD. Although some limitations are still being pointed out (e.g., estimation of the population size, use of suitable biomarkers or pharmacokinetics studies), the non-invasive and potential for monitoring real-time data on geographical and temporal trends in drug use have been showing its capacity as a routine and complementary tool. Chromatographic methods, both non-enantioselective and enantioselective are the analytical tools used for quantification of PAD in wastewaters and further estimation of consumption. Therefore, this manuscript aims to summarize and critically discuss the works used for wastewater analysis of PAD based on WBE using non-enantioselective and enantioselective methods for estimation of consumption. Non-enantioselective methods are among the most reported including for chiral PAD. Nevertheless, a trend has been seen towards the development of enantioselective methods as most PAD are chiral and determination of the enantiomeric fraction can provide additional information (e.g., distinction between consumption or direct disposal, or manufacture processes) and fulfill some WBE gaps.

Gene alteration in zebrafish exposed to a mixture of substances of abuse

A recent surge in the use and abuse of diverse prescribed psychotic and illicit drugs necessitates the surveillance of drug residues in source water and the associated ecological impacts of chronic exposure to the aquatic organism. Thirty-six psychotic and illicit drug residues were determined in discharged wastewater from two centralized municipal wastewater treatment facilities and two wastewater receiving creeks for seven consecutive days in Kentucky. Zebrafish (Danio rerio) larvae were exposed to the environmental relevant mixtures of all drug residues, all illicit drugs, and all prescribed psychotic drugs. The extracted RNA from fish homogenates was sequenced, and differentially expressed sequences were analyzed for known or predicted nervous system expression, and screened annotated protein-coding genes to the true environmental cocktail mixture. Illicit stimulant (cocaine and one metabolite), opioids (methadone, methadone metabolite, and oxycodone), hallucinogen (MDA), benzodiazepine (oxazepam and temazepam), carbamazepine, and all target selective serotonin reuptake inhibitors including sertraline, fluoxetine, venlafaxine, and citalopram were quantified in 100% of collected samples from both creeks. The high dose cocktail mixture exposure group revealed the largest group of differentially expressed genes: 100 upregulated and 77 downregulated (p ≤ 0.05; q ≤ 0.05). The top 20 differentially expressed sequences in each exposure group comprise 82 unique transcripts corresponding to 74% annotated genes, 7% non-coding sequences, and 19% uncharacterized sequences. Among 61 differentially expressed sequences that corresponded to annotated protein-coding genes, 23 (38%) genes or their homologs are known to be expressed in the nervous system of fish or other organisms. Several of the differentially expressed sequences are associated primarily with the immune system, including several major histocompatibility complex class I and interferon-induced proteins. Interleukin-1 beta (downregulated in this study) abnormalities are considered a risk factor for psychosis. This is the first study to assess the contributions of multiple classes of psychotic and illicit drugs in combination with developmental gene expression.

Dopant for detection of methamphetamine in the presence of nicotine with ion mobility spectrometry

Methamphetamine (MA) is a highly addictive and illegal psychostimulant drug and is currently one of the most commonly abused illicit drugs in the world. The on-site rapid detection of trace amounts of MA and screening illicit drugs in clandestine laboratories is important for drug enforcement agencies and the forensic community in general. However, detecting methamphetamine in the presence of nicotine and cigarette smoke by ion mobility spectrometry faces difficulty due to the overlapped spectral peaks of methamphetamine and nicotine. In this work, a new method was developed to detect MA using pyridine as a dopant in the presence of nicotine by a homemade ion mobility spectrometry. The reduced mobilities of MA and nicotine were measured under the temperatures of the drift tube from 40 to 120 °C and doping with pyridine. The result shows that the temperature of 100 °C is beneficial to resolve the two substances. The concentration of doped pyridine is optimized to be 18 ppm. In this doped experiment, the reaction rate of nicotine is higher than that of MA by measuring the instrumental responses of MA and nicotine. No matter how high the nicotine content is, the interference of nicotine can be eliminated in the detection of MA doped with pyridine. This method is also successfully applied for the determination of MA and nicotine simultaneously in real saliva samples. The limit of detection of MA was measured to be about 0.5 ng/μL. The promising results in this work provide an effective method for on-site detection of MA.

Estimating drug consumption during a college sporting event from wastewater using liquid chromatography mass spectrometry

Consumption of licit and/or illicit compounds during sporting events has traditionally been monitored using population surveys, medical records, and law enforcement seizure data. This pilot study evaluated the temporal and geospatial patterns in drug consumption during a university football game from wastewater using liquid chromatography tandem mass spectrometry (LC-MS/MS). Untreated wastewater samples were collected from three locations within or near the same football stadium every 30 min during a university football game. This analysis leveraged two LCMS/ MS instruments (Waters Acquity TQD and a Shimadzu 8040) to analyze samples for 58 licit or illicit compounds and some of their metabolites. Bayesian multilevel models were implemented to estimate mass load and population-level drug consumption, while accounting for multiple instrument runs and concentrations censored at the lower limit of quantitation. Overall, 29 compounds were detected in at least one wastewater sample collected during the game. The 10 most common compounds included opioids, anorectics, stimulants, and decongestants. For compounds detected in more than 50% of samples, temporal trends in median mass load were correlated with the timing of the game; peak loads for cocaine and tramadol occurred during the first quarter of the game and for phentermine during the third quarter. Stadium-wide estimates of the number of doses of drugs consumed were rank ordered as follows: oxycodone (n = 3246) > hydrocodone (n = 2260) > phentermine (n = 513) > cocaine (n = 415) > amphetamine (n = 372) > tramadol (n = 360) > pseudoephedrine (n = 324). This analysis represents the most comprehensive assessment of drug consumption during a university football game and indicates that wastewater-based epidemiology has potential to inform public health interventions focused on reducing recreational drug consumption during large-scale sporting events.

Determination of illicit drugs and psychoactive pharmaceuticals in wastewater from the area of Thessaloniki (Greece) using LC-MS/MS: estimation of drug consumption

This study presents the development of an analytical method for the simultaneous determination of multiclass illicit drugs (cocainoids, opiates, amphetamines, and cannabinoids) and psychoactive pharmaceuticals (anxiolytics, hypnotics, antipsychotics, antidepressants, and antiparkinsonian), in municipal wastewater. The analytical method was validated in terms of specificity, linearity, precision, and accuracy. The recoveries (%) for the majority of the analytes ranged between 70 and 120%, while the method showed good repeatability (2.4-29.2%). The limits of detection (LOD) of the method ranged between 0.8 and 9.4 ng L^-1. The method was implemented on influent and effluent samples from Thessaloniki (N. Greece) wastewater treatment plant (WWTP), and it revealed the daily presence of benzoylecgonine (BEG) (84.0-202.2 ng L^-1), methadone (12.3-17.5 ng L^-1), 11-Nor-9-carboxy-Δ⁹-tetrahydrocannabinol (THC-COOH) (80.3-171.9 ng L^-1), morphine (144.2-264.3 ng L^-1), and 6-monoacetylmorphine (6-MAM) (5.8-12.0 ng L^-1) in the influent samples of WWTP. Clozapine (101.6-315.5 ng L^-1), quetiapine (33.5-109.7 ng L^-1), and fluoxetine (20.9-124.4 ng L^-1) were pharmaceutical psychotics with the highest concentration in the influents. Back calculation estimated that the daily consumption of cocaine, heroin, cannabis, and methadone was 36-95, 86-164, 2300-5400, and 8-12 mg day^-1 per 1000 inhabitants, respectively. The consumption was estimated between 7-16 and 15 mg day^-1 per 1000 inhabitants for methyl diethanolamine (MDEA) and 3,4-methylenedioxymethamphetamine (MDMA), respectively.

Occurrence, distribution, and potential health risks of psychoactive substances in Chinese surface waters

Ten psychoactive substances (PSs) and metabolites were identified and quantified in 217 surface water samples collected across China to reveal the occurrence, distribution, and potential health risks in Chinese surface waters. The results showed the ubiquitous occurrence of caffeine (CFI), paraxanthine (PXT) and cotinine (CTN) at all the monitored sites, the concentrations of which ranged from not detected to 3460 ng L^-1, while the remaining PSs were detected at trace levels (<50 ng L^-1). High concentrations of diet-related PSs (CTN, CFI, and PXT) typically occurred in areas with high population densities. Traditional drugs tended to occur in megacities and the illegal manufacturing bases of the illicit drugs. Emerging drugs were found to be very popular across the whole country, with no significant differences among the samples. The risk assessment results suggest that drinking water containing these PS residues posed no potential human health risk in any life stage. However, the age-dependent risk quotients (RQs) of the 5 assessed PSs for the 12 age intervals ranged from < 1.0 × 10^-7 to 0.005. In terms of the evaluated life stages, the RQs for early stages (from birth to <2 years) were significantly higher than the RQs for other stages.

Tracing consumption patterns of stimulants, opioids, and ketamine in China by wastewater-based epidemiology

Illicit drug use has long been a key issue of international concern, and the true situation is unknown to the relevant authorities. To develop a profile of comprehensive consumption patterns of illicit drugs in China, data from 34 wastewater treatment plants in 25 cities were collected to analyze four classes of drugs, including amphetamine-type stimulants, opioids, ketamine, and cocaine. They were identified and quantified in samples using methods based on gas chromatography coupled to mass spectrometry. According to the wastewater-based epidemiology (WBE) approach, an analysis of the consumption pattern was performed regarding per inhabitant consumption based on the revised metabolic rate. The consumption quantity of illicit drug and precursor was divided into four categories based on statistical difference analyses: methamphetamine and ephedrine (precursor) were the predominant drugs in the first category, followed by ketamine and heroin in the second category, methcathinone and 3,4-methylenedioxymethamphetamine (MDMA) in the third category, and cocaine and methadone in the fourth category. There were distinctive spatial patterns: heroin and cocaine consumption was higher in Southern China than in Northern China, heroin consumption was higher in Western China than in Eastern China, and the consumption of each drug differed across seven regions of China, especially with ephedrine and methcathinone consumption higher in North China; heroin consumption higher in Southwest, Central, and Northwest China; and ketamine and MDMA consumption higher in East, South, and Central China. Compared with findings in previous studies, there were temporal patterns, in which ketamine consumption presented a downward trend but heroin remained stable. Based on correlation analyses, there were the polydrug abuse patterns between heroin and cocaine, methcathinone and ketamine, and cocaine and MDMA. In general, this study based on WBE provides a comprehensive evaluation of drug consumption in China.

Removal efficiency of emerging micropollutants in biofilter wastewater treatment plants in tropical areas

We studied the removal of 61 emerging micropollutants, including illicit drugs, in a biofilter wastewater treatment plant located in the French Indies (Martinique). Raw wastewater concentrations were the highest for paracetamol followed by caffeine, naproxen, ibuprofen, its metabolite 2-hydroxyibuprofen, atenolol, ketoprofen, furosemide, methylparaben, cocaine, benzoylecgonine, and 11-nor-delta-9-carboxytetrahydrocannabinol (THC-COOH). The calculated removals were better than those reported in the literature, while the cumulative removal efficacy (i.e., removal of the total mass load) was estimated to be 92 ± 4%. However, this good performance may be partly explained by the removal of paracetamol (also named acetaminophen) and caffeine, which represented 86.4% of the total mass load. Our results point to the adsorption of some molecules on sludge, thus raising the question about local soil pollution from sludge spreading.

Comparison of community illicit drug use in 11 cities of Turkey through wastewater-based epidemiology

Wastewater-based epidemiology (WBE) is an ever-increasing discipline that enables researchers to track near-real-time data concerning the recreational use of illicit drugs. Community illicit drug use was estimated in eleven Turkish cities, using eighteen wastewater treatment plants, representing the metropolitan cities and rural areas with different socio-demographic characteristics. In this study, 24-h composite influent wastewater samples were collected for 1 week per season between March 2019 and December 2019. Heroin, amphetamine, methamphetamine, ecstasy, cocaine, and marijuana were covered as illicit drugs in this study. Solid-phase extraction, LC-MS/MS separation, identification, and quantification were used as the analytical methods. Overall results indicate that both cocaine and MDMA usage increased in all cities on weekends. More specifically, it was observed that the average amount of cocaine use regarding 11 cities was 14.7 mg/1000 person/day, while figures for other substances are as follows: 9.5 for amphetamine, 34.5 for methamphetamine, 38.4 for MDMA, 42.2 for heroin, and lastly 5412 mg/1000p/day for marijuana. This study holds the position of being the most comprehensive one conducted, considering spatial and temporal datasets on illicit drug consumption obtained via WBE in Turkey.

Investigation of temporal illicit drugs, alcohol and tobacco trends in Istanbul city: Wastewater analysis of 14 treatment plants

Wastewater-based drug monitoring is a complementary tool that has been used worldwide in recent years, and many cities have periodically reported monitoring results. However, this study is the first to analyze drugs in wastewater in a single city with a high population during four periods simultaneously from 14 treatment plants. The aim was to estimate the consumption of conventional illicit drugs [amphetamine (AMP), methamphetamine (METH), 3,4-methylenedioxymethamphetamine (MDMA), cannabis, cocaine, and heroin], tobacco, and alcohol in 2019 for quarterly periods in Istanbul city, which has a population of almost 20 million, to aid in implementing evidence-based measures. Additionally, the seasonal variations among the 14 wastewater treatment plants and their weekday/weekend comparison of drug use patterns and consumption per substance were examined. Solid phase extraction was followed by liquid chromatography-tandem mass spectrometry and a previously validated method was enhanced by adding new parameters (morphine, cotinine, and ethyl sulfate), and satisfactory results were obtained. In this study, alcohol, nicotine, and cannabis had the highest estimated per capita consumption with mean values of 29655.3 mL/1000 inh/day, 5507.6 mg/1000 inh/day and 3607.0 mg/1000 inh/day, respectively. These results were followed by heroin and cocaine consumption with mean values of 557.0 and 200.9 mg/1000 inh/day, respectively, whereas AMP-type stimulants had the lowest values among the targeted substances. METH and cannabis were also highly consumed drugs when compared with the results of other metropolitan cities, whereas heroin consumption was remarkably high owing to Turkey's location on a possible heroin trafficking route. Because Istanbul is the business center of the country and has the potential to attract tourists in all four seasons, meaningful seasonal consumption differences were not observed for all substances.

Occurrence, fate and mass loading of benzodiazepines and their transformation products in eleven wastewater treatment plants in Guangdong province, China

Benzodiazepines (BZDs) are one of the most widely prescribed psychoactive drugs, however their persistence in the receiving environment has raised great concerns about their potential ecological risks. Here we investigated the occurrence, fate and mass loading of 17 BZDs and their 3 transformation products in 11 wastewater treatment plants (WWTPs) in Guangdong province, China. A total of 10 BZDs and 1 transformation product were found in the WWTPs influents, effluents and excess sludge, with concentrations reaching up to 44.5 ng/L (clozapine), 27.1 ng/L (oxazepam) and 62.9 ng/g (clozapine), respectively. The overall removal efficiency varied widely from negative to complete removal in these 11 WWTPs. Mass balance analysis of two representative WWTPs (WWTP_A and WWTP_B) with different treatment processes showed that their removals were mainly attributed to the sludge adsorption and biodegradation/biotransformation. The total usage of detected BZDs was estimated to be 185 kg/y in Guangdong province, China, while the total emission was 143 kg/y. Based on sewage epidemiology method, the total back-estimated consumption and emissions of BZDs and their transformation products in one district of Guangzhou (WWTP_C service area) were 1012 mg/d/1000 people and 10.1 mg/d/1000 people, respectively. The findings from this study demonstrate the persistence of BZDs in WWTPs and also provide basis for further investigation into the potential ecological risks from this group of chemicals.

High-throughput wastewater analysis for substance use assessment in central New York during the COVID-19 pandemic

Wastewater entering sewer networks represents a unique source of pooled epidemiological information. In this study, we coupled online solid-phase extraction with liquid chromatography-high resolution mass spectrometry to achieve high-throughput analysis of health and lifestyle-related substances in untreated municipal wastewater during the coronavirus disease 2019 (COVID-19) pandemic. Twenty-six substances were identified and quantified in influent samples collected from six wastewater treatment plants during the COVID-19 pandemic in central New York. Over a 12 week sampling period, the mean summed consumption rate of six major substance groups (i.e., antidepressants, antiepileptics, antihistamines, antihypertensives, synthetic opioids, and central nervous system stimulants) correlated with disparities in household income, marital status, and age of the contributing populations as well as the detection frequency of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in wastewater and the COVID-19 test positivity in the studied sewersheds. Nontarget screening revealed the covariation of piperine, a nontarget substance, with SARS-CoV-2 RNA in wastewater collected from one of the sewersheds. Overall, this proof-of-the-concept study demonstrated the utility of high-throughput wastewater analysis for assessing the population-level substance use patterns during a public health crisis such as COVID-19.

Transformation of Illicit Drugs and Pharmaceuticals in Sewer Sediments

In-sewer stability of human excreted biomarkers is a critical factor of wastewater-based epidemiology in back-estimating illicit drug and pharmaceutical use in the community. Biomarker stability has been investigated in sewers with the presence of biofilms, but the understanding in sewer sediments is still lacking. This study for the first time employed a laboratory sediment reactor to measure 18 illicit drug and pharmaceutical biomarkers under gravity sewer environments with the presence of sediments. Biomarkers exhibited various stability patterns due to transformation processes occurring in the bulk wastewater and sediments. The attenuation of a biomarker by sediments is driven by complex processes involving biodegradation, diffusion, and sorption, which is directly proportional to the ratio of sediment surface area against wastewater volume. The sediment-driven transformation coefficients of biomarkers are higher than the accordingly biofilm-mediated rates because of stronger microbial activities in sediments. Additionally, the stability of most biomarkers was insensitive to the natural pH variation in sewers, except for a few compounds (e.g., methadone, ketamine, and paracetamol) susceptible to pH changes. In general, this study delineates the stability data of various biomarkers in gravity sewers with sediments, which are novel and long-missing information for wastewater-based epidemiology and improve the reliability of back-estimation in complex sewer networks.

A global systematic review and meta-analysis on illicit drug consumption rate through wastewater-based epidemiology

Wastewater-based epidemiology (WBE) is a complementary, well-established comprehensive, cost-effective, and rapid technique for monitoring of illicit drugs used in a general population. This systematic review and meta-analysis is the first to estimate the rank and consumption rate of illicit drugs through WBE studies. In the current study, the related investigations regarding the illicit drug consumption rate based on WBE were searched among the international databases including Scopus, PubMed, Science direct, Google scholar, and local database, Magiran from 2012 up to May 2019. The illicit drug consumption rate with 95% confidence intervals was pooled between studies by using random effect model. The heterogeneity was determined using I² statistics. Also, subgroup analyses were conducted to examine the possible effects of year and location of studies on observed heterogeneity. Meta-analysis of 37 articles indicates that the overall rank order of illicit drugs according to their pooled consumption rate can be summarized as tetrahydrocannabinol or cannabis (7417.9 mg/day/1000 people) > cocaine (655.7 mg/day/1000 people) > morphine (384.9 mg/day/1000 people) > methamphetamine (296.2 mg/day/1000 people) > codeine (222.7 mg/day/1000 people) > methadone (200.2 mg/day/1000 people) > 3,4-methylenedioxymethamphetamine (126.3 mg/day/1000 people) > amphetamine (118.2 mg/day/1000 people) > 2-ethylidene-1,5-dimethyl-3, 3-diphenylpyrrolidine (33.7 mg/day/1000 people). The pooled level rate was 190.16 mg/day/1000 people for benzoylecgonine (main urinary cocaine metabolite), 137.9 mg/day/1000 people for 11-nor-9-carboxy-delta9-tetrahydrocannabinol (main metabolite of cannabis), and 33.7 mg/day/1000 people for 2-ethylidene-1,5-dimethyl-3, 3-diphenylpyrrolidine (main metabolite of methadone). The I² values for all selected drugs were 100% (P value < 0.001). The results of year subgroup indicated that the changes of heterogeneity for all selected drugs were nearly negligible. The heterogeneity within studies based on continents subgroup just decreased in America for drugs like 11-nor-9-carboxy-delta9-tetrahydrocannabinol (I² = 24.4%) and benzoylecgonine (I² = 94.1%). The outcome of this meta-analysis can be used for finding the illicit drugs with global serious problem in view of consumption rate (i.e., cannabis and cocaine) and helping authorities to combat them.

Nanomaterial-based aptamer sensors for analysis of illicit drugs and evaluation of drugs consumption for wastewater-based epidemiology

The abuse of illicit drugs usually associated with dramatic crimes may cause significant problems for the whole society. Wastewater-based epidemiology (WBE) has been demonstrated to be a novel and cost-effective way to evaluate the abuse of illicit drugs at the community level, and has been used as a routine method for monitoring and played a significant role for combating the crimes in some countries, e.g. China. The method can also provide temporal and spatial variation of drugs of abuse. The detection methods mainly remain on the conventional liquid chromatography coupled with mass spectrometry, which is extremely sensitive and selective, however needs advanced facility and well-trained personals, thus limit it in the lab. As an alternative, sensors have emerged to be a powerful analytical tool for a wide spectrum of analytes, in particular aptamer sensors (aptasensors) have attracted increasing attention and could act as an efficient tool in this field due to the excellent characteristics of selectivity, sensitivity, low cost, miniaturization, easy-to-use, and automation. In this review, we will briefly introduce the context, specific assessment process and applications of WBE and the recent progress of illicit drug aptasensors, in particular focusing on optical and electrochemical sensors. We then highlight several recent aptasensors for illicit drugs in new technology integration and discuss the feasibility of these aptasensor for WBE. We will summarize the challenges and propose our insights and opportunity on aptasensor for WBE to evaluate community-wide drug use trends and public health.

Tracking the occurrence of psychotropic pharmaceuticals in Brazilian wastewater treatment plants and surface water, with assessment of environmental risks

According to the World Health Organization, >360 million people worldwide suffer from mental diseases such as depression, anxiety, or bipolar disorder, for which psychotropic drugs are frequently prescribed. Despite being highly metabolized in the human organism, non-metabolized portions of these drugs are excreted, subsequently reaching wastewater treatment plants (WWTPs), where they may be incompletely removed during treatment, leading to the contamination of surface waters. In this work, ten psychotropic drugs widely consumed in Brazil (alprazolam, amitriptyline, bupropion, carbamazepine, clonazepam, escitalopram, fluoxetine, nortriptyline, sertraline, and trazadone) were monitored at five WWTPs located in the metropolitan region of Campinas (São Paulo State, Brazil). The drugs were determined in the influents, at different stages of the treatments, and in the effluents. Surface waters from the Atibaia River and the Anhumas Creek were also monitored. Quantitation of the pharmaceuticals was carried out by online solid-phase extraction coupled with ultra-high performance liquid chromatography and tandem mass spectrometry. The method was validated and presented a limit of quantitation of 50 ng L^-1 for all the drugs assessed. Six of the substances monitored were quantified in the samples collected from the different treatment processes employed at the WWTPs. These technologies were unable to act as barriers for these psychotropics drugs. The concentrations ranged from 50 to 3000 ng L^-1 in the WWTP effluents, while the main contaminants were found in surface waters at concentrations from 25 to 3530 ng L^-1. The levels of the psychotropic detected in this work did not appear to present risks to the aquatic biota.

A multi-residue method by supercritical fluid chromatography coupled with tandem mass spectrometry method for the analysis of chiral and non-chiral chemicals of emerging concern in environmental samples

This manuscript presents the development, validation and application of a multi-residue supercritical fluid chromatography coupled with tandem mass spectrometry method for the analysis of 140 chiral and non-chiral chemicals of emerging concern in environmental samples, with 81 compounds being fully quantitative, 14 semi-quantitative and 45 qualitative, validated according to European Medicine Agency (EMA) guidelines (European Medicines Agency 2019). One unified LC-MS method was used to analyse all analytes, which were split into three injection methods to ensure sufficient peak resolution. The unified method provided an average of 113% accuracy and 4.5% precision across the analyte range. Limits of detection were in the range of 35 pg L⁻¹–0.7 μg L⁻¹, in both river water and wastewater, with an average LOD of 33 ng L⁻¹. The method was combined with solid-phase extraction and applied in environmental samples, showing very good accuracy and precision, as well as excellent chromatographic resolution of a range of chiral enantiomers including beta-blockers, benzodiazepines and antidepressants. The method resulted in quantification of 75% of analytes in at least two matrices, and 56% in the trio of environmental matrices of river water, effluent wastewater and influent wastewater, enabling its use in monitoring compounds of environmental concern, from their sources of origin through to their discharge into the environment.

Prevalence of illicit and prescribed neuropsychiatric drugs in three communities in Kentucky using wastewater-based epidemiology and Monte Carlo simulation for the estimation of associated uncertainties

A cost-effective alternative approach capable of determining the prevalence of substance use in communities can complement the existing efforts of combating drug abuse and addiction. In this study, the prevalence of 10 illicit and 19 prescribed psychoactive drugs of potential abuse was determined utilizing wastewater-based epidemiology, and compared in two adjoined urban communities and a rural community. This is the first application of the Monte Carlo simulation method to account multiple uncertainties and propagation of errors associated with the individual parameter of wastewater based epidemiological estimations in the U.S. A significantly higher prevalence of cocaine [3830 (mean difference, MD: 2960) mg/d/1000 people] was found in the central business district while the per-capita consumption rates of amphetamine [738 (MD: 338) mg/d/1000 people] and methamphetamine [1660 (MD: 629) mg/d/1000 people] were higher in a rural community. Among narcotics, the per-capita consumption rate of fentanyl and morphine was significantly higher in urban communities while codeine, hydrocodone, hydromorphone, and buprenorphine were dominant in a rural community. The significantly higher prevalence of buprenorphine (˜20-30 folds), oxycodone (˜2-3 folds), and alprazolam (˜2-3 folds) determined in these communities compared to the conventional estimates based on the electronically reported prescriptions and drug-related inpatient hospitalizations suggest the abuse of these drugs.