The spatial epidemiology of cocaine, methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA) use: a demonstration using a population measure of community drug load derived from municipal wastewater
Article first published online: 14 JUL 2009
© 2009 The Authors. Journal compilation © 2009 Society for the Study of Addiction
Volume 104, Issue 11, pages 1874–1880, November 2009
How to Cite
Banta-Green, C. J., Field, J. A., Chiaia, A. C., Sudakin, D. L., Power, L. and De Montigny, L. (2009), The spatial epidemiology of cocaine, methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA) use: a demonstration using a population measure of community drug load derived from municipal wastewater. Addiction, 104: 1874–1880. doi: 10.1111/j.1360-0443.2009.02678.x
- Issue published online: 9 OCT 2009
- Article first published online: 14 JUL 2009
- Submitted 3 February 2009; initial review completed 30 April 2009; final version accepted 4 May 2009
- drug epidemiology;
- spatial analysis;
- wastewater analysis
Aims To determine the utility of community-wide drug testing with wastewater samples as a population measure of community drug use and to test the hypothesis that the association with urbanicity would vary for three different stimulant drugs of abuse.
Design and participants Single-day samples were obtained from a convenience sample of 96 municipalities representing 65% of the population of the State of Oregon.
Measurements Chemical analysis of 24-hour composite influent samples for benzoylecgonine (BZE, a cocaine metabolite), methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA). The distribution of community index drug loads accounting for total wastewater flow (i.e. dilution) and population are reported.
Findings The distribution of wastewater-derived drug index loads was found to correspond with expected epidemiological drug patterns. Index loads of BZE were significantly higher in urban areas and below detection in many rural areas. Conversely, methamphetamine was present in all municipalities, with no significant differences in index loads by urbanicity. MDMA was at quantifiable levels in fewer than half the communities, with a significant trend towards higher index loads in more urban areas.
Conclusion This demonstration provides the first evidence of the utility of wastewater-derived community drug loads for spatial analyses. Such data have the potential to improve dramatically the measurement of the true level and distribution of a range of drugs. Drug index load data provide information for all people in a community and are potentially applicable to a much larger proportion of the total population than existing measures.