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Cocaine, MDMA and methamphetamine residues in wastewater: Consumption trends (2009–2015) in South East Queensland, Australia
STOTEN-20085; No of Pages 7 Science of the Total Environment xxx (2016) xxx–xxx
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Cocaine, MDMA and methamphetamine residues in wastewater: Consumption trends (2009–2015) in South East Queensland, Australia☆ Foon Yin Lai a,⁎, Jake W. O'Brien a, Phong K. Thai a,b, Wayne Hall c, Gary Chan c, Raimondo Bruno d, Christoph Ort e, Jeremy Prichard f, Steve Carter g, Shalona Anuj g, K. Paul Kirkbride h, Coral Gartner c, Melissa Humphries i, Jochen F. Mueller a,⁎ a
The University of Queensland, The National Research Centre for Environmental Toxicology (Entox), 39 Kessels Road, Coopers Plains, QLD 4108, Australia Queensland University of Technology, International Laboratory for Air Quality and Health, Brisbane, QLD 4001, Australia c The University of Queensland, Centre for Youth Substance Abuse Research, Herston, QLD, 4029, Australia. d School of Psychology, University of Tasmania, Private Bag 30, Hobart, TAS, 7001, Australia e Swiss Federal Institute of Aquatic Science and Technology (Eawag) Urban Water Management, Ueberlandstrasse 133, CH 8600, Duebendorf, Switzerland f Faculty of Law, University of Tasmania, Private Bag 30, Hobart, TAS 7001, Australia g Queensland Health Forensic Scientific Services, Queensland Government, 39 Kessels Road, Coopers Plains, QLD 4108, Australia h School of Chemical and Physical Sciences, Flinders University, Bedford Park, Adelaide, South Australia 5042, Australia i School of Physical Science, University of Tasmania, Private Bag 30, Hobart, TAS, 7001, Australia b
H I G H L I G H T S
G R A P H I C A L
A B S T R A C T
• The most intensive temporal dataset on illicit stimulants use via WBE in Australia • Illicit stimulants use assessed over 6 years in two populations (urban & rural) • No noticeable trends for cocaine and MDMA use in the urban area • A five-fold increase in methamphetamine use in the urban area • A three-fold increase in methamphetamine use in the rural area
a r t i c l e
i n f o
Article history: Received 12 April 2016 Received in revised form 25 May 2016 Accepted 25 May 2016 Available online xxxx Keywords: Urban cities
a b s t r a c t Wastewater analysis, or wastewater-based epidemiology, has become a common tool to monitor trends of illicit drug consumption around the world. In this study, we examined trends in cocaine, 3,4methylenedioxymethamphetamine (MDMA) and methamphetamine consumption by measuring their residues in wastewater from two wastewater treatment plants in Australia (specifically, an urban and a rural catchment, both in South East Queensland) between 2009 and 2015. With direct injection of the samples, target analytes were identified and quantified using liquid chromatography-mass spectrometry. Cocaine and MDMA residues and metabolites were mainly quantifiable in the urban catchment while methamphetamine residues were
☆ Data of methamphetamine were presented as a short report in the Medical Journal of Australia (Lai et al., 2016). ⁎ Corresponding authors. E-mail addresses: [email protected] (F.Y. Lai), [email protected] (J.F. Mueller).
http://dx.doi.org/10.1016/j.scitotenv.2016.05.181 0048-9697/© 2016 Elsevier B.V. All rights reserved.
Please cite this article as: Lai, F.Y., et al., Cocaine, MDMA and methamphetamine residues in wastewater: Consumption trends (2009–2015) in South East Queensland, Australia, Sci Total Environ (2016), http://dx.doi.org/10.1016/j.scitotenv.2016.05.181
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Rural areas Illicit stimulants Drug markets Drug epidemiology LC-MS/MS
consistently detected in both urban and rural catchments. There was no consistent trend in the population normalised mass loads observed for cocaine and MDMA at the urban site between 2009 and 2015. In contrast, there was a five-fold increase in methamphetamine consumption over this period in this catchment. For methamphetamine consumption, the rural area showed a very similar trend as the urban catchment starting at a lower baseline. The observed increase in per capita loads of methamphetamine via wastewater analysis over the past six years in South East Queensland provides objective evidence for increased methamphetamine consumption in the Australian population while the use of other illicit stimulants remained relatively stable. © 2016 Elsevier B.V. All rights reserved.
1. Introduction
by the Australian Customs and Border Protection Service, increased arrests for possession and supply of methamphetamine within State and Territory jurisdictions, and increased treatment seeking by problem users (Roche et al., 2015). Regular injection and smoking of methamphetamine can produce a variety of serious adverse effects, such as anxiety and depressive disorders, and a dependence syndrome (McKetin et al., 2006b). Heavy users may develop an acute paranoid psychosis (Darke et al., 2008; McKetin et al., 2010), become violent and aggressive (McKetin et al., 2006a) and engage in criminal activity to fund their drug use (McKetin et al., 2005). Users may die from myocardial infarctions and strokes (Degenhardt et al., 2007; Kaye et al., 2007; De Letter et al., 2006). The current study applied WWA to monitor population consumption of three commonly used illicit stimulant drugs, including cocaine, 3,4-methylenedioxymethamphetamine (MDMA) and methamphetamine, in South East Queensland between 2009 and 2015. Trends in consumption of methamphetamine were compared between two catchment areas: a major urban community (2009–2015) and a rural community (2010–2015). We also examined trends in consumption of two other illicit stimulants, cocaine and MDMA, in the urban catchment area between 2009 and 2015.
Illicit drug use contributes substantially to the global burden of disease, morbidity, and organised crime (Lim et al., 2012; UNODC, 2015). It is, therefore, important to monitor the level of illicit drug use in the population so that appropriate policies can be developed to minimise drug-related harms. Traditionally, the monitoring of illicit drug use has been done through population surveys and the analysis of indicators of drug use (e.g. drug seizures) or drug-related harm (e.g. drug overdoses, and drug-related hospital admissions) but these methods have their limitations. For example, Australia's national household survey is only conducted every three years because of its expense (Prichard et al., 2012). Also, only 2% of participants in the national household survey reported using a drug, such as methamphetamine, so the survey has limited statistical power to detect changes in its prevalence. It is also likely that heavy illicit drug users are under-represented in national household surveys (Degenhardt and Hall, 2012). Supplementary methodologies are needed to better understand illicit drug use in the population and to provide more timely data to inform the most efficient allocation of public health and law enforcement resources to reduce drug-related harm. Wastewater analysis (WWA) is an approach to monitor illicit drug consumption in the population that overcomes some of the limitations of surveys (Castiglioni et al., 2014; Hall et al., 2012). WWA is a relatively new approach with considerable research evidence for its validity. WWA studies clearly show recognised patterns of illicit drug consumption over time (e.g. cocaine consumption is higher on weekends than on weekdays while cannabis consumption is more stable throughout the week) and by location (higher consumption of illicit drugs are detected in larger cities than in rural areas) (van Nuijs et al., 2011a, Ort et al., 2014) that are also reflected in epidemiological studies. The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) recognised the potential of WWA to become an important adjunct to established drug monitoring tools by delivering near-real-time data on changes in mercurial illicit drug markets. WWA has been used in Australia to assess patterns of drug consumption over different time frames and across different community settings (e.g. cities, rural areas, prisons, major events, etc.) (e.g. Lai et al., 2011, 2013b, 2015; Irvine et al., 2011). It has also been applied broadly in different countries (Gerrity et al., 2011; Kankaanpää et al., 2014; Östman et al., 2014) and in multi-country studies (Ort et al., 2014; Thomas et al., 2012). There are, however, few WWA studies that have measured illicit drug consumption over long time periods using extensive sampling campaigns. For example, to our knowledge, only three studies have performed continuous (daily) monitoring over an entire year (van Nuijs et al., 2011b; Ort et al., 2014; Lai et al., 2015). Other studies have used intermittent sampling to monitor drug consumption trends over time (e.g. Lai et al., 2013a, 2013c; Chen et al., 2011; Tscharke et al., 2015; Zuccato et al., 2011; Castiglioni et al., 2014). Over the past several years, the popular media in Australia have reported increased harm arising from the use of crystalline methamphetamine, colloquially known as “ice” (e.g. ABC, 2015; Hildebrand, 2015; Lee, 2015). This is a highly pure form of methamphetamine that can be smoked or injected (McKetin et al., 2005; O'Brien et al., 2007). Since the mid-2000s, there have been substantial seizures of the drug
2. Methods 2.1. Wastewater sampling and analysis Wastewater sampling was conducted at the major wastewater treatment plants (WWTPs) in each of two locations in South East Queensland, Australia. A total of 498 (urban) and 712 (rural) samples were successfully collected in 2009–2015. In the urban area, we collected daily composite samples as follows: Nov 2009 (12 days), Nov–Dec 2010 (21 days), Jan–Dec 2011 (160 days), Jan–Dec 2012 (188 days), Jan–Dec 2013 (61 days), Jan–Dec 2014 (49 days) and Mar 2015 (7 days). In the rural area we collected daily composite samples as follows: Aug–Dec 2010 (34 days), Jan–Dec 2011 (84 days), Jan–Dec 2012 (243 days), Jan–Dec 2013 (273 days), Jan–Dec 2014 (51 days) and Jan–May 2015 (27 days). Daily composite samples were collected using a sampling system installed at the inlet of a wastewater treatment plant. For the urban catchment, a continuous flow proportional sampling mode was used to collect the samples between November 2009 and October 2012. From November 2012 onwards sampling was scaled down to once a week on Tuesday or Wednesday due to limited access to the treatment plant. In this period, daily composite samples were taken using a timeproportional sampling technique with a sampling frequency of 100 mL per 15 min. For the rural area, volume-proportional sampling mode was used to collect a sub-sample at 100 m3 intervals. At both sites, sample collection (over 24 h) was conducted under refrigeration. To keep the target chemicals stable in wastewater, samples were acidified to pH 2 onsite and frozen until analysis. Data on daily wastewater volumes were recorded by the WWTP operators. We obtained catchment map boundaries from the WWTP operators and gave them to Australian Bureau of Statistics personnel to calculate the population for each catchment. The estimated number of people in the catchment area was based on the latest census data.
Please cite this article as: Lai, F.Y., et al., Cocaine, MDMA and methamphetamine residues in wastewater: Consumption trends (2009–2015) in South East Queensland, Australia, Sci Total Environ (2016), http://dx.doi.org/10.1016/j.scitotenv.2016.05.181
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Table 1 Summary of cocaine and MDMA consumption (mg/day/1000 people) measured in wastewater samples in the urban catchment from 2009 to 2015. 2009
2010
2011
2012
2013
2014
2015
Cocaine Range Median Average CV%
229–692 339 382 36
57–395 104 157 68
63–839 225 266 53
133–2441 343 415 59
62–739 310 326 37
183–993 330 362 41
241–642 327 416 41
MDMA Range Median Average CV%
100–387 192 199 41
58–552 148 187 78
10–1202 121 206 106
58–3244 271 387 102
12–639 47 69 125
82–1422 211 272 83
85–518 126 237 72
The analytical method applied in this study has been validated and previously published (Lai et al., 2011; Lai et al., 2015). The method has also been validated through an inter-laboratory comparison (SCORE, 2015). Briefly, for all compounds, filtered wastewater samples (1 mL) were spiked with mass-labelled internal standards and then analysed without extraction process. All samples were analysed together with calibration standards by high-performance liquid chromatography (Shimadzu Nexera UHPLC system) coupled to a triple quadrupole tandem mass spectrometer (AB SCIEX QTRAP®5500). Drug residues of the parent drug and/or its major metabolite included 3,4methylenedioxymethamphetamine (MDMA), cocaine, benzoylecgonine (cocaine's main metabolite), and methamphetamine. Adsorption of these hydrophilic compounds (drug residues) onto particulate matters of the wastewater is negligible (Baker and Kasprzyk-Hordern, 2011; Senta et al., 2014); thus measuring their concentrations in the water phase are justified for valid estimates of consumption (Zuccato et al., 2008). 2.2. Data analysis Drug consumption was back-calculated using a formula established previously (Zuccato et al., 2008). Briefly, the drug residue concentration (μg/L) measured is multiplied by the total daily wastewater volume (ML/day) to produce an estimated amount (mg/day) of the drug residue. This estimate was then corrected using the excretion factor and normalised to the catchment area population based on the latest census data to produce an estimate of the consumption level (mg/day/1000 people). Correction factors for the target drugs were calculated using published values (Lai et al., 2011). For example, a correction factor of 3.1 (1.1/0.35) was from an average excretion rate of 35% and the molar mass ratio of 1.1 (cocaine to benzoylecgonine). A correction factor of 6.7 was used to back estimate MDMA using MDMA residues (1/
0.15). A correction factor of 2.6 was used to back estimate methamphetamine from methamphetamine residues (1/0.39). Given the proven stability of benzoylecgonine, MDMA and methamphetamine residues in wastewater (Thai et al., 2014; McCall et al., 2016), these backestimated figures reasonably reflect the collective daily consumption of these drugs in the catchments (g/day). We used the inter-quartile range of box-whisker plots to summarise variability in the estimated amount detected in each year. Linear regression models were used to test for trends in detections of cocaine, MDMA, and methamphetamine across each year of study. The presence of higher order trends (quadratic and cubic) were tested but did not improve any model fits and are hence not reported here. All analyses were performed in Stata 13, SPSS 22 and R.
3. Results Methamphetamine residue was quantifiable in all samples in both urban and rural areas. Residues of cocaine, benzoylecgonine, and MDMA were only found in the samples of the urban catchment. Detailed estimates are presented in follows: In the urban catchment, daily consumption (per 1000 people) of cocaine (estimated from benzoylecgonine) ranged from 57 to 2441 mg and the yearly averages fluctuated from 157 mg to 416 mg/day during the study period (Table 1). Consumption of MDMA was at a similar level, with the recorded daily amount ranging from 12 to 3244 mg and the yearly average from 69–387 mg/day in the studied urban catchment (Table 1). Figs. 1 and 2 indicate that there was no meaningful trend in cocaine (R2 = 0.03; β = 31.4, 95%CI = 16.5–46.2) or MDMA consumption (R2 = 0.01; β = 4.2, 95%CI = − 19.2–27.6) during the study period. Also, there was no significant difference in per capita consumption of these two drugs between 2009 and 2015.
Fig. 1. Estimated cocaine consumption in the urban catchment in 2009–2015. Data is presented in the box-and-whisker plot, with the linear trend (red dotted line). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
Please cite this article as: Lai, F.Y., et al., Cocaine, MDMA and methamphetamine residues in wastewater: Consumption trends (2009–2015) in South East Queensland, Australia, Sci Total Environ (2016), http://dx.doi.org/10.1016/j.scitotenv.2016.05.181
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Fig. 2. Estimated MDMA consumption in the urban catchment in 2009–2015. Data is presented in the box-and-whisker plot, with the linear trend (red dotted line). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
Per capita methamphetamine consumption was higher in the urban area than the rural area over the monitoring period (Table 2). Both areas showed an increase in methamphetamine consumption. In the urban catchment, the estimated average increased from 234 to 1126 mg per day per 1000 people between 2009 and 2015, an approximately 4.8 fold increase (Fig. 3). Similarly, in the rural area (Fig. 4), the average estimates rose from 112 to 381 mg per day among 1000 people between 2010 and 2015, an approximately 3.5 fold increase. Analyses indicated that there was a significant linear increase in per capita methamphetamine consumption in the urban area between 2009 and 2015 (F(1,496) = 312.4, p b 0.001; R2 = 0.39, β = 114.4, 95%CI = 101.7–127.1) (Fig. 3). There was a smaller linear increase (F(1,710) = 539.5, p b 0.001; R2 = 0.43, β = 59.5, 95%CI = 54.5– 64.5) in methamphetamine consumption in the rural area between 2010 and 2015 (Fig. 4). 4. Discussion This study monitored trends in the consumption of three illicit stimulant drugs which have been commonly measured in WWAs. The most comprehensive monitoring of these illicit drugs to date is the SCORE project where international research partners collectively monitored illicit drug consumption in more than a dozen cities around the world, mostly located in Europe (SCORE, 2015) with the most recent data published in 2014 (Ort et al., 2014). Benzoylecgonine was only detected in the samples from the urban catchment and in low levels, with the annual average daily loads ranging from 51 to 134 mg per 1000 people over the study period. Our result was at the lower range of the European data reported in the SCORE project, similar to data from cities in Norway and Portugal (Ort et al., 2014). The finding is in line with the fact that the cocaine market in Europe is larger than that in Australia (UNODC, 2015). Cocaine is relatively less
available, lower in purity and more expensive in Australia compared to Europe and more cocaine seizures have been reported in Europe than Australia (World Drug Report 2015). The detection of higher cocaine consumption in our studied urban catchment than another Australian city (Adelaide) by Tscharke et al. (2015) (15–18 mg/day/ 1000 people) is in agreement with other Australian data that suggests the cocaine market in South Australia is smaller than that in the eastern seaboard jurisdictions (ACC, 2014). MDMA was also only found in the urban catchment. Its overall average daily loads were stable in 2009–2015. The overall mass load of MDMA in the urban catchment was at the median level of the European data reported in the SCORE project and most similar to that in cities in Finland, Denmark and Spain (Ort et al., 2014). It was higher than that observed in Adelaide (Tscharke et al., 2015). As with cocaine, ecstasy is more available, cheaper and typically purer in Europe than Australia (UNODC, 2015). In Australia, the markets of ecstasy have been found larger in Queensland compared to South Australia (ACC, 2014). An increase in the purity of ecstasy during 2012–2013 was reported by the EMCDDA and in seizure data from Australia (ACC, 2014). Thus, the noticed downturn in MDMA consumption from 2012 to 2013 suggests a potential decrease in its availability during that period in our urban catchment. This is consistent with the national household survey report showing a decline in ecstasy use in 2013 (AIHW, 2014). Our study revealed a large increase in methamphetamine consumption in both monitored catchments over the period 2009/2010 to 2015, an approximately five-fold rise in the urban area and a three-fold one in the rural area. This is in agreement with the two fold increase in methamphetamine consumption recently reported in Adelaide (Australia) during 2010–2013 (Tscharke et al., 2015). The annual average of daily loads of methamphetamine in 2010, when the data were first obtained in both catchments, were 44 and 139 mg/day/1000 people in the rural
Table 2 Summary of methamphetamine consumption (mg/day/1000 people) measured in wastewater between the urban and rural catchments from 2009 to 2015. 2009
2010
2011
2012
2013
2014
2015
Urban area Range Median Average CV%
173–353 222 234 23
246–526 343 363 22
142–978 452 467 31
254–1279 514 553 32
330–1511 615 599 31
566–1416 825 839 21
952–1401 1062 1126 14
Rural area Range Median Average CV%
– – – –
73–188 112 115 20
69–229 126 127 24
64–448 150 158 33
61–492 210 228 41
188–485 315 323 23
318–518 381 398 14
Please cite this article as: Lai, F.Y., et al., Cocaine, MDMA and methamphetamine residues in wastewater: Consumption trends (2009–2015) in South East Queensland, Australia, Sci Total Environ (2016), http://dx.doi.org/10.1016/j.scitotenv.2016.05.181
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Fig. 3. Estimated methamphetamine consumption in the urban catchment in 2009–2015. Data is presented in the box-and-whisker plot, with the linear trend (red dotted line). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
and urban areas, respectively. These levels are equivalent if not higher to the highest consumption reported in the SCORE project in Europe in 2011–2013 (Ort et al., 2014). The high level of methamphetamine use in Australia is consistent with data in the World Drug Report (World Drug Report 2015). Smaller increases in methamphetamine consumption have also been observed in the last few years in the Czech Republic (about 2 fold in Budweis and Prague, in 2012–2013) and China (about 2 times in Beijing, Shanghai, and Shenzhen, in 2012–2014) (Ort et al., 2014; Du et al., 2015). Comparing consumption trends across these three illicit stimulants, the rate of increase in methamphetamine in Australia is unique. There has been a debate in Australia about whether the increase in methamphetamine-related harm recorded is due to an increase in the amount of drug used by existing users, an increase in drug purity, or whether there has been an increase in the number of users, or a combination of these factors. Existing users who smoke or inject methamphetamine are undoubtedly experiencing an increase in harm, which correlates with heavier use among current users (McKetin and Farrell, 2015). However, there is other evidence that younger users have been recruited to methamphetamine use, which may indicate an increase in the number of users. This is shown by increases in the arrests of younger persons for amphetamine offences, younger people seeking hospital treatment for methamphetamine-related morbidity, and more treatment-seeking among young adults for methamphetamine-related problems (Degenhardt et al., 2016; Nathan et al., 2016).
The purity of the methamphetamine in Australia has increased from between 20–30% in 2009 to over 50–70% in 2014 (ACC, 2014). Hence, the increase in the drug purity is also an important factor in the observed increase in use and harm. Our analysis is only able to provide data on the overall amount of methamphetamine used in the catchments and cannot determine who used it and in what average doses. However, the scale of the increase in consumption observed in our data, combined with other recent epidemiological evidence, suggests that it is unlikely that recent increases in methamphetamine-related harm in Australia can be totally explained by increased use among existing regular and dependent methamphetamine users and/or higher drug purity. While WWA provided solid evidence for temporal and spatial patterns of the three stimulants in this study, we cannot use these data to estimate the number of users who contributed to the measured drug loads. Furthermore, the populations contributing to wastewater samples in each area were based on the most recent census data so changes in the population over time are not taken into account. Lastly, for the estimation of consumption we assumed that the average excretion factor of the drugs remained constant and was not influenced by activities such as poly-drug use, the effects of which on excretion rates are not known. Notwithstanding these limitations, our findings agree with trends in other indicators of drug consumption, especially for methamphetamine consumption, such as increased police seizures, increased numbers of arrests for methamphetamine consumption and supply, and increased numbers of persons seeking treatment for
Fig. 4. Estimated methamphetamine consumption in the rural catchment in 2010–2015. Data is presented in the box-and-whisker plot, with the linear trend (red dotted line). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
Please cite this article as: Lai, F.Y., et al., Cocaine, MDMA and methamphetamine residues in wastewater: Consumption trends (2009–2015) in South East Queensland, Australia, Sci Total Environ (2016), http://dx.doi.org/10.1016/j.scitotenv.2016.05.181
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methamphetamine-related problems (Degenhardt et al., 2016; Lee, 2015). 5. Conclusions Our analyses of wastewater showed different consumption trends for the three illicit stimulants. There was no consistent change in the consumption of cocaine or MDMA in the urban catchment over the study period. By contrast, there was about a five-fold increase in per capita methamphetamine consumption in the urban area and a threefold increase in the rural area in South East Queensland, Australia. The results confirmed similar analyses of wastewater in Adelaide, another large city in Australia. Our findings are consistent with epidemiological and law enforcement data in showing that problems related to methamphetamine consumption have increased substantially in Australia over the past five years. Our results demonstrate the value of WWA in detecting changes in per capita consumption of stimulant drugs which can provide timely data to policy makers on trends in illicit drug consumption in urban and rural areas. Acknowledgments Entox is a joint venture of UQ and QHFSS. We acknowledge the financial support from the Australia Crime Commission and the Crime and Corruption Commission of Queensland. We thank the Regional Council for the sampling opportunity. F.Y.L. is funded through the UQ CIEF and UQ HABS grants. J.M. is funded through the Australian Research Council Future Fellowship. P.K.T. was funded by the UQ Postdoctoral Research Fellowship and is currently funded by the Vice Chancellor's Research Fellowship of Queensland University of Technology. J.O'B. is funded by an Australian Postgraduate Award PhD Scholarship. C.G. is funded by a NHMRC Career Development Fellowship. CYSAR receives funding from the Graeme Wood Foundation. References Australian Broadcasting Commission, 2015. Australia's war on ice. http://www.abc.net. au/news/story-streams/ice-epidemic/ (accessed Sept 2015). ACC, 2014. Illicit Drug Data Report 2013–14. 2013. Canberra: Australian Crime Commission (ACC) (Available at:) https://crimecommission.gov.au/publications/intelligenceproducts/illicit-drug-data-report. Australian Institute of Health (AIHW), 2014. National drug strategy household survey detailed report 2013. Drug statistics series no. 28. Cat. no. PHE 183. AIHW, Canberra. Baker, D., Kasprzyk-Hordern, B., 2011. Multi-residue determination of the sorption of illicit drugs and pharmaceuticals to wastewater suspended particulate matter using pressurised liquid extraction, solid phase extraction and liquid chromatography coupled with tandem mass spectrometry. J. Chromatogr. A 1218, 7901–7913. Castiglioni, S., Thomas, K.V., Kasprzyk-Hordern, B., Vandam, L., Griffiths, P., 2014. Testing wastewater to detect illicit drugs: state of the art, potential and research needs. Sci. Total Environ. 487, 613–620. Chen, C., Kostakis, C., Harpas, P., Felgate, P.D., Irvine, R.J., White, J.M., 2011. Marked decline in 3,4-methylenedioxymethamphetamine (MDMA) based on wastewater analysis. J. Stud. Alcohol Drugs 72, 737–740. Darke, S., Kaye, S., McKetin, R., Duflou, J., 2008. Major physical and psychological harms of methamphetamine use. Drug Alcohol Rev. 27, 253–262. Degenhardt, L., Hall, W.D., 2012. Extent of illicit drug use and dependence, and their contribution to the global burden of disease. Lancet 379, 55–70. Degenhardt, L., Larney, S., Chan, G., et al., 2016. Estimating the number of regular and dependent methamphetamine users in Australia. Med. J. Aust. 204, 1.e1–1.e5. Degenhardt, L., Roxburgh, A., McKetin, R., 2007. Hospital separations for cannabis- and methamphetamine-related psychotic episodes in Australia. Med. J. Aust. 186, 342–345. De Letter, E.A., Piette, M.H., Lambert, W.E., Cordonnier, J.A., 2006. Amphetamines as potential inducers of fatalities: a review in the district of Ghent from 1976–2004. Med. Sci. Law 46, 37–65. Du, P., Li, K., Li, J., Xu, Z., Fu, X., Yang, J., Zhang, H., Li, X., 2015. Methamphetamine and ketamine use in major Chinese cities, a nationwide reconnaissance through sewagebased epidemiology. Water Res. 84, 76–84. Gerrity, D., Trenholm, R., Snyder, S., 2011. Temporal variability of pharmaceuticals and illicit drugs in wastewater and the effects of a major sporting event. Water Res. 45, 5399–5411. Hall, W., Prichard, J., Kirkbride, P., Bruno, R., Thai, P.K., Gartner, C., et al., 2012. An analysis of ethical issues in using wastewater analysis to monitor illicit drug use. Addiction 107, 1767–1773.
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Please cite this article as: Lai, F.Y., et al., Cocaine, MDMA and methamphetamine residues in wastewater: Consumption trends (2009–2015) in South East Queensland, Australia, Sci Total Environ (2016), http://dx.doi.org/10.1016/j.scitotenv.2016.05.181
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Please cite this article as: Lai, F.Y., et al., Cocaine, MDMA and methamphetamine residues in wastewater: Consumption trends (2009–2015) in South East Queensland, Australia, Sci Total Environ (2016), http://dx.doi.org/10.1016/j.scitotenv.2016.05.181
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Cocaine, MDMA and methamphetamine residues in wastewater: Consumption trends (2009–2015) in South East Queensland, Australia☆ Foon Yin Lai a,⁎, Jake W. O'Brien a, Phong K. Thai a,b, Wayne Hall c, Gary Chan c, Raimondo Bruno d, Christoph Ort e, Jeremy Prichard f, Steve Carter g, Shalona Anuj g, K. Paul Kirkbride h, Coral Gartner c, Melissa Humphries i, Jochen F. Mueller a,⁎ a
The University of Queensland, The National Research Centre for Environmental Toxicology (Entox), 39 Kessels Road, Coopers Plains, QLD 4108, Australia Queensland University of Technology, International Laboratory for Air Quality and Health, Brisbane, QLD 4001, Australia c The University of Queensland, Centre for Youth Substance Abuse Research, Herston, QLD, 4029, Australia. d School of Psychology, University of Tasmania, Private Bag 30, Hobart, TAS, 7001, Australia e Swiss Federal Institute of Aquatic Science and Technology (Eawag) Urban Water Management, Ueberlandstrasse 133, CH 8600, Duebendorf, Switzerland f Faculty of Law, University of Tasmania, Private Bag 30, Hobart, TAS 7001, Australia g Queensland Health Forensic Scientific Services, Queensland Government, 39 Kessels Road, Coopers Plains, QLD 4108, Australia h School of Chemical and Physical Sciences, Flinders University, Bedford Park, Adelaide, South Australia 5042, Australia i School of Physical Science, University of Tasmania, Private Bag 30, Hobart, TAS, 7001, Australia b
H I G H L I G H T S
G R A P H I C A L
A B S T R A C T
• The most intensive temporal dataset on illicit stimulants use via WBE in Australia • Illicit stimulants use assessed over 6 years in two populations (urban & rural) • No noticeable trends for cocaine and MDMA use in the urban area • A five-fold increase in methamphetamine use in the urban area • A three-fold increase in methamphetamine use in the rural area
a r t i c l e
i n f o
Article history: Received 12 April 2016 Received in revised form 25 May 2016 Accepted 25 May 2016 Available online xxxx Keywords: Urban cities
a b s t r a c t Wastewater analysis, or wastewater-based epidemiology, has become a common tool to monitor trends of illicit drug consumption around the world. In this study, we examined trends in cocaine, 3,4methylenedioxymethamphetamine (MDMA) and methamphetamine consumption by measuring their residues in wastewater from two wastewater treatment plants in Australia (specifically, an urban and a rural catchment, both in South East Queensland) between 2009 and 2015. With direct injection of the samples, target analytes were identified and quantified using liquid chromatography-mass spectrometry. Cocaine and MDMA residues and metabolites were mainly quantifiable in the urban catchment while methamphetamine residues were
☆ Data of methamphetamine were presented as a short report in the Medical Journal of Australia (Lai et al., 2016). ⁎ Corresponding authors. E-mail addresses: [email protected] (F.Y. Lai), [email protected] (J.F. Mueller).
http://dx.doi.org/10.1016/j.scitotenv.2016.05.181 0048-9697/© 2016 Elsevier B.V. All rights reserved.
Please cite this article as: Lai, F.Y., et al., Cocaine, MDMA and methamphetamine residues in wastewater: Consumption trends (2009–2015) in South East Queensland, Australia, Sci Total Environ (2016), http://dx.doi.org/10.1016/j.scitotenv.2016.05.181
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Rural areas Illicit stimulants Drug markets Drug epidemiology LC-MS/MS
consistently detected in both urban and rural catchments. There was no consistent trend in the population normalised mass loads observed for cocaine and MDMA at the urban site between 2009 and 2015. In contrast, there was a five-fold increase in methamphetamine consumption over this period in this catchment. For methamphetamine consumption, the rural area showed a very similar trend as the urban catchment starting at a lower baseline. The observed increase in per capita loads of methamphetamine via wastewater analysis over the past six years in South East Queensland provides objective evidence for increased methamphetamine consumption in the Australian population while the use of other illicit stimulants remained relatively stable. © 2016 Elsevier B.V. All rights reserved.
1. Introduction
by the Australian Customs and Border Protection Service, increased arrests for possession and supply of methamphetamine within State and Territory jurisdictions, and increased treatment seeking by problem users (Roche et al., 2015). Regular injection and smoking of methamphetamine can produce a variety of serious adverse effects, such as anxiety and depressive disorders, and a dependence syndrome (McKetin et al., 2006b). Heavy users may develop an acute paranoid psychosis (Darke et al., 2008; McKetin et al., 2010), become violent and aggressive (McKetin et al., 2006a) and engage in criminal activity to fund their drug use (McKetin et al., 2005). Users may die from myocardial infarctions and strokes (Degenhardt et al., 2007; Kaye et al., 2007; De Letter et al., 2006). The current study applied WWA to monitor population consumption of three commonly used illicit stimulant drugs, including cocaine, 3,4-methylenedioxymethamphetamine (MDMA) and methamphetamine, in South East Queensland between 2009 and 2015. Trends in consumption of methamphetamine were compared between two catchment areas: a major urban community (2009–2015) and a rural community (2010–2015). We also examined trends in consumption of two other illicit stimulants, cocaine and MDMA, in the urban catchment area between 2009 and 2015.
Illicit drug use contributes substantially to the global burden of disease, morbidity, and organised crime (Lim et al., 2012; UNODC, 2015). It is, therefore, important to monitor the level of illicit drug use in the population so that appropriate policies can be developed to minimise drug-related harms. Traditionally, the monitoring of illicit drug use has been done through population surveys and the analysis of indicators of drug use (e.g. drug seizures) or drug-related harm (e.g. drug overdoses, and drug-related hospital admissions) but these methods have their limitations. For example, Australia's national household survey is only conducted every three years because of its expense (Prichard et al., 2012). Also, only 2% of participants in the national household survey reported using a drug, such as methamphetamine, so the survey has limited statistical power to detect changes in its prevalence. It is also likely that heavy illicit drug users are under-represented in national household surveys (Degenhardt and Hall, 2012). Supplementary methodologies are needed to better understand illicit drug use in the population and to provide more timely data to inform the most efficient allocation of public health and law enforcement resources to reduce drug-related harm. Wastewater analysis (WWA) is an approach to monitor illicit drug consumption in the population that overcomes some of the limitations of surveys (Castiglioni et al., 2014; Hall et al., 2012). WWA is a relatively new approach with considerable research evidence for its validity. WWA studies clearly show recognised patterns of illicit drug consumption over time (e.g. cocaine consumption is higher on weekends than on weekdays while cannabis consumption is more stable throughout the week) and by location (higher consumption of illicit drugs are detected in larger cities than in rural areas) (van Nuijs et al., 2011a, Ort et al., 2014) that are also reflected in epidemiological studies. The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) recognised the potential of WWA to become an important adjunct to established drug monitoring tools by delivering near-real-time data on changes in mercurial illicit drug markets. WWA has been used in Australia to assess patterns of drug consumption over different time frames and across different community settings (e.g. cities, rural areas, prisons, major events, etc.) (e.g. Lai et al., 2011, 2013b, 2015; Irvine et al., 2011). It has also been applied broadly in different countries (Gerrity et al., 2011; Kankaanpää et al., 2014; Östman et al., 2014) and in multi-country studies (Ort et al., 2014; Thomas et al., 2012). There are, however, few WWA studies that have measured illicit drug consumption over long time periods using extensive sampling campaigns. For example, to our knowledge, only three studies have performed continuous (daily) monitoring over an entire year (van Nuijs et al., 2011b; Ort et al., 2014; Lai et al., 2015). Other studies have used intermittent sampling to monitor drug consumption trends over time (e.g. Lai et al., 2013a, 2013c; Chen et al., 2011; Tscharke et al., 2015; Zuccato et al., 2011; Castiglioni et al., 2014). Over the past several years, the popular media in Australia have reported increased harm arising from the use of crystalline methamphetamine, colloquially known as “ice” (e.g. ABC, 2015; Hildebrand, 2015; Lee, 2015). This is a highly pure form of methamphetamine that can be smoked or injected (McKetin et al., 2005; O'Brien et al., 2007). Since the mid-2000s, there have been substantial seizures of the drug
2. Methods 2.1. Wastewater sampling and analysis Wastewater sampling was conducted at the major wastewater treatment plants (WWTPs) in each of two locations in South East Queensland, Australia. A total of 498 (urban) and 712 (rural) samples were successfully collected in 2009–2015. In the urban area, we collected daily composite samples as follows: Nov 2009 (12 days), Nov–Dec 2010 (21 days), Jan–Dec 2011 (160 days), Jan–Dec 2012 (188 days), Jan–Dec 2013 (61 days), Jan–Dec 2014 (49 days) and Mar 2015 (7 days). In the rural area we collected daily composite samples as follows: Aug–Dec 2010 (34 days), Jan–Dec 2011 (84 days), Jan–Dec 2012 (243 days), Jan–Dec 2013 (273 days), Jan–Dec 2014 (51 days) and Jan–May 2015 (27 days). Daily composite samples were collected using a sampling system installed at the inlet of a wastewater treatment plant. For the urban catchment, a continuous flow proportional sampling mode was used to collect the samples between November 2009 and October 2012. From November 2012 onwards sampling was scaled down to once a week on Tuesday or Wednesday due to limited access to the treatment plant. In this period, daily composite samples were taken using a timeproportional sampling technique with a sampling frequency of 100 mL per 15 min. For the rural area, volume-proportional sampling mode was used to collect a sub-sample at 100 m3 intervals. At both sites, sample collection (over 24 h) was conducted under refrigeration. To keep the target chemicals stable in wastewater, samples were acidified to pH 2 onsite and frozen until analysis. Data on daily wastewater volumes were recorded by the WWTP operators. We obtained catchment map boundaries from the WWTP operators and gave them to Australian Bureau of Statistics personnel to calculate the population for each catchment. The estimated number of people in the catchment area was based on the latest census data.
Please cite this article as: Lai, F.Y., et al., Cocaine, MDMA and methamphetamine residues in wastewater: Consumption trends (2009–2015) in South East Queensland, Australia, Sci Total Environ (2016), http://dx.doi.org/10.1016/j.scitotenv.2016.05.181
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Table 1 Summary of cocaine and MDMA consumption (mg/day/1000 people) measured in wastewater samples in the urban catchment from 2009 to 2015. 2009
2010
2011
2012
2013
2014
2015
Cocaine Range Median Average CV%
229–692 339 382 36
57–395 104 157 68
63–839 225 266 53
133–2441 343 415 59
62–739 310 326 37
183–993 330 362 41
241–642 327 416 41
MDMA Range Median Average CV%
100–387 192 199 41
58–552 148 187 78
10–1202 121 206 106
58–3244 271 387 102
12–639 47 69 125
82–1422 211 272 83
85–518 126 237 72
The analytical method applied in this study has been validated and previously published (Lai et al., 2011; Lai et al., 2015). The method has also been validated through an inter-laboratory comparison (SCORE, 2015). Briefly, for all compounds, filtered wastewater samples (1 mL) were spiked with mass-labelled internal standards and then analysed without extraction process. All samples were analysed together with calibration standards by high-performance liquid chromatography (Shimadzu Nexera UHPLC system) coupled to a triple quadrupole tandem mass spectrometer (AB SCIEX QTRAP®5500). Drug residues of the parent drug and/or its major metabolite included 3,4methylenedioxymethamphetamine (MDMA), cocaine, benzoylecgonine (cocaine's main metabolite), and methamphetamine. Adsorption of these hydrophilic compounds (drug residues) onto particulate matters of the wastewater is negligible (Baker and Kasprzyk-Hordern, 2011; Senta et al., 2014); thus measuring their concentrations in the water phase are justified for valid estimates of consumption (Zuccato et al., 2008). 2.2. Data analysis Drug consumption was back-calculated using a formula established previously (Zuccato et al., 2008). Briefly, the drug residue concentration (μg/L) measured is multiplied by the total daily wastewater volume (ML/day) to produce an estimated amount (mg/day) of the drug residue. This estimate was then corrected using the excretion factor and normalised to the catchment area population based on the latest census data to produce an estimate of the consumption level (mg/day/1000 people). Correction factors for the target drugs were calculated using published values (Lai et al., 2011). For example, a correction factor of 3.1 (1.1/0.35) was from an average excretion rate of 35% and the molar mass ratio of 1.1 (cocaine to benzoylecgonine). A correction factor of 6.7 was used to back estimate MDMA using MDMA residues (1/
0.15). A correction factor of 2.6 was used to back estimate methamphetamine from methamphetamine residues (1/0.39). Given the proven stability of benzoylecgonine, MDMA and methamphetamine residues in wastewater (Thai et al., 2014; McCall et al., 2016), these backestimated figures reasonably reflect the collective daily consumption of these drugs in the catchments (g/day). We used the inter-quartile range of box-whisker plots to summarise variability in the estimated amount detected in each year. Linear regression models were used to test for trends in detections of cocaine, MDMA, and methamphetamine across each year of study. The presence of higher order trends (quadratic and cubic) were tested but did not improve any model fits and are hence not reported here. All analyses were performed in Stata 13, SPSS 22 and R.
3. Results Methamphetamine residue was quantifiable in all samples in both urban and rural areas. Residues of cocaine, benzoylecgonine, and MDMA were only found in the samples of the urban catchment. Detailed estimates are presented in follows: In the urban catchment, daily consumption (per 1000 people) of cocaine (estimated from benzoylecgonine) ranged from 57 to 2441 mg and the yearly averages fluctuated from 157 mg to 416 mg/day during the study period (Table 1). Consumption of MDMA was at a similar level, with the recorded daily amount ranging from 12 to 3244 mg and the yearly average from 69–387 mg/day in the studied urban catchment (Table 1). Figs. 1 and 2 indicate that there was no meaningful trend in cocaine (R2 = 0.03; β = 31.4, 95%CI = 16.5–46.2) or MDMA consumption (R2 = 0.01; β = 4.2, 95%CI = − 19.2–27.6) during the study period. Also, there was no significant difference in per capita consumption of these two drugs between 2009 and 2015.
Fig. 1. Estimated cocaine consumption in the urban catchment in 2009–2015. Data is presented in the box-and-whisker plot, with the linear trend (red dotted line). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
Please cite this article as: Lai, F.Y., et al., Cocaine, MDMA and methamphetamine residues in wastewater: Consumption trends (2009–2015) in South East Queensland, Australia, Sci Total Environ (2016), http://dx.doi.org/10.1016/j.scitotenv.2016.05.181
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Fig. 2. Estimated MDMA consumption in the urban catchment in 2009–2015. Data is presented in the box-and-whisker plot, with the linear trend (red dotted line). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
Per capita methamphetamine consumption was higher in the urban area than the rural area over the monitoring period (Table 2). Both areas showed an increase in methamphetamine consumption. In the urban catchment, the estimated average increased from 234 to 1126 mg per day per 1000 people between 2009 and 2015, an approximately 4.8 fold increase (Fig. 3). Similarly, in the rural area (Fig. 4), the average estimates rose from 112 to 381 mg per day among 1000 people between 2010 and 2015, an approximately 3.5 fold increase. Analyses indicated that there was a significant linear increase in per capita methamphetamine consumption in the urban area between 2009 and 2015 (F(1,496) = 312.4, p b 0.001; R2 = 0.39, β = 114.4, 95%CI = 101.7–127.1) (Fig. 3). There was a smaller linear increase (F(1,710) = 539.5, p b 0.001; R2 = 0.43, β = 59.5, 95%CI = 54.5– 64.5) in methamphetamine consumption in the rural area between 2010 and 2015 (Fig. 4). 4. Discussion This study monitored trends in the consumption of three illicit stimulant drugs which have been commonly measured in WWAs. The most comprehensive monitoring of these illicit drugs to date is the SCORE project where international research partners collectively monitored illicit drug consumption in more than a dozen cities around the world, mostly located in Europe (SCORE, 2015) with the most recent data published in 2014 (Ort et al., 2014). Benzoylecgonine was only detected in the samples from the urban catchment and in low levels, with the annual average daily loads ranging from 51 to 134 mg per 1000 people over the study period. Our result was at the lower range of the European data reported in the SCORE project, similar to data from cities in Norway and Portugal (Ort et al., 2014). The finding is in line with the fact that the cocaine market in Europe is larger than that in Australia (UNODC, 2015). Cocaine is relatively less
available, lower in purity and more expensive in Australia compared to Europe and more cocaine seizures have been reported in Europe than Australia (World Drug Report 2015). The detection of higher cocaine consumption in our studied urban catchment than another Australian city (Adelaide) by Tscharke et al. (2015) (15–18 mg/day/ 1000 people) is in agreement with other Australian data that suggests the cocaine market in South Australia is smaller than that in the eastern seaboard jurisdictions (ACC, 2014). MDMA was also only found in the urban catchment. Its overall average daily loads were stable in 2009–2015. The overall mass load of MDMA in the urban catchment was at the median level of the European data reported in the SCORE project and most similar to that in cities in Finland, Denmark and Spain (Ort et al., 2014). It was higher than that observed in Adelaide (Tscharke et al., 2015). As with cocaine, ecstasy is more available, cheaper and typically purer in Europe than Australia (UNODC, 2015). In Australia, the markets of ecstasy have been found larger in Queensland compared to South Australia (ACC, 2014). An increase in the purity of ecstasy during 2012–2013 was reported by the EMCDDA and in seizure data from Australia (ACC, 2014). Thus, the noticed downturn in MDMA consumption from 2012 to 2013 suggests a potential decrease in its availability during that period in our urban catchment. This is consistent with the national household survey report showing a decline in ecstasy use in 2013 (AIHW, 2014). Our study revealed a large increase in methamphetamine consumption in both monitored catchments over the period 2009/2010 to 2015, an approximately five-fold rise in the urban area and a three-fold one in the rural area. This is in agreement with the two fold increase in methamphetamine consumption recently reported in Adelaide (Australia) during 2010–2013 (Tscharke et al., 2015). The annual average of daily loads of methamphetamine in 2010, when the data were first obtained in both catchments, were 44 and 139 mg/day/1000 people in the rural
Table 2 Summary of methamphetamine consumption (mg/day/1000 people) measured in wastewater between the urban and rural catchments from 2009 to 2015. 2009
2010
2011
2012
2013
2014
2015
Urban area Range Median Average CV%
173–353 222 234 23
246–526 343 363 22
142–978 452 467 31
254–1279 514 553 32
330–1511 615 599 31
566–1416 825 839 21
952–1401 1062 1126 14
Rural area Range Median Average CV%
– – – –
73–188 112 115 20
69–229 126 127 24
64–448 150 158 33
61–492 210 228 41
188–485 315 323 23
318–518 381 398 14
Please cite this article as: Lai, F.Y., et al., Cocaine, MDMA and methamphetamine residues in wastewater: Consumption trends (2009–2015) in South East Queensland, Australia, Sci Total Environ (2016), http://dx.doi.org/10.1016/j.scitotenv.2016.05.181
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Fig. 3. Estimated methamphetamine consumption in the urban catchment in 2009–2015. Data is presented in the box-and-whisker plot, with the linear trend (red dotted line). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
and urban areas, respectively. These levels are equivalent if not higher to the highest consumption reported in the SCORE project in Europe in 2011–2013 (Ort et al., 2014). The high level of methamphetamine use in Australia is consistent with data in the World Drug Report (World Drug Report 2015). Smaller increases in methamphetamine consumption have also been observed in the last few years in the Czech Republic (about 2 fold in Budweis and Prague, in 2012–2013) and China (about 2 times in Beijing, Shanghai, and Shenzhen, in 2012–2014) (Ort et al., 2014; Du et al., 2015). Comparing consumption trends across these three illicit stimulants, the rate of increase in methamphetamine in Australia is unique. There has been a debate in Australia about whether the increase in methamphetamine-related harm recorded is due to an increase in the amount of drug used by existing users, an increase in drug purity, or whether there has been an increase in the number of users, or a combination of these factors. Existing users who smoke or inject methamphetamine are undoubtedly experiencing an increase in harm, which correlates with heavier use among current users (McKetin and Farrell, 2015). However, there is other evidence that younger users have been recruited to methamphetamine use, which may indicate an increase in the number of users. This is shown by increases in the arrests of younger persons for amphetamine offences, younger people seeking hospital treatment for methamphetamine-related morbidity, and more treatment-seeking among young adults for methamphetamine-related problems (Degenhardt et al., 2016; Nathan et al., 2016).
The purity of the methamphetamine in Australia has increased from between 20–30% in 2009 to over 50–70% in 2014 (ACC, 2014). Hence, the increase in the drug purity is also an important factor in the observed increase in use and harm. Our analysis is only able to provide data on the overall amount of methamphetamine used in the catchments and cannot determine who used it and in what average doses. However, the scale of the increase in consumption observed in our data, combined with other recent epidemiological evidence, suggests that it is unlikely that recent increases in methamphetamine-related harm in Australia can be totally explained by increased use among existing regular and dependent methamphetamine users and/or higher drug purity. While WWA provided solid evidence for temporal and spatial patterns of the three stimulants in this study, we cannot use these data to estimate the number of users who contributed to the measured drug loads. Furthermore, the populations contributing to wastewater samples in each area were based on the most recent census data so changes in the population over time are not taken into account. Lastly, for the estimation of consumption we assumed that the average excretion factor of the drugs remained constant and was not influenced by activities such as poly-drug use, the effects of which on excretion rates are not known. Notwithstanding these limitations, our findings agree with trends in other indicators of drug consumption, especially for methamphetamine consumption, such as increased police seizures, increased numbers of arrests for methamphetamine consumption and supply, and increased numbers of persons seeking treatment for
Fig. 4. Estimated methamphetamine consumption in the rural catchment in 2010–2015. Data is presented in the box-and-whisker plot, with the linear trend (red dotted line). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
Please cite this article as: Lai, F.Y., et al., Cocaine, MDMA and methamphetamine residues in wastewater: Consumption trends (2009–2015) in South East Queensland, Australia, Sci Total Environ (2016), http://dx.doi.org/10.1016/j.scitotenv.2016.05.181
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methamphetamine-related problems (Degenhardt et al., 2016; Lee, 2015). 5. Conclusions Our analyses of wastewater showed different consumption trends for the three illicit stimulants. There was no consistent change in the consumption of cocaine or MDMA in the urban catchment over the study period. By contrast, there was about a five-fold increase in per capita methamphetamine consumption in the urban area and a threefold increase in the rural area in South East Queensland, Australia. The results confirmed similar analyses of wastewater in Adelaide, another large city in Australia. Our findings are consistent with epidemiological and law enforcement data in showing that problems related to methamphetamine consumption have increased substantially in Australia over the past five years. Our results demonstrate the value of WWA in detecting changes in per capita consumption of stimulant drugs which can provide timely data to policy makers on trends in illicit drug consumption in urban and rural areas. Acknowledgments Entox is a joint venture of UQ and QHFSS. We acknowledge the financial support from the Australia Crime Commission and the Crime and Corruption Commission of Queensland. We thank the Regional Council for the sampling opportunity. F.Y.L. is funded through the UQ CIEF and UQ HABS grants. J.M. is funded through the Australian Research Council Future Fellowship. P.K.T. was funded by the UQ Postdoctoral Research Fellowship and is currently funded by the Vice Chancellor's Research Fellowship of Queensland University of Technology. J.O'B. is funded by an Australian Postgraduate Award PhD Scholarship. C.G. is funded by a NHMRC Career Development Fellowship. CYSAR receives funding from the Graeme Wood Foundation. References Australian Broadcasting Commission, 2015. Australia's war on ice. http://www.abc.net. au/news/story-streams/ice-epidemic/ (accessed Sept 2015). ACC, 2014. Illicit Drug Data Report 2013–14. 2013. Canberra: Australian Crime Commission (ACC) (Available at:) https://crimecommission.gov.au/publications/intelligenceproducts/illicit-drug-data-report. Australian Institute of Health (AIHW), 2014. National drug strategy household survey detailed report 2013. Drug statistics series no. 28. Cat. no. PHE 183. AIHW, Canberra. Baker, D., Kasprzyk-Hordern, B., 2011. Multi-residue determination of the sorption of illicit drugs and pharmaceuticals to wastewater suspended particulate matter using pressurised liquid extraction, solid phase extraction and liquid chromatography coupled with tandem mass spectrometry. J. Chromatogr. A 1218, 7901–7913. Castiglioni, S., Thomas, K.V., Kasprzyk-Hordern, B., Vandam, L., Griffiths, P., 2014. Testing wastewater to detect illicit drugs: state of the art, potential and research needs. Sci. Total Environ. 487, 613–620. Chen, C., Kostakis, C., Harpas, P., Felgate, P.D., Irvine, R.J., White, J.M., 2011. Marked decline in 3,4-methylenedioxymethamphetamine (MDMA) based on wastewater analysis. J. Stud. Alcohol Drugs 72, 737–740. Darke, S., Kaye, S., McKetin, R., Duflou, J., 2008. Major physical and psychological harms of methamphetamine use. Drug Alcohol Rev. 27, 253–262. Degenhardt, L., Hall, W.D., 2012. Extent of illicit drug use and dependence, and their contribution to the global burden of disease. Lancet 379, 55–70. Degenhardt, L., Larney, S., Chan, G., et al., 2016. Estimating the number of regular and dependent methamphetamine users in Australia. Med. J. Aust. 204, 1.e1–1.e5. Degenhardt, L., Roxburgh, A., McKetin, R., 2007. Hospital separations for cannabis- and methamphetamine-related psychotic episodes in Australia. Med. J. Aust. 186, 342–345. De Letter, E.A., Piette, M.H., Lambert, W.E., Cordonnier, J.A., 2006. Amphetamines as potential inducers of fatalities: a review in the district of Ghent from 1976–2004. Med. Sci. Law 46, 37–65. Du, P., Li, K., Li, J., Xu, Z., Fu, X., Yang, J., Zhang, H., Li, X., 2015. Methamphetamine and ketamine use in major Chinese cities, a nationwide reconnaissance through sewagebased epidemiology. Water Res. 84, 76–84. Gerrity, D., Trenholm, R., Snyder, S., 2011. Temporal variability of pharmaceuticals and illicit drugs in wastewater and the effects of a major sporting event. Water Res. 45, 5399–5411. Hall, W., Prichard, J., Kirkbride, P., Bruno, R., Thai, P.K., Gartner, C., et al., 2012. An analysis of ethical issues in using wastewater analysis to monitor illicit drug use. Addiction 107, 1767–1773.
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Please cite this article as: Lai, F.Y., et al., Cocaine, MDMA and methamphetamine residues in wastewater: Consumption trends (2009–2015) in South East Queensland, Australia, Sci Total Environ (2016), http://dx.doi.org/10.1016/j.scitotenv.2016.05.181