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Wastewater helped us track COVID-19 strains. Some say it can do the same for drug use


During the pandemic, cities across the country discovered an unexpected ally right beneath our feet - sewers. Yes, you heard that correctly. Wastewater became a reliable tool to monitor which strains of COVID were peaking and where. Now, governments are beginning to use the same methodology to keep track of other public health concerns, such as illicit drug use. That's been happening across the Atlantic for more than a decade. The European Monitoring Centre for Drugs and Drug Addiction just released its findings for samples taken last year in 88 cities, plus a few outside Europe, including Seattle. Joao Matias, epidemiologist and the organization's head wastewater expert, joins us now. Welcome to the show.

JOAO MATIAS: Thank you.

RASCOE: So what trends did you find in drug use?

MATIAS: So the results basically are showing an increase in cocaine detections in more than two-thirds of the cities that participated, and also increases on the MDMA or ecstasy detections also in more than two-thirds of the cities. For the first time, we are also adding cities outside Europe. So we can see that, for example, the levels of cocaine use in Europe are very similar to the ones in Brazil, United States - a few of the examples of the cities that we now cover.

RASCOE: And so can you explain what cities can do when they get this data? Do they try to target outreach efforts geared specifically to those drugs, or what can they do with this?

MATIAS: This is just a complementary method to a wide variety of methods that, at least in Europe, we have been developing for more than two decades. So we have a national household service that collects information on the number of people that use a specific substance. Wastewater, on the other hand, allows us to have city-level data. So then you have to put all this in a pot, mix all the different studies, and then you can try to understand what's happening in your city and what interventions you need to implement.

RASCOE: And so why did it take so long to get these results? This data you just released was collected 10 to 12 months ago. And, you know, obviously with, COVID you had health departments who were turning around their data almost immediately.

MATIAS: So I would say that the big difference is that for COVID, health departments were looking at their specific cities or country and did not have to compare with the other locations. It would be one lab doing the analysis. What is the difference here? We're talking about 30 countries all over the world, and we want to make sure that the data is comparable.

RASCOE: As you may have heard, California state lawmakers proposed a system for that state in large part because of the opioid epidemic. Can wastewater analysis test for fentanyl?

MATIAS: Wastewater can test for fentanyl and for other opioids. The opioids in Europe, the levels of using, the general population, are super low. Because of that, when researchers go and take samples, it would be almost impossible to detect any opioids there. I know that the levels of use are higher in the U.S., so probably it would be easier to detect them, which would be a good early warning system in place, definitely.

RASCOE: New Mexico this year began testing the sewage from public high schools for drugs. What do you think about that?

MATIAS: We have developed back in 2016 ethical guidelines on how to use wastewater-based epidemiology. And one of the recommendations is not to use it in small communities also because of the stigma still associated with drug use. So I would say that my recommendation is not to use it in very small settings or in small communities.

RASCOE: That's Joao Matias, epidemiologist and head wastewater expert at the European Monitoring Centre for Drugs and Drug Addiction. Thank you so much for joining us.

MATIAS: Thank you. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Ayesha Rascoe is a White House correspondent for NPR. She is currently covering her third presidential administration. Rascoe's White House coverage has included a number of high profile foreign trips, including President Trump's 2019 summit with North Korean leader Kim Jong Un in Hanoi, Vietnam, and President Obama's final NATO summit in Warsaw, Poland in 2016. As a part of the White House team, she's also a regular on the NPR Politics Podcast.

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