Article

Illicit drugs in wastewater of the city of Zagreb (Croatia) - Estimation of drug abuse in a transition country

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Abstract

A comprehensive study of various psychoactive substances and their metabolites was performed in the wastewater treatment plant of the city of Zagreb (780 000 inhabitants) using liquid chromatography/tandem mass spectrometry (LC-MS-MS). The estimation of drug abuse for five different illicit drugs, including heroin, cocaine, marijuana, amphetamine and ecstasy, was made on the basis of their representative excretion rates, which were determined over a period of 8 months. Marijuana (1000 kg/year), heroin (75 kg/year) and cocaine (47 kg/year) were found to be the most frequently consumed illicit drugs, while the consumption of amphetamine-type drugs was much lower (1-3 kg/year). A comparison with other reports indicated that drug abuse profiles in transition countries might be different from those reported for Western Europe, in particular with respect to the comparatively increased consumption of heroin. Enhanced consumption of stimulating drugs (cocaine and ectasy) was systematically detected during weekends.

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... In recent years, wastewater-based epidemiology (WBE) has been used as a complementary approach for the estimation of drug consumption across the world (e.g. Bijlsma et al., 2016;Bones et al., 2007;Huerta-Fontela et al., 2008;Khan et al., 2014;Kankaanpää et al., 2014;Kasprzyk-Hordern et al., 2009;Irvine et al., 2011;Lai et al., 2013aLai et al., , 2016Metcalfe et al., 2010;Postigo et al., 2010;Terzic et al., 2010;van Nuijs et al., 2009;Zuccato et al., 2008). ...
... A number of WBE studies performed in different countries confirmed an enhanced consumption of stimulating illicit drugs during the weekend (e.g. Krizman et al., 2016;Terzic et al., 2010;Thomas et al., 2012), large sport events (Gerrity et al., 2011), music festivals (Bijlsma et al., 2014;Jiang et al., 2015;Lai et al., 2013b;Mackuľak et al., 2014) and the peak of tourist season in the vacation areas (Krizman et al., 2016;Lai et al., 2013c). In contrast, only few reports addressed the issue of multiannual changes in drug consumption patterns within the selected population (e.g. ...
... The city of Zagreb is the capital and the largest Croatian city, representing almost 20% of Croatia's population. Furthermore, an initial WBE study conducted in Zagreb (Terzic et al., 2010) indicated specific drug consumption patterns which were different from those reported for most of the other European cities, in particular regarding comparatively higher prevalence of heroin consumption and lower prevalence of cocaine and amphetamine drug consumption. ...
Article
A comprehensive study aimed at monitoring of temporal variability of illicit drugs (heroin, cocaine, amphetamine, MDMA, methamphetamine and cannabis) and therapeutic opiate methadone in a large-sized European city using wastewater-based epidemiology (WBE) was conducted in the city of Zagreb, Croatia, during an 8-year period (2009-2016). The study addressed the impact of different sampling schemes on the assessment of temporal drug consumption patterns, in particular multiannual consumption trends and documented the possible errors associated with the one-week sampling scheme. The highest drug consumption prevalence was determined for cannabis (from 59 ± 18 to 156 ± 37 doses/day/1000 inhabitants 15-64 years), followed by heroin (from 11 ± 10 to 71 ± 19 doses/day/1000 inhabitants 15-64 years), cocaine (from 8.3 ± 0.9 to 23 ± 4.0 doses/day/1000 inhabitants 15-64 years) and amphetamine (from 1.3 ± 0.9 to 21 ± 6.1 doses/day/1000 inhabitants 15-64 years) whereas the consumption of MDMA was comparatively lower (from 0.18 ± 0.08 to 2.7 doses ±0.7 doses/day/1000 inhabitants 15-64 years). The drug consumption patterns were characterized by clearly enhanced weekend and Christmas season consumption of stimulating drugs (cocaine, MDMA and amphetamine) and somewhat lower summer consumption of almost all drugs. Pronounced multiannual consumption trends were determined for most of the illicit drugs. The investigated 8-year period was characterized by a marked increase of the consumption of pure cocaine (1.6-fold), THC (2.7-fold), amphetamine (16-fold) and MDMA (15-fold) and a concomitant decrease (2.3-fold) of the consumption of pure heroin. The heroin consumption decrease was associated with an increase of methadone consumption (1.4-fold), which can be linked to its use in the heroin substitution therapy. The estimated number of average methadone doses consumed in the city of Zagreb was in a good agreement with the prescription data on treated opioid addicts in Croatia.
... WWTPs play an important role in the life cycle and occurrence of illicit drugs and their metabolites in the aquatic environment. Once excreted in the sewage, these substances are transported to WWTPs, but most facilities are not designed to remove such compounds, resulting in continuous release of contaminated effluents into the water bodies (Terzic et al. 2010;Vazquez-Roig et al. 2013;Evgenidou et al. 2015). ...
... The concentrations of MOR ranged from < 0.55 ng L −1 in Po river and Thames river (Zuccato et al. 2008) to 2400 ng L −1 in WWTP from a Taipei hospital (Lin et al. 2014). Residues of 6-ACM ranged from < 0.2 ng L −1 in secondary effluent from Zagreb (Terzic et al. 2010) to 224 ng L −1 in influents from England (Baker and Kasprzyk-Hordern 2013). For EDDP, the concentrations ranged from 0.1 ng L −1 in Yellow River and Pearl River (Li et al. 2016) to 1150 ng L −1 in effluents from Catalonia (Boleda et al. 2009). ...
... Concentrations of MAMP ranged from < 0.2 ng L −1 Llobregat river and samples from a DWTP intake (Hue) to 2670 ng L −1 in influent samples from the USA after Super Bowl weekend (Gerrity et al. 2011). The lowest concentration of MDMA was detected in secondary effluent (< 0.3 ng L −1 ) from Zagreb (Terzic et al. 2010) and the highest concentration was found in influent (> 27,000 ng L −1 ) from Valencia . Huerta-Fontela et al. (2008b) detected low concentration of MDA (< 0.2 ng L −1 ) in samples of DWTP intake from Spain and Huerta-Fontela et al. (2008a). ...
Article
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Illicit drugs (IDs) and their metabolites are recognized as contaminants of emerging concern. After consumption, illicit drugs are partially metabolized and excreted unchanged in urine and feces or as active metabolites reaching wastewater treatment plants (WWTPs). Furthermore, most WWTPs are insufficient in the treatment of effluents containing IDs, which may be released into aquatic ecosystems. Once in the water or sediment, these substances may interact and affect non-target organisms and some evidences suggest that illicit drugs may exhibit pseudo-persistence because of a continuous environmental input, resulting in long-term exposure to aquatic organisms that may be negatively affected by these biologically active compounds. We reviewed the literature on origin and consumption, human metabolism after consumption, aquatic occurrences, and toxicity of the major groups of illicit drugs (opioids, cannabis, synthetic drugs, and cocaine). As a result, it could be concluded that illicit drugs and their metabolites are widespread in diverse aquatic ecosystems in levels able to trigger sublethal effects to non-target organisms, besides to concentrate in seafood. This class of emerging contaminants represents a new environmental concern to academics, managers, and policymakers, whose would be able to assess risks and identify proper responses to reduce environmental impacts.
... These authors described the presence of the illicit drug cocaine (COC) and its metabolite benzoylecgonine (BE) in wastewaters and surface waters to estimate collective cocaine usage. The ability of WBE to provide useful and timely information on temporal (daily, weekly, monthly, and annually) and spatial (within-and between-countries) variations in illicit drug consumption has been demonstrated [7,8,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. Presented as an objective, evidence-based and non-invasive approach, it has seen great developments in the past decade. ...
... The founding principle of WBE is related to the mechanism by which the consumption of illegal (and prescription) drugs can be detected, and eventually quantified, by measuring the occurrence of the parent compound or its metabolites in biological matrices [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. Each xenobiotic will undergo specific pharmacokinetic and metabolization processes, which, depending on the substance, can last for longer periods and excretion products will thus be found in urine up to several days after administration [29]. ...
... COC has been the target of most WBE studies published in the literature, mainly because of its widespread use [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. After consumption, between 85 and 90% of the initial cocaine dose is excreted in urines in various forms within 24h [33], as shown in Table 2. Liver carboxylases are responsible for the formation of BE, by the hydrolysis of the ester linkages of the parent compound. ...
Article
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Illicit drugs, belonging to a category of contaminants of growing and threatening concern, must be taken into account in environmental management due to their social and public health risks. Wastewater-based epidemiology consists in acquiring relevant information about the lifestyle and health status of the population through the analysis of wastewater samples collected at the influent of a wastewater treatment plant (WWTP). This method has been applied to the analysis of influent samples from 4 WWTPs located in Rio de Janeiro Municipality, Brazil, in order to investigate the presence of illicit drugs and their metabolites. These included cocaine (COC), benzoylecgonine (BE, cocaine metabolite), amphetamine (AMP), methamphetamine (METH), and 11-nor-9-carboxy-tetrahydrocannabinol (THC-COOH, THC metabolite). Concentrations of COC and its main metabolite BE ranged from 201.3 to 2751.5 ng/L and from 630.7 to 5849.2 ng/L, respectively. Amphetamine-like stimulants ranged from 1.7 to 110.0 ng/L for AMP, and from 55.3 ng/L to 477.4 ng/L for METH. THC-COOH ranged from 188.8 to 940.2 ng/L. The concentrations found, besides being significant to public health, can potentially influence the functioning of the ecosystem. It is important to detach that COC and amphetamines (including metabolites as well) have potent pharmacological activities and their presence as complex mixtures in the environment may cause an adverse effect on aquatic organisms and in human health. However, unfortunately, there is no current regulation demanding the determination of the occurrence of these pollutants at the environment. This way, researches on the distribution pattern of these illicit drugs and their potentially harmful impact on our environment needs immediate attention and regulatory limits.
... In the past decade, wastewater-based epidemiology has been applied in many countries, mainly in Europe (van Nuijs et al., 2009(van Nuijs et al., , 2011aSubedi and Kannan, 2014;Jiang et al., 2015;Senta et al., 2015;Mackulak et al., 2015Mackulak et al., , 2016Karolak et al., 2010;Repice et al., 2013;Andres-Costa et al., 2014;Bijlsma et al., 2014;Damien et al., 2014;de Castro et al., 2014;Guerra et al., 2014;Kankaanpaa et al., 2014;McCall et al., 2016). In particular, this approach has been used to estimate heroin use in Spain (Boleda et al., 2009;Postigo et al., 2010), Belgium (van Nuijs et al., 2011b), Italy (Zuccato et al., 2008(Zuccato et al., , 2011(Zuccato et al., , 2016, Switzerland (Zuccato et al., 2008;Been et al., 2015), UK (Zuccato et al., 2008), Canada (Yargeau et al., 2014), and Croatia (Terzic et al., 2010). In these studies, heroin consumption was back-calculated based on concentrations of either of its two metabolites, morphine or 6acetylmorphine in wastewater. ...
... Analysis of 124 heroin seizure samples across China indicated that street heroin contains 0.2 ± 0.4% COD and 14.4 ± 11.5% acetylcodeine (personal communication, National Laboratory of Narcotics of China). Contribution of COD and acetylcodeine from street heroin to MOR loads in wastewater has not been accounted for in the literature (Zuccato et al., 2008;Postigo et al., 2010;Terzic et al., 2010). Acetylcodeine is metabolized into COD and then into MOR (Staub et al., 2001). ...
... The mean MOR load in influent of all 49 WWTPs was 25.2 ± 27.0 mg/1000 inh/d. This value was much lower than the loads reported in most European countries, such as UK, Sweden (Ostman et al., 2014), France (Nefau et al., 2013), lower than those in Spain (Boleda et al., 2009), Croatia (Terzic et al., 2010), (Baker et al., 2014), similar to those of Finland (Vuori et al., 2014), and slightly higher than the level reported in Czech Republic (Baker et al., 2012). The mean MOR load in China was also much lower than those reported in Australia (Lai et al., 2013) and some American cities (Gerrity et al., 2011;Subedi and Kannan, 2014), similar with those reported in Hong Kong and large cities in Canada (Yargeau et al., 2014), and much higher than loads in South Korea (Kim et al., 2015). ...
Article
Heroin consumption in major cities across China was estimated for the first time via wastewater-based epidemiology. Influent and effluent wastewater samples were collected from 49 wastewater treatment plants (WWTPs) in 24 major cities that cover all the geographic regions of the country. Concentrations of morphine, 6-acetylmorphine, and codeine were measured. Near complete removal of morphine by wastewater treatment processes was observed, whereas removal rates of codeine were slightly lower. Morphine loads were much higher than codeine loads at most WWTPs in China, a trend opposite to that in many European countries. In addition, morphine and codeine loads were strongly correlated at most WWTPs, indicating morphine and codeine in wastewater were predominantly from the same source, street heroin. At WWTPs in Guangzhou and Shenzhen, codeine loads were considerably higher than morphine loads, consistent with previous reports of codeine abuse (e.g., as cough syrup) among middle and high school students in Guangdong province. Heroin consumption was derived based on morphine loads and taking into account therapeutic use of morphine and codeine, as well as contribution of codeine and acetylcodeine in street heroin. Highest heroin consumption was observed in northwestern and southwestern China. The average heroin consumption of the sampled cities was 64.6 ± 78.7 mg/1000 inh/d. The nation-wide average heroin consumption was much lower than that of methamphetamine, consistent with seizure data and numbers of registered heroin and methamphetamine users in China.
... Thus, these substances and their metabolites are basically discharged into the wastewater (WW) network due to human excretion after consumption. Moreover, several numbers of studies have been published showing the evidence that opioids are inefficiently removed in wastewater treatment plants (WWTPs) [31][32][33][34]. Consequently, these contaminants can reach surface waters (SW), groundwaters (GW) or even the drinking water treatment plants (DWTPs), when wastewater effluents are discharged even after treatment. ...
... Several studies preconcentrated 100 mL of wastewater and surface water for SPE [23,35,42,44,45], obtaining very similar recoveries for both matrices, 57-141% and 43-153%, respectively. Larger volume may imply an improvement in SPE recoveries since some studies used 250 mL and the recoveries ranged between 61 and 123% [32,34]. However, other studies did not include the volume load in their experimental sections, so it is hard to make a general concluding argument. ...
... 1.7 mm) from Waters [8,23,35,44,50,51] was the most used among them. The Synergi Polar RP 80 A (150 mm x 3 mm, 4 mm) [7,11,32,49] together with the ZORBAX XDB C18 (150 mm x 4.6 mm, 5 mm) [47,52], the Focused-Core Ascentis Express C18 (50 mm x 4.6 mm, 2.7 mm) [38,48] and the Acquity UPLC HSS C18 column (100 mm x 2.1 mm, 1.7 mm) [42] were also used as well. Opioids are usually medium polar compounds, so their separation using C18 or C8 columns works well, generally. ...
Article
Opioids are a class of controlled and illicit drugs (narcotics) that act on the nervous system to relieve pain or to create euphoria. Currently, the abuse and addiction to opioids is an epidemic, which is reflected by an exponential increase in deaths by overdose. The occurrence of opioids in the environment may be used both as a tool to estimate human consumption and for making regulatory decisions. This review interprets the last 15 years of opioid detections in wastewater, surface water and drinking-water sources worldwide, in order to establish baseline information for future years. Most opioid studies used liquid chromatography-mass spectrometry with targeted analytical techniques. The majority of the studies discussed a minor number of opioids, suggesting that a wide range of these compounds have not yet been identified, given the extensive prescription usage. The occurrence of opioids in environmental waters included mainly Europe, UK, the US and Canada. The most frequently detected opioids in wastewater, which is a major source of opioids in surface water, were morphine (5–1240 ng L⁻¹), codeine (3.1–1206 ng L⁻¹), methadone (0.9–732 ng L⁻¹) and methadone's metabolite, EDDP (0.12–1150 ng L⁻¹). These opioids were also found in surface waters, albeit at lower concentrations. Finally, a few non-targeted studies used high resolution accurate mass to determine the transformation products or metabolites, which is an important topic for future research.
... The analyses also revealed that most of the investigated compounds were detected in low concentrations during the The concentrations of the illicit drugs and their metabolites measured in the Seyhan and Yuregir WWTPs were similar or significantly lower than the concentrations reported for other countries [2,4,8,9,12,[19][20][21][23][24][25][26][27][28]. For instance, the average concentration of cocaine, benzoylecgonine, amphetamine, MDMA, THC-COOH and codeine in the influent wastewater of Zagreb city were 56, 186, 9.9, 6.8, 21, and 262 ng/L, respectively [20]. ...
... The analyses also revealed that most of the investigated compounds were detected in low concentrations during the The concentrations of the illicit drugs and their metabolites measured in the Seyhan and Yuregir WWTPs were similar or significantly lower than the concentrations reported for other countries [2,4,8,9,12,[19][20][21][23][24][25][26][27][28]. For instance, the average concentration of cocaine, benzoylecgonine, amphetamine, MDMA, THC-COOH and codeine in the influent wastewater of Zagreb city were 56, 186, 9.9, 6.8, 21, and 262 ng/L, respectively [20]. Similarly, the concentrations of amphetamine, methamphetamine, MDMA, cocaine, and benzoylecgonine measured in the influent wastewaters of WWTPs serving three Canadian cities were in a range of <LOQ-25 ng/L, <LOQ-65 ng/L, 9-35 ng/L, 209-823 ng/L and 287-2624 ng/L, respectively [24]. ...
... Illicit drug consumption estimations for 6 illicit drugs, including cocaine, amphetamine, methamphetamine, MDMA (ecstasy), morphine, and THC (marijuana), were performed in accordance with the guidelines proposed by previous studies [4,6,12,20,29]. Table 4 presents the estimated illicit drug consumption rates. To compare these rates with those reported for other countries, illicit drug consumption rates were shown in different consumption units (mg/1000 p/day, mg/1000 p/day (15-64 years), dose/1000 p/ day (15- 64 years)). ...
Article
Wastewater-based epidemiology (WBE) is a rapidly developing discipline that has the potential to monitor real-time data on regional and temporal differences regarding the use of illicit drugs. With WBE, metabolic products discharged for drug consumption are rapidly collected by sewage systems, which provide valuable evidence on the types and quantities of drugs consumed by a given community. In this study, the samples were collected from the wastewaters entering the facilities in Seyhan and Yuregir Waste Water Treatment Plants (WWTPs), in Adana Province. Composite wastewater analysis was performed by using liquid chromatography tandem mass spectrometry (LC–MS/MS) and the analysis revealed multiple drugs including cocaine and its main metabolite, benzoylecgonine, amphetamine-like stimulants including amphetamine, methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA), 3,4-methylenedioxyamphetamine (MDA), and 3,4-methylenedioxyethamphetamine (MDEA), opiates including morphine, codeine, heroin metabolite 6-acetylmorphine (6-MAM), the metabolite of cannabis, 11-nor-carboxy-THC (THC-COOH), and the main metabolite of Δ9-tetrahydrocannabinol (THC), 11-hydroxy (THC-OH). Mean drug consumption rates were as follows: cocaine, 0.18; amphetamine, 0.43; methamphetamine, 0.06; MDMA (ecstasy), 1.30; heroin, 1.03; THC (marijuana), 28.60 doses/day/1000 persons (15–64 years). The consumption rates for some illicit drugs showed a significant difference between seasons, regions, and weekdays–weekends.
... Concentration levels of 6-AM in wastewater influents ranged up to 715 ng/L (Gilart et al., 2014), while in most effluents its concentration was found to be bLOQ (Table 4). High removal efficiency was estimated by Terzic et al. (2010) for 6-AM in WWTPs after the secondary treatment that reaches 78%. Although morphine is excreted in urine mainly as glucuronide metabolites, M3G was detected at low concentrations in WWTP influents (2-18.1 ng/L) (Castiglioni et al., 2006), thus suggesting cleavage of the conjugated molecule in wastewater (Ternes, 1998;D'Ascenzo et al., 2003). ...
... Concentrations of EDDP ranged between nondetection to 206 ng/L and generally were higher than the concentrations of the parent compound (Berset et al., 2010). EDDP was present in most effluents samples, exhibiting very poor removal (3%) during treatment (Terzic et al., 2010). ...
... Morphine is known to degrade very quickly in wastewater environments such as sewers (Thai et al., 2014) and others have reported similarly high removals for morphine (N85%) in WWTPs operating internationally with activated sludge processes (Devault et al., 2017;Subedi and Kannan, 2014). A negative removal for MDMA, BE and codeine was reported earlier that might be due to difficulties in pairing raw influent and treated effluent samples due to long hydraulic retention times, as well as potentially large temporal variability of these compounds in influents (Bijlsma et al., 2012;Terzic et al., 2010;Yadav et al., 2018). The negative removal of these compounds might also be due to deconjugation of glucuronides or transformation of conjugated metabolites into parent compounds during the treatment (Bijlsma et al., 2012;Boleda et al., 2009;Cosenza et al., 2018;Gilart et al., 2014;Rodayan et al., 2014;Terzic et al., 2010;Yadav et al., 2017). ...
... A negative removal for MDMA, BE and codeine was reported earlier that might be due to difficulties in pairing raw influent and treated effluent samples due to long hydraulic retention times, as well as potentially large temporal variability of these compounds in influents (Bijlsma et al., 2012;Terzic et al., 2010;Yadav et al., 2018). The negative removal of these compounds might also be due to deconjugation of glucuronides or transformation of conjugated metabolites into parent compounds during the treatment (Bijlsma et al., 2012;Boleda et al., 2009;Cosenza et al., 2018;Gilart et al., 2014;Rodayan et al., 2014;Terzic et al., 2010;Yadav et al., 2017). ...
Article
Drugs of addiction, have been recognized as potential contaminants of concern to the environment. Effluent wastewater discharge is a major source of contamination to aquatic receiving environments. A year-long monitoring program was undertaken in Australia to characterise the fate of four emerging drugs of addiction: methamphetamine; MDMA; pharmaceutical opioids: codeine and morphine and a metabolite: benzoylecgonine in four wastewater treatment plants operating with different secondary treatment technologies: conventional activated sludge (CAS), membrane bioreactors (MBR), integrated fixed-film AS (IFAS) and sequencing batch reactor (SBR). The effect of subsequent tertiary treatment (coagulation/flocculation) on the removal efficiency was also assessed. Drugs were detected in influent and effluent samples (mean concentration ranged from 43-4777 and 17-1721 ng/L, respectively). Treated effluents had noticeably lower levels compared to raw influents. Removal efficiency of compounds depended on the secondary treatment employed, with IFAS and MBR performing the best with significant removal of compounds (≈90%) followed by CAS (54-96%) and lastly SBR (42-83%). Despite the low levels of drugs measured after the secondary treatment, near complete removal after tertiary treatment (≈99%) was recorded, which demonstrated the effectiveness of using the coagulation/flocculation process as an effective step for enhancing the removal efficiency. The levels of drugs were at a low level in the effluents released into the environment and used for recycling and all posed a low environmental risk in urban water courses based on the risk assessment. The information given here provides new and useful information to the water industry and regulators on the efficiency of drug removal in a range of wastewater treatment configurations.
... College-aged adults (ages [18][19][20][21][22] throughout the United States have historically been associated with the highest percentage of drug abuse rates of all U.S. age groups, with 24-28% of respondents in a 2016 survey admitting to illicit drug use within the past 30 days [1]. While 48% of high school respondents to the same survey reported trying at least one illicit drug in their lifetime, prevalence of drug use has been shown to be higher for those aged 18-29 years [1]. ...
... Analysis of time-and flow-weighted samples of composited wastewater may provide unique wastewater-based epidemiological insights into consumption statistics, with flow-weighted estimates providing a more statistically favorable result, and theoretically could be obtained for a broad spectrum of chemical products consumed and excreted by a population [18]. Sampling for the purpose of wastewater epidemiological analyses generally focuses on the headworks of wastewater treatment plants (WWTP) [13,15,19] but the technique also has been applied to obtain equivalent information for smaller population sizes, such as college campuses [20][21][22] or prisons [14,23]. ...
Article
Full-text available
Wastewater-based epidemiology (WBE) was applied to estimate the consumption of twelve narcotics within a Southwestern U.S. university campus. Seven consecutive 24-hour composite raw wastewater samples (n = 80) were obtained once per month from sampling locations capturing >95% of campus-generated wastewater. Samples were analyzed for indicators of consumption of morphine, codeine, oxycodone, heroin, fentanyl, methadone, buprenorphine, amphetamine, methylphenidate, alprazolam, cocaine, and MDMA using LC-MS/MS. Eleven indicator compounds (oxycodone, codeine, norcodeine, 6-acetylmorphine, EDDP, amphetamine, alprazolam, alpha-hydroxyalprazolam, cocaine, benzoylecgonine, and MDMA) occurred at 100% detection frequency across the study, followed by morphine-3-glucuronide (98%), noroxycodone (95%), methylphenidate (90%), heroin (7%), norfentanyl (7%), and fentanyl (5%). Estimates of average narcotics consumption ranked as follows in units of mg/day/1000 persons: heroin (474 ± 32), cocaine (551 ± 49), amphetamine (256 ± 12), methylphenidate (236 ± 28), methadone (72 ± 8), oxycodone (80 ± 6), alprazolam (60 ± 2), MDMA (88 ± 35), codeine (50 ± 4), and morphine (18 ± 3). This campus-based WBE study yielded baseline data on 12 narcotics for a U.S. campus and demonstrated for the first time the feasibility of detecting the fentanyl metabolite norfentanyl in this setting.
... Con los informes del consumo de COC de los artículos fue posible calcular que tanto la COC como su principal metabolito urinario, la BE, el consumo promedio en torno a 230 (mg/día)/(1000 personas). Esto equivale a, aproximadamente dos dosis diarias entre 1000 personas, suponiendo que la dosis de referencia de COC es de 100 mg 52 , para el metabolito del cannabis varía entre 108 -133 (mg/día)/(1000 personas) [34][35][36][38][39][40]41,44,45,48,[56][57][58] . ...
... Terzic, et al. 58 Zagreb; Croacia La estimación del uso indebido de drogas para cinco drogas ilícitas diferentes, incluida la heroína, la cocaína, la marihuana, la anfetamina y el éxtasis, se hizo sobre la base de sus tasas de excreción representativas, que se determinaron en un período de 8 meses. Se encontró que la marihuana (1000 kg/año), la heroína (75 kg/año) y la cocaína (47 kg/año) eran las drogas ilícitas consumidas con mayor frecuencia, mientras que el consumo de drogas de tipo anfetamínico era mucho menor (1-3 kg/año). ...
Article
Full-text available
La medición cuantitativa de drogas ilícitas en aguas residuales puede proporcionar información objetiva sobre los patrones y tendencias del uso de psicotrópicos en la comunidad. Se analizó la presencia de psicoactivos en plantas de tratamiento para aguas residuales y en el medio ambiente por epidemiología de alcantarillado, mediante una revisión sistemática de 2008-2017 por medio de los descriptores controlados: “drogas ilícitas”, “plantas de tratamiento de aguas residuales” y “ambiente” hecha en las bases de datos Medline vía PubMed, SciELO, BVS vía LILACS y Google Académico. La búsqueda arrojó 439 estudios y fueron seleccionados 34 estudios para análisis. Los años de publicación variaron, siendo 2016 el de mayor de publicaciones (diez), seguido de 2014 y 2012 (cinco), 2017, 2013, 2010 (tres), 2011 (dos), 2015, 2009 y 2008 (uno cada uno). Los resultados mostraron la presencia de indicadores químicos de las drogas clásicas cocaína y cannabis. La investigación sobre la presencia de drogas ilícitas, particularmente como compuestos activos en el medio ambiente, es vital para mejorar el conocimiento de los tipos consumidos, su prevalencia; siendo capaz desplegar para analizar la exposición y el impacto de estos compuestos en el medio ambiente y la salud pública. Los resultados de esta revisión han resaltado que la epidemiología basada en aguas residuales es un enfoque útil y poderoso.
... The removal efficiencies of DOAs in a wastewater treatment plant (WWTP) are still not well known, especially with advanced treatment processes such as membrane bioreactors (MBR) (Evgenidou et al., 2015;Kim et al., 2014). Although few studies have assessed removal efficiencies of DOAs by WWTPs (Andrés-Costa et al., 2014;Kasprzyk-Hordern et al., 2009;Postigo et al., 2010;Terzic et al., 2010), more research is needed to assess and compare their removal through conventional and advanced treatments. Furthermore, in New Zealand, the previous studies have mainly focussed on DOAs' consumption, based on catchment population data given by WWTP operators and wastewater influent concentrations only (Lai et al., 2017). ...
... Average removal of methamphetamine, cotinine, and nicotine was of the same order as obtained by Subedi and Kannan (2014) in the U.S. study. Negative removal of amphetamine has also been reported by Terzic et al. (2010). Cocaine, benzoylecgonine, and MDMA removals were higher than the reported removal efficiencies from several studies compiled in a review article by Yadav et al. (2017). ...
Article
In this study, 24-hour composite wastewater samples were collected from a wastewater treatment plant of New Zealand with parallel secondary treatment units. The aim was to investigate the occurrence, removal, and consumption of 13 drugs of abuse (DOAs) including illicit drugs, alcohol, nicotine, and their metabolites. The filtered samples were analysed through direct injection on LC-MS/MS. Ethyl sulfate, one of the major metabolites of alcohol, was detected at the highest concentration (mean = 8300 ng/L) in wastewater influent. The mean concentrations of methamphetamine and hydroxycotinine in the influent were found to be 935 ng/L and 5000 ng/L, respectively. Amphetamine (383 ng/L) and cocaine (286 ng/L) were detected at the highest concentrations in the effluent. The removal efficiency of the treatment plant varied for DOAs: >99% for morphine, ethyl sulfate, and hydroxycotinine and <50% for methadone and 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP). Primary treatment did not show any significant removal of DOAs while the removal efficiencies of total monitored DOAs by Membrane Bioreactor (MBR) and Bardenpho processes were found to be similar (~95% removal). The population was estimated using hydrochemical parameters and human urine biomarkers and showed good agreement with wastewater treatment plant's estimates. Weekday-weekend variation in the consumption of alcohol and methamphetamine was found to be significant, with a higher estimated consumption during the weekends. Monitored DOAs in influent were present at highest concentrations during summer (23 μg/L), at low concentrations during winter (17 μg/L), and at lowest concentrations during heavy rainfall event (11 μg/L), possibly due to dilution. The population normalised mass loads of DOAs were found to correlate with their metabolites, and morphine was found to correlate with nicotine metabolites.
... Thus, an increase of these substances in the wastewater during weekends is plausible. This effect was already observed by several other studies [2,23,24]. Methamphetamine showed a constantly high load in the first week. In contrast to MDMA and methamphetamine, amphetamine loads were stable throughout the 2 weeks. ...
Article
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Wastewater analysis offers objective and complementary information to illicit drug agencies by monitoring patterns of illicit drug consumption. In this study, wastewater samples from three different wastewater treatment plants in Sydney, Australia were collected in March 2016. Ten targeted drugs were analysed and temporal and geographical analyses were performed to obtain a better understanding of the type and amount of illicit drugs consumed in Sydney in comparison with similar studies conducted around Australia and in Europe. Among the targeted drugs, methamphetamine was consumed the most, followed by cocaine and 3,4-methylenedioxymethamphetamine (MDMA). Weekly patterns were observed where a peak during the weekend was present. The geographical analysis showed differences between the regions targeted. This observation may be related to socio-demographic aspects. The comparison of our study to other data sources from Australia showed a high consumption of methamphetamine in Sydney and Western Australia. The comparison between Sydney and different European cities revealed a difference in consumption, which is in line with traditional market indicators. The information obtained through wastewater analysis provides complementary information regarding illicit drug consumption, the size, and the evolution of the illicit drug market. This, ultimately, will assist authorities in making informed decisions.
... China is under strict supervision for analgesic and opioiddependence detoxification treatment since 2004 (Sun et al. 2015;INCB 2017). Compared with developed countries, the usage amount of MTD among Guangzhou residents was about 60 times lower than the values reported in the UK (113 mg/day/1000 people) (Baker et al. 2014), Croatia (148 mg/day/1000 people) (Terzic et al. 2010), and Belgium (138 mg/day/1000 people) (van Nuijs et al. 2011a) ( Table 2). ...
Article
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Wastewater-based epidemiology (WBE) has been widely used as a complementary method for estimating consumption of illicit drugs in the population. Temporal drug consumption estimates derived from WBE can provide important information for law enforcement and public health authorities in understanding changes in supply and demand of illicit drugs, but currently lacking in China. In this study, influent wastewater samples from a municipal sewage treatment plant in Guangzhou, China were collected for 8 weeks to investigate the temporal change in consumption of six illicit drugs in the catchment. The results indicated that methamphetamine and ketamine were the dominant illicit drugs in Guangzhou with the per capita use of 14.7–470.7 mg/day/1000 people and 64.9–673.7 mg/day/1000 people, respectively. No distinct weekly patterns were observed for illicit drug consumption in Guangzhou, indicating that drug users are likely to be regular ones. Further assessment about the impact of public holidays on the consumption behavior of drugs showed little impact for ketamine (p = 0.689), but higher consumptions of methamphetamine (p = 0.003) and cocaine (p = 0.027) were observed during public holidays than the control period. The considerable decrease in drug consumption observed in October 2017 compared with January and May 2017 was possibly the consequence of law enforcement action.
... After consumption, cocaine is rapidly metabolized; a total of 35-54% of the parent compound is hydrolyzed to benzoylecgonine (BE), 32-49% to ecgonine methyl ester (EME), 5% to norcocaine, and only 1-9% of the parent compound is excreted intact [15,16]. Cocaine has been detected in aquatic ecosystems around the world in concentrations ranging from ng L −1 to µg L −1 [7,9,10,[17][18][19]. Once in the environment, cocaine may interact with nontarget organisms and cause negative effects. ...
Article
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Pollution is one of the main causes of the loss of biodiversity, currently one of the most important environmental problems. Important sources of aquatic pollution are illicit drugs, whose presence in waters is closely related to human consumption; their psychoactive properties and biological activity suggest potential adverse effects on non-target organisms, such as aquatic biota. In this study, we evaluated the effect of an environmentally relevant concentration of cocaine (20 ng L−1), an illicit drug widely found in surface waters, on the ovaries of Anguilla anguilla, a species critically endangered and able to accumulate cocaine in its tissues following chronic exposure. The following parameters were evaluated: (1) the morphology of the ovaries; (2) the presence and distribution of enzymes involved in oogenesis; (3) serum cortisol, FSH, and LH levels. The eels exposed to cocaine showed a smaller follicular area and a higher percentage of connective tissue than controls (p < 0.05), as well as many previtellogenic oocytes compared with controls having numerous fully vitellogenic and early vitellogenic oocytes. In addition, the presence and location of 3β-hydroxysteroid dehydrogenase, 17β-hydroxysteroid dehydrogenase, and P450 aromatase differed in the two groups. Finally, cocaine exposure decreased FSH and LH levels, while it increased cortisol levels. These findings show that even a low environmental concentration of cocaine affects the ovarian morphology and activity of A. anguilla, suggesting a potential impact on reproduction in this species.
... After consumption, COC is rapidly metabolized; 35-54% of the parent compound is hydrolyzed to benzoylecgonine (BE), 32-49% to ecgonine methyl ester, and 5% to norcocaine (Pal et al., 2012). These compounds are continually released into the environment via wastewater treatment plants (WWTPs), recognized as the main source of surface water contamination as a result of inefficient removal and treatment of effluents ( Terzic et al., 2010;Vazquez-Roig et al., 2013;Borova et al., 2014;Evgenidou et al., 2015). This problem becomes more evident in coastal zones such as Santos Bay (São Paulo, Brazil), where the submarine sewage disposal system is known to cause different types of disturbances that may alters the water quality (Ortiz et al., 2011 level of treatment combined with adverse release conditions in the region (shallow waters) have resulted in high concentrations of contaminants in seawater (Subtil et al., 2012). ...
Article
Illicit drugs and their metabolites represent a new class of emerging contaminants. These substances are continuously discharged into wastewater which have been detected in the aquatic environment in concentrations ranging from ng.L −1 to μg.L −1. Our study detected the occurrence of cocaine (COC) and benzoylecgonine (BE) in a subtropical coastal zone (Santos Bay, SP, Brazil) within one year. Water samples (surface and bottom) were collected from the Santos Submarine Sewage Outfall (SSOS) area. COC and BE were measured in the samples using ultra-performance liquid chromatography coupled to tandem mass spectrometry (UPLC-ESI-MS/MS). Concentrations ranged from 12.18 to 203.6 ng.L −1 (COC) and 8.20 to 38.59 ng.L −1 (BE). Higher concentrations of COC were observed during the end of spring, following the population increase at summer season. COC and its metabolite occurrence in this coastal zone represent a threat to coastal organisms.
... 1,2 Since 2008 3 the analysis of metabolites of illicit drugs in wastewater have been widely investigated firstly throughout multiple studies from different cities in Europe e.g. Paris 4 , Zagreb 5 and Brussels 6 . Secondly to survey spatial differences and temporal changes in an even larger population Thomas et al. and Ort C. et al. published the first Europewide studies of illicit drug consumption estimation through municipal wastewater and sewage analysis. ...
Thesis
This review focuses on the presence and the expected concentration of ions related to inorganic explosives in wastewater/sewage. The ionic composition of waste water treatment plant (WWTP) influent has been frequently reported, but has been limited to a few inorganic anions and cations. Identified concentrations of ions in wastewater are 5-200 mg/L for major ions, 0.1-217 µg/L for heavy metal ions and 0.014-1.6 mg/L for some also explosive related anions. The discussed methods to monitor wastewater/sewage over an extended period of time look promising, but need to overcome pre-treatment and sampling issues (filtration, dilution) and also the selectivity and sensitivity needs to be improved. The most promising method is based on sequential injection capillary electrophorese coupled with capacitive-coupled contactless conductivity detection (SI-CE-C 4 D) and is capable of simultaneous detection of cations and anions with an LOD of 0.005 to 0.061 mg/L, and more importantly portable and automatable. The data provided for this work shows that the levels for the ions of interest cover a broad range, from values under the limit of quantification (<LOQ) up to 200 mg/L for chloride. These findings will also contribute valid information to the selection of ions for monitoring purposes and therefore be a possible application for the evaluation of the New Year's Eve Effect (NYEE) in wastewater/sewage.
... WBE can give reliable results that may quickly reveal short and long-term trends in the scale of drug use. This approach can therefore provide a valuable source of complementary data to support more traditional epidemiological methods (Ort et al., 2014;Terzic et al., 2010;Thomas et al., 2012;van Nuijs et al., 2011;Zuccato et al., 2011). The EMCDDA has published the findings of the European inter-disciplinary network "Sewage analysis CORe group -Europe" (SCORE) (SCORE, 2017). ...
Article
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Wastewater-based epidemiology is an efficient way to assess illicit drug use, complementing currently used methods retrieved from different data sources. The aim of this study is to compare stimulant drug use in five Nordic capital cities that include for the first time wastewater samples from Torshavn in the Faroe Islands. Currently there are no published reports that compare stimulant drug use in these Nordic capitals. All wastewater samples were analyzed using solid phase extraction and ultra-high performance liquid chromatography coupled to tandem mass spectrometry. The results were compared with data published by the European Monitoring Centre for Drugs and Drug Addiction based on illicit drugs in wastewater from over 50 European cities. Confirming previous reports, the results showed high amphetamine loads compared with other European countries. Very little apparent abuse of stimulant drugs was detected in Torshavn. Methamphetamine loads were the highest from Helsinki of the Nordic countries, indicating substantial fluctuations in the availability of the drug compared with previous studies. Methamphetamine loads from Oslo confirmed that the use continues to be high. Estimated cocaine use was found to be in the lower range compared with other cities in the southern and western part of Europe. Ecstasy and cocaine showed clear variations between weekdays and weekends, indicating recreational use. This study further demonstrates geographical trends in the stimulant drug market in five Nordic capitals, which enables a better comparison with other areas of the continent.
... For example, almost complete removal was seen in WWTP 3 (> 90%) and WWTP 4 (97%), whereas < 50% removals were recorded by WWTP 1 and WWTP 2. We observed that chlorination after activated sludge treatment appears to be an efficient method for removal of studied opioids from wastewater. Our findings are in good agreement with several other published studies reporting higher removal for opioids: morphine and codeine during wastewater treatment (Baker and Kasprzyk-Hordern 2013;Daouk et al. 2016;Gros et al. 2010;Terzic et al. 2010). ...
Article
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The occurrence and fate of five drugs of abuse in raw influent and treated effluent wastewater were investigated over a period of 1 year in the Adelaide region of South Australia. Four wastewater treatment plants were chosen for this study and monitored for five drugs which included cocaine in the form of its metabolite benzoylecgonine (BE), methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA) and two opioids (codeine and morphine) during the period April 2016 to February 2017. Alongside concentrations in raw sewage, the levels of drugs in the treated effluent were assessed and removal efficiencies were calculated. Drug concentrations were measured by mixed-mode solid phase extraction and liquid chromatography coupled to a quadrupole mass spectrometer. Drug concentrations detected in the raw wastewater ranged from 7 to 6510 ng/L and < LOD to 4264 ng/L in treated effluent samples. Drug removal rates varied seasonally and spatially. The mass loads of drugs discharged into the environment were in descending order: codeine > methamphetamine > morphine > MDMA > BE. Results showed that all the targeted drugs were on average incompletely removed by wastewater treatment, with removal performance highest for morphine (94%) and lowest for MDMA (58%). A screening-level environmental risk assessment was subsequently performed for the drugs based on effluent wastewater concentrations. Based on calculated risk quotients, overall environmental risk for these compounds appears low, with codeine and methamphetamine likely to pose the greatest potential risk to receiving environments. Given the recognised limitations of current ecotoxicological models and risk assessment methods for these and other pharmaceutical drugs, the potential for environmental impacts associated with the continuous discharge of these compounds in wastewater effluents should not be overlooked.
... The level of economic development in countries also plays an important role. The burden from psychoactive substance use is higher in the developed countries than especially in the high mortality developing countries (Terzic, Senta, & Ahel, 2010). The co-occurrence of comorbid psychiatric disorders such as anxiety, depression, and schizophrenia highlights the importance of comorbid psychiatric disorder as the cause of relapse to drug abuse (Tate, Brown, Unrod, & Ramo, 2004). ...
Article
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ABSTRACT Drug abuse in some addicts progresses to compulsive drug seeking and taking behaviors. High-risk addictive behaviors tend to make interactions between an addict and the community more complex. Socialization is a necessary process that needs to be developed to accommodate to social life.The aim of this study was to evaluate the benefits of social interaction during addiction. Forty-two (42) male Sprague-Dawley rats were randomly divided into four groups: social, isolated, socialized morphine-treated (SMT) and isolated morphine-treated (IMT). At the end of the study, neurogenesis, corticosterone, nitrite/nitrate, anhedonia with forced swim test and sucrose and salt craving were examined. Neurogenesis was reduced in IMT group compared to SMT group. SMT animals and control demonstrated better forced swim test performance compared to IMT animals. Furthermore, sucrose and salt (NaCl 3%) consumption was found to be higher in IMT animals compared to SMT animals. Corticosterone was higher in IMT rats compared to SMT rats. Nitrite/nitrate was higher in IMT rats compared to SMT rats. Socialization preserves brain functions necessary for life. Hence, socialized addicts can better tolerate addiction-induced adverse effects. Keywords: Neurogenesis, morphine, forced swim test, sucrose, nitrite/nitrate, salt, craving
... The only substances not removed were the cocaine metabolite anhydroecgonine, ketamine, methadone and its main metabolite EDDP. Similar results were reported for methadone and EDDP in Italy (Castiglioni et al., 2006b) and Croatia (Terzic et al., 2010) and for ketamine in the UK (Petrie et al., 2015). The behaviour of IDs was almost the same in all the WWTPs, except for codeine and morphine which were less removed in the BF than the CAS WWTPs. ...
Article
The occurrence of several classes of emerging contaminants (ECs) was assessed in the River Lambro basin, one of the most urbanized and industrialized areas of Italy. The study aims were to identify the main sources of ECs, quantify their amounts circulating in the water cycle, and study their fate in the aquatic environment. More than 80 ECs were selected among pharmaceuticals (PHARM), personal care products (PCPs), disinfectants (DIS), illicit drugs (IDs), perfluorinated compounds (PERF), alkylphenols and bisphenol A (Alk-BPA), and anthropogenic markers (AM). Specific analytical methods were developed for quantitative analysis based on solid phase extraction and liquid chromatography tandem mass spectrometry. ECs were measured in rivers upstream and downstream of the main city (Milan), and in untreated and treated wastewater from Milan to assess the contribution to river contamination, and in superficial and deep groundwater in the city area to study the relationship between river and groundwater contamination. Samples were collected in a two-year monitoring campaign. Almost all ECs were ubiquitous in untreated wastewater, at concentrations up to the μg/L range, and the most abundant classes were PHARM and AM. Removals during different wastewater treatment processes were studied and the most stable substances were PHARM, PCPs and PERF. The mass loads increased for all the classes of ECs along the River Lambro basin. A mass balance was done in the river basin and allowed to identify the main sources of contamination, which were domestic, from treated or untreated wastewater, for PHARM, PCPs and IDs, mainly industrial for PERF, and both industrial and domestic for Alk-BPA. The study of AM helped to identify direct discharges of untreated wastewater. A substantial contribution of surface water to groundwater contamination was observed. This study improves the knowledge on occurrence, sources and fate of multiple classes of ECs in a highly urbanized area providing useful information to help the establishment of EU regulations for ECs.
... Due to their poor or incomplete removal by wastewater treatment plants (WWTPs), different IDrgs have been detected in raw or treated wastewater, in surface water, and tap water (ng/L to mg/L; Yadav et al., 2017). IDrgs were also detected in Zagreb WWTP effluent that discharges into the Sava River (Terzi c et al., 2010). ...
Article
Chemical analysis of plasma samples of wild fish from the Sava River (Croatia) revealed the presence of 90 different pharmaceuticals/illicit drugs and their metabolites (PhACs/IDrgs). The concentrations of these PhACs/IDrgs in plasma were 10 to 1000 times higher than their concentrations in river water. Antibiotics, allergy/cold medications and analgesics were categories with the highest plasma concentrations. Fifty PhACs/IDrgs were identified as chemicals of concern based on the fish plasma model (FPM) effect ratios (ER) and their potential to activate evolutionary conserved biological targets. Chemicals of concern were also prioritized by calculating exposure-activity ratios (EARs) where plasma concentrations of chemicals were compared to their bioactivities in comprehensive ToxCast suite of in vitro assays. Overall, the applied prioritization methods indicated stimulants (nicotine, cotinine) and allergy/cold medications (prednisolone, dexamethasone) as having the highest potential biological impact on fish. The FPM model pointed to psychoactive substances (hallucinogens/stimulants and opioids) and psychotropic substances in the cannabinoids category (i.e. CBD and THC). EAR confirmed above and singled out additional chemicals of concern - anticholesteremic simvastatin and antiepileptic haloperidol. Present study demonstrates how the use of a combination of chemical analyses, and bio-effects based risk predictions with multiple criteria can help identify priority contaminants in freshwaters. The results reveal a widespread exposure of fish to complex mixtures of PhACs/IDrgs, which may target common molecular targets. While many of the prioritized chemicals occurred at low concentrations, their adverse effect on aquatic communities, due to continuous chronic exposure and additive effects, should not be neglected.
... Recently, a significant increase in the use of opioids, as both a therapeutic agent and recreational drug, has raised concerns that they will soon emerge as a major contaminant in local water treatment facilities [24], Among addiction treatment options for opiate-abusing patients, buprenorphine has become a popular alternative to methadone as a maintenance/weaning agent, particularly in the Appalachian region [25]. As a result, renewed efforts to monitor local water treatment plants for buprenorphine have been initiated. ...
Article
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The presence of endocrine-disrupting chemicals (EDCs) in our local waterways is becoming an increasing threat to the surrounding population. These compounds and their degradation products (found in pesticides, herbicides, and plastic waste) are known to interfere with a range of biological functions from reproduction to differentiation. To better understand these effects, we used an in silico ontological pathway analysis to identify the genes affected by the most commonly detected EDCs in large river water supplies, which we grouped together based on four common functions: Organismal injuries, cell death, cancer, and behavior. In addition to EDCs, we included the opioid buprenorphine in our study, as this similar ecological threat has become increasingly detected in river water supplies. Through the identification of the pleiotropic biological effects associated with both the acute and chronic exposure to EDCs and opioids in local water supplies, our results highlight a serious health threat worthy of additional investigations with a potential emphasis on the effects linked to increased DNA damage.
... Indeed, the analysis of carefully selected biomarkers, which are often unique human urinary metabolic excretion products, has allowed for near real-time profiling of the community-wide use of a number of illicit drugs (Thomas et al., 2012;, new psychoactive substances (NPS) Castiglioni et al., 2015a), alcohol (Reid et al., 2011a) and tobacco (Castiglioni et al., 2015b) use and counterfeit medicines . The study by Zuccato et al. was followed and further developed by other research groups (Van Nuijs et al., 2009a,b;van Nuijs et al., 2009a,b;Karolak et al., 2010;Metcalfe et al., 2010;Terzic et al., 2010;Reid et al., 2011b;van Nuijs, Castiglioni et al., 2011). The first Europe-wide study in 2011, led by the SCORE group (www.score-cost.eu), ...
Article
The aim of this paper is to present the first study on spatial and temporal variation in the enantiomeric profile of chiral drugs in eight European cities. Wastewater-based epidemiology (WBE) and enantioselective analysis were combined to evaluate trends in illicit drug use in the context of their consumption vs direct disposal as well as their synthetic production routes. Spatial variations in amphetamine loads were observed with higher use in Northern European cities. Enantioselective analysis showed a general enrichment of amphetamine with the R-(-)-enantiomer in wastewater indicating its abuse. High loads of racemic methamphetamine were detected in Oslo (EF = 0.49 ± 0.02). This is in contrast to other European cities where S-(+)-methamphetamine was the predominant enantiomer. This indicates different methods of methamphetamine synthesis and/or trafficking routes in Oslo, compared with the other cities tested. An enrichment of MDMA with the R-(-)-enantiomer was observed in European wastewaters indicating MDMA consumption rather than disposal of unused drug. MDA's chiral signature indicated its enrichment with the S-(+)-enantiomer, which confirms its origin from MDMA metabolism in humans. HMMA was also detected at quantifiable concentrations in wastewater and was found to be a suitable biomarker for MDMA consumption. Mephedrone was only detected in wastewater from the United Kingdom with population-normalised loads up to 47.7 mg 1000 people-1 day-1. The enrichment of mephedrone in the R-(+)-enantiomer in wastewater suggests stereoselective metabolism in humans, hence consumption, rather than direct disposal of the drug. The investigation of drug precursors, such as ephedrine, showed that their presence was reasonably ascribed to their medical use.
... Wastewater-based epidemiology (WBE) is a new approach that utilises biomarker analysis in wastewater with the aim of understanding, estimating and monitoring populations' health and lifestyle. WBE is being currently applied to monitor spatial and temporal illicit drug usage at local, national and international scales [1][2][3][4][5][6][7][8][9][10][11][12] . A list of biomarkers including cocaine, benzoylecgonine, amphetamine, methamphetamine, (±)-3,4-methy lenedioxymethamphetamine (MDMA), 11-nor-9-carboxy-delta(9)-tetrahydrocannabinol and other compounds (e.g. ...
Article
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Wastewater-based epidemiology is an innovative approach to estimate public health status using biomarker analysis in wastewater. A new compound detected in wastewater can be a potential biomarker of an emerging trend in public health. However, it is currently difficult to select new biomarkers mainly due to limited human metabolism data. This manuscript presents a new framework, which enables the identification and selection of new biomarkers of human exposure to drugs with scarce or unknown human metabolism data. Mephedrone was targeted to elucidate the assessment of biomarkers for emerging drugs of abuse using a four-step analytical procedure. This framework consists of: (i) identification of possible metabolic biomarkers present in wastewater using an in-vivo study; (ii) verification of chiral signature of the target compound; (iii) confirmation of human metabolic residues in in-vivo/vitro studies and (iv) verification of stability of biomarkers in wastewater. Mephedrone was selected as a suitable biomarker due to its high stability profile in wastewater. Its enantiomeric profiling was studied for the first time in biological and environmental matrices, showing stereoselective metabolism of mephedrone in humans. Further biomarker candidates were also proposed for future investigation: 4'-carboxy-mephedrone, 4'-carboxy-normephedrone, 1-dihydro-mephedrone, 1-dihydro-normephedrone and 4'-hydroxy-normephedrone.
... Several early studies also reported the increased use of KET during weekends. 24,35,39 The comparison of the three drug concentrations with the levels in the literature is provided in the SI. ...
... 10 Recent studies have shown the presence of opioids in water around the world. These concentrations range from 100 ng/L to over 2000 ng/L, [11][12][13][14][15][16] concentrations at which there have been demonstrated effects in animals, and long term effects on humans are unknown. ...
Article
In this study, the effect of nanocellulose sulfonate group content on adsorption of an opioid simulant was tested. The opioid simulant used was Victoria blue R, an amine dye. Nanocellulose filters were fabricated by crosslinking cellulose nanocrystals (CNCs) with chitosan to improve the mechanical stability of freeze-dried CNCs. Thermogravimetric analysis confirmed the filter’s thermal stability and operating temperatures. Conductometric titration, Fourier transform infrared spectroscopy, and scanning electron microscopy techniques were used to characterize the degree of nanocellulose functionalization. Lastly, the adsorption performance of the sulfonated nanocellulose filter was tested and fitted to kinetic models and adsorption isotherms. The adsorption of the dye by the sulfonated nanocellulose followed pseudo-second order kinetics and the Langmuir isotherm. The maximum adsorption of Victoria blue R dye by sulfonated nanocellulose (68.56 mg/g) is significantly higher than those of other adsorbents, like activated carbon (0.59-2.97 mg/g) and magnetic microparticles (40.98 mg/g). Thus, sulfonated cellulose nanocrystals are a promising material for the sequestration of opioids from water.
... Target analytes can be quantified at trace levels (ng/L) by applying specific, accurate and precise bioanalytical methods such as solid phase extraction and liquid chromatography mass spectrometry (LC-MS/MS) (Andrés-Costa et al., 2017;Baker and Kasprzyk-Hordern, 2011a;Botero-Coy et al., 2018;Fatta et al., 2007). Although WBE is a relatively new scientific discipline, it has rapidly realised its potential to provide independent, timely, low cost/resource and complementary epidemiologic information on the exposure to and consumption of xenobiotics at high spatial and temporal resolutions (Banta-Green et al., 2009;Huerta-Fontela et al., 2008;Karolak et al., 2010;Kasprzyk-Hordern et al., 2009;Mari et al., 2009;Metcalfe et al., 2010;Postigo et al., 2010;Terzic et al., 2010;van Nuijs et al., 2009;Zuccato et al., 2005). This is reflected in the increasing numbers of publications in this field (Fig. S1) (P. ...
Article
The medical and societal consequences of the misuse of pharmaceuticals clearly justifies the need for comprehensive drug utilization research (DUR). Wastewater-based epidemiology (WBE) employs the analysis of human metabolic excretion products in wastewater to monitor consumption patterns of xenobiotics at the population level. Recently, WBE has demonstrated its potential to evaluate lifestyle factors such as illicit drug, alcohol and tobacco consumption at the population level, in near real-time and with high spatial and temporal resolution. Up until now there have been fewer WBE studies investigating health biomarkers such as pharmaceuticals. WBE publications monitoring the consumption of pharmaceuticals were systematically reviewed from three databases (PubMed, Web of Science and Google Scholar). 64 publications that reported population-normalised loads or defined daily doses of pharmaceuticals were selected. We document that WBE could be employed as a complementary information source for DUR. Interest in using WBE approaches for monitoring pharmaceutical use is growing but more foundation research (e.g. compound-specific uncertainties) is required to link WBE data to routine pharmacoepidemiologic information sources and workflows. WBE offers the possiblity of i) estimating consumption of pharmaceuticals through the analysis of human metabolic excretion products in wastewater; ii) monitoring spatial and temporal comsumption patterns of pharmaceuticals continuously and in near real-time; and iii) triangulating data with other DUR information sources to assess the impacts of strategies or interventions to reduce inappropriate use of pharmaceuticals.
... Long-term Fig. 1 Occurrence of cocaine and benzoylecgonine in aquatic environments around the world. Values refer to the highest concentrations detected [99][100][101][102][103][104][105][106][107][108][109][110][111][112][113][114]. ...
Chapter
The inefficient or lack of treatment of wastewaters in developing countries can lead to increased input of pharmaceuticals, personal care products, and illicit drugs (PPCPIDs) into the environment. Current scenarios, as acidification of oceans and pollution by microplastics should increase the impacts of PPCPIDs. This chapter reviews the sources, concentrations, and potential impacts of PPCPIDs in tropical coastal environments to support risk assessments and to identify key knowledge gaps as priorities for future research.
... as DTR of heroin (Baker et al., 2014;Gatidou et al., 2016;Terzic et al., 2010). However, MOR is mostly consumed as a therapeutic drug whereas the use of heroin is illicit. ...
Article
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The occurrence of 25 drug target residues (illicit drugs or pharmaceutically active compounds) was investigated during 85 consecutive days in the influents of a wastewater treatment plant in the Region Centre-Val de Loire, France. This long tracking period allowed a better understanding of the patterns affecting the occurrence of this type of contaminants. Among them, 2 were never detected (i.e. heroin and amphetamine). Concerning illicit drugs two patterns were found. Cocaine and ecstasy median loads varied considerably between weekdays and weekend days (i.e. 18.3 and 35.9 % respectively) whereas cannabis and heroin (based on 6-mono-acetylmorphine loads) loads were within the same order of magnitude with a significant statistical correlation with pharmaceuticals such as acetaminophen or ketoprofen. The consumption of selected drugs was back-calculated from the loads. Among illicit drugs the highest consumption was found for cannabis with a median consumption of 51 mg.day-1.inhabitant-1 (inh) whereas the median consumption for cocaine (based on benzoylecgonine loads) and ecstasy was 32 and 6 mg.day-1.103.inh-1 respectively. The highest consumption values of pharmaceutically active compounds (PACs) were found for acetaminophen and acetylsalicylic acid with 108.8 and 34.1 mg.day-1.inh-1 respectively, in good agreement with national sales data. A statistically significant weekly pattern was found for several PACs such as metoprolol and trimethoprim, but with the opposite pattern to that of illicit drugs. The variations in daily PAC loads could provide information about the mobility of people in the catchment, especially on the basis of daily taken PACs (i.e. to treat chronicle diseases).
... The method of sewage epidemiology relies on measuring the concentrations of selected drugs or their metabolites in the influent of wastewater treatment plants (WWTPs), as a means of back-calculating the epidemiological prevalence and consumption Zuccato et al., 2008;Zuccato et al., 2005). This method of monitoring drug consumption based on wastewater analysis had been widely used in order to estimate abuse of illicit drugs and alcohol Kasprzyk-Hordern et al., 2009;Lai et al., 2013;Ort et al., 2014;Postigo et al., 2011;Reid et al., 2011;Terzic et al., 2010;Thai et al., 2016;Thomas et al., 2012;van Nuijs et al., 2011a). The wastewater analysis of active nicotine excretion products has been recently used to estimate tobacco consumption in several cities in Spain (Rodríguez-Álvarez et al., 2014), Italy and China (Wang et al., 2016). ...
Article
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Sewage epidemiology is a real-time tool used to monitor tobacco consumption. In this study, we investigated the tobacco consumption in eight cities in Jilin province using sewage epidemiology. We collected influent wastewater samples from ten wastewater treatment plants (WWTPs) that serve nearly four million people. Mean nicotine (NIC) loads ranged from 1.42 to 14.2 mg/d/capita, whereas mean cotinine (COT) loads showed lower levels with 0.33 to 2.15 mg/d/capita. Population size was estimated to provide an accurate and real-time population based on ammonia nitrogen (NH4-N) concentration in influent. To verify the NH4-N equivalent population, we compared these results with the corresponding population estimated based on the expert knowledge of the local WWTPs operators. Daily consumption of NIC was estimated to be approximately 2.39 ± 1.47 mg/d/capita. Monte Carlo simulation was used to analyze uncertainty and variability in the number of cigarettes consumed by smokers in the range of 9.8 to 31.4 per day with a median of 16.9. The data of tobacco consumption in this study coordinated strongly with a traditional survey on the consumption of tobacco in China, indicating sewage epidemiology with NH4-N equivalent population estimation may provide a suitable and useful tool for tobacco use monitoring.
... Daglıoglu et al. (2019) determined that cocaine use was higher based on the sample taken from the influent of WWTP-1 in Adana and ecstasy was higher for both influent WWTPs during the weekend compared to weekdays. Statistically significant differences in weekday and weekend drug consumption of cocaine, MDMA, and amphetamine were determined earlier (Andrés-Costa et al., 2014;Bijlsma et al., 2014;Huerta-Fontela et al., 2008;Terzic et al., 2010). ...
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... Only APIs that matched the Anatomical Therapeutic Chemical (ATC) classification "N -Nervous System" were included in the study. Illicit drugs and associated metabolites were selected from the following studies: Terzic et al., Hahn et al. and van Nuijs et al. that have investigated the occurrence of these compounds in wastewater from different locations in Europe [24][25][26]. Finally, selection of NPS class compounds was based on a highly comprehensive review article by Gent and Paul (2021), where over 40 different studies (2013-2020) from all over the world have been complied to summarize the occurrence rate of NPS in wastewater samples. ...
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... Codeine is a popular painkiller with relatively constant consumption during weekdays and also rather uniform excretion rate throughout the week (Terzic et al. 2010a). It is also one of the most accessible opioids, available without prescription (as over-the-counter medicine) in many countries such as the UK, Canada, Australia, New Zealand, and France (Roxburgh et al. 2015). ...
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Opioids are required by a majority of patients with advanced cancer. Oncologists and palliative care clinicians are faced with the challenge of safely prescribing opioids in the current environment of an opioid crisis. Many patients with cancer use opioids unsafely, store them in unsecure locations, and do not dispose of unused opioids, leading to increased availability of these opioids for others to misuse. More than 50% of people who misuse opioids obtain the drugs from a friend or relative with or without their consent. Patient and provider education has been shown to improve safe opioid use, promote secure storage, and also increase disposal of unused opioids safely in drug take-back programs that are now widely available. This article highlights the importance of patient education and cautious opioid prescribing in patients with cancer. Implications for Practice: The current opioid crisis makes it challenging to effectively manage cancer pain. Providers play a prominent role in minimizing opioid misuse. Cautious prescribing with limits enforced on the quantity of opioids prescribed, close follow-up, and consistent and frequent provision of opioid education are a must. Evidence points to the impact of patient education in promoting safety around opioid use. Most people who misuse prescription opioids obtain them from family or friends. Storing opioids in the open or not disposing of unused opioids increases the availability of these opioids for misuse by others. The importance of not sharing, always locking up, and disposing of unused and expired opioids must be highlighted as part of the opioid education that must be delivered every time that opioids are prescribed. Information about local drug take-back programs may also help increase disposal of unused opioids.
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N-nitrosodimethylamine (NDMA), a well-known human carcinogen, is widely considered to form through the chloramination of amine-containing compounds; however, there is very limited knowledge regarding how sunlight photolysis affects NDMA formation during chloramination. This study selected methadone, a potential NDMA precursor, as a model compound and found that compared to chloramination alone, chloramine sunlight photolysis (sunlight/chloramine) enhances methadone degradation and reduces NDMA formation. The NDMA formation mechanism during the sunlight/chloramine (or chloramination) process was elucidated. The effects of the chloramine species (monochloramine (NH2Cl) and dichloramine (NHCl2)), chlorine-to-ammonia (Cl2/N) molar ratio (0.5–1.5), solution pH (4–9.5) and nitrate concentration (5 and 10 mM) on the sunlight/chloramine degradation of methadone were examined. The methadone degradation under all investigated sunlight/chloramine conditions followed pseudo-first-order kinetics, and the degradation rate constant increased with increasing NHCl2 concentration. Furthermore, NDMA formation increased with increasing Cl2/N molar ratio and solution pH but decreased in the presence of nitrate.
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In this study, we developed a novel on-line solid phase extraction (SPE)-ultra-high-performance liquid chromatography (UHPLC)-tandem mass spectrometry (MS/MS)-based analytical method for simultaneously quantifying 12 illicit drugs and metabolites (methamphetamine, amphetamine, morphine, codeine, 6-monoacetylmorphine, benzoylecgonine, 3,4-methylenedioxymethamphetamine, 3,4-methylenedioxyamphetamine, cocaine, ketamine, norketamine, and methcathinone) and cotinine in wastewater samples. The analysis was performed by loading 2 mL of the sample onto an Oasis hydrophilic-lipophilic balance (HLB) cartridge and using a cleanup step (5% methanol) to eliminate interference with a total run time of 13 min. The isotope-labeled internal standard method was used to quantify the target substances and correct for unavoidable losses and matrix effects during the on-line SPE process. Typical analytical characteristics used for method validation were sensitivity, linearity, precision, repeatability, recovery, and matrix effects. The limit of detection (LOD) and limit of quantification (LOQ) of each target were set at 0.20 ng/L and 0.50 ng/L, respectively. The linearity was between 0.5 ng/L and -250 ng/L, except for that of COT. The intra- and inter-day precisions were < 10.45% and 25.64%, respectively, and the relative recovery ranged from 83.74% to 162.26%. The method was used to analyze various wastewater samples from 33 cities in China, and the results were compared with the experimental results of identical samples analyzed using off-line SPE. The difference rate was between 19.91% and -20.44%, and the error range could be considered acceptable. These findings showed that on-line SPE is a suitable alternative to off-line SPE for the analysis of illicit drugs in samples.
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The abuse of psychoactive substances has been increasing dramatically over the last few years, which is becoming a concern for human health and social stability. How to accurately estimate psychoactive substances' total consumption in certain areas is the key to manage such substances. In order to control psychoactive substances, 8 psychoactive substances' consumption within 12 wastewater treatment plants (WWTPs) service areas in a certain city of Guangxi, China was investigated in 2019. Firstly, a solid-phase extraction-liquid chromatography-tandem mass spectrometry method was used to determine the influent concentrations. Morphine (MOR), 3, 4-methylenedioxymethamphetamine (MDMA), methamphetamine (METH), ketamine (KET), and norketamine (NK) were detected, with the concentrations ranging from less than method detection limit (NK, MDMA) to 170.91 (METH) ng/L. Then, the back-estimation of consumption was conducted according to the objective and near real-time wastewater-based epidemiology (WBE). The results demonstrate that KET, MOR, and METH are the most abused psychoactive substances, with the mean consumption of 682.42, 167.81, and 44.56 mg/day/1000 inh, respectively. The psychoactive substance residues of WWTPs influent were analyzed to estimate such substances' consumption in specific areas, so as to provide support for risk prevention and control.
Chapter
The increasing knowledge and awareness concerning the presence of pharmaceutical residues and their negative impact on the marine environment create a need to develop new tools to investigate and monitor their pathways. Multiresidue methods allow the determination of a vast number of target compounds from different classes of pharmaceuticals in a single analysis. The application of these methods to seawater samples is more complicated compared with freshwater analysis due to matrix impact and dilution of the target compounds. This chapter presents a review of the published research papers from the last decade and discusses the analytical methodologies presented there. Based on the current knowledge, authors also try to predict and point out the future trends and challenges in multiresidue analysis methodology.
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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.
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Global surface waters are increasingly shown to be contaminated by anthropogenic chemical pollutants which, in turn exert potential lethal- and sub-lethal toxicity risks to the aquatic environment and humans. In particular, pollutants which are able to modulate endocrine system pathways, known as endocrine disrupting contaminants (EDCs) are of an emerging global concern. Treated wastewater discharge is a major contributing source of this pollution, with the recalcitrance and passage of various contaminants through wastewater treatment posing a risk to water security. This is highlighted as a critically important global challenge which need to be further addressed, especially for developing countries that are subjected to increased demands for clean water and sanitation services due to rapid population growth and urbanisation. Furthermore, routine monitoring and refinement of analytical methodologies for risk assessment are largely limited in the country, which points to the needed to assess the harmful impact of priority micro-pollutants in surface water systems. One of the aims of the present study was to assess the presence and fate of EDCs and other emerging contaminants (ECs) within a selection of South African wastewater treatment works (WWTWs) and associated environmental waters in order to refine the monitoring tools and methodology used for risk assessment approaches. Endocrine-disrupting activities generated by in vitro steroid hormone receptor binding assays, namely the yeast (anti)estrogen screen (YES/YAES), highlighted the complexity when dealing with environmental samples containing a mixture of analytes. Even though notable reductions of estrogenicity by the WWTWs were measured, some remaining loads in effluent receiving river waters remained above risk-based trigger values, therefore potentially compromising human- and aquatic health. Estimation of the potential toxic masking by analytes with anti-estrogenic effect/activity highlighted further refinement that will be needed evaluating potential endocrine disrupting activity when applying bioassays for risk assessment. Both diurnal as well as seasonal variation in endocrine disrupting activities were recorded and discussed. Also, treated wastewater effluent served as a diluting medium to lower estrogenicity within recipient river waters at some study sites, and highlighted the contribution of alternative pollution sources that may significantly impact the quality of river systems. Although EDCs are mostly assumed to be associated with steroid hormones, in the present study I conducted scoping studies at selected WWTWs and showed the extent of regularly-used pharmaceuticals & personal care products (PPCPs) and drugs of abuse (DOA) present within wastewater and surface waters - having variable degradation profiles during wastewater treatment. In particular, ECs which were highlighted as priority micro-pollutants, such as anti-epileptics, non-steroidal anti-inflammatory drugs (NSAIDs), opioids and anti-depressants showed moderate- to negative removal during wastewater treatment, even during advanced activated sludge treatment processes. Although all of these pollutants are known to undergo biological degradation, the present study recommended further refinement of current treatment processes to improve on the removal of such persistent ECs. The need to define the environmental impact of EC breakdown-products were also discussed, as their potential health risks are largely unknown. The dissertation also showed the value of urban water profiling to report on the use and abuse of licit and illicit DOA within communities connected to sewer networks at two study sites. Several prescription and over-the-counter (OTC) medications were detected within wastewater originating from domestic sewage, in particular opioids, an anaesthetic and anti-depressant drug – all of which are reported to be abused in South Africa, although limited statistics exist. For illicit DOA, the loads of cocaine, 3,4-methylenedioxymethamphetamine (MDMA), methamphetamine, heroin and the new psychoactive substance (NPS) mephedrone confirmed their consumption within the communities connected to the WWTWs, which were enriched by including the detection of their metabolic breakdown products, as well as enantiomeric profiling of the chiral drugs. The present study encapsulated the benefit of urban water profiling to address current- and emerging global challenges for environmental- and human sustainability. Incorporation of the research outputs from the current study during refinement of risk-based approaches in South Africa may greatly improve water reclamation and management strategies to ultimately safeguard this valuable commodity for driving community- and environmental resilience.
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This paper reviews the current state of knowledge on illicit drugs as emerging environmental contaminants. Several studies have recently reported that illicit drugs are detectable in wastewater from municipal sewage treatment plants (STPs) and surface waters. These substances are excreted in urine and faeces unchanged or as active metabolites in high percentages after consumption and continuously discharged into domestic wastewaters. Residues of illicit drugs can therefore reach STPs in substantial amounts, escaping degradation, and are then released into surface waters. Environmental concentrations are low, but risks for human health and the environment cannot be excluded. Morphine, cocaine, methamphetamine and ecstasy all have potent pharmacological activities, and their presence as complex mixtures in surface waters may be toxic to aquatic organisms. Levels of residues in untreated wastewater have been used to estimate illicit drug consumption in the population. Given that current epidemiological methods are indirect and possibly biased, this evidence-based approach offers a new tool for estimating drug abuse in real time.
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The occurrence of several opiates and cannabinoids in wastewaters and surface waters has been investigated. Most of the compounds (8 out of 11) were identified in both influent and effluents of fifteen wastewater treatment plants (WWTPs). Codeine, morphine, EDDP and methadone were detected in almost all samples with median values of 69ng/L; 63ng/L; 28ng/L and 18ng/L, respectively, whereas the main cannabinoid metabolite THC-COOH presented a median value of 57ng/L in influents. A rough estimate of heroin and cannabis consumption was performed from the analysis of target urinary metabolites in wastewater influents. Data obtained from influents of rural and urban WWTPs gave 0.07% of heroin consumption (0.67% for the largest urban WWTP) and 4% consumption of cannabinoids, respectively for the population aged between 15 and 64 years old. The presence of opiates and cannabinoids in surface waters used for drinking water production showed the presence of the same compounds identified in wastewater effluents at concentrations up to 76ng/L for codeine; 31ng/L for EDDP; 12ng/L for morphine and 9ng/L for methadone at the intake of the DWTP. A complete removal of all studied drugs present in surface water was achieved during the potabilization process except for methadone and EDDP (91% and 87% removal, respectively).
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A 5-month monitoring program was undertaken in South Wales in the UK to determine the fate of 55 pharmaceuticals, personal care products, endocrine disruptors and illicit drugs (PPCPs) in two contrasting wastewater plants utilising two different wastewater treatment technologies: activated sludge and trickling filter beds. The impact of treated wastewater effluent on the quality of receiving waters was also assessed. PPCPs were found to be present at high loads reaching 10kgday(-1) in the raw sewage. Concentrations of PPCPs in raw sewage were found to correlate with their usage/consumption patterns in Wales and their metabolism. The efficiency of the removal of PPCPs was found to be strongly dependent on the technology implemented in the wastewater treatment plant (WWTP). In general, the WWTP utilising trickling filter beds resulted in, on average, less than 70% removal of all 55 PPCPs studied, while the WWTP utilising activated sludge treatment gave a much higher removal efficiency of over 85%. The monitoring programme revealed that treated wastewater effluents were the main contributors to PPCPs concentrations (up to 3kg of PPCPsday(-1)) in the rivers studied. Bearing in mind that in the cases examined here the WWTP effluents were also major contributors to rivers' flows (dilution factor for the studied rivers did not exceed 23 times) the effect of WWTP effluent on the quality of river water is significant and cannot be underestimated.
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The social and medical problems of drug abuse are a matter of increasing global concern. To tackle drug abuse in changing scenarios, international drug agencies need fresh methods to monitor trends and patterns of illicit drug consumption. We tested a sewage epidemiology approach, using levels of excreted drug residues in wastewater, to monitor collective use of the major drugs of abuse in near real time. Selected drug target residues derived from use of cocaine, opiates, cannabis, and amphetamines were measured by mass spectrometry in wastewater collected at major sewage treatment plants in Milan (Italy), Lugano (Switzerland), and London (United Kingdom). The amounts of drug residues conveyed to the treatment plants, reflecting the amounts collectively excreted with urine, were used to estimate consumption of the active parent drugs. Reproducible and characteristic profiles of illicit drug use were obtained in the three cities, thus for the first time quickly revealing changes in local consumption (e.g., cocaine consumption rose significantly on weekends in Milan). Profiles of local drug consumption based on waste-water measurements are in line with national annual prevalence estimates. Patterns and trends of drug abuse in local communities can be promptly monitored by this tool, a convenient new complement to more complex, lengthy survey methods. In principle, searching the sewage for excreted compounds relevant to public health issues appears to have the potential to become a convenient source of real-time epidemiologic information.
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During the last three decades, the impact of chemical pollution has focused almost exclusively on the conventional "priority" pollutants, especially those acutely toxic/carcinogenic pesticides and industrial intermediates displaying persistence in the environment. This spectrum of chemicals, however, is only one piece of the larger puzzle in "holistic" risk assessment. Another diverse group of bioactive chemicals receiving comparatively little attention as potential environmental pollutants includes the pharmaceuticals and active ingredients in personal care products (in this review collectively termed PPCPs), both human and veterinary, including not just prescription drugs and biologics, but also diagnostic agents, "nutraceuticals," fragrances, sun-screen agents, and numerous others. These compounds and their bioactive metabolites can be continually introduced to the aquatic environment as complex mixtures via a number of routes but primarily by both untreated and treated sewage. Aquatic pollution is particularly troublesome because aquatic organisms are captive to continual life-cycle, multigenerational exposure. The possibility for continual but undetectable or unnoticed effects on aquatic organisms is particularly worrisome because effects could accumulate so slowly that major change goes undetected until the cumulative level of these effects finally cascades to irreversible change--change that would otherwise be attributed to natural adaptation or ecologic succession. As opposed to the conventional, persistent priority pollutants, PPCPs need not be persistent if they are continually introduced to surface waters, even at low parts-per-trillion/parts-per-billion concentrations (ng-microg/L). Even though some PPCPs are extremely persistent and introduced to the environment in very high quantities and perhaps have already gained ubiquity worldwide, others could act as if they were persistent, simply because their continual infusion into the aquatic environment serves to sustain perpetual life-cycle exposures for aquatic organisms. This review attempts to synthesize the literature on environmental origin, distribution/occurrence, and effects and to catalyze a more focused discussion in the environmental science community.
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Cocaine use seems to be increasing in some urban areas worldwide, but it is not straightforward to determine the real extent of this phenomenon. Trends in drug abuse are currently estimated indirectly, mainly by large-scale social, medical, and crime statistics that may be biased or too generic. We thus tested a more direct approach based on 'field' evidence of cocaine use by the general population. Cocaine and its main urinary metabolite (benzoylecgonine, BE) were measured by mass spectrometry in water samples collected from the River Po and urban waste water treatment plants of medium-size Italian cities. Drug concentration, water flow rate, and population at each site were used to estimate local cocaine consumption. We showed that cocaine and BE are present, and measurable, in surface waters of populated areas. The largest Italian river, the Po, with a five-million people catchment basin, steadily carried the equivalent of about 4 kg cocaine per day. This would imply an average daily use of at least 27 +/- 5 doses (100 mg each) for every 1000 young adults, an estimate that greatly exceeds official national figures. Data from waste water treatment plants serving medium-size Italian cities were consistent with this figure. This paper shows for the first time that an illicit drug, cocaine, is present in the aquatic environment, namely untreated urban waste water and a major river. We used environmental cocaine levels for estimating collective consumption of the drug, an approach with the unique potential ability to monitor local drug abuse trends in real time, while preserving the anonymity of individuals. The method tested here--in principle extendable to other drugs of abuse--might be further refined to become a standardized, objective tool for monitoring drug abuse.
Article
Full-text available
A solid phase extraction (SPE) method has been developed and applied in conjunction with a previously reported liquid chromatography tandem mass spectrometry (LC-MS-MS) procedure for the determination of illicit drugs and abused pharmaceuticals in treated wastewater and surface water samples at the ng L(-1) level. A full method validation was also performed and determined levels of analytical sensitivity were found to lie in the 1-10 ng L(-1) range using river water as a test sample matrix and a sample size of 500 mL. The developed procedure was successfully applied for the determination of the chosen analytes in wastewater treatment plants in Dublin, Ireland and rapidly expanding commuter towns in the surrounding counties. Cocaine was detected in 70% of the collected samples in the range of 25-489 ng L(-1), its primary metabolite, benzoylecognine (BZE) was also detected in the range of 22-290 ng L(-1). Other substances detected included morphine, Tempazepam and the primary metabolite of methadone.
Article
Drugs of abuse and their metabolites have been recently recognized as environmental emerging organic contaminants. Assessment of their concentration in different environmental compartments is essential to evaluate their potential ecotoxicological effects. It also constitutes an indirect tool to estimate drug abuse by the population at the community level. The present work reports for the first time the occurrence of drugs of abuse and metabolites residues along the Ebro River basin (NE Spain) and also evaluates the contribution of sewage treatment plants (STPs) effluents to the presence of these chemicals in natural surface waters. Concentrations measured in influent sewage waters were used to back calculate drug usage at the community level in the main urban areas of the investigated river basin.
Article
This biennial review covers developments in water analysis for emerging environmental contaminants over the period of October 2013-October 2015. Analytical Chemistry's policy is to limit reviews to a maximum of 250 significant references and to mainly focus on new trends. Therefore, only a small fraction of the quality research publications are discussed. The previous Water Analysis review (with Thomas Ternes) was published in 2014. This year, Susana Y. Kimura joined me to cover the section on Pharmaceuticals and Hormones. We welcome any comments you have on this Review (richardson.susan@sc.edu). Numerous abstracts were consulted before choosing the best representative ones to present here. Abstract searches were carried out using Web of Science, and in many cases, full articles were obtained. A table of acronyms is provided (Table 1) as a quick reference to the acronyms of analytical techniques and other terms discussed in this Review. Table 2 provides some useful websites.
Article
Based on a monitoring program over the course of a year, we characterize the temporal and spatial distribution of selected micropollutants in an urban watershed within the city of Leipzig, Germany. Micropollutants revealed a ubiquitous presence in untreated and treated wastewater, surface water and groundwater. The loads of 4-nonylphenol in the effluents of the municipal wastewater treatment plant followed a seasonal trend, whereas the loads of all other micropollutants were highly variable and not correlated to seasons. In the surface water, load seasonality of caffeine, galaxolide and tonalide resulted from a rapid removal with increased water temperature. The loads of 4-nonylphenol and of caffeine in the colder months increased when rainfall occurred. In the groundwater, complex spatial and temporal patterns were apparent and were related to varying input, retardation and removal processes. As a consequence, an assessment of micropollutants in urban waters should consider different micropollutants' temporal and spatial variability.
Article
The diffusion and trends in use of each substance is a basic information in policy planning of strategies aiming at deterrence of drug abuse or in the organization of the fight against drug trafficking. The actual diffusion of illicit drugs in a population is hardly measurable, but, among the various measures available, the analysis of waste water plants represents one of the most reliable source of data. We analyzed waste water in order to monitor illicit drug use by local population. We investigated the use of cocaine and heroin in the city of Florence, Italy, over a 1-year (July 2006-June 2007) period using state-of-the-art measuring techniques from waste water samples. Cocaine, benzoylecgonine, and morphine were determined in water samples by gas chromatography-mass spectrometer, and the amount of illicit substance was estimated. Data indicate for cocaine a bimodal distribution (December and March), while heroin showed a main peak in April. The heroin-to-cocaine use ratio in terms of estimated doses per month ranged from 0.11 to 0.76, representing new evidence of wider distribution of cocaine than heroin in Florence. Waste water analysis can become a valuable tool in monitoring use of illicit drugs over time. In particular, it can highlight changes in the magnitude and relative use of illicit drug at a population level thereby becoming useful to develop strategies against drug trafficking and abuse. If routinely performed, it can be part of Epidemiologic Surveillance Programmes on drug abuse.
Article
Aims: Cocaine is the second most-used illicit drug world-wide and its consumption is increasing significantly, especially in western Europe. Until now, the annual prevalence has been estimated indirectly by means of interviews. A recently introduced and direct nation-wide approach based on measurements of the major urinary excreted metabolite of cocaine, benzoylecgonine, in wastewater is proposed. Design: Wastewater samples from 41 wastewater treatment plants (WWTPs) in Belgium, covering approximately 3,700,000 residents, were collected. Each WWTP was sampled on Wednesdays and Sundays during two sampling campaigns in 2007-08. Samples were analysed for cocaine (COC) and its metabolites, benzoylecgonine (BE) and ecgonine methylester (EME) by a validated procedure based on liquid chromatography coupled with tandem mass spectrometry. Concentrations of BE were used to calculate cocaine consumption (g/day per 1000 inhabitants) for each WWTP region and for both sampling campaigns (g/year per 1000 inhabitants). Findings: Weekend days showed significantly higher cocaine consumption compared with weekdays. The highest cocaine consumption was observed for WWTPs receiving wastewater from large cities, such as Antwerp, Brussels and Charleroi. Results were extrapolated for the total Belgian population and an estimation of a yearly prevalence of cocaine use was made based on various assumptions. An amount of 1.88 tonnes (t) per year [standard error (SE) 0.05 t] cocaine is consumed in Belgium, corresponding to a yearly prevalence of 0.80% (SE 0.02%) for the Belgian population aged 15-64 years. This result is in agreement with an earlier reported estimate of the Belgian prevalence of cocaine use conducted through socio-epidemiological studies (0.9% for people aged 15-64 years). Conclusions: Wastewater analysis is a promising tool to evaluate cocaine consumption at both local and national scale. This rapid and direct estimation of the prevalence of cocaine use in Belgium corresponds with socio-epidemiological data. However, the strategy needs to be refined further to allow a more exact calculation of cocaine consumption from concentrations of BE in wastewater.
Article
Pharmaceuticals and recently also illicit drugs have been recognised as emerging environmental contaminants due to their potential environmental impact: frequent occurrence, persistence and risk to aquatic life and humans. This manuscript is part one of the two-part study aiming to provide a better understanding and application of environmental data not only for environmental aims but also to meet forensic objectives. An attempt to use wastewater data is made in order to verify patterns of the usage of drugs (in particular illicit) in local communities. The average usage of cocaine in South Wales was estimated at 0.9 g day(-1) 1000 people(-1), which equals 1 tonne of this drug used or disposed of to sewage annually in Wales. The calculated usage of amphetamine denoted 2.5 g day(-1) 1000 people(-1) and is suspected to be an overestimate. Because no analysis of enantiomers of amphetamine was undertaken, no distinction between amphetamine's legal and illicit usage could be made.
Article
An ultra-high-pressure liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method has been developed for the simultaneous quantification and confirmation of 11 basic/acidic illicit drugs and relevant metabolites in surface and urban wastewater at ng/L levels. The sample pre-treatment consisted of a solid-phase extraction using Oasis MCX cartridges. Analyte deuterated compounds were used as surrogate internal standards (except for norbenzoylecgonine and norcocaine) to compensate for possible errors resulting from matrix effects and those associated to the sample preparation procedure. After SPE enrichment, the selected drugs were separated within 6min under UHPLC optimized conditions. To efficiently combine UHPLC with MS/MS, a fast-acquisition triple quadrupole mass analyzer (TQD from Waters) in positive-ion mode (ESI+) was used. The excellent selectivity and sensitivity of the TQD analyzer in selected reaction monitoring mode allowed quantification and reliable identification at the LOQ levels. Satisfactory recoveries (70-120%) and precision (RSD<20%) were obtained for most compounds in different types of water samples, spiked at two concentration levels [limit of quantification (LOQ) and 10LOQ]. Thus, surface water was spiked at 30 ng/L and 300 ng/L (amphetamine and amphetamine-like stimulants), 10 ng/L and 100 ng/L (cocaine and its metabolites), 300 ng/L and 3000 ng/L (tetrahydrocannabinol-COOH). Recovery experiments in effluent and influent wastewater were performed at spiking levels of three and fifteen times higher than the levels spiked in surface water, respectively. The validated method was applied to urban wastewater samples (influent and effluent). The acquisition of three selected reaction monitoring transitions per analyte allowed positive findings to be confirmed by accomplishment of ion ratios between the quantification transition and two additional specific confirmation transitions. In general, drug consumption increased in the weekends and during an important musical event. The highest concentration levels were 27.5 microg/L and 10.5 microg/L, which corresponded to 3,4-methylenedioxymethamphetamine (MDMA, or ecstasy) and to benzoylecgonine (a cocaine metabolite), respectively. The wastewater treatment plants showed good removal efficiency (>99%) for low levels of illicit drugs in water, but some difficulties were observed when high drug levels were present in wastewaters.
Article
Large-volume (1800 microL) injection (LVI) followed by liquid chromatography/tandem mass spectrometry was developed and optimized to eliminate the need for off- and on-line solid phase extraction as a sample preparation step. Centrifugation of raw municipal influent followed by LVI was optimized for the routine determination of illicit drugs and related substances in municipal wastewaters. The accuracy of the method is demonstrated by standard addition for analytes with concentrations ranging from 4 to 3,500,000 ng/L. Precision, as indicated by relative standard deviation is <12% within a day and < or =20% for between-days for analytes with corresponding stable-isotope-labeled internal standards. Instrumental detection limits range from 0.5 to 4 ng/L while lower limits of quantification range from 2.5 to 10 ng/L The method is demonstrated on wastewater treatment plant influents (24 h, flow-normalized) collected from seven municipalities located in the US. Methamphetamine concentrations and loads are the greatest yet reported while cocaine concentrations and index loads are similar to European locations. Creatinine is introduced as human urine indicatorthat can be potentially used as an alternative to population estimates for indexing illicit drug loads for different municipalities.
Article
Estimates of cocaine consumption are currently resulting from population surveys, consumer interviews and crime statistics. A new approach ("sewage epidemiology") based on the analysis of cocaine (COC) and its metabolite, benzoylecgonine (BE), in water samples was applied to 10 river sites and 30 wastewater treatment plants (WWTPs) in Belgium. Each river site was sampled twice, during the summer of 2007 and the winter of 2007-2008, while each WWTP was sampled on a Sunday and a Wednesday, during the summer-autumn of 2007 and the winter of 2007-2008. This sampling strategy allowed for the evaluation of spatial and seasonal variations in the occurrence of COC and BE in waste- and surface water. WWTP Brussel-Noord was sampled for 19 consecutive days to evaluate daily and weekly variations in the presence of COC and BE in wastewater. For 7 WWTPs, influent and effluent water samples were collected to investigate the removal of COC and BE during the wastewater treatment process. Analysis of water samples was performed using solid-phase extraction and liquid chromatography coupled to tandem mass spectrometry. Measured concentrations were further converted into an amount of used cocaine, called cocaine equivalents, as previously described in the literature. Results showed no significant difference in cocaine use between the investigated seasons. A constant cocaine consumption was observed during the week (Monday-Friday) with peaks during the weekend for WWTP Brussel-Noord. The COC/BE ratio in water samples was significantly higher during winter, most probably due to a slower hydrolysis of cocaine in low-temperature water. COC and BE were removed in the investigated WWTPs with a removal efficiency of >93%.
Article
Organic pollutants are a highly relevant topic in environmental science and technology. This article briefly reviews historic developments, and then focuses on the current state of the art and future perspectives on the qualitative and quantitative trace determination of polar organic contaminants, which are of particular concern in municipal and industrial wastewater effluents, ambient surface waters, run-off waters, atmospheric waters, groundwaters and drinking waters. The pivotal role of advanced analytical methods is emphasized and an overview of some contaminant classes is presented. Some examples of polar water pollutants, which are discussed in a bit more detail here, are chosen from projects tackled by the research group led by the author of this article.
Article
The presence of psychoactive stimulatory drugs in raw waters used for drinking water production and in finished drinking water was evaluated in a Spanish drinking water treatment plant (DWTP). Contamination of the river basin which provides raw water to this DWTP was also studied. In surface waters, illicit drugs such as cocaine, benzoylecgonine (cocaine metabolite), amphetamine, methamphetamine, MDMA (ecstasy), and MDA were detected at mean concentrations ranging from 4 to 350 ng/L. Nicotine, caffeine, and their metabolites were also found at the microg/L level. The elimination of these compounds during drinking water treatment was investigated in a real waterworks. Amphetamine-type stimulants (except MDMA) were completely removed during prechlorination, flocculation, and sand filtration steps, yielding concentrations lowerthan their limits of detection (LODs). Further, ozone treatment was shown to be effective in partially eliminating caffeine (76%), while subsequent granulated activated carbon (GAC) filtration removed cocaine (100%), MDMA(88%), benzoylecgonine (72%), and cotinine (63%). Postchlorination achieved the complete elimination of cocaine and nicotine and only one parent compound (caffeine) and two metabolites (cotinine and benzoylecgonine) persisted throughout treatment although reductions of 90% for caffeine and benzoylecgonine and 74% for cotinine were obtained.
Article
Cocaine abuse, a growing social problem, is currently estimated from population surveys, consumer interviews and crime statistics. A new approach based on the analysis of cocaine (COC) and metabolites, benzoylecgonine (BE) and ecgonine methyl ester (EME), in water samples was applied to 28 rivers and 37 waste water treatment plants in Belgium using solid-phase extraction and liquid chromatography coupled to tandem mass spectrometry. While EME was undetectable, COC and BE were detectable with concentrations ranging from <1 to 753 ng/L and <1 to 2258 ng/L, respectively. BE concentrations were employed to calculate the local amount of abused cocaine. The highest values (up to 1.8 g/day cocaine per 1000 inhabitants) were found in large cities and during weekends. The estimation of cocaine abuse through water analysis can be executed on regular basis without cooperation of patients. It also gives clear geographical information, while prevention campaigns can easily be implemented and evaluated.
Article
Residues of illicit drugs and their metabolites that are excreted by humans may flow into and through wastewater treatment plants. The aim of this study was to develop a method for the determination of cocaine, amphetamines, morphine, cannabinoids, methadone, and some of their metabolites in wastewater. Composite 24-h samples from urban treatment plants were enriched with deuterated internal standards before solid-phase extraction. High-pressure liquid chromatography tandem mass spectrometry with multiple reaction monitoring was used for quantitation. Recoveries were generally higher than 80%, and limits of quantifications were in the low nanograms-per-liter range for untreated and treated wastewater. The overall variability of the method was lower than 10% for untreated and 5% for treated wastewater. The method was applied to wastewater samples coming from two treatment plants in Italy and Switzerland. Quantification ranges were found to be 0.2-1 microg/L for cocaine and its metabolite benzoylecgonine, 80-200 ng/L for morphine, 10 ng/L for 6-acetylmorphine, 60-90 ng/L for 11-nor-9-carboxy-Delta9-tetrahydrocannabinol, 10-90 ng/L for methadone and its main metabolite 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine, and lower than 20 ng/L for amphetamines. As previously reported for cocaine, this method could be useful to estimate and monitor drug consumption in the population in real time, helping social scientists and authorities to combat drug abuse.
Article
Ultraperformance liquid chromatography coupled to electrospray tandem mass spectrometry was used for the rapid and simultaneous analysis of 15 stimulatory drugs in water. Cocaine, amphetamine-related compounds, LSD, ketamine, PCP, fentanyl, and metabolites, among the controlled drugs, and nicotine, caffeine, and their metabolites, among the noncontrolled drugs, were studied. Chromatographic separation was achieved in less than 4.5 min, with improved peak resolution and sensitivity. Identification and quantification of the compounds of interest was performed by selected reaction monitoring, using an electrospray ionization source. Isotope dilution (except for paraxanthine) was used for quantitation. Quality parameters of the method were established, and limits of quantification were obtained for controlled drugs in surface waters from 0.1 to 3.1 ng/L and in wastewaters from 0.2 to 4.0 ng/L. Run-to-run and day-to-day precisions were evaluated in different water matrixes (Milli-Q water, surface water, wastewater). To assess the presence of these drugs in real water samples, the optimized method was applied to the analysis of wastewater and surface river water. The analysis of several samples from wastewater treatment plants in northeast Spain revealed the presence of drugs such as cocaine and amphetamine-related compounds, in both influent and effluent samples. Cocaine metabolite and MDMA (ecstasy) were also found in surface waters while nicotine and caffeine were detected in all the analyzed samples. The results obtained demonstrate that the presence of these drugs in the aquatic media must be considered a matter of environmental concern.
Article
The occurrence of several psychoactive drugs in water resources from north-eastern Spain (NE-Spain) has been evaluated. The drugs were analyzed using ultra-performance liquid chromatography coupled to tandem mass spectrometry (UPLC-ESI-MS/MS) after enrichment by solid-phase extraction (SPE). Most of the studied controlled drugs (8 out of 11) were found in both influent and effluent samples from several wastewater treatment plants. Cocaine and its metabolite were detected in wastewaters at concentrations ranging from 4 ng/L to 4.7 mug/L and from 9 ng/L to 7.5 mug/L respectively while concentrations of amphetamine type stimulatory drugs ranged from 2 to 688 ng/L. Removal percentages were estimated by sampling eight WWTPs (n=4). Cocaine and benzoylecgonine removal percentages were higher than 88% while those of amphetamine type stimulants varied ranging from 40% to more than 99%. Daily variability was also evaluated by performing a sequential survey, which revealed important fluctuations in the concentrations of nicotine, paraxanthine, amphetamine and ecstasy during the week. From the total concentrations found in wastewater influents estimations of the cocaine and ecstasy consumption were performed. For cocaine the results were approximately 14 doses per 1000 inhabitants (15-64 years old) per day and for ecstasy, approximately 4 doses per 1000 young adults (15-34 years old) per day for ecstasy.
Report on the Patients Treated for Psychoactive Drug Abuse in Croatia in 2008
  • D Katalinic
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  • M Pejak
Katalinic, D., Kuzman, M., Mayer, D., Pejak, M., 2009. Report on the Patients Treated for Psychoactive Drug Abuse in Croatia in 2008. Croatian Institute for Public Health. http://www.hzjz.hr/publikacije/ovisnici2008.pdf (in Croatian).
School Programmes for the Prevention of Drug Abuse. Ministry of Science, Education and Sports of the Republic of Croatia, Government of the Republic Croatia e Office for Combating Narcotic Drug Abuse, Education and Teacher Training Agency
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Sakoman, S., 2009. School Programmes for the Prevention of Drug Abuse. Ministry of Science, Education and Sports of the Republic of Croatia, Government of the Republic Croatia e Office for Combating Narcotic Drug Abuse, Education and Teacher Training Agency, Zagreb. http://www.azoo.hr/ admin/fckeditor/File/S%20%20Sakoman%20Skolski%20programi%20prevencije %20ovisnosti.pdf (in Croatian).
Clarke's Analyses of Drugs and Poisons
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Osselton, D., Widdop, B., Galichet, L.Y., 2003. Clarke's Analyses of Drugs and Poisons. Pharmaceutical Press.
Estimating average lifetime cocaine consumption. In: An Ounce of Prevention a Pound of Uncertainty. The Cost-Effectiveness of School-Based Drug Prevention Programs. Drug Policy Research Center
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Caulkins, J.P., Rydell, C.P., Everingham, S.S., Chiesa, J., Bushway, S., 1999. Estimating average lifetime cocaine consumption. In: An Ounce of Prevention a Pound of Uncertainty. The Cost-Effectiveness of School-Based Drug Prevention Programs. Drug Policy Research Center, RAND 1999, pp. 89e96.
Hydrophilic and amphiphilic water pollutants: using advanced analytical methods for classic and emerging contaminants Analytical and Bioanalytical Chemistry 393, 37e44. Government of the Republic of Croatia e Office for Combating Narcotic Drug Abuse
  • W Giger
Giger, W., 2009. Hydrophilic and amphiphilic water pollutants: using advanced analytical methods for classic and emerging contaminants. Analytical and Bioanalytical Chemistry 393, 37e44. Government of the Republic of Croatia e Office for Combating Narcotic Drug Abuse, 2009. Report on the Execution of the National Strategy for the Combating of Drug Abuse in 2008, Zagreb. http://www.uredzadroge.hr/upload/File/ Dokumenti/FINAL_Izvjesce_o_provedbi_NS_2008.doc.pdf.
Cocaine and metabolites in waste and surface water across Belgium Can cocaine use be evaluated through analysis of wastewater? A nation-wide approach conducted in Belgium
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  • B Pecceu
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  • P G Jorens
  • L Bervoets
  • R Blust
  • H Neels
  • A A L N Covaci
  • B Pecceu
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  • N Dubois
  • C Charlier
  • P G Jorens
  • L Bervoets
UNODC (United Nations Office on Drugs and Crime), 2009. World Drug Report. http://www.unodc.org/documents/wdr/WDR_2009/WDR2009_eng_web.pdf. van Nuijs, A.L.N., Pecceu, B., Theunis, L., Dubois, N., Charlier, C., Jorens, P.G., Bervoets, L., Blust, R., Neels, H., Covaci, A., 2009a. Cocaine and metabolites in waste and surface water across Belgium. Environmental Pollution 157, 123e129. van Nuijs, A.L.N., Pecceu, B., Theunis, L., Dubois, N., Charlier, C., Jorens, P.G., Bervoets, L., Blust, R., Meulemans, H., Neels, H., Covaci, A., 2009b. Can cocaine use be evaluated through analysis of wastewater? A nation-wide approach conducted in Belgium. Addiction 104, 734e741. van Nuijs, A.L.N., Pecceu, B., Theunis, L., Dubois, N., Charlier, C., Jorens, P.G., Bervoets, L., Blust, R., Neels, H., Covaci, A., 2009c. Spatial and temporal variations in the occurrence of cocaine and benzoylecgonine in waste-and surface water from Belgium and removal during wastewater treatment. Water Research 43, 1341e1349.
Identification and measurement of illicit drugs and their metabolites in urban wastewater by liquid chromatographyetandem mass spectrometry
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  • E Zuccato
  • E Crisci
  • C Chiabrando
  • R Fanelli
  • R Bagnatti
Castiglioni, S., Zuccato, E., Crisci, E., Chiabrando, C., Fanelli, R., Bagnatti, R., 2006. Identification and measurement of illicit drugs and their metabolites in urban wastewater by liquid chromatographyetandem mass spectrometry. Analytical Chemistry 78, 8421e8429.
Analytical and Bioanalytical Chemistry 393, 37e44. Government of the Republic of Croatia e Office for Combating Narcotic Drug Abuse
  • W Giger
Giger, W., 2009. Hydrophilic and amphiphilic water pollutants: using advanced analytical methods for classic and emerging contaminants. Analytical and Bioanalytical Chemistry 393, 37e44. Government of the Republic of Croatia e Office for Combating Narcotic Drug Abuse, 2009. Report on the Execution of the National Strategy for the Combating of Drug Abuse in 2008, Zagreb. http://www.uredzadroge.hr/upload/File/ Dokumenti/FINAL_Izvjesce_o_provedbi_NS_2008.doc.pdf.
Cocaine and heroin in waste water plants: a 1-year study in the city of
  • F Mari
  • L Politi
  • A Biggeri
  • G Acceta
  • C Trignano
  • M Di Padua
  • E Bertol
Mari, F., Politi, L., Biggeri, A., Acceta, G., Trignano, C., Di Padua, M., Bertol, E., 2009. Cocaine and heroin in waste water plants: a 1-year study in the city of Florence, Italy. Forensic Science International 189, 88e92.
Estimating average lifetime cocaine consumption
  • Caulkins