Long-term tracking of opioid consumption in two United States cities using wastewater-based epidemiology approach

Adam J. Gushgari, Arjun K. Venkatesan, Jing Chen, Joshua C. Steele, Rolf Halden

Research output: Contribution to journalArticle

Abstract

Access to near-real time opioid use data is essential to the effective management of the U.S. opioid crisis. Current narcotic data collection methods are limited by time delay and would be complimented by a rapid data acquisition technique. Use of wastewater-based epidemiology (WBE) analysis may offer access to near real-time data on opioid consumption but application in the United States has been limited. From 2015 to 2017, monthly 24-h time-weighted composite samples of municipal raw wastewater from two Midwestern U.S. cities were routinely analyzed using liquid chromatography-tandem mass spectrometry for morphine, codeine, oxycodone, heroin, fentanyl, and select opioid metabolites. Concentrations of opioids (ng/L) in raw wastewater from City 1 and 2, respectively, were: morphine (713 ± 38; 306 ± 29; detection frequency (DF): 100%), oxycodone (17.8 ± 1.1; 78 ± 6; DF: 100%), codeine (332 ± 37; 100 ± 27; DF: 93%), heroin (41 ± 16; 9 ± 11; DF: 81%), and fentanyl (1.7 ± 0.2; 1.0 ± 0.5; DF: 62%). Average opioid consumption rates estimated using WBE ranged between 9 and 2590 mg/day/1000 persons. Anticipated overdoses and overdose-deaths calculated from analyte concentrations in wastewater forecasted 200 opioid-related overdoses/year and 39 opioid related overdose-deaths/year across the two cities during the year 2016, which aligned well with observed coroner-reported opioid deaths. This long-term U.S. screening study of opioids in wastewater was the first to utilize wastewater epidemiological data to estimate the number of expected overdose and overdose-deaths, and to identify detectable levels of the powerful synthetic opioid fentanyl in community wastewater consistently over the course of one whole year.

Original languageEnglish (US)
Pages (from-to)171-180
Number of pages10
JournalWater Research
Volume161
DOIs
StatePublished - Sep 15 2019
Externally publishedYes

Fingerprint

Epidemiology
epidemiology
Wastewater
wastewater
consumption
city
Liquid chromatography
Metabolites
data acquisition
Mass spectrometry
liquid chromatography
Data acquisition
Time delay
metabolite
Screening
mass spectrometry
detection
Composite materials

Keywords

  • Fentanyl
  • Heroin
  • Opioid death estimation
  • Opioid overdose estimation
  • Sewage epidemiology

ASJC Scopus subject areas

  • Ecological Modeling
  • Water Science and Technology
  • Waste Management and Disposal
  • Pollution

Cite this

Long-term tracking of opioid consumption in two United States cities using wastewater-based epidemiology approach. / Gushgari, Adam J.; Venkatesan, Arjun K.; Chen, Jing; Steele, Joshua C.; Halden, Rolf.

In: Water Research, Vol. 161, 15.09.2019, p. 171-180.

Research output: Contribution to journalArticle

Gushgari, Adam J. ; Venkatesan, Arjun K. ; Chen, Jing ; Steele, Joshua C. ; Halden, Rolf. / Long-term tracking of opioid consumption in two United States cities using wastewater-based epidemiology approach. In: Water Research. 2019 ; Vol. 161. pp. 171-180.
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abstract = "Access to near-real time opioid use data is essential to the effective management of the U.S. opioid crisis. Current narcotic data collection methods are limited by time delay and would be complimented by a rapid data acquisition technique. Use of wastewater-based epidemiology (WBE) analysis may offer access to near real-time data on opioid consumption but application in the United States has been limited. From 2015 to 2017, monthly 24-h time-weighted composite samples of municipal raw wastewater from two Midwestern U.S. cities were routinely analyzed using liquid chromatography-tandem mass spectrometry for morphine, codeine, oxycodone, heroin, fentanyl, and select opioid metabolites. Concentrations of opioids (ng/L) in raw wastewater from City 1 and 2, respectively, were: morphine (713 ± 38; 306 ± 29; detection frequency (DF): 100{\%}), oxycodone (17.8 ± 1.1; 78 ± 6; DF: 100{\%}), codeine (332 ± 37; 100 ± 27; DF: 93{\%}), heroin (41 ± 16; 9 ± 11; DF: 81{\%}), and fentanyl (1.7 ± 0.2; 1.0 ± 0.5; DF: 62{\%}). Average opioid consumption rates estimated using WBE ranged between 9 and 2590 mg/day/1000 persons. Anticipated overdoses and overdose-deaths calculated from analyte concentrations in wastewater forecasted 200 opioid-related overdoses/year and 39 opioid related overdose-deaths/year across the two cities during the year 2016, which aligned well with observed coroner-reported opioid deaths. This long-term U.S. screening study of opioids in wastewater was the first to utilize wastewater epidemiological data to estimate the number of expected overdose and overdose-deaths, and to identify detectable levels of the powerful synthetic opioid fentanyl in community wastewater consistently over the course of one whole year.",
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