Basketball and drugs: Wastewater-based epidemiological estimation of discharged drugs during basketball games in Kentucky.

High school sports gather a significantly larger number of fans than college and professional sports in the U.S. Adolescent and adult students in high schools and colleges (aged 12-25) are among the most vulnerable population to substance use. Event planners, risk managers, and emergency medical service personnel can extrapolate the mass loads of drugs in wastewater in this study to evaluate the spectator behavior in relatively larger basketball gatherings. Thirty-three illicit and prescribed psychotic drug residues (out of target 36) and five new psychoactive substances (NPS, out of target 40) were quantified in wastewater, using ultra-performance liquid chromatography and tandem mass spectrometry, discharged during a college and a high school basketball games that were played in the same stadium in Kentucky. The wastewater concentrations of amphetamine, methylphenidate, hydromorphone were significantly higher (p ≤ 0.040) during a high school basketball game whereas cocaine, hydrocodone, and gabapentin was significantly higher (p ≤ 0.006) in a college basketball game. Higher cocaine to its metabolite ratio suggested that a significant amount of cocaine may have directly discharged down the drain during the college basketball game. Two synthetic cathinones (methcathinone and 4-methyl pentedrone) and three other NPSs (4-ANPP, mCPP, and 4-methylamphetamine) were also quantified in wastewater indicate the prevalence of NPSs in Kentucky. This is the first report of quantified substances of potential abuses at basketball games.