Institute for Biodiversity and Ecosystem Dynamics (IBED), University of Amsterdam, Amsterdam, the Netherlands.
Institute for Biodiversity and Ecosystem Dynamics (IBED), University of Amsterdam, Amsterdam, the Netherlands; KWR, Nieuwegein, the Netherlands.
Water Res. 2021 Dec 1;207:117789. doi: 10.1016/j.watres.2021.117789. Epub 2021 Oct 21.
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.
非法药物使用是一种复杂、隐蔽且常常受到高度污名化的行为，这给药物监测系统带来了巨大的挑战。可以通过测量未经处理的废水中人体排泄物来估计药物的使用情况，这种方法被称为基于废水的流行病学（WBE）。在过去的十年中，基于废水的流行病学在监测非法药物负荷方面的应用不断增加，目前已经在全球范围内得到应用。对来自全球各地的研究进行了评估，涉及采样方法、分析准确性和消费计算，旨在进一步减少相关不确定性，以便在全球范围内进行可靠的比较。只有少数研究被确定为高质量研究，因此需要进一步规范非法药物的 WBE 方法，特别是采样方法。只有一小部分审查过的论文明确报告了其消费数据的不确定范围。最近发表的研究可靠性最高，表明 WBE 数据的报告有所改善。到目前为止，WBE 尚未在非洲大部分地区、中东和俄罗斯使用。本文提供了在各大洲对常见研究药物（可卡因、MDMA、苯丙胺和甲基苯丙胺）的消费数据概述。总体而言，美国的消费率很高，尤其是可卡因和甲基苯丙胺，而亚洲的非法药物消费相对较低。
