Adopting a Whole Community Approach to Addressing High-Risk Substance Use

In addition to identifying common infectious disease pathogens like influenza or SARS-CoV-2, wastewater epidemiology proves invaluable in detecting a diverse array of substances, from illicit drugs to environmental toxins. This data generated from wastewater can inform public health strategies, first responder efforts, and urban planning initiatives. In our dynamically evolving scientific landscape, wastewater epidemiology has emerged as an increasingly essential tool for understanding public health at a community level.

To tackle the opioid epidemic, a holistic community perspective paired with complementary strategies are essential. This insight was underscored in a recent webinar featuring Biobot epidemiologist Marisa Donnelly, Michael Harris (New Castle County’s Stormwater and Environmental Programs Manager), and Brett Waninger (Director of Executive Programs and Grant Administration at Delaware Division of Substance Abuse and Mental Health), entitled “An Equitable View of Community Substance Use: New Castle County’s Use of Wastewater Monitoring for High Risk Substance Intervention.”

While wastewater is a powerful tool for understanding community substance use trends and generating data in near real-time to complement other public health tools, it is only as powerful as the programs and insights it supports. One of the most important takeaways from the session was that when building a wastewater epidemiology program aimed at reducing overdose deaths, it is paramount to include the right stakeholders to inform a holistic community strategy.  

Below are four key groups of stakeholders to consider as part of your holistic community approach to addressing substance use. Each group can help strengthen your program while simultaneously benefitting from the insights generated by wastewater data to inform their work. 

Community Members and Local Organizations: Focus groups with individuals who currently use drugs or who are in recovery provide valuable information on substance use behaviors and trends and important perspectives on wastewater monitoring. Community organizations that work with individuals who use drugs contribute critical boots-on-the-ground perspectives, playing a pivotal role in maximizing the utilization and value of wastewater insights. These groups offer vital street-level views into the crisis, offering insights into what works – or doesn’t – in programming and data dissemination.

First Responders: First responders, including emergency personnel and street response teams, play a critical role in addressing the immediate impact and crisis of high-risk substances. Being first on the scene, they stand to benefit from insights derived from wastewater-based epidemiology to better understand drug use trends, enhance response plans, and direct resources to the most in-need areas.

Policymakers: Policymakers are key players in funding allocation and public health policy design. Their involvement in wastewater based epidemiology programs is important to craft sustainable and scalable initiatives informed by wastewater and other data related to the opioid epidemic. Without sustained investment in data sources to understand and evaluate programs, progress will be challenging.

Public Health Practitioners: Public health practitioners play a critical role in analyzing data, interpreting trends, and providing recommendations for community-based strategies, implementation plans, and program evaluations. Their involvement ensures initiatives are not only scientifically sound and data driven, but can also be implemented within each unique community.

Our guest speakers emphasized the crucial role of securing robust funding and fostering strong community partnerships across both public and private spheres. Collaborations spanning government, private entities, and community organizations promise a multidimensional and holistic approach that is both sustainable and impactful for each unique community.