Key Takeaways: Addressing High Risk Substance Use Through Wastewater Intelligence

August 9, 2023

The overdose epidemic has inflicted staggering losses across the United States, with intervention efforts often hindered by untimely and incomplete data sources. In our recent webinar with Marin County we discuss how wastewater intelligence can offer real-time data to prevent overdoses before they happen. 

Dr. Haylea Hannah, County of Marin, joined Biobot epidemiologist Alex Bubin and Biobot CEO and Cofounder Mariana Matus sat down to discuss how together in partnership, they’ve developed  an innovative and responsive program to help address high-risk substance use in their community. 

This collaboration revolves around three key principles that are shared below, and necessary to create effective wastewater substance use monitoring programs. 

To watch the full webinar recording, click here

Principle 1: Wastewater intelligence unlocks more than just overdose prevention opportunities

Public attention usually focuses on the relationship between substance use and overdoses, but substance use pathways are complex and non-linear. Understanding substance use pathways in their entirety, as opposed to just overdose outcomes, provides a comprehensive perspective that unlocks a multitude of public health solutions, such as primary prevention, screening and referral to treatment, and criminal justice diversion. 

Marin County’s program uses wastewater data on substance use to move upstream of overdose outcomes to address the health and wellness of people who use drugs to implement harm reduction and prevention interventions. By looking at consumption alongside outcomes, we better identify potential risk factors and intervene early, preventing substance use issues from escalating into emergencies. 

Principle 2: Wastewater data should be one component of a holistic approach to substance use data infrastructure

Creating an effective wastewater substance use monitoring program requires integrating multiple data sources, recognizing that no single dataset can offer a complete solution. In combination with existing substance use, overdose, and intervention data, wastewater intelligence can help distribute limited prevention, treatment, and harm reduction resources more effectively and equitably; signal changes in drug trends before they devolve into widespread medical emergencies and/or criminal justice issues; and identify successes and gaps in policies and interventions.

Marin County combines wastewater intelligence with other pertinent data, such as 911 calls, treatment encounters, and deaths, to develop a comprehensive and nuanced understanding of substance use challenges in the area. 

Principle 3: Incorporating community voices is essential for ethical programs with community trust

An ethical wastewater substance use monitoring program prioritizes community involvement and trust-building. Open communication and transparent partnerships with affected communities are paramount. Understanding community concerns and incorporating their perspectives ensures that interventions are ethical, effective, and well-received.

Marin County has prioritized community involvement at every step of the pilot. Focus groups and one-on-one interviews with community members who use drugs or are currently in treatment for a substance use disorder have informed the ethical use of wastewater data to foster trust within the community. 

Watch the webinar replay to see how a partnership with Biobot can help chart a path towards a healthier, safer, and more resilient society.

Written by Jana Epstein

Jana Epstein is the product manager for Biobot's chemistry applications. With a passion for public health and an unconventional appreciation for sewage's hidden gems, she's on a mission to turn muck into meaningful public health solutions.