Wastewater data to end the drug epidemic

June 28, 2023

Opioid misuse and drug overdose have become a public health crisis, claiming thousands of lives around the world every year–and an estimated 300 Americans per day in 2022 alone. Wastewater monitoring, including Biobot’s new High Risk Substances platform, has emerged as a powerful tool in the fight against this crisis. By analyzing wastewater, epidemiologists, public health officials, and behavioral health specialists can better understand the extent and patterns of drug use in a community, allowing for more targeted prevention and intervention efforts. In this blog post, we will explore the role of wastewater monitoring in combating opioid misuse and drug overdose. To learn more, download our new eBook.

The opioid epidemic is a complex problem that requires a multifaceted solution. While significant efforts and investments have been made to address the issue, big gaps in data continue to hinder timely solutions. The sources of information state and local officials are using to inform programs are often significantly delayed and don’t represent the full picture of a community’s drug use. Public health teams currently rely on survey data, emergency medical services (EMS) data, mortality data, and hospitalization data to estimate substance use. These sources tend to vastly undercount substance use in communities for a number of reasons. For example, lack of access to health services and stigmatization of substance use can impede hospitalization records and survey results. Wastewater data is much more timely, offering near real-time insights into a community’s drug use behaviors.  

Wastewater fills this critical data gap that exists for communities today and provides a valuable source of information in planning and evaluating intervention and prevention programs.

How Wastewater Monitoring Works and Why it’s Powerful

Wastewater-based epidemiology (WBE) involves the collection and analysis of wastewater to detect drug metabolites and, at Biobot, parent drugs. Because of these differences in the chemical makeup of the consumed drug’s byproduct – or “metabolite” – compared to the unmetabolized chemical – or “parent drug” – we can identify both of these concentrations via wastewater analysis to help differentiate “flush” events of unconsumed drugs versus actual community consumption. 

Samples are collected from wastewater treatment plants or at specific points in the sewer system and analyzed in a laboratory. The resulting data can provide a picture of drug use in a given area, including the type and frequency of drug use and changes in patterns over time. This information can be used to inform public health interventions, such as targeted outreach and education campaigns, increased access to treatment, and harm reduction strategies such as syringe service programs.

Wastewater is a particularly valuable source of information because

  1. It is anonymous.
  2. It is comprehensive and equitable.
  3. It is timely and can inform real-time response.

We’ve also learned from testing 53 sites over the course of year, that our data can

  1. Distinguish between drug consumption and environmental disposal events, allowing for more detailed understanding of drug use in a particular community.
  2. Give access to timely and granular data that informs public health responses and helps assess the effectiveness of interventions.

Successful Applications of Wastewater Monitoring

Several successful applications of wastewater monitoring have been implemented around the world and are currently emerging. One example is Biobot’s partnership with Cary, NC. Based on the wastewater data, the city leveraged the findings that drove a 40% reduction in annual overdoses. They also dramatically increased proper disposal of medications – two-and-a-half times more prescription medications through take back events the year after the program began. An increase from 924 pounds of medication to 2,511 pounds.

Biobot also partnered with Marin, CA where detection of xylazine in wastewater allowed the county to put forth a public health advisory for the emerging threat before the drug ever appeared in toxicology reports.

Moving forward

As the opioid epidemic continues to rage on, wastewater monitoring is critical to community infrastructure for more complete tracking of drug use that is more timely than traditional methods. By collecting and analyzing sewage samples we can have a more accurate picture of the drug epidemic, providing community leaders more accurate data – data that can save lives.

Biobot recently released the findings from monitoring 53 sites across the United States for one year to paint a picture of the value of this data and its potential and use. To learn more, download the eBook. 

Written by Biobot Analytics

Biobot provides wastewater epidemiology data & analysis to help governments & businesses focus on public health efforts and improve lives.