City-wide drug testing using municipal wastewater A new tool for drug epidemiology

摘要

Drug users do not want to be identified and do not want to reply to surveys. So how do you find out how many of them there are? The answer lies below the city streets.Drug use is just a big-city problem. Or is it? Measuring actual drug use is notoriously difficult. Measuring the effects of drug use is easier-fatal overdoses, drug treatment admissions, emergency department visits, new cases of hepatitis and HIV. But by the time these measurable effects occur and a drug takes hold in a community, any chance to intervene has long since been lost. Similarly our ability to measure the impacts of major drug policy changes or interventions, whether through law enforcement or public health measures, is greatly weakened by our poor ability to measure the true level of drug use for an entire community, in real time or with any resolution into time intervals. Has use in this borough or this suburb gone up or down this year? Does it happen more at weekends or midweek? We generally do not know-and it would be very useful indeed if we could know.