A Spoonful of Opiates...

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Most of us don’t spend much time thinking about the water services we use every day. Until a crisis like lead in the water catches our attention, we generally take the benefits of clean drinking water and reliable wastewater systems for granted.

But the reason that we don’t have to think about it is that the water industry is constantly evolving, and making new technological advances to solve problems like the cost of water treatment and distribution, or how to make the industry more environmentally friendly.

Now, the wastewater industry is contributing to the fight against a new problem: America’s growing opioid epidemic.

How?

The use of opioids among the American population has skyrocketed in the past five years, and many attribute it to the increase in the use and prescriptions of painkillers. Regardless of the cause, the data speaks for itself.

National Institute on Drug Abuse

MIT-founded startup Biobot Analytics has developed a method of measuring drug metabolites in the wastewater systems of cities across America. One of the first cities to partner with them is Cary, North Carolina, a city of approximately 162,000 people who saw a 70% increase in drug overdoses from 2016 to 2017.

Before you start flushing your goodies down the toilet at work, relax: the data isn’t specific enough to pinpoint individuals or households (file that under “legal issues of the future”). Biobot explains that the data they collect from these measurements “reveals a democratized assessment of opioid use, providing aggregated, anonymized, and unbiased insights into the health of communities.” In other words, the results are being used to inform communities about exactly how much drug use is going on as a whole, so they can decide what preventative measures are appropriate.

One of the reasons that it’s difficult to estimate drug use is that users tend to under-report their usage, either out of denial, embarrassment, or fear of repercussions. Furthermore, many frequent drug users aren’t actually aware of exactly what they’re taking.

Mike Bajorek, the deputy town manager of Cary, NC, stresses that these tests are not being used as a police investigation tool. Rather, the results will indicate the general extent of drug and opioid use in a community, giving those in leadership positions an accurate picture of what’s going on. Equipped with this data, public health officials will be able to develop programs to respond to the specific needs of their community.

When Did This Happen?

Biobot isn’t the only deer in the forest. Europe has been using this same technology for years, conducting the first similar study in 19 European cities in 2011, and following up with an even more expansive study in 2017.

Arizona State University’s Center for Environmental Health Engineering is also analyzing raw sewage in an attempt to find out what we can glean about the general health of communities - and specifically, opioid use. The lab has tested wastewater samples from 200 anonymous wastewater treatment plants, and identified traces of drugs including morphine, codeine, oxycodone, fentanyl, and heroin. Other studies have found measurable evidence of amphetamines, methamphetamines, MDMA, cocaine, and alcohol.

But wait, you say. How do we know for sure if these drugs were actually consumed, or flushed in a moment of resolve (or panic)? The answer is enantiomeric profiling, which allows analysts to determine whether or not a drug was metabolized, and therefore whether it ended up in the sewer due to consumption, or direct disposal of unused drugs.

Of course, no developing technology is without its challenges. One particular challenge in this research is accurately estimating the number of people contributing to a particular sample. Interestingly, mobile device data is being used to improve the accuracy of this metric.

What’s Next?

Eielson AFB

The future application of this technology is wide open: there is potential for it to be able to provide data on other aspects of public health that are vital to the efforts of cities and towns.

Wastewater analysis has the potential to identify:

• markers of health and illness in a community
• use of legal but dangerous “new psychoactive substances” (NPS)
• widespread use and misuse of alcohol
• the effectiveness of drug interventions and public health campaigns

Biobot and ASU are currently looking for cities interested in being a part of developing this technology. If your city could benefit from data on exactly how bad its drug problem is, sign up to be a part of this scientific advancement.

Elisa Meyer is a researcher and writer at At Your Pace Online, where she’s always learning.