Spatial differences and temporal changes in illicit drug use in Europe quantified by wastewater analysis

Christoph Ort, Alexander L. N. van Nuijs, Jean-Daniel Berset, Lubertus Bijlsma, Sara Castiglioni, Adrian Covaci, Pim de Voogt, Erik Emke, Despo Fatta-Kassino, Paul Griffiths, Félix Hernández, Iria González-Mariño, Roman Grabic, B Kasprzyk-Hordern, Nicola Mastroianni, Axel Meierjohann, Thomas Nefau, Marcus Östman, Yolanda Pico, Ines RacamondeMalcolm Reid, Jaroslav Slobodnik, Senka Terzic, Nikolaos Thomaidis, Kevin V. Thomas

Research output: Contribution to journalArticlepeer-review

307 Citations (SciVal)


Aims To perform wastewater analyses to assess spatial differences and temporal changes of illicit drug use in a large European population. Design Analyses of raw wastewater over a 1-week period in 2012 and 2013. Setting and Participants Catchment areas of wastewater treatment plants (WWTPs) across Europe, as follows: 2012: 25 WWTPs in 11 countries (23 cities, total population 11.50 million); 2013: 47 WWTPs in 21 countries (42 cities, total population 24.74 million). Measurements Excretion products of five illicit drugs (cocaine, amphetamine, ecstasy, methamphetamine, cannabis) were quantified in wastewater samples using methods based on liquid chromatography coupled to mass spectrometry. Findings Spatial differences were assessed and confirmed to vary greatly across European metropolitan areas. In general, results were in agreement with traditional surveillance data, where available. While temporal changes were substantial in individual cities and years (P ranging from insignificant to <10-3), overall means were relatively stable. The overall mean of methamphetamine was an exception (apparent decline in 2012), as it was influenced mainly by four cities. Conclusions Wastewater analysis performed across Europe provides complementary evidence on illicit drug consumption and generally concurs with traditional surveillance data.Wastewater analysis can measure total illicit drug use more quickly and regularly than is the current norm for national surveys, and creates estimates where such data does not exist.

Original languageEnglish
Pages (from-to)1338-1352
Number of pages15
Issue number8
Early online date27 May 2014
Publication statusPublished - 1 Aug 2014


  • Amphetamine
  • cannabis
  • cocaine
  • drugs of abuse
  • ecstasy
  • methamphetamine
  • sewage


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