A snapshot of illicit drug use in Sweden acquired through sewage water analysis

• Published in: The Science of the total environment 2014-02, Vol.472, p.862-871
• Main Authors: Östman, Marcus, Fick, Jerker, Näsström, Elin, Lindberg, Richard H.
• Format: Article
• Language: English
• Subjects: Analysis; Analytical chemistry; Applied sciences; Biological and medical sciences; Chemistry; Chromatographic methods and physical methods associated with chromatography; Cities; Epidemiology; Exact sciences and technology; General aspects; Illicit drugs; LC-MS/MS; Medical sciences; Multivariate data analysis; Other chromatographic methods; Other wastewaters; Pollution; Public health. Hygiene; Public health. Hygiene-occupational medicine; Sewage - chemistry; Street Drugs - analysis; Substance-Related Disorders - epidemiology; Sweden; Sweden - epidemiology; Waste Disposal, Fluid - statistics & numerical data; Wastewater; Wastewaters; Water Pollutants, Chemical - analysis; Water Pollution, Chemical - statistics & numerical data; Water treatment and pollution
• ISSN: 0048-9697; 1879-1026; 1879-1026
• DOI: 10.1016/j.scitotenv.2013.11.081

Analytical measurements of sewage water have been used many times to estimate the consumption of specific drugs in an area. This study measured a large number of illicit drugs and metabolites (>30) at a large number of sewage treatment plants (STPs) distributed across Sweden. Twenty-four illicit and prescription drugs, classified as narcotic substances in Sweden, and seven selected metabolites were included in the study. A 24hour composite sample of incoming sewage water was collected from 33 different municipalities at various geographic locations across Sweden. Species were analyzed using an on-line solid-phase extraction–liquid chromatography electrospray tandem mass spectrometry method. The method proved to be rapid with minimum need for sample work up and was able to detect 13 compounds above their respective limits of quantification. The results for all compounds were presented as per capita loads. Multivariate data analysis was used to relate drug consumption to geographical location and/or population of cities. The results showed that geographical differences in drug consumption were apparent across the country. For the narcotic pharmaceuticals, the geographical differences suggested by the multivariate model were supported by prescription statistics. •An online-SPE LC–MS/MS method for illicit drugs was developed.•Incoming water from 33 sewage treatment plants was analyzed for illicit drugs.•Regional drug consumption differences were highlighted by multivariate data analysis.•The differences were supported by prescription statistics for pharmaceuticals.