Comparison of community illicit drug use in 11 cities of Turkey through wastewater-based epidemiology

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RESEARCH ARTICLE

Comparison of community illicit drug use in 11 cities of Turkey through wastewater-based epidemiology Nebile Daglioglu 1

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Evsen Yavuz Guzel 2

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Aslı Atasoy 3

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İsmail Ethem Gören 1

Received: 5 August 2020 / Accepted: 23 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020

Abstract Wastewater-based epidemiology (WBE) is an ever-increasing discipline that enables researchers to track near-real-time data concerning the recreational use of illicit drugs. Community illicit drug use was estimated in eleven Turkish cities, using eighteen wastewater treatment plants, representing the metropolitan cities and rural areas with different sociodemographic characteristics. In this study, 24-h composite influent wastewater samples were collected for 1 week per season between March 2019 and December 2019. Heroin, amphetamine, methamphetamine, ecstasy, cocaine, and marijuana were covered as illicit drugs in this study. Solid-phase extraction, LC-MS/MS separation, identification, and quantification were used as the analytical methods. Overall results indicate that both cocaine and MDMA usage increased in all cities on weekends. More specifically, it was observed that the average amount of cocaine use regarding 11 cities was 14.7 mg/1000 person/day, while figures for other substances are as follows: 9.5 for amphetamine, 34.5 for methamphetamine, 38.4 for MDMA, 42.2 for heroin, and lastly 5412 mg/1000p/day for marijuana. This study holds the position of being the most comprehensive one conducted, considering spatial and temporal datasets on illicit drug consumption obtained via WBE in Turkey. Keywords Wastewater biomarker analysis . Drug abuse . Marijuana . MDMA . LC-MS/MS . Turkey

Introduction

Responsible Editor: Lotfi Aleya * Nebile Daglioglu [email protected] Evsen Yavuz Guzel [email protected] Aslı Atasoy [email protected] İsmail Ethem Gören [email protected] 1

Department of Forensic Medicine, School of Medicine, Cukurova University, 01330 Adana, Turkey

2

Faculty of Fisheries, Department of Basic Science, Cukurova University, 01330 Adana, Turkey

3

Institute of Addiction and Forensic Science, Cukurova University, 01330 Adana, Turkey

Conventional means of researching the recreational use of illicit drugs consist of surveys, hospital records, analysis of crime statistics, and rates of drug seizures. Although these methods are the most commonly applied, standard practices, they are not without limitations. In many cases, a fine-grained approach is required, as it is essential to monitor the recreational use of illicit drugs to make policies to minimize the drug-related harms (drug overdoses and drug-related hospital discharges) (Lai et al. 2013). The method of measuring the rate of drug use via analysis of drug concentrations in wastewater was first suggested in 2001 (Daughton 2001). Following this, Zuccato et al. (2005a) conducted the initial study via analysis of wastewater on cocaine use. Wastewater-based epidemiology (WBE) is a very useful tool for monit