Wastewater Epidemiology To Examine Stimulant Trends (weTEST)

The increasing availability of licit and illicit stimulants including cocaine, amphetamine and methamphetamine has emerged as a major drug threat to communities in the United States. Unfortunately, the warning signals were present for years, but the awareness of this threat largely depended upon existing public health surveillance systems (e.g., forensic laboratory submissions, U.S. Centers for Disease Control and Prevention drug overdose reports) that experience significant delays and other surveillance limitations. Wastewater based epidemiology, a chemistry-based approach to identify specific drugs and their concentrations in samples taken from wastewater systems and then statistically extrapolated to population-level use, is an established scientific method for non-invasively monitoring drug flows in communities. Law enforcement applications include understanding the impact that large scale operations may have on removing drug threats from communities. The United States lags behind many other countries in the use of this technology. Thus, larger scale, statewide efforts are needed. Our project based in Kentucky seeks to 1) build a robust wastewater surveillance system along traffic rest areas and facilities servicing truck drivers along interstate highways, 2) examine prospectively stimulant use trends in the populations using these facilities and traversing areas of the state, 3) compare rest area wastewater results to municipal water systems to examine variability between roadways and community use, 4) compare wastewater results to other population-based drug use indicators (e.g., stimulants dispensed according the Kentucky prescription drug monitoring program), 5) establish a unique collaboration between the Appalachian High Intensity Drug Trafficking Area (HIDTA), the Kentucky Transportation Cabinet, Cabinet for Health and Family Services, Murray State University and the University of Kentucky. When this project is complete, we will have the most comprehensive set of wastewater samples anywhere in the United States.