Assessing patterns of illicit drug use in a Chinese city by analyzing daily wastewater samples over a one-year period

Wastewater-based epidemiology (WBE) has been used extensively around the globe to provide information on illicit drug consumption. In China, most WBE studies to date only include a limited number of samples per catchment, making it difficult to derive any temporal consumption patterns. This study addresses this knowledge gap by identifying the temporal consumption trends of nine drugs in a Chinese megacity using WBE over a one-year period. Daily influent samples (n = 279) were collected from a wastewater treatment plant serving ~500,000 residents. All target drugs showed similar levels of consumption throughout the week. These findings were different to previous WBE studies in developed countries, where amphetamine-type drugs have shown higher consumption on weekends than during the week. Such a difference could be due to the users’ demographics and behaviors as reported in previous surveys and warrant more research to help formulate appropriate drug control policies in China. Our study also observed that declining methamphetamine and ketamine consumption between 2012 and 2018, while consumption of MDMA and methadone were stable over the same period.