ac detective

Drugs in the water

Levels of a cocaine metabolite in wastewater point
to widespread abuse of the drug.

I f you wanted to know the extent

of the drug-abuse problem in
your community, how would you
go about gathering data? Would
you simply ask people whether or
not they use illegal drugs? Despite
the obvious drawbacks to this ap-
proach, most estimates of drug use
rely heavily on population surveys.
Recently, however, Roberto Fanel-
li and his colleagues at the Mario
Negri Institute for Pharmacological
Research and the University of
Insubria (both in Italy) devised an
accurate and objective means of
measuring drug use. Applying the
principle that what goes in must
come out, the researchers measured
the level of benzoylecgonine (BE),
the major urinary metabolite of co-
caine, in the wastewater of several
Italian cities. What they found was
startling—cocaine use appears to
be far more common than public-
health officials previously thought.
Because Fanelli’s group has a long-
standing interest in chemical pollution
and the Mario Negri Institute studies all problem of human drug abuse.
aspects of drugs, including mechanism,
metabolism, and patterns of use, it was
very natural to explore where drugs go
after they are consumed, says Fanelli.
“It’s the end of the story,” he adds. The ter samples from one site along the Po
researchers first measured the levels of
several prescription drugs in wastewater
and found that most of the time their
results correlated well with prescription
records. At one particular sampling site
on the Po River, however, the level of
the anti-asthma drug salbutamol was
excessively high (Environ. Sci. Technol.
2003, 37, 1241–1248). The researchers of BE exists other than the urine of co-
realized that their finding reflected the
illegal use of salbutamol by local farmers their work turned out to be obtaining
to promote muscle growth in cattle.
Varese
Sampling site
Cuneo
Latina
Cagliari
Monitoring drug abuse. Researchers have analyzed
water from the Po River and at four wastewater treat-
ment plants in Italy to determine the extent of cocaine
use. (Adapted from Environ. Health 2005, 4, 14.)
From there, they got the idea that they
could apply their methodology to the
Fanelli’s group turned their attention most probably cocaine [consumption] is
to cocaine. With the help of HPLC/
ESI-MS/MS, they measured the levels
of cocaine and its metabolite BE in wa-
River and in the wastewater entering
sewage treatment plants in four medi-
um-sized Italian cities—Cagliari, Latina, discussion of the drug-abuse problem
Cuneo, and Varese (Environ. Health
2005, 4, 14). They based their esti-
mates of cocaine use on BE levels be-
cause nearly half of a cocaine dose is ex- other drugs of abuse and yields accurate
creted as BE, and no plausible source
caine users. One of the trickiest parts of
cocaine to use as an analytical standard.
Even the tiny amount they needed
is highly regulated. “It took almost
four months to have the standards
in the laboratory after the order,”
says Fanelli.
The analysis indicated that the
Po River site carried the equivalent
of 4 kg, or ~40,000 doses, of co-
caine per day. Assuming that 5 mil-
lion people contribute to the waste
found at that site, Fanelli’s group
calculated that cocaine use averages
7 doses per 1000 people per day. If
only young adults (ages 15–34),
who are the primary users of co-
caine, are counted, the daily-use
level jumps to 27 doses per 1000
people. The data from the four
wastewater treatment plants were
similar. According to the official
figures based on interviews, only
15,000 people (1.1% of the young
adults) admitted to using cocaine at
least once a month—a discrepancy
of ~2 orders of magnitude. Fanelli
also noted that the levels did not vary
much with time. This indicates that,
“contrary to what is currently believed,
shifting from a so-called recreational use
occurring mainly during weekends to a
steady everyday use by a significant part
of the population.”
The dismaying results were reported
widely by the media and reinvigorated
among public-health officials. Fanelli’s
approach could be in high demand in
the future. It can be easily adapted to
real-time information about drug use
anonymously and cheaply, allowing offi-
cials to monitor the effectiveness of in-
terventions. a
—Karen Ross

© 2006 AMERICAN CHEMICAL SOCIETY J A N U A R Y 1 , 2 0 0 6 / A N A LY T I C A L C H E M I S T R Y 13