Evaluating the potential of wastewater-based epidemiology to estimate the retail illicit drug market size in Europe: A case study

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy Pub Date : 2025-03-13 DOI:10.1016/j.drugpo.2025.104771

Maarten Quireyns , Natan Van Wichelen , Tim Boogaerts , Tim Surmont , Andrew Cunningham , João Matias , Celine Gys , Adrian Covaci , Alexander L.N. van Nuijs

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引用次数: 0

Abstract

Background and aims

Estimating the retail drug market size is complex due to its clandestine nature, yet useful for intervention and policy planning. Wastewater-based epidemiology (WBE) offers an alternative strategy to estimate population-wide consumption trends by analysing influent wastewater, avoiding self-reporting biases associated with other estimation techniques, e.g., consumption or expenditure-based models. This study evaluates the applicability of WBE for drug market size estimation.

Methods

Using WBE data the drug market situation of amphetamine, cocaine, MDMA, and methamphetamine is estimated in European cities (n=75) through combination with price/purity information (Statistical Bulletin) published by the European Union Drugs Agency. Market sizes were estimated at three levels: (L1) pure drug quantities, (L2) adulterated retail drugs quantities, and (L3) market value. Furthermore, yearly consumption estimates from the commonly applied consecutive seven-day sampling is compared to a randomised stratified sampling approach in Brussels, Belgium.

Results

Challenges include the availability and accuracy of price and purity data, which complicates cross-country comparisons and hinders the higher-levels calculations. Due to missing data, the market value (L3) could only be calculated for a limited number of cities, i.e., 39% (amphetamine), 39% (cocaine), 1% (MDMA), and 23% (methamphetamine). Furthermore, statistically significant differences were shown for amphetamine (up to 139% measurement error) and methamphetamine (up to 58% measurement error) between both sampling approaches.

Conclusions

Particularly at city level, WBE can complement traditional market size estimations, but significant uncertainties remain. Future research should expand one-week consecutive sampling to a randomised stratified sampling approach tailored to drug and location.

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评价基于废水的流行病学在估计欧洲零售非法药物市场规模方面的潜力：一个案例研究

背景和目的由于药品零售市场的秘密性质，估计其规模是复杂的，但对干预和政策规划是有用的。基于废水的流行病学（WBE）提供了一种通过分析流入废水来估计全人口消费趋势的替代战略，避免了与其他估计技术（例如基于消费或支出的模型）相关的自我报告偏差。本研究评估WBE在药品市场规模估算中的适用性。方法利用WBE数据，结合欧盟药品管理局发布的价格/纯度信息（《统计公报》），对欧洲各城市（n=75）苯丙胺、可卡因、摇头丸和甲基苯丙胺的市场情况进行估算。市场规模估计在三个层面：（L1）纯药品数量，（L2）掺假零售药品数量，（L3）市场价值。此外，从通常应用的连续7天抽样的年消费量估计与比利时布鲁塞尔的随机分层抽样方法进行了比较。结果价格和纯度数据的可获得性和准确性存在问题，使跨国比较复杂化，阻碍了更高层次的计算。由于数据缺失，只能计算有限城市的市场价值（L3），即39%（安非他明）、39%（可卡因）、1% （MDMA）和23%（甲基苯丙胺）。此外，在两种抽样方法之间，安非他明（测量误差高达139%）和甲基苯丙胺（测量误差高达58%）的统计差异具有统计学意义。结论特别是在城市层面，WBE可以补充传统的市场规模估算，但仍存在显著的不确定性。未来的研究应该将一周的连续抽样扩展为针对药物和地点的随机分层抽样方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Drug Policy SUBSTANCE ABUSE-

CiteScore

7.80

自引率

11.40%

发文量

307

审稿时长

62 days

期刊介绍： The International Journal of Drug Policy provides a forum for the dissemination of current research, reviews, debate, and critical analysis on drug use and drug policy in a global context. It seeks to publish material on the social, political, legal, and health contexts of psychoactive substance use, both licit and illicit. The journal is particularly concerned to explore the effects of drug policy and practice on drug-using behaviour and its health and social consequences. It is the policy of the journal to represent a wide range of material on drug-related matters from around the world.