Integrating community perspectives to enhance the utility of wastewater-based epidemiology for addressing substance use in the United States.

Purpose of review: Wastewater-based epidemiology (WBE) of substances can serve as a valuable tool to supplement traditional surveillance techniques, providing information rapidly on community use. Despite ongoing WBE-opioid programs occurring throughout the world, few have integrated such data into public health decision-making to drive meaningful interventions. This gap could be due to several factors and concerns that vary across diverse communities. This perspective examines multiple levels of stakeholders involved in the implementation of WBE for substance use, their roles, and the challenges facing each.

Recent findings: Challenges have been identified by our team while conducting a multiyear project focused on integrating WBE in several communities across the United States. We also highlight communities that have successfully implemented such programs and the benefits they have seen from this approach. Based on our experience and the current state of the literature, we identify current priority needs to increase the utility and impact of using WBE for monitoring substance use across communities.

Summary: There is great promise for the utility of WBE as a tool for strengthening public health systems to address substance use. Understanding the roles and perspectives of stakeholders broadly will help to move this concept into an effective and trusted approach.