Who is Getting High in Europe (and Where)?

Bill Yates
Brain Posts

Dec 15 / 2014

My research training is in psychiatric epidemiology.

Alcohol and drug dependence have been two of my topic areas of research.

So I found a recent novel study of the epidemiology of illicit drug use in Europe intriguing.

Typical methods of looking for the prevalence of drug use in populations are direct diagnostic interviews and studies of emergency room attendees or autopsy cases with medical complications of drug use.

However, Christopher Ort from Switzerland along with a host of European colleagues took an interesting approach to studying illicit drug use in European populations.

They conducted population wastewater illicit drug concentration analyses using liquid chromatography. They examined changes in illicit drug concentrations over time and across a number of cities and regions in Europe.

This approach is slightly messy (pun intended) but logically follows a reasonable argument: high illicit drug concentrations in waste water reflects high drug use in the population producing the waste.

Their full text manuscript can be accessed by clicking on the PMID link below. But for the few lazy readers of my blog here are the five highest ranked European cities by the five illicit drug classes. This list is produced by me through the precise method known as "eyeballing" from charts in the manuscript. Countries are listed after municipalities where waste water was sampled when city first makes a list.

Cannabis

1. Amsterdam, Netherlands
2. Paris, France
3. Novisad, Serbia
4. Antwerp, Belgium
5. Utrecht, Netherlands

Amphetamines

1. Eindhoven, Netherlands
2. Antwerp
3. Gothenburg, Sweden
4. Ninove, Belgium
5. Helsinki, Finland

Methamphetamine

1. Prague, Czech Republic
2. Budweis, Czech Republic
3. Oslo, Norway
4. Bratislava, Slovakia
5. Dresden, Germany

Cocaine

1. Antwerp
2. London, England
3. Zurich, Switzerland
4. Amsterdam
5. Barcelona, Spain

MDMA (Ecstasy)

1. Eindhoven
2. Utrecht
3. Amsterdam
4. Antwerp
5. Zurich/Barcelona (Eyeball tie)

The authors note their findings for the prevalence of illicit drugs in wastewater generally match regional prevalence estimates for drug use using other methods.

They note wastewater samples can be done by day of the week to follow chronological patterns of drug use (no surprise levels of drugs in wastewater samples are higher on the weekend). Additionally, this approach may be a valuable secondary source of trends in regional drug use over longer periods such as years.  

I found the differences in metabolite rankings for amphetamine versus methamphetamine interesting. The methamphetamine rank list is made up of more cities with lower per capita incomes.

This suggests possible local production of methamphetamine while amphetamine is more likely diverted from pharmaceutical grade manufacture.

This study did not include samples from the U.S., South America, Japan, China or Russia so it only reflects the cities listed in the methods section of the paper.

Again, click on the citation PMID link below if you are interested in getting into more detail of this study. I would be interested in any comments from readers in Europe on whether these results seem valid.

Image is from a Wikipedia Commons file showing tablets of ecstasy (MDMA) from a public domain file produced by the U.S. DEA.

Follow the author on Twitter WRY999

Ort C, van Nuijs AL, Berset JD, Bijlsma L, Castiglioni S, Covaci A, de Voogt P, Emke E, Fatta-Kassinos D, Griffiths P, Hernández F, González-Mariño I, Grabic R, Kasprzyk-Hordern B, Mastroianni N, Meierjohann A, Nefau T, Ostman M, Pico Y, Racamonde I, Reid M, Slobodnik J, Terzic S, Thomaidis N, & Thomas KV (2014). Spatial differences and temporal changes in illicit drug use in Europe quantified by wastewater analysis. Addiction (Abingdon, England), 109 (8), 1338-52 PMID: 24861844

See the original article:

Who is Getting High in Europe (and Where)?

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