Refined sewer epidemiology mass balances and their application to heroin, cocaine and ecstasy

Environ Int. 2011 Oct;37(7):1236-52. doi: 10.1016/j.envint.2011.05.009. Epub 2011 Jun 17.


The detection of illicit drugs in environmental matrices may be a cause for concern, both from the perspective of their potential environmental impacts and the fact that their presence in detectable concentrations would be an indicator of significant drug use. The primary goal behind recent studies on this subject has been to use measured influent concentrations of selected illicit drugs or their in vivo metabolites in the environment as a means of estimating the abuse level of these drugs and patterns of consumption. Thus-far, such calculations have hinged on the use of solitary excretion estimates from single studies of limited scope and/or studies of limited applicability. Therefore, the need exists to conduct a comprehensive meta-analysis of metabolic disposition studies to construct excretions profiles for the various illicit drugs and their in vivo metabolites. The constructed excretory profiles should not only provide mean excretion values but also indicate the expected variations in excreted fractions that arise due to differences not only in the metabolic capacity of users but also in the efficiencies of various routes of administration for a given illicit drug. Therefore, the primary goal of the research presented here was to refine sewer epidemiology extrapolation mass balances for various illicit drugs of interest by constructing their excretory profiles segregated by route-of-administration. After conducting such a study with a multi-national scope on illicit drugs including cocaine, heroin and ecstasy, the results obtained clearly indicate that extrapolation factors currently being used in literature for these drugs to enumerate prevalence of abuse required significant refinement to increase their reliability.

MeSH terms

  • Cocaine / analysis*
  • Heroin / analysis*
  • Humans
  • Illicit Drugs / analysis*
  • N-Methyl-3,4-methylenedioxyamphetamine / analysis*
  • Sewage / chemistry*
  • Substance Abuse Detection
  • Substance-Related Disorders / epidemiology
  • Water Pollutants, Chemical / analysis*


  • Illicit Drugs
  • Sewage
  • Water Pollutants, Chemical
  • Heroin
  • Cocaine
  • N-Methyl-3,4-methylenedioxyamphetamine