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Countless initiatives have been employed to reduce methamphetamine use and drug\u2010related harm. Wastewater analysis (WWA) has been used effectively as an objective measure of drug use at a population level and can be compared to indicators of harm, such as the number of drug\u2010related fatalities. This paper attempts to describe methamphetamine use in the context of changes in levels measured in wastewater in South Australia whilst recognising considerable interventions over an 8\u2010year period. Validated liquid chromatography\u2013mass spectrometry methods were used to determine methamphetamine (and MDMA) levels in wastewater over an 8\u2010year interval. The number of drug\u2010induced deaths and driver fatalities involving methamphetamine (and MDMA) was presented and described in the context of changes in use measured by WWA. A rise in methamphetamine use according to WWA was evident up to 2017, followed by a gradual decrease to 2020 back to 2015 levels. Both driver fatalities and drug\u2010induced deaths correlated well with use measured by WWA over the 8\u2010year period. Multiple initiatives to curb supply, distribution and harm within the state and nationally have been implemented. The decrease in methamphetamine use after 2017 suggests that timely interventions have successfully reduced overall drug use and has led to fewer fatalities. This study shows that the response to increasing methamphetamine use in South Australia has resulted in a reversal of the upward trend in consumption and fewer drug\u2010related fatalities.<\/jats:p>","DOI":"10.1002\/dta.3641","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T06:54:53Z","timestamp":1704869693000},"page":"1137-1143","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Amphetamine\u2010type drug\u2010related fatalities in the context of 8\u00a0years of methamphetamine use measured by wastewater analysis in South Australia"],"prefix":"10.1002","volume":"16","author":[{"given":"Emma L.","family":"Jaunay","sequence":"first","affiliation":[{"name":"Health and Biomedical Innovation, Clinical and Health Sciences University of South Australia  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley S.","family":"Simpson","sequence":"additional","affiliation":[{"name":"Health and Biomedical Innovation, Clinical and Health Sciences University of South Australia  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason M.","family":"White","sequence":"additional","affiliation":[{"name":"Health and Biomedical Innovation, Clinical and Health Sciences University of South Australia  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cobus","family":"Gerber","sequence":"additional","affiliation":[{"name":"Health and Biomedical Innovation, Clinical and Health Sciences University of South Australia  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,1,10]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2020.110190"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.13252"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.13468"},{"key":"e_1_2_6_5_1","unstructured":"Australian Criminal Intelligence Commission.National wastewater drug monitoring program report 15. 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