{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T02:03:38Z","timestamp":1792461818556,"version":"4.5.0"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:00:00Z","timestamp":1750204800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100007660","name":"Universiteit Antwerpen","doi-asserted-by":"publisher","award":["41222"],"award-info":[{"award-number":["41222"]}],"id":[{"id":"10.13039\/501100007660","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007660","name":"Universiteit Antwerpen","doi-asserted-by":"publisher","award":["50360"],"award-info":[{"award-number":["50360"]}],"id":[{"id":"10.13039\/501100007660","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["analyticalsciencejournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug Testing and Analysis"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Benzodiazepines and related z\u2010drugs (BZDs) are widely used pharmaceuticals but require careful monitoring due to limited efficacy, tolerance development and the risk of dependence. Wastewater\u2010based epidemiology (WBE) is a valuable approach to gather population\u2010wide information on consumption patterns through analysis of influent wastewater. This study examines how overlapping metabolic pathways within the BZD drug class can lead to misinterpretation if not carefully considered. An analytical method is developed and validated for 26 biomarkers of prescription BZDs in influent wastewater using solid\u2010phase extraction and liquid chromatography\u2013tandem mass spectrometry and applied to influent wastewater samples for the first time in Belgium (13 locations), Latvia (1), Lithuania (3) and Romania (1). The countries were chosen for their differing prescription BZD market registration, allowing testing of different hypotheses. To aid in complex data interpretation, this study presents a structured categorisation of BZDs into\n                    <jats:italic>direct<\/jats:italic>\n                    biomarkers, which directly reflect consumption, and\n                    <jats:italic>downstream<\/jats:italic>\n                    biomarkers, which are influenced by multiple BZDs, and further discusses the implication this has on the interpretation. Spatial differences were noted among\n                    <jats:italic>direct<\/jats:italic>\n                    biomarkers such as higher consumption of zolpidem in Belgium and zopiclone in Riga (LVA). Downstream biomarkers had higher population\u2010normalised mass loads but cannot be interpreted in isolation, for example, lorazepam (ranging 4\u201325\u2009mg\/day\/1000 inhabitants over all locations), lormetazepam (8\u201330), oxazepam (10\u201350) and temazepam (1\u201312). These findings highlight challenges in interpreting BZD consumption trends and emphasise the need of distinguishing different biomarker classes to ensure accurate and comparable results across studies needed to guide informed decision\u2010making.\n                  <\/jats:p>","DOI":"10.1002\/dta.3915","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T19:04:17Z","timestamp":1750273457000},"page":"2066-2077","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Monitoring Community Use of Benzodiazepines Through Wastewater\u2010Based Epidemiology"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3397-3186","authenticated-orcid":false,"given":"Maarten","family":"Quireyns","sequence":"first","affiliation":[{"name":"Toxicological Centre University of Antwerp  Wilrijk Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Boogaerts","sequence":"additional","affiliation":[{"name":"Toxicological Centre University of Antwerp  Wilrijk Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natan","family":"Van\u00a0Wichelen","sequence":"additional","affiliation":[{"name":"Toxicological Centre University of Antwerp  Wilrijk Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Di\u0101na","family":"Vanaga\u2010Ar\u0101ja","sequence":"additional","affiliation":[{"name":"Slim\u012bbu Profilakses un Kontroles Centrs  Riga Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olesia","family":"Rudminien\u0117","sequence":"additional","affiliation":[{"name":"Narkotik\u0173, Tabako ir Alkoholio kontrol\u0117s Departamentas  Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruxanda","family":"Iliescu","sequence":"additional","affiliation":[{"name":"Agen\u021bia Na\u021bional\u0103 Antidrog  Bucharest Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milica","family":"Georgescu","sequence":"additional","affiliation":[{"name":"Agen\u021bia Na\u021bional\u0103 Antidrog  Bucharest Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofie","family":"Schaerlaekens","sequence":"additional","affiliation":[{"name":"Laboratory for Microbiology, Parasitology and Hygiene University of Antwerp  Wilrijk Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"De\u00a0Roeck","sequence":"additional","affiliation":[{"name":"Laboratory for Microbiology, Parasitology and Hygiene University of Antwerp  Wilrijk Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Delputte","sequence":"additional","affiliation":[{"name":"Laboratory for Microbiology, Parasitology and Hygiene University of Antwerp  Wilrijk Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Covaci","sequence":"additional","affiliation":[{"name":"Toxicological Centre University of Antwerp  Wilrijk Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9377-6160","authenticated-orcid":false,"given":"Alexander\u00a0L.\u00a0N.","family":"van Nuijs","sequence":"additional","affiliation":[{"name":"Toxicological Centre University of Antwerp  Wilrijk Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,18]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Basic & Clinical Pharmacology","author":"Trevor A. 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