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Choice of stimulants modelled in each region was primarily determined by availability of useable data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>In Oslo, wastewater data, driving under the influence of drugs statistics and seizure data all suggested increasing MDMA use between 2009 and 2017. In South\u2010East Queensland, there was an estimated 31.1% [95% confidence interval (CI)\u00a0=\u00a029.4\u201332.9%] annual increase in daily loads of methamphetamine in wastewater between 2009 and 2016, compared with a 14.1% (95% CI\u00a0=\u00a010.9\u201317.3%) annual increase in seizures. Some of the increase in wastewater can be explained by increased purity. In Eindhoven, there was no evidence of a change in cocaine consumption from wastewater, but a reduction was observed in numbers in treatment for cocaine use from 2012 to 2017. In approximately half the cases examined in Oslo, credible intervals around estimates of annual average loads from a regression model versus estimates based on a single week of sampling did not overlap.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Long\u2010term trends in loads of stimulants in wastewater appear to be broadly consistent with trends in other indicators of stimulant use in three locations. Wastewater data should be interpreted alongside epidemiological indicators and purity data. One week of wastewater sampling may not be sufficient for valid inference about drug consumption.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.14852","type":"journal-article","created":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T14:41:41Z","timestamp":1571668901000},"page":"462-472","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["A comparison of trends in wastewater\u2010based data and traditional epidemiological indicators of stimulant consumption in three locations"],"prefix":"10.1111","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2488-4598","authenticated-orcid":false,"given":"Neil","family":"Goulding","sequence":"first","affiliation":[{"name":"Population Health Sciences University of Bristol, Canynge Hall  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9864-459X","authenticated-orcid":false,"given":"Matthew","family":"Hickman","sequence":"additional","affiliation":[{"name":"Population Health Sciences University of Bristol, Canynge Hall  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm","family":"Reid","sequence":"additional","affiliation":[{"name":"Norwegian Institute for Water Research  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen J.","family":"Amundsen","sequence":"additional","affiliation":[{"name":"Department of Alcohol, Tobacco and Drugs Norwegian Institute of Public Health  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Antonio","family":"Baz\u2010Lomba","sequence":"additional","affiliation":[{"name":"Norwegian Institute for Water Research  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jake W.","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Queensland Alliance for Environmental Health Sciences (QAEHS) The University of Queensland  Woolloongabba QLD Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben J.","family":"Tscharke","sequence":"additional","affiliation":[{"name":"Queensland Alliance for Environmental Health Sciences (QAEHS) The University of Queensland  Woolloongabba QLD Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pim","family":"de Voogt","sequence":"additional","affiliation":[{"name":"KWR Water Research Institute  Nieuwegein the Netherlands"},{"name":"Institute for Biodiversity and Ecosystem Dynamics University of Amsterdam  the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Emke","sequence":"additional","affiliation":[{"name":"KWR Water Research Institute  Nieuwegein the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wil","family":"Kuijpers","sequence":"additional","affiliation":[{"name":"Stichting Informatievoorziening Zorg (IVZ)  Houten the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1984-0096","authenticated-orcid":false,"given":"Wayne","family":"Hall","sequence":"additional","affiliation":[{"name":"Centre for Youth Substance Abuse Research The University of Queensland  Herston QLD Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4265-2854","authenticated-orcid":false,"given":"Hayley E.","family":"Jones","sequence":"additional","affiliation":[{"name":"Population Health Sciences University of Bristol, Canynge Hall  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,29]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2013.10.034"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1476-069X-4-14"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chroma.2011.01.060"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1021\/es302722f"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2012.06.069"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.12570"},{"key":"e_1_2_8_8_1","unstructured":"SCORE.Wastewater monitoring data 2011\u20132017.2018. 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