{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T21:49:50Z","timestamp":1770760190507,"version":"3.50.0"},"reference-count":51,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Illicit drug use causes great harm and economical loss to society, yet there is limited understanding of its prevalence in the population in low\u2010income countries like Vietnam where survey resources are scarce. In this study, we used wastewater analysis as a cost\u2010effective monitoring tool to measure illicit drug use in a population of Hanoi, Vietnam, a low\u2010income country in Southeast Asia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design, setting and participants<\/jats:title><jats:p>This is a longitudinal observational study. Wastewater samples were collected at a sewage canal serving &gt; 430\u2009000 people, in Hanoi, Vietnam, over a six\u2010year period (2018\u20132023).<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Drug biomarkers for amphetamine, methamphetamine, 3,4\u2010Methylenedioxymethamphetamine (MDMA), ketamine, morphine, codeine and benzoylecgonine were measured using liquid chromatography\u2010tandem mass spectrometry via direct injection. The results were used to back\u2010estimate per capita drug consumption. Together with an evaluation of general temporal trend, an interrupted time series analysis using segmented linear regression was conducted to examine the potential changes in drug use associated with the post\u2010COVID\u201019 restriction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>There was a statistically significant decrease in methamphetamine use, with annual averages declining from a peak value of 359.2 to 125.6\u00a0mg\/day\/1000 people between 2018 and 2023 (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). In contrast, ketamine use increased statistically significantly, rising from 149.7 to 465.9\u00a0mg\/day\/1000 people over the study period (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), making it the most commonly used illicit drug. Cocaine and heroin use levels remained relatively low, while MDMA use was relatively stable over time. In the post\u2010COVID\u201019 restriction period, declines were observed in methamphetamine, MDMA, cocaine and codeine consumption; however, only cocaine [Coefficient (standard error, SE)\u2009=\u2009\u22121.9 (0.9), <jats:italic>P<\/jats:italic>\u2009=\u20090.034] and codeine [Coefficient (SE)\u2009=\u2009\u221242.4 (12.4), <jats:italic>P<\/jats:italic>\u2009=\u20090.001] showed statistically significant downward trends. In contrast, ketamine and heroin consumption exhibited slight but non\u2010significant increases, suggesting limited disruption during the post\u2010restriction period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Wastewater analysis shows that the market of illicit drugs in Vietnam is dynamic and shifting toward synthetic drugs. Methamphetamine replaced heroin as the substance with the highest estimated per capita use in Vietnam from 2018 to 2020 and was subsequently overtaken by ketamine by the end of 2022. Wastewater analysis can provide information on population use of multiple substances, including changes due to different factors in a cost\u2010effective way, which is essential in data\u2010poor countries.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.70147","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T17:01:06Z","timestamp":1753290066000},"page":"2295-2304","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Significant changes in preference of illicit drug use in a population of Hanoi, Vietnam\u2014A 6\u2010year wastewater study (2018\u20132023)"],"prefix":"10.1111","volume":"120","author":[{"given":"Tran Thi Thanh","family":"Hue","sequence":"first","affiliation":[{"name":"Hanoi University of Pharmacy Faculty of Analytical Chemistry and Drug Quality Control  Hanoi Vietnam"},{"name":"Department of Science and Training Management National Institute of Drug Quality Control  Hanoi Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4949-2950","authenticated-orcid":false,"given":"Hieu K. 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