{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:39:30Z","timestamp":1791549570986,"version":"4.3.4"},"reference-count":77,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T00:00:00Z","timestamp":1777161600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T00:00:00Z","timestamp":1777161600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To monitor community\u2010level consumption of 20 illicit drugs across urban areas of England using wastewater\u2010based epidemiology (WBE) surveillance at high temporal resolution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting, cases<\/jats:title>\n                    <jats:p>This study was conducted over a 12\u2010month period in 2022 sampling 24\u2010hour composite wastewater samples at 15 wastewater treatment plants (WWTPs) covering catchment population equivalents ranging from ~100\u2009000 to &gt;1 million. Analysis was conducted using rapid liquid chromatography\u2013tandem mass spectrometry methods. The sampled WWTPs collectively covered 21% of the national population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Primary data outcomes were the population\u2010normalised daily loads (PNLs) entering the WWTP, estimated population\u2010normalised consumption (both in mg\/1000 people\/day) and total mass (g\/day) of 20 targeted illicit drugs and total mass in each catchment, quantified using suitable drug target residue markers in 1746 wastewater samples. Covariables included temporal indicators (e.g. public holidays, events) and regional factors. Presence, quantity and correlation of WBE\u2010derived drug use data were used to infer drug use patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      Of the 20 illicit drugs investigated, 18 were detected in at least one sample. Cocaine exhibited the highest average daily PNL (2770\u2009\u00b1\u2009829\u2009mg\/1000 people\/day), followed by heroin (382\u2009\u00b1\u2009248), ketamine (287\u2009\u00b1\u2009183), amphetamine (272\u2009\u00b1\u2009268), 3,4\u2010methylenedioxymethamphetamine (MDMA) (80\u2009\u00b1\u200957) and methamphetamine (60\u2009\u00b1\u200999) across 2022. When comparing PNLs to Sewage analysis CORe group\u2014Europe (SCORE) and European Drugs Agency WBE data for 109 other WWTPs across Europe from March to May, 2022 cocaine and ketamine PNLs from sites in England were ranked statistically higher [cocaine: Wilcoxon rank\u2010sum test statistic (W)\u2009=\u2009971, adjusted\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.000115; ketamine: W\u2009=\u2009264, adjusted\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0000389]. Importantly, seven English WWTPs recorded higher mean ketamine PNLs than any other European site over the same period in 2022. Temporal spikes in drug consumption aligned with public holidays and major events. A notable decrease in cocaine use coincided with a 3.7\u2010t UK seizure. Strong inter\u2010drug correlations were observed across catchments, particularly for benzoylecgonine\/ketamine and benzoylecgonine\/cocaethylene. Extrapolation to generate a representative national average consumption estimate is not recommended, as the WWTPs studied were mostly classified as urban areas and found not to be representative of the entire population of England.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Wastewater analysis revealed widespread and temporally variable illicit drug use across England in 2022, with ketamine use exceeding European levels at multiple sites. The findings highlight wastewater\u2010based epidemiology's capacity to monitor drug use trends and identify community\u2010level impacts of interventions and events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.70398","type":"journal-article","created":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T23:01:23Z","timestamp":1777244483000},"page":"2043-2059","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["High temporal resolution monitoring of illicit drug consumption across England via wastewater analysis"],"prefix":"10.1111","volume":"121","author":[{"given":"Helena","family":"Rapp\u2010Wright","sequence":"first","affiliation":[{"name":"Medical Research Council (MRC) Centre for Environment and Health, Environmental Research Group, School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keng Tiong","family":"Ng","sequence":"additional","affiliation":[{"name":"Medical Research Council (MRC) Centre for Environment and Health, Environmental Research Group, School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derryn","family":"Grant","sequence":"additional","affiliation":[{"name":"Medical Research Council (MRC) Centre for Environment and Health, Environmental Research Group, School of Public Health Imperial College London  London UK"},{"name":"National Institute for Health Research Health Protection Research Units (NIHR HPRU) in Environmental Exposures and Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Francis","sequence":"additional","affiliation":[{"name":"Medical Research Council (MRC) Centre for Environment and Health, Environmental Research Group, School of Public Health Imperial College London  London UK"},{"name":"National Institute for Health Research Health Protection Research Units (NIHR HPRU) in Environmental Exposures and Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarita","family":"White","sequence":"additional","affiliation":[{"name":"Medical Research Council (MRC) Centre for Environment and Health, Environmental Research Group, School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitris","family":"Evangelopoulos","sequence":"additional","affiliation":[{"name":"Medical Research Council (MRC) Centre for Environment and Health, Environmental Research Group, School of Public Health Imperial College London  London UK"},{"name":"National Institute for Health Research Health Protection Research Units (NIHR HPRU) in Environmental Exposures and Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxing","family":"Liu","sequence":"additional","affiliation":[{"name":"Medical Research Council (MRC) Centre for Environment and Health, Environmental Research Group, School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantina","family":"Dimakopoulou","sequence":"additional","affiliation":[{"name":"Department of Hygiene, Epidemiology and Medical Statistics, Medical School National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Zafeiratou","sequence":"additional","affiliation":[{"name":"Department of Hygiene, Epidemiology and Medical Statistics, Medical School National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan","family":"Wood","sequence":"additional","affiliation":[{"name":"Medical Research Council (MRC) Centre for Environment and Health, Environmental Research Group, School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chryshanthi","family":"Christy","sequence":"additional","affiliation":[{"name":"Medical Research Council (MRC) Centre for Environment and Health, Environmental Research Group, School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stav","family":"Friedman","sequence":"additional","affiliation":[{"name":"Medical Research Council (MRC) Centre for Environment and Health, Environmental Research Group, School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy W.","family":"Gant","sequence":"additional","affiliation":[{"name":"Medical Research Council (MRC) Centre for Environment and Health, Environmental Research Group, School of Public Health Imperial College London  London UK"},{"name":"National Institute for Health Research Health Protection Research Units (NIHR HPRU) in Environmental Exposures and Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klea","family":"Katsouyanni","sequence":"additional","affiliation":[{"name":"Medical Research Council (MRC) Centre for Environment and Health, Environmental Research Group, School of Public Health Imperial College London  London UK"},{"name":"National Institute for Health Research Health Protection Research Units (NIHR HPRU) in Environmental Exposures and Health Imperial College London  London UK"},{"name":"Department of Hygiene, Epidemiology and Medical Statistics, Medical School National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5986-3853","authenticated-orcid":false,"given":"Leon P.","family":"Barron","sequence":"additional","affiliation":[{"name":"Medical Research Council (MRC) Centre for Environment and Health, Environmental Research Group, School of Public Health Imperial College London  London UK"},{"name":"National Institute for Health Research Health Protection Research Units (NIHR HPRU) in Environmental Exposures and Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,26]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Office for National Statistics.Deaths related to drug poisoning in England and Wales: 2022 registrations [Internet].2023[cited 2024 Oct 23]. Available from:https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/birthsdeathsandmarriages\/deaths\/bulletins\/deathsrelatedtodrugpoisoninginenglandandwales\/2022registrations"},{"key":"e_1_2_9_3_1","unstructured":"Office for National Statistics.Drug misuse in England and Wales: year ending March 2023 [Internet].2023[cited 2024 Mar 27]. Available from:https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/crimeandjustice\/articles\/drugmisuseinenglandandwales\/yearendingmarch2023"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fchem.2021.596875"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.o2005"},{"key":"e_1_2_9_6_1","unstructured":"Home Office.Review of drugs: summary (accessible version) [Internet].2020[cited 2024 Apr 4]. Available from:https:\/\/www.gov.uk\/government\/publications\/review-of-drugs-phase-one-report\/review-of-drugs-summary#:~:text=Taking%20the%20health%20and%20criminal scale%20of%20magnitude%20to%20the"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.watres.2018.03.036"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2022.159351"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2022.156956"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2016.06.060"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.11022"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.14767"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.5864\/d2021-015"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.watres.2021.117789"},{"key":"e_1_2_9_15_1","unstructured":"ACIC.National Wastewater Drug Monitoring Program [Internet].2016[cited 2023 Aug 21]. Available from:https:\/\/www.acic.gov.au\/publications\/national-wastewater-drug-monitoring-program-reports"},{"key":"e_1_2_9_16_1","unstructured":"New Zealand Police.National Drugs in Wastewater Testing Programme \u2010 Quarter 2 2024 [Internet].2024. Available from:https:\/\/www.police.govt.nz\/about-us\/publication\/national-drugs-wastewater-testing-programme-quarter-2-2024"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s44221-023-00136-y"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/s44221-023-00144-y"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chroma.2011.09.012"},{"key":"e_1_2_9_20_1","unstructured":"ACIC.National Wastewater Drug Monitoring Program. Australian Criminal Intelligence Commission;2024. Report No.: Report 21."},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhazmat.2023.130989"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/s44221-023-00083-8"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.watres.2024.121864"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.talanta.2024.126401"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2020.140551"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2023.108210"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/molecules26185431"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhazmat.2020.122933"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2022.160379"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1039\/D0AY02013C"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1021\/acs.est.1c00396"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.4135\/9781446269374.n2"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhazmat.2012.04.030"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.watres.2015.10.040"},{"key":"e_1_2_9_35_1","unstructured":"ICH.Validation of analytical procedures: text and methodology Q2(R1).2005."},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2013.11.107"},{"key":"e_1_2_9_37_1","unstructured":"EMCDDA.Assessing illicit drugs in wastewater \u2010 advances in wastewater\u2010based drug epidemiology. Insights 22 Publications Office of the European Union Luxembourg2016"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2016.09.179"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2010.06.012"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2010.12.006"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chroma.2011.08.092"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trac.2018.03.009"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms232314619"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/1556-4029.13968"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2024.170781"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcac039"},{"key":"e_1_2_9_47_1","unstructured":"EUDA.EMCDDA technical report on the new psychoactive substance N N\u2010diethyl\u20102\u2010[[4\u2010(1\u2010methylethoxy)phenyl]methyl]\u20105\u2010nitro\u20101H\u2010benzimidazole\u20101\u2010ethanamine (isotonitazene). Lisbon;2020."},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n3143"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.talanta.2022.123767"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.talanta.2019.120479"},{"key":"e_1_2_9_51_1","unstructured":"UNODC.2023Afghanistan opium survey 2023 \u2010 Cultivation and production after the ban: effects and implications"},{"key":"e_1_2_9_52_1","unstructured":"BBC News.Cocaine worth \u00a3302m found in Southampton is \u2018largest in UK\u2019 [Internet].2022[cited 2024 Aug 8]. Available from:https:\/\/www.bbc.co.uk\/news\/uk-england-hampshire-60995125"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2018.02.002"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2019.03.021"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wroa.2023.100179"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2017.04.019"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2023.108233"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951116002274"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.22536"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1002\/bmc.1549"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.15761\/JSIN.1000227"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2015.07.016"},{"key":"e_1_2_9_63_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13051475"},{"key":"e_1_2_9_64_1","doi-asserted-by":"publisher","DOI":"10.1080\/10550887.2025.2581566"},{"key":"e_1_2_9_65_1","doi-asserted-by":"publisher","DOI":"10.1093\/alcalc\/agh260"},{"key":"e_1_2_9_66_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.13260"},{"key":"e_1_2_9_67_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/22.4.299"},{"key":"e_1_2_9_68_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1989.tb01788.x"},{"key":"e_1_2_9_69_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/28.6.432"},{"key":"e_1_2_9_70_1","doi-asserted-by":"publisher","DOI":"10.1520\/JFS14406J"},{"key":"e_1_2_9_71_1","doi-asserted-by":"publisher","DOI":"10.1124\/dmd.116.074708"},{"key":"e_1_2_9_72_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2014.02.101"},{"key":"e_1_2_9_73_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhazmat.2021.127456"},{"key":"e_1_2_9_74_1","doi-asserted-by":"publisher","DOI":"10.1021\/acs.est.5c08178"},{"key":"e_1_2_9_75_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.16649"},{"key":"e_1_2_9_76_1","unstructured":"Environment Agency.Waste water treatment works: treatment monitoring and compliance limits [Internet].2019[cited 2025 Jan 22]. Available from:https:\/\/www.gov.uk\/government\/publications\/waste-water-treatment-works-treatment-monitoring-and-compliance-limits\/waste-water-treatment-works-treatment-monitoring-and-compliance-limits"},{"key":"e_1_2_9_77_1","unstructured":"Home Office.About Project ADDER [Internet].2023[cited 2025 Jan 22]. Available from:https:\/\/www.gov.uk\/government\/publications\/project-adder\/about-project-adder"},{"key":"e_1_2_9_78_1","unstructured":"EUDA.Communicating results of wastewater\u2010based epidemiology applied to illicit drugs: the do's and don'ts [Internet].2020[cited 2025 Jan 22]. Available from:https:\/\/www.euda.europa.eu\/publications\/html\/manuals-and-guidelines\/communicating-the-results-of-wastewater-based-epidemiology_en"}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.70398","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/add.70398","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.70398","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T03:16:31Z","timestamp":1783912591000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/add.70398"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,26]]},"references-count":77,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/add.70398"],"URL":"https:\/\/doi.org\/10.1111\/add.70398","archive":["Portico"],"relation":{},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"value":"0965-2140","type":"print"},{"value":"1360-0443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,26]]},"assertion":[{"value":"2025-07-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}