{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T23:59:06Z","timestamp":1776470346704,"version":"3.51.2"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T00:00:00Z","timestamp":1744156800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Key R&D Program Project of China","award":["2018YFC0807405"],"award-info":[{"award-number":["2018YFC0807405"]}]},{"name":"Guangdong Provincial Public Security Department Drug Abuse Scale Investigation Project","award":["2019-54"],"award-info":[{"award-number":["2019-54"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec015\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>The widespread use of illegal drugs and their associated problems have emerged as a significant public health concern. This study was conducted to estimate the consumption and prevalence of substance use in selected cities of Guangdong Province through wastewater-based epidemiology.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec016\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We collected influent wastewater samples from 67 wastewater treatment plants across four cities of Guangdong from May 2023 to April 2024. The samples were analyzed using solid-phase extraction and liquid chromatography-mass spectrometry to identify 10 commonly used drugs and their metabolites in wastewater. By measuring the concentrations of these drug biomarkers, we estimated drug consumption, prevalence, and the number of individuals abusing drugs.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec017\">\n<jats:title>Results<\/jats:title>\n<jats:p>Our analysis revealed the presence of six out of ten monitored illicit drugs in the samples from the four cities. Methamphetamine emerged as the most consumed drug in Guangdong Province, with consumption ranging from 65 to 223\u2009mg\/1000 inh\/d. This was followed by heroin (19\u201355\u2009mg\/1000 inh\/d), codeine (7\u201320\u2009mg\/1000 inh\/d) and ketamine (1\u201313\u2009mg\/1000 inh\/d). The prevalence rates of methamphetamine, heroin, and ketamine across four cities of Guangdong Province were found to be 0.149%-0.411%, 0.003%-0.019%, and 0.003%-0.196%, respectively. Notably, between 2023 and 2024, the prevalence of heroin displayed a notable downward trend, while the prevalence of both methamphetamine and ketamine exhibited a marked upward trend.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec018\">\n<jats:title>Discussion<\/jats:title>\n<jats:p>Our comprehensive analysis of the substance use situation in these cities indicated that methamphetamine, heroin, and ketamine were the most used substances. Cocaine was detected in only two WWTPs whereas MDMA was found in two separate plants. The cities with the highest and lowest prevalence rates of these three drugs were variant. This study provides valuable data that can support real-time monitoring of regional substance use situations, aiding in developing effective intervention strategies.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0320141","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T17:41:57Z","timestamp":1744220517000},"page":"e0320141","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Estimation of the prevalence of substance use by wastewater-based epidemiology study in four cities of Guangdong, China"],"prefix":"10.1371","volume":"20","author":[{"given":"Wei","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7364-1273","authenticated-orcid":true,"given":"Li","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cunxi","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junyi","family":"Fan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuhan","family":"Jin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,4,9]]},"reference":[{"issue":"1","key":"pone.0320141.ref001","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1186\/s12877-024-04678-y","article-title":"Smoking, alcohol consumption, drug abuse, and osteoporosis among older adults: a cross-sectional study on PERSIAN cohort study in Fasa","volume":"24","author":"Z Khiyali","year":"2024","journal-title":"BMC Geriatr"},{"issue":"1","key":"pone.0320141.ref002","doi-asserted-by":"crossref","first-page":"22889","DOI":"10.1038\/s41598-023-50192-3","article-title":"DSM-5 conduct disorder and symptoms in youths at high risk of psychosis in Kenya with DSM-5 mental disorders and substance use: towards integrated management","volume":"13","author":"DM Ndetei","year":"2023","journal-title":"Sci Rep"},{"key":"pone.0320141.ref003","doi-asserted-by":"crossref","unstructured":"Di Lorenzo R, Reami M, Dragone D, Morgante M, Panini G, Rovesti S, et al. 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