Ettore Zuccato1, Sara Castiglioni2, Ivan Senta3, Andrea Borsotti4, Bruno Genetti5, Alessandra Andreotti6, Giovanni Pieretti7, Giovanni Serpelloni8. 1. Department of Environmental Health Sciences, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Via G. La Masa 19, 20156 Milan, Italy. Electronic address: ettore.zuccato@marionegri.it. 2. Department of Environmental Health Sciences, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Via G. La Masa 19, 20156 Milan, Italy. Electronic address: sara.castiglioni@marionegri.it. 3. Rudjer Boskovic Institute, Division for Marine and Environmental Research, Bijenicka c. 54, 10000 Zagreb, Croatia. Electronic address: isenta@irb.hr. 4. Department of Environmental Health Sciences, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Via G. La Masa 19, 20156 Milan, Italy. Electronic address: andreaborsotti@hotmail.it. 5. Explora, Ricerca e Analisi Statistica. Via Ca' Pisani, Vigodarzere, 7-35010 Padua, Italy. Electronic address: bruno.genetti@centroexplora.it. 6. Explora, Ricerca e Analisi Statistica. Via Ca' Pisani, Vigodarzere, 7-35010 Padua, Italy. Electronic address: alessandra.andreotti@centroexplora.it. 7. Dipartimento di Sociologia e Diritto dell'Economia, Università di Bologna, Bologna, Italy. Electronic address: giovanni.pieretti@unibo.it. 8. Former of the Department for Antidrug Policies, Presidency of the Council of Ministers, Rome, Italy. Electronic address: g.serpelloni@gmail.com.
Abstract
BACKGROUND: Monitoring consumption by population surveys (PS) is an important way to challenge the spread of illicit drugs (ID). To improve the information, we explored a complementary method, particularly wastewater analysis (WWA). METHODS: We estimated the prevalence of use by PS, and the consumption by WWA, of cocaine, opioids, cannabis, methamphetamine and MDMA (ecstasy) from 2010 to 2014 in Italy and compared the results. RESULTS: According to PS, cannabis and cocaine were the ID most used in Italy (last month prevalence 3.0% and 0.43% respectively in 2010) followed by opioids (0.17%) and amphetamines (0.14%). WWA gave similar findings, with cannabis consumption (4.35 g THC/day/1000 inhabitants) exceeding cocaine (0.78 g), heroin (0.092 g), methamphetamine and MDMA (0.103 g). The time trend investigated by PS showed significant decreases for all ID from 2010 to 2012. WWA also indicated a reduction of consumption for methamphetamine (p<0.0001) and heroin (p<0.01). Both methods showed an increase for cannabis in 2014 (p<0.001) with the other ID unchanged. Spatial investigations by WWA showed that cannabis and cocaine were consumed significantly more in central Italy than in the north and south. PS indicated the same but only for cannabis. WWA was helpful to study weekly patterns of consumption, showing increases in cocaine and MDMA at weekends. CONCLUSIONS: PS and WWA were confirmed as complementary methods and when used together improved the information on ID use in Italy. We suggest that the combined use of the two approaches can give better information on ID use in the population.
BACKGROUND: Monitoring consumption by population surveys (PS) is an important way to challenge the spread of illicit drugs (ID). To improve the information, we explored a complementary method, particularly wastewater analysis (WWA). METHODS: We estimated the prevalence of use by PS, and the consumption by WWA, of cocaine, opioids, cannabis, methamphetamine and MDMA (ecstasy) from 2010 to 2014 in Italy and compared the results. RESULTS: According to PS, cannabis and cocaine were the ID most used in Italy (last month prevalence 3.0% and 0.43% respectively in 2010) followed by opioids (0.17%) and amphetamines (0.14%). WWA gave similar findings, with cannabis consumption (4.35 g THC/day/1000 inhabitants) exceeding cocaine (0.78 g), heroin (0.092 g), methamphetamine and MDMA (0.103 g). The time trend investigated by PS showed significant decreases for all ID from 2010 to 2012. WWA also indicated a reduction of consumption for methamphetamine (p<0.0001) and heroin (p<0.01). Both methods showed an increase for cannabis in 2014 (p<0.001) with the other ID unchanged. Spatial investigations by WWA showed that cannabis and cocaine were consumed significantly more in central Italy than in the north and south. PS indicated the same but only for cannabis. WWA was helpful to study weekly patterns of consumption, showing increases in cocaine and MDMA at weekends. CONCLUSIONS: PS and WWA were confirmed as complementary methods and when used together improved the information on ID use in Italy. We suggest that the combined use of the two approaches can give better information on ID use in the population.
Authors: Iria González-Mariño; Jose Antonio Baz-Lomba; Nikiforos A Alygizakis; Maria Jesús Andrés-Costa; Richard Bade; Anne Bannwarth; Leon P Barron; Frederic Been; Lisa Benaglia; Jean-Daniel Berset; Lubertus Bijlsma; Igor Bodík; Asher Brenner; Andreas L Brock; Daniel A Burgard; Erika Castrignanò; Alberto Celma; Christophoros E Christophoridis; Adrian Covaci; Olivier Delémont; Pim de Voogt; Damien A Devault; Mário J Dias; Erik Emke; Pierre Esseiva; Despo Fatta-Kassinos; Ganna Fedorova; Konstantinos Fytianos; Cobus Gerber; Roman Grabic; Emma Gracia-Lor; Stefan Grüner; Teemu Gunnar; Evroula Hapeshi; Ester Heath; Björn Helm; Félix Hernández; Aino Kankaanpaa; Sara Karolak; Barbara Kasprzyk-Hordern; Ivona Krizman-Matasic; Foon Yin Lai; Wojciech Lechowicz; Alvaro Lopes; Miren López de Alda; Ester López-García; Arndís S C Löve; Nicola Mastroianni; Gillian L McEneff; Rosa Montes; Kelly Munro; Thomas Nefau; Herbert Oberacher; Jake W O'Brien; Reinhard Oertel; Kristin Olafsdottir; Yolanda Picó; Benedek G Plósz; Fabio Polesel; Cristina Postigo; José Benito Quintana; Pedram Ramin; Malcolm J Reid; Jack Rice; Rosario Rodil; Noelia Salgueiro-González; Sara Schubert; Ivan Senta; Susana M Simões; Maja M Sremacki; Katarzyna Styszko; Senka Terzic; Nikolaos S Thomaidis; Kevin V Thomas; Ben J Tscharke; Robin Udrisard; Alexander L N van Nuijs; Viviane Yargeau; Ettore Zuccato; Sara Castiglioni; Christoph Ort Journal: Addiction Date: 2019-10-23 Impact factor: 7.256