tetano
Editor, Senior Moderator
Int J Drug Policy
. 2026 Sep 12;157(Pt A):105507.
doi: 10.1016/j.drugpo.2026.105507. Online ahead of print.
Tim Boogaerts 1 , Maarten Quireyns 2 , Erik Fransen 3 , Natan Van Wichelen 2 , Shuo Chen 4 , Richard Bade 4 , Ben Tscharke 4 , Phong Thai 4 , Noelia Salgueiro-Gonzalez 5 , Andrea Estévez-Danta 6 , Thomas Ter Laak 7 , Aino Kankaanpää 8 , Magda Psichoudaki 9 , Sara Castiglioni 5 , João Matias 10 , Cobus Gerber 11 , Nicola Ceolotto 12 , Miguel M Santos 13 , José Benito Quintana 6 , Sara McCormick 14 , Herbert Oberacher 15 , Erik Emke 16 , Nikolaos Rousis 17 , Frederic Been 18 , Despo Fatta-Kassinos 9 , Dan Burgard 19 , Alberto Celma 20 , Vera Reinstadler 15 , Emma L Keller 11 , Bradley S Simpson 11 , Lubertus Bijlsma 20 , Teemu Gunnar 8 , Andrew Chappell 14 , Diāna Vanaga 21 , Olesia Rudminienė 22 , Brigita Rasimaite 22 , Lisa Oliver 23 , Ricardo Capela 13 , Barbara Kasprzyk-Hordern 12 , Viviane Yargeau 24 , Carol Perez-Iratxeta 23 , Andressa S Reis 25 , Francisca Corthorn 26 , Cristóbal Galbán-Malagón 27 , Adrian Covaci 2 , Alexander L N van Nuijs 2 , Jochen F Mueller 4
Affiliations Expand
Background and aims: A limited number of studies have employed wastewater-based epidemiology (WBE) to assess the impact of specific COVID-19 public health directives on stimulant consumption. This study investigates the potential of WBE as a complementary information source to support decision-making, by examining drug use changes during the pandemic.
Methods: WBE data on stimulant use from 2019 through 2022 was obtained from 17 countries covering a total of 47 wastewater treatment plants worldwide. The Oxford Coronavirus Government Response Tracker stringency index was used to standardize the severity of the COVID-19 interventions across different countries. A multiple linear regression model was fitted for the population-normalized mass loads of amphetamine, cocaine (through its metabolite benzoylecgonine), MDMA, and methamphetamine to investigate whether changes in COVID-19 restrictions influenced stimulant use, controlling for possible week-weekend and spatial effects.
Results: In most locations, WBE suggests that stimulant use was not significantly affected by the COVID-19 interventions, or even increased under the stricter measures. Methamphetamine use showed the largest decrease with increasing policy stringency, with a negative linear relationship found in 19% of cities, followed by MDMA (18%), cocaine (15%) and amphetamine (6%). Social gathering restrictions mainly impacted cocaine and MDMA use, while methamphetamine consumption declined most under stringent travel restrictions.
Conclusions: This study highlights the heterogeneous effects of the COVID-19 policy changes on stimulant use, even within countries. The ability of WBE to compile consecutive daily estimates proves to be particularly useful to assess the direct effect of specific policy changes on the consumption of different stimulants.
Keywords: COVID-19 interventions; Modeling; Policy evaluation; Stimulants; Urban wastewater.
. 2026 Sep 12;157(Pt A):105507.
doi: 10.1016/j.drugpo.2026.105507. Online ahead of print.
Assessing the potential of wastewater-based epidemiology to evaluate the impact of COVID-19 policy changes on stimulant use across 17 countries
Tim Boogaerts 1 , Maarten Quireyns 2 , Erik Fransen 3 , Natan Van Wichelen 2 , Shuo Chen 4 , Richard Bade 4 , Ben Tscharke 4 , Phong Thai 4 , Noelia Salgueiro-Gonzalez 5 , Andrea Estévez-Danta 6 , Thomas Ter Laak 7 , Aino Kankaanpää 8 , Magda Psichoudaki 9 , Sara Castiglioni 5 , João Matias 10 , Cobus Gerber 11 , Nicola Ceolotto 12 , Miguel M Santos 13 , José Benito Quintana 6 , Sara McCormick 14 , Herbert Oberacher 15 , Erik Emke 16 , Nikolaos Rousis 17 , Frederic Been 18 , Despo Fatta-Kassinos 9 , Dan Burgard 19 , Alberto Celma 20 , Vera Reinstadler 15 , Emma L Keller 11 , Bradley S Simpson 11 , Lubertus Bijlsma 20 , Teemu Gunnar 8 , Andrew Chappell 14 , Diāna Vanaga 21 , Olesia Rudminienė 22 , Brigita Rasimaite 22 , Lisa Oliver 23 , Ricardo Capela 13 , Barbara Kasprzyk-Hordern 12 , Viviane Yargeau 24 , Carol Perez-Iratxeta 23 , Andressa S Reis 25 , Francisca Corthorn 26 , Cristóbal Galbán-Malagón 27 , Adrian Covaci 2 , Alexander L N van Nuijs 2 , Jochen F Mueller 4
Affiliations Expand
- PMID: 42731532
- DOI: 10.1016/j.drugpo.2026.105507
Abstract
Background and aims: A limited number of studies have employed wastewater-based epidemiology (WBE) to assess the impact of specific COVID-19 public health directives on stimulant consumption. This study investigates the potential of WBE as a complementary information source to support decision-making, by examining drug use changes during the pandemic.
Methods: WBE data on stimulant use from 2019 through 2022 was obtained from 17 countries covering a total of 47 wastewater treatment plants worldwide. The Oxford Coronavirus Government Response Tracker stringency index was used to standardize the severity of the COVID-19 interventions across different countries. A multiple linear regression model was fitted for the population-normalized mass loads of amphetamine, cocaine (through its metabolite benzoylecgonine), MDMA, and methamphetamine to investigate whether changes in COVID-19 restrictions influenced stimulant use, controlling for possible week-weekend and spatial effects.
Results: In most locations, WBE suggests that stimulant use was not significantly affected by the COVID-19 interventions, or even increased under the stricter measures. Methamphetamine use showed the largest decrease with increasing policy stringency, with a negative linear relationship found in 19% of cities, followed by MDMA (18%), cocaine (15%) and amphetamine (6%). Social gathering restrictions mainly impacted cocaine and MDMA use, while methamphetamine consumption declined most under stringent travel restrictions.
Conclusions: This study highlights the heterogeneous effects of the COVID-19 policy changes on stimulant use, even within countries. The ability of WBE to compile consecutive daily estimates proves to be particularly useful to assess the direct effect of specific policy changes on the consumption of different stimulants.
Keywords: COVID-19 interventions; Modeling; Policy evaluation; Stimulants; Urban wastewater.