Consumption Profiles of Illicit and Neuropsychiatric Drugs in Urban and Rural Communities in Kentucky Using Sewage Epidemiology

Grade Level at Time of Presentation

Junior

Major

Biomedical Science

Minor

Chemistry

Institution

Murray State University

KY House District #

5

KY Senate District #

10

Department

Chemistry

Abstract

The drug overdose deaths in the USA increased by ~20% from 2015 to 2016 to the total >63,600 drug overdose deaths in 2016. Kentucky is among the highest rate of drug overdose death states in the USA. The current estimates of the prevalence of substance abuse are based on the self-reported surveys, overdose/toxicological reports, and drug-related crime statistics. Survey-based conventional approaches are not only cost and time-intensive but also underestimate the actual consumption of drugs. As “wastewater never lie,” the drug residues in raw wastewater collected from the centralized wastewater treatment plants were utilized to determine the consumption rate of 10 illicit and 26 prescribed neuropsychiatric residues in two urban communities in eastern Kentucky and two rural communities in western Kentucky. Communities investigated in eastern Kentucky had the ~10-fold larger population and ~2-fold higher per-capita income than in western Kentucky. Cocaine was the dominant illicit drug consumed in the eastern communities (~3-fold higher than in western communities) while methamphetamine controls the consumption profile in the western communities (2 folds higher than in eastern communities). However, venlafaxine and citalopram were the two major prescribed neuropsychiatric drugs consumed in all communities. While the opioid epidemic has been declared as a national public health emergency in the USA, codeine and hydrocodone were the most consumed prescription opioids. A cost-effective and semi-real time approach – Sewage Epidemiology – can provide authorities critical information for the identification of susceptible areas/populations for policy development, prompt intervention, and evaluation of the effectiveness of new drug treatment and prevention program.

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Consumption Profiles of Illicit and Neuropsychiatric Drugs in Urban and Rural Communities in Kentucky Using Sewage Epidemiology

The drug overdose deaths in the USA increased by ~20% from 2015 to 2016 to the total >63,600 drug overdose deaths in 2016. Kentucky is among the highest rate of drug overdose death states in the USA. The current estimates of the prevalence of substance abuse are based on the self-reported surveys, overdose/toxicological reports, and drug-related crime statistics. Survey-based conventional approaches are not only cost and time-intensive but also underestimate the actual consumption of drugs. As “wastewater never lie,” the drug residues in raw wastewater collected from the centralized wastewater treatment plants were utilized to determine the consumption rate of 10 illicit and 26 prescribed neuropsychiatric residues in two urban communities in eastern Kentucky and two rural communities in western Kentucky. Communities investigated in eastern Kentucky had the ~10-fold larger population and ~2-fold higher per-capita income than in western Kentucky. Cocaine was the dominant illicit drug consumed in the eastern communities (~3-fold higher than in western communities) while methamphetamine controls the consumption profile in the western communities (2 folds higher than in eastern communities). However, venlafaxine and citalopram were the two major prescribed neuropsychiatric drugs consumed in all communities. While the opioid epidemic has been declared as a national public health emergency in the USA, codeine and hydrocodone were the most consumed prescription opioids. A cost-effective and semi-real time approach – Sewage Epidemiology – can provide authorities critical information for the identification of susceptible areas/populations for policy development, prompt intervention, and evaluation of the effectiveness of new drug treatment and prevention program.