Interpreting methamphetamine levels in a high-use community

Introduction Illicit drug use is a largely hidden phenomenon, and population measures are notoriously problematic. Reliable and valid data for local, regional, and national public health and other interventions are needed. Methods To address this information, we examined temporal trends within and across weeks in methamphetamine (MA) in a single location in order to inform a sampling plan for understanding long-term trends in MA use based on sampling raw influent to wastewater treatment plants. The measured concentrations in the wastewater are used to estimate the total mass of MA consumed rather than the number of doses due to the uncertainty surrounding methamphetamine purity, mass of MA per dose, and the number of doses used per day. Results Results from a region with high levels of MA use indicate that MA levels do not differ significantly between weekdays and weekends (p=0.1), consistent with a predominately regular, daily use pattern use. The potential contribution of legal sales of D- and L-MA to the mass of MA consumed within the community was estimated to range from 3-8%. Limitations and uncertainties associated with estimating the mass of MA consumption include small contributions of prescription and over-the-counter drugs that are metabolized to MA as well as measurement and sampling variability.