A Rude Awakening – Researchers Use Wastewater to Measure Countries’ Drug Problems

Wastewater test

If you were looking for an indicator that the human race has a problem with drug abuse, research uncovering detectable traces of drugs in urban wastewater might be a critical warning of just that. It sounds almost ludicrous to hear, but it’s true. Cities all across the planet have commissioned scientists to test their wastewater, and the results are that the water tests positive for drugs.

Not only is this a wake-up call regarding how prevalent drug use is within our society, one cannot read this information without also thinking about the environmental implications of drug use.

Uncovering the Crisis – Drug Chemicals in Urban Wastewater

This story is interesting and eye-catching. And beyond that, it’s an alarm bell for the health and safety of urban populations and entire ecosystems. Sadly, it has not received the broad public attention that it should.

In April of 2021, a group of researchers published findings on wastewater samples taken from eight countries. Their research is available in the journal Water Research. The countries tested included New Zealand, Australia, China, Italy, Spain, the Netherlands, Norway, and the United States. Traces of multiple drugs came back from American wastewater samples, including traces of:

  • Acetyl Fentanyl
  • Butylene
  • Ketamine
  • Methacathinone
  • Mitragynine
  • N-Ethylpentylone
  • Norketamine
  • Pentylone

The drugs tested for are called New Psychoactive Substances, or “NPS” for short. According to the samples, people living in the Netherlands, Australia, New Zealand, and the United States consume the highest amounts of designer drugs. Quoting analytical chemist and study author, Dr. Richard Bade, “What makes the NPS so dangerous is that they were originally sold as legal alternatives to conventional illicit drugs such as ecstasy and cannabis, suggesting they were safe when, in fact, there was very little information about their toxicity. Governments soon intervened after hospitalizations and fatalities were linked to these classes of drugs with some countries enforcing blanket bans. However, despite these bans, NPS are still synthesized, transported and consumed across the world, often with fatal consequences.”

Crowded bar

A region’s population has to be using a significant amount of drugs for testing equipment to pick up trace elements of such drugs in wastewater. The reality here is chilling. Across the world, urban centers have a high enough frequency and prevalence of drug use that when people living in those regions use the bathroom, the collective expulsion of waste has a high enough concentration of drugs that those concentrations are easily detectable.

The research cited above limited itself solely to designer drugs, sometimes called “party drugs.” If designer drugs are that prevalent in city wastewater systems, what about other drugs? Like opiates? Or amphetamines? Or pharmaceuticals?

It’s Not Just a Human Health Issue; It’s an Environmental Health Issue

The implications of this research on human health are concerning. But there are also implications for the environment to consider. Quoting research published by Harvard Health: “A study found measurable amounts of one or more medications in 80% of the water samples drawn from a network of 139 streams in 30 states. The drugs identified included a witches' brew of antibiotics, antidepressants, blood thinners, heart medications, hormones, and painkillers. Sewage treatment plants are not currently designed to remove pharmaceuticals from water. Nor are the facilities that treat water to make it drinkable.” One only needs to pause for a moment to consider the environmental harm that may occur from untreated pharmaceutical drugs making their way into a region’s ecosystem.

“In contrast to the uncertainty about human health effects, there’s quite a bit of evidence for pharmaceuticals in the water affecting aquatic life, particularly fish…”

But what are some of the environmental effects of drugs leeching into our water? Again quoting Harvard Health research: “In contrast to the uncertainty about human health effects, there’s quite a bit of evidence for pharmaceuticals in the water affecting aquatic life, particularly fish. Research has uncovered popular antidepressant medications concentrated in the brain tissue of fish downstream from wastewater treatment plants.” That’s just one example of many.

Waste from pharmacy

To complicate the issue, it’s not just human drug use that puts drugs into the water system. Drug manufacturing plays a role in contaminating nearby lakes, streams, ponds, even underground aquifers. Quoting detailed research published by the United States Geological Survey: “Scientists found that pharmaceutical manufacturing facilities can be a significant source of pharmaceuticals to the environment. Effluents from two wastewater treatment plants (WWTPs) that receive discharge from pharmaceutical manufacturing facilities (PMFs) had 10 to 1,000 times higher concentrations of pharmaceuticals than effluents from 24 WWTPs across the nation that do not receive PMF discharge. The release waters from these two WWTPs were discharged to streams where the measured pharmaceuticals were traced downstream, and as far as 30 kilometers from one plant’s outfall.”

That research paper also discusses how the livestock industry is a leading culprit in putting drugs into the water system, namely pharmaceuticals such as acetaminophen, caffeine, cotinine, diphenhydramine, and carbamazepine.

Do We Want to be a Country That Uses So Many Drugs that We Pollute Our Water with Them?

The words of Dr. Alistair B.A. Boxall, professor of environmental science, are worth considering here: “We have only begun to research whether and how they [drugs] affect a wide range of organisms in the environment and what this means for environmental health. Future work must therefore focus on understanding the biotic and abiotic processes underlying the release, environmental fate, and effects of pharmaceuticals.” His warning should be heeded, if Americans and citizens of other nations want to protect their respective environments.

Do we want to be a country that uses so many drugs that we pollute our water with drugs?

There is no doubt that better solutions will have to be found for the safe processing of wastewater. Americans will not stop taking heart medications, oral contraceptives, cold medicine, allergy meds, and other OTC drugs any time soon. So it goes without saying that wastewater treatment must be revolutionized to contend with humanity’s ever-encroaching effects on the environment.

But beyond that, those who are misusing mind-altering substances like NPS drugs, opioid painkillers, amphetamines, and synthetic substances should enter into drug treatment centers as soon as possible. Getting help for an addiction is not only the right thing to do for themselves and their loved ones, it’s also the right thing to do for Planet Earth. An addict guided into and through treatment is a life saved, and a boon to the environment, too.


Reviewed by Matt Hawk, BS, CADC-II, ICADC



After working in addiction treatment for several years, Ren now travels the country, studying drug trends and writing about addiction in our society. Ren is focused on using his skill as an author and counselor to promote recovery and effective solutions to the drug crisis. Connect with Ren on LinkedIn.