Esther Earl died at age 16 from cancer. Her parents have published a collection of her writings.
From heroin in Zagreb to methamphetamines in London and cocaine in Oregon, scientists are now able to figure out which drugs are running through a city just by looking at something everyone leaves behind: wastewater.
On why wastewater testing is appealing to drug researchers
“Drug use is a hidden phenomenon. People are generally not very public with that, and may be actually hard to find people that to give you honest responses in surveys. And on the flip side, you may actually have a hard time finding the people who are using drugs at the highest levels because they don’t respond to surveys — they’re in jail or or they’re in a hospital setting or something like that. So the idea of actually getting a real measure of the actual level of use is quite compelling to people.”
On the importance of accurate drug use trend numbers
“When it comes the drugs, everybody’s an expert. Drugs are actually a very complicated issue. And what we find out is that it’s very easy for people to think they know what’s going on. You may be in a mid- to small-sized town and hear from the sheriff or the PTA, you know, drug Q is the new big, hot thing. And you have no way of know if that’s true or not. There has not been good information for everybody, from my perspective, in terms of really informing whatever the policy debate needs to be around drugs. And I think we need to be having good, vigorous policy debates. We need good quality information, and right now we have very poor information. We can’t have a good conversation without that high quality data.”
On the question of privacy
“What we’re doing is looking at a chemical makeup. Something like methamphetamine, we’re actually looking for that chemical compound. There are no identifiers at all of the individual associated with that. We’re just looking at the methamphetamine. In fact, we’re looking at methamphetamine that could have come from a thousand different people. We’re just looking for the amount of that chemical in the wastewater. So when we’re looking at a community-wide perspective like an entire city or even a smaller town, like three or five thousand people, that’s all getting mixed together. And what I can tell you at the end of the day, for instance, might be that while on average per thousand people there might be 300 milligrams of methamphetamine used, and I might be able to back-calculate that and say, well I think in a city of 5,000 people that might mean you have 50 users. But I can’t tell you who they are or where they are.”
ROBIN YOUNG, HOST:
It's HERE AND NOW.
Heroin in Zagreb. Methamphetamines in London. A powerful amphetamine in Tacoma, Washington. Scientists are finding all of these things, tracking the drugs that run through a city by looking at the wastewater that runs as well. So, for instance, a professor in Tacoma heard from a student that kids were taking the powerful deficit disorder drug Adderall during finals. He tested the sewage water, and sure enough Adderall levels went through the roof during finals week.
Caleb Banta-Green is a research scientist at the Alcohol and Drug Abuse Institute at the University of Washington School of Public Health, where he's also an affiliate assistant professor. We want to learn more from him. He joins us from KUOW in Seattle. Dr. Banta-Green, welcome.
CALEB BANTA-GREEN: Thank you.
YOUNG: And what's the response in the science community to this idea that you can test wastewater and find out at least what the trends are for people who live there?
BANTA-GREEN: Well, I think people are very interested in it. One of the hardest things we can do is actually figure out what the level of drug use is in a community. Drug use is a hidden phenomenon. People are generally not very public with that and it may be hard to actually find people to give you honest responses and surveys.
And on the flipside, you may actually have a hard time finding the people who are using drugs at the highest levels because they don't respond to surveys. They're in jail or they're in a hospital setting or something like that. So the idea of actually getting a real measure of the actual level of use is quite compelling to people.
YOUNG: Well, we want to talk about how this testing of wastewater works. But in the meantime, why is it important to know?
BANTA-GREEN: Yeah. So I've been working in this content area for about 19 years, and what I found out is that when it comes to drugs, everybody is an expert. Drugs is actually a fairly complicated issue, and what we find out is that it's very easy for people to think they know what's going on. You may be in a mid to small-size town and hear from the sheriff or the PTA that, you know, drug queue is the new big hot thing, and you have no way of knowing if that's true or not. There has not been good information for everybody.
So from my perspective, in terms of really informing whatever the policy debate needs to be around drugs - and I think we need to be having good, vigorous policy debates - we need good quality information. And right now we have very poor information. We can't have a good conversation without that high-quality data.
YOUNG: Well, that also allows people to think it's something that happens somewhere else, and then they find out that it's maybe happening in their own, well, sewage system. So let's talk about that. I mean, how is this done, testing wastewater?
BANTA-GREEN: Sure. Very simply, what happens is, is that at a treatment plant, for instance, in Seattle, where I live, there is a very large treatment plant that serves almost the entire city, and they already, for environmental regulation purposes, they take a sample that comes into the plant and they take a sample that leaves the plant. They do this for every 24-hour period. And they do this to see how well the plant is working.
What's the removal efficiency? What are we getting out of here? We're supposed to be removing hormones and other things. Is the plant actually doing what it's required to do? We're basically saying, as these data come into the plant and you're collecting, you know, a gallon or two of wastewater over a day, do you mind if we have a hundred milliliters? We'd like some free wastewater. And people are very happy to share their free wastewater with us. And they're already doing a very nice what we call a sample. They're getting a 24-hour estimate.
You could imagine, if you happen to measure once in a day, you just do what we call a grab sample, you just stick a cup in the wastewater and pull it out, you might find some incredibly high level, you might find some tiny levels. So you really need a good 24-hour estimate of what's going on because a lot of things vary during the day.
YOUNG: Well - and what are researchers finding across the country? I read one interesting fact that on the West Coast methamphetamine use, at least by the testing in the wastewater, flatlines midweek. Well, that, you know, that somewhat makes sense, you know, so that officials can be thinking, well, it's used mostly around the weekends. But what are the kinds of things that are being discovered?
BANTA-GREEN: A lot of different things are going on. I'll give you a couple of examples. A one-day study in Oregon back in 2008 was in 96 cities, covered two-thirds of the state's population. And Oregon has one large metropolitan area, a few mid-sized towns, and then some very small cities. Methamphetamine was in every single one of those cities, every single one. So there's no point to finger any one direction or the other. It's really everywhere. So that was a very important finding.
What we typically see in a place like the West Coast, where there's been a longtime methamphetamine problem for 10, 15 years, people who use methamphetamine tend to use it a lot. They tend to use it in an addictive, regular way. They use it most days out of the month. And in that case, we see flat levels in terms of midweek to weekend. There's actually the same level of use midweek to weekend because there isn't a weekend partying spike.
We see a different thing with cocaine. There's a more pronounced pattern where there's more of a pattern of methamphetamine users being more intermittent with a higher level on weekends. So that's the type of thing that we can look at with these data.
YOUNG: What else do we do with that knowledge besides, as you pointed out, really underscoring for people that it's in their town, it's happening all around them? What else do we do with that data? And are you worried about privacy concerns? There's no DNA with this, right? You don't - you can't trace it to the individual people?
BANTA-GREEN: No. So what we're doing is we're looking at a chemical makeup, something like methamphetamine. We're actually looking for that chemical compound. There are no identifiers at all of an individual associated with that. We're just looking at the methamphetamine. In fact, we're looking at methamphetamine that might have come from a thousand different people. We're just looking for that amount of that chemical in the wastewater.
And so when we're looking at a community-wide perspective, like an entire city or even a smaller town like three or 5,000 people, that's all getting mixed together. What I can tell you at the end of the day, for instance, might be that, well, on average, for a thousand people, there might be 300 milligrams of methamphetamine used. And I might be able to back-calculate that and say, well, I think in a city of 5,000 people, that might mean you have 50 users.
But I can't tell you who they are or where they are, or are they old or are they young; are they addicted, are they not; are they injecting, are they not. I can't tell you all those things. Those are very important things that we need to know, and we need other data sources to fill in that. But it's quite important to just know how much is getting used, how much is getting used in this place today, how does it compare to this place last year, and next year, how does it compare to the neighboring town.
And the reason for all those things, that comparison is very important. One to understand are the things that we can do, positively, to decrease drug use. You know, if we measure the amount of use in the community, we could actually go back to the community and say, hey, we're seeing a lot of methamphetamine used. What do you want to do about it? And they might say nothing. They might say, well, we want to try increasing arrests.
Or they might say, well, we want to increase drug treatment. And they can do those interventions, and then we could come back the next year and say, well, it worked, or it didn't work.
YOUNG: That's Caleb Banta-Green, a research scientist at the Alcohol and Drug Abuse Institute at the University of Washington School of Public Health where he's also an affiliate assistant professor. Dr. Banta-Green, fascinating. Thanks for talking to us about it.
BANTA-GREEN: Thank you for your interest.
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YOUNG: And we have a quick note now on the Super Bowl, the most watched TV show ever. But the Broncos' Peyton Manning only shouted out Omaha twice to telegraph plays. Manning did use his famed hand signals. And according to the Seahawks' outspoken quarterback Richard Sherman, the Seahawks figured them out. Peter King of "Monday Morning Quarterback" told ESPN Radio he doubts that.
PETER KING: They felt like they knew, very much, what the Broncos were doing and what Peyton Manning was doing, especially in some of what he was doing with his eyes. And he would telegraph where he was going with the ball. Now, I don't really know whether this is absolutely true.
YOUNG: Peyton Manning can take solace in one thing. He lost but set a record for most completions in a game. Probably small solace. You're listening to HERE AND NOW. Transcript provided by NPR, Copyright NPR.