Methadone has been used in maintenance treatment for the rehabilitation of heroin addicts but there is concern that methadone could also be abused. In this study, we aimed to utilise wastewater-based epidemiology (WBE) approach to measure the actual level of methadone consumption in Australia and China. The WBE data were subsequently compared with methadone dispense data from health agencies.  In Australia, &gt; 500 wastewater samples were collected from 83 wastewater treatment plants (WWTP) across Australia (covering &gt;60% of the Australian population) during the 2016 Australian Census week and analysed for methadone and methadone metabolite, EDDP. Annual dispense data for methadone in different States were obtained from the Department of Health. In China, wastewater samples were collected during 4 days from 4 WWTPs that serve &gt;4.5 million people in two cities in 2016. The methadone consumption data in the two cities were provided by methadone maintenance treatment agencies in those cities.  The estimated methadone consumption by WBE matched very well with the dispense data both in Australia and in China. The WBE data reflected accurately the variation of methadone dispense rates among different States in Australia with NSW and VIC have more than double the consumption of QLD and WA. In China, the WBE data fitted well with the dispense data of the agencies in both cities with their different levels.  It is thus suggested that with the strict control, the level of methadone abuse, if exists, is not sufficiently high to be detected with high certainty by WBE. Our findings also demonstrate again the potential of WBE approach to monitor the total consumption other opioid drugs of interest in the population.

Monitoring opioid use through wastewater-based epidemiology: Case of methadone in Australia and China

2019 Fall National Meeting

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