An Opioid Observatory
In the Arizona city of Tempe, researchers are tracking drug use in real-time.
Matt Hallam | | Quick Read
The opioid crisis has become a prevailing and pervasive issue underscoring America’s transition into the 21st century. An estimated 47,600 deaths were caused by drug overdoses in the US in 2017 (1) – and more recent data is expected to demonstrate an even bigger impact, as the spread of illegally manufactured fentanyl and the rise of synthetic opioids continue to drive the epidemic forward.
Rolf Halden has discussed how his analytical techniques have been used to compile the so-called “human health observatory” – a massive database that tracks community behaviors and predicts imminent threats based on chemical measurements in sewage samples. So, what can one see through their telescope? Now, with the Public Health Dashboard developed in an ongoing collaborative effort between Arizona State University and the city of Tempe, Arizona, you can square up to the eyepiece and watch the skies shift with your own eyes.
This first-of-its-kind dashboard shares data on opioid consumption in the city with Tempe’s citizens – and anybody else who might be interested – in near-real time. The intuitive interface lets users filter through the data presented to show detected levels of parent opioids (fentanyl, heroin, oxycodone and codeine) or their primary metabolites (norfentanyl, 6-acetylmorphine and noroxycodone) across distinct areas of the city, which can then be viewed in context with individual neighborhoods – and even streets – by navigating the central map. But how are these numbers calculated, and how are they used?
Following the detection of a drug in wastewater, the amount present can be used to estimate the equivalent number of regular users in the area, by calculating the “population normalized mass load” for each sample. For every gram of heroin found in wastewater, it is reasonable to estimate that there are 20 regular users in that area based on an average consumption of 50 milligrams of heroin a day; as each sample represents approximately 1,000 people, the number of suspected users can then be estimated as a proportion of the local population. This novel technique has been successfully implemented to provide a fast stream of anonymous health data for US cities (2), but has also been used to track narcotic use within smaller areas such as a US university campus (3).
Given the scale of the opioid crisis in the US, powerful methods to track opioid prevalence have never been more important. Armed with knowledge of how opioid levels change over time in Tempe, Halden’s data allows policymakers to monitor the impact of interventions (for example, education efforts or drug amnesty points) and modify next moves accordingly.
The observatory is certainly a powerful tool, but a huge number of points must be mapped to give us a national view of the opioid crisis. What constellations will reveal themselves – and how will they inform new or modified intervention approaches?
- L Scholl et al., “Drug and opioid-involved overdose deaths – United States, 2013-2017”, Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report, 67, 1419 (2019).
- AJ Gushgari et al., “Long-term tracking of opioid consumption in two United States cities using wastewater-based epidemiology approach”, Water Res, 161, 171 (2019). DOI: 10.1016/j.watres.2019.06.003
- AJ Gushgari et al., “Tracking narcotics consumption at a Southwestern US university campus by wastewater-based epidemiology”, J Hazard Mat, 359, 437 (2018). DOI: 10.1016/j.jhazmat.2018.07.073