Objective:

To analyze changes in illicit drug consumption across urban populations in England using high-frequency chemical monitoring of wastewater.

Key Findings:

• Cocaine showed the highest average population-normalized daily load, followed by heroin, ketamine, amphetamine, MDMA, and methamphetamine.
• Cocaine and ketamine loads were significantly higher in England compared to other European sites.
• Cocaine and MDMA markers showed clear weekend increases, while heroin levels remained steady throughout the week.
• A notable decrease in cocaine markers (14-74%) was observed in March 2022 following a major drug seizure.

Interpretation:

Limitations:

• The study's spatial and temporal coverage is limited, as large-scale monitoring cannot test everywhere all the time.
• Sample logistics and preparation speed can affect the scalability of surveillance.

Conclusion: