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Wastewater Analysis From the Happiest Places on Earth

Wastewater analysis is a controversial but highly accurate way of measuring the levels of usage of various substances by a target population. You might recall it came in handy during the COVID-19 pandemic for measuring levels of the virus at wastewater treatment facilities.

Wastewater analysis can also be used on smaller populations, such as prisons, schools, and workplaces, with valid concerns over privacy rights. The scientific term for the process is wastewater-based epidemiology (WBE), and it has many advantages. WBE is fast, non-invasive, and doesn’t require self-reporting. It is most often anonymous as well.

In comparison to conventional surveillance methods, WBE provides a more accurate snapshot of the health of the community through a pooled sample.

That quote is from an article in the journal International Journal of Environmental Research and Public Health on wastewater analysis in Atlanta, Georgia. The authors point to a pilot study of wastewater analysis in Cary, North Carolina, that helped law enforcement determine which drugs were being abused, and whether they were coming from the pharmacy or the street.

A wastewater analysis in Europe came to the following conclusions about which countries had the highest per capita drug use. And the winners are:

Amphetamine Use: Sweden, Belgium, Germany, Netherlands, and Finland

Methamphetamine Use: Sweden, Belgium, Germany, the Netherlands, and Finland

MDMA Use: Belgium, France, Germany, the Netherlands, and Spain

Ketamine Use: Belgium, France, the Netherlands, and Spain

Now, if those countries sound familiar to you, here’s a list of the top six countries in the 2024 World Happiness Survey making the rounds:

  1. Finland
  2. Denmark
  3. Iceland
  4. Sweden
  5. Israel
  6. Netherlands

The WBE study of Europe did not include Israel, or it might also have ranked high on the use of stimulants. What would a wastewater analysis reveal about drug use patterns in the USA? The use of WBE has been extremely limited so far. A comprehensive testing program could be instrumental in community awareness, in directing prevention and recovery resources, and reducing stigma. After all, the European study found every drug present in every country, just in greater or lower concentrations.

Written by Steve O’Keefe. First published April 2, 2024.


“An analysis of ethical issues in using wastewater analysis to monitor illicit drug use,” Addiction: The Society for Study of Addiction, October 2012.

“Utilizing a National Wastewater Monitoring Program to Address the U.S. Opioid Epidemic: A Focus on Metro Atlanta, Georgia,” Environmental Research and Public Health, April 2023.

“Wastewater analysis and drugs — a European multi-city study,” European Monitoring Centre for Drugs and Drug Addiction, March 2024.

“Top 20 happiest countries in the world in 2024,” Forbes, March 20, 2024.

Image Copyright: totojang1977.


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