This study uses wastewater epidemiology to examine stimulant trends.
In this project, researchers utilize wastewater-based epidemiology (WBE) to develop a temporary wastewater surveillance system targeting select traffic rest areas and truck weigh stations along three interstate highways passing through Kentucky. The project offers insights into stimulant use patterns and drug use trends among populations utilizing these select rest areas, truck weigh stations, and wastewater treatment facilities (WWTFs). WBE is a novel, yet established, scientific approach that offers a robust, non-invasive, and near real-time method for detecting population drug exposures. By analyzing trace drug residues in untreated wastewater, WBE provides a comprehensive tool for ongoing surveillance and early warning of drug exposure. During the project period, researchers partnered with the University of Kentucky’s Substance Use Priority Research Area (SUPRA) to obtain additional wastewater samples from four WWTFs in the eastern part of Kentucky (i.e., Appalachian area). Drug overdose mortality, particularly involving psychostimulants such as cocaine and methamphetamine, has become a significant public health crisis in the United States. Kentucky, already severely affected by the opioid epidemic, has experienced alarming rates of fatal drug overdoses, with stimulant use contributing increasingly to these fatalities. In 2018, Kentucky reported 439 stimulant-involved overdose deaths, with a rate of 10.6 per 100,000. By 2022, this number surged to 1,113, with a rate of 26.5 per 100,000 population—a 153.5% increase. This sharp increase has compounded the state's existing public health burden associated with drug misuse. Moreover, Kentucky’s counties exhibit significant variability in demographic, economic, and healthcare access characteristics, which are key determinants influencing the rates of drug overdose mortality. New drug surveillance methods are needed to enhance the speed and accuracy of identifying substances affecting U.S. communities, including those in Kentucky.