A Calgary research facility that developed the most comprehensive wastewater monitoring program in the country during the COVID-19 pandemic is targeting another growing public health problem: illicit drug use.
Advancing Canada Water Assets (ACWA), a joint initiative between the City of Calgary and the University of Calgary, is using the same techniques it used to monitor COVID-19 case numbers to track illegal drugs in the province's wastewater.
Dr. Mike Parkins, an infectious disease specialist and professor at the University of Calgary Cummings School of Medicine, is a founding member of the Wastewater Oversight Group. He hopes the findings of the pilot project will ultimately help reduce harm to drug users once dangerous toxins are detected.
“As this platform grows, we have the potential to provide warning information to health care workers, policy makers, and ultimately substance users about the changing nature of the drug supply,” Parkins said.
Parkins said wastewater is a great equalizer, making it an ideal source of data for public health issues that affect large segments of the population and are potentially difficult to measure.
“One of the challenges we have in understanding population health is the metrics we use are all very biased, we're only getting the tip of the iceberg,” Parkins said.
“Effluents which [is collected] is inherently inclusive, comprehensive and unbiased and provides objective data on the populations being monitored.”
Kayla Moffett, an analytical chemist at ACWA, said she and her team are currently testing wastewater samples for opiates, fentanyl, psychedelics and cocaine, as well as dangerous cutting agents — substances used to get high on drugs like levamisole and xylazine.
“We have several municipalities that we are checking [in]And we test for 48 different analytes related to illicit drugs,” Moffett said.
Dangerous opioids are on the rise
Parkins said that based on data provided by researchers like Moffett, he was able to identify troubling trends in the supply of drugs in the province.
One is the intermittent appearance in wastewater samples of carfentanil, a synthetic opioid that is 100 times more toxic than fentanyl. Originally created as a tranquilizer for large animals, carfentanil has been found across the country, leading to drug poisoning deaths.
“When carfentanil enters the drug supply, its potency increases dramatically and the potential for overdose increases significantly. [higher]Parkins said.
The data also shows the introduction of cutting agents such as levamisole, a toxin that can have a variety of side effects, from causing severe rashes to suppressing the human immune system, into the drug supply.
Because toxins like levamisole can cause a wide range of symptoms, it would save doctors time, money and lives if health officials knew what was in the drug supply at any time, Parkins said.
According to data According to the Alberta Substance Abuse Surveillance System, EMS responses to opioid-related incidents are already higher in 2023 than last year. The current figures for 2023 are the highest in the last five years.
Communication of findings
Kevin Frankowski is the Executive Director of ACWA. He said wastewater monitoring technology could be used to track a whole set of pathogens in the future, not just traces of illegal drugs. ACWA already monitors and reports findings for influenza A, influenza B, and respiratory syncytial virus (RSV).
Key to the research facility's performance, he said, is providing timely and accurate data and trends to the public, including health officials.
“It's vital to share data and get it into the hands of those who can best use it, whether it's people trying to help themselves or their loved ones, or practitioners trying to help patients,” Frankowski said.
“This is important as people, their families and their communities continue to suffer from the drug crisis we now face.”
Parkins noted that mobilizing resources during the COVID-19 pandemic allowed ACWA to immediately share its findings, allowing public health officials to predict peak case numbers and track the spread of different strains.
“We've been able to be very transparent with the data [and] Share information in real time, not only with decision makers and policy makers, but with the public,” Parkins said.
“Public [were] They can use this small amount of information to inform their behavior and change their risk. We want to get it [there] Finally, with substances of abuse.”
Parkins envisions that a future warning system that uses ACWA's findings could come in the form of an app, for example, that could alert drug users when dangerous toxins show up in a city's drug supply.
“Ultimately, the more people who have access to the information, the more harm we can prevent.”
With files from Erin Collins and Joshua McLean