Presence of illicit drugs and metabolites in influents and effluents of 25 sewage water treatment plants and map of drug consumption in France Thomas Nefau a,b, ⁎, Sara Karolak a , Luis Castillo b , Véronique Boireau b , Yves Levi a a Univ. Paris Sud/UMR CNRS 8079, Public Health & Environment Group, France b Veolia Environment Research and Innovation, Maisons-Laffitte, France HIGHLIGHTS • Complete study with weekday and weekend samplings in 25 STPs in France. • Qualitative and quantitative differences in illicit drug consumption are observed. • LLAS treatments seem more efficient than MLAS treatments and biofilters. • Methadone and its metabolite EDDP appeared difficult to remove whatever the treatment. abstract article info Article history: Received 5 March 2013 Received in revised form 13 May 2013 Accepted 14 May 2013 Available online 14 June 2013 Editor: Damia Barcelo Keywords: Illicit drug Drug consumption Wastewater HPLC–MS/MS analysis Removal Consumption of illicit drugs is a new concern for water management that must be considered not only because of the social and public health aspects but also in an environmental context in relation with the contamination of surface waters. Indeed, sewage treatment plant (STP) effluents contain drug residues that have not been elimi- nated since STP treatments are not completely efficient in their removal. We developed and validated an HPLC–MS/MS analytical method to assess the concentrations of 17 illicit drugs and metabolites in raw urban wastewaters: cocaine and its metabolites, amphetamine and amphetamine-likes (methamphetamine, MDMA, MDEA, MDA), opiates and opiate substitutes (methadone and buprenorphine), and THC-COOH cannabis metabolite. This method has been applied to the analysis of influent and effluent samples from 25 STPs located in France all over the country. The results allowed evaluating the drug consumption in the areas connected to the STPs and the efficiency of the treatment technology implied. We selected STPs according to their volume capacity, their treatment technologies (biofilters, activated sludges, MBR) and their geographical location. In influents, the concentrations varied between 6 ng/L for EDDP (main metabolite of methadone) and 3050 ng/L for benzoylecgonine (cocaine metabolite). Consumption maps were drawn for cocaine, MDMA, opiates, cannabis and amphetamine-like compounds. Geographical significant differences were observed and highlighted the fact that drug consumption inside a country is not homogeneous. In parallel, compari- sons between STP technology processes showed differences of efficiency. More, some compounds appear very resistant to STP processes leading to the contamination of receiving water. © 2013 Elsevier B.V. All rights reserved. 1. Introduction The increasing use of illicit drugs and the nonmedical use of prescrip- tion medications are a growing concern for public health authorities. According to data supplied by surveys on populations, some 230 million people worldwide use illicit drugs each year (UNODC, 2012). When con- sumption data for the different drugs are combined, the numbers of European citizens who have used an illicit drug during their life reach approximately a third of the population (EMCDDA, 2012). These estima- tions are calculated from population surveys, seizure data and mortality rates related to illicit drug use. Such data makes it possible to improve our understanding of the evolution of drug consumption to develop ap- propriate prevention and harm-reduction programs. These approaches are however limited by their biases, especially a lack of representative- ness. Using them, it takes a long time to establish a complete overview of consumption and, generally, results are published several years after the surveys. Hence, it is difficult to obtain a true estimation of cur- rent consumption and to follow its evolution. Moreover, current assess- ment techniques are generally not deployed to a defined scale, thus limiting true information for a specified area inside a country. Science of the Total Environment 461–462 (2013) 712–722 ⁎ Corresponding author at: Univ. Paris Sud/UMR CNRS 8079, Public Health & Environment Group, France. Tel.: +33 146835855. E-mail address: thomas.nefau@u-psud.fr (T. Nefau). 0048-9697/$ – see front matter © 2013 Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.scitotenv.2013.05.038 Contents lists available at SciVerse ScienceDirect Science of the Total Environment journal homepage: www.elsevier.com/locate/scitotenv