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Aims To compare long-term trends in wastewater data with other indicators of stimulant use in three locations and to test the reliability of estimates based on one week of sampling.DesignComparison of trends in quantities (‘loads’) of stimulants or their metabolites in wastewater with trends in other indicators of stimulant use (e.g. treatment, police, population survey data).Setting and Participants Populations in Oslo (Norway), South-East Queensland (Australia) and Eindhoven (The Netherlands).Measurements Wastewater data were modelled for MDMA (3,4-Methylenedioxy methamphetamine), benzoylecgonine (a metabolite of cocaine), amphetamine and methamphetamine in Oslo; benzoylecgonine in Eindhoven; and methamphetamine in South-East Queensland. Choice of stimulants modelled in each region was primarily determined by availability of useable data.Findings In Oslo, wastewater data, driving under the influence of drugs statistics and seizure data all suggested increasing MDMA use between 2009 and 2017. In South-East Queensland, there was an estimated 31.1% (95%CI 29.4-32.9%) annualincrease in daily loads of methamphetamine in wastewater between 2009 and 2016, compared with a 14.1% (95%CI 10.9-17.3%) annual increase in seizures. Some of the increase in wastewater can be explained by increased purity. In Eindhoven, there was no evidence of a change in cocaine consumption from wastewater, but a reduction was observed in numbers in treatment for cocaine use from 2012 to 2017. In approximately half the cases examined in Oslo, credible intervals around estimates of annual average loads from a regression model versus estimates based on a single week of sampling did not overlap.ConclusionsLong-term trends in loads of stimulants in wastewater appear to be broadly consistent with trends in other indicators of stimulant use in three locations. Wastewater data should be interpreted alongside epidemiological indicators and purity data. One week of wastewater sampling may not be sufficient for valid inference about drug consumption.

Sinds 2007 is er sprake van een groeiende hulpvraag voor GHB-afhankelijkheid. De terugval in GHB-gebruik bij clienten met een GHBafhankelijkheid is bovendien groot. Een uitspraak van Novadic- Kentron-directeur Hermanides was aanleiding te onderzoeken in hoeverre clienten met GHB-problematiek vaker recidiveren dan clienten met andere primaire problematiek. We onderzochten dit aan de hand van gegevens gegenereerd uit het LADIS. De resultaten laten onder meer zien dat GHB-clienten veel vaker begonnen met een tweede behandelepisode, dan clienten met andere primaire problematiek. Het relatieve risico van recidive was meer dan tweemaal zo groot. Geconcludeerd kan worden dat de LADIS-data Hermanides’ uitspraak ondersteunen. Het ontwikkelen van een behandeling om terugval te verminderen, is dan ook dringend noodzakelijk.