In the context of an international trend of cannabis legalisation and regulation, Switzerland is now allowing strictly supervised local pilot trials of cannabis sales. One of these is the Cann-L project in Lausanne, which will evaluate the impact on cannabis consumption of an access to a non-profit, public health-oriented distribution model. Opening in December 2023, it already has more than 500 participants whose profiles differ from those usually found in population surveys. In addition, around twenty people have already contacted the study's referring doctor, demonstrating a need and interest in advice and support.

In the context of an international trend of cannabis legalisation and regulation, Switzerland is now allowing strictly supervised local pilot trials of cannabis sales. One of these is the Cann-L project in Lausanne, which will evaluate the impact on cannabis consumption of an access to a non-profit, public health-oriented distribution model. Opening in December 2023, it already has more than 500 participants whose profiles differ from those usually found in population surveys. In addition, around twenty people have already contacted the study's referring doctor, demonstrating a need and interest in advice and support.

Both policymakers and the public are interested in the size of the drug market. However, often both the origin and the veracity of estimates made in this area are unclear. To help understand this topic, this chapter summarizes the findings from a literature review of studies that have attempted to produce an estimate of the size of the drug market. Different methodological approaches and the challenges inherent in estimating the size of drug markets are discussed. The greatest attention is given to demand side approaches as they have been most commonly used; however, the supply side and some more recent innovative approaches are also considered. The chapter concludes by making some recommendations for future studies intended to improve the evidence base in this area.&nbsp;<br>

Both policymakers and the public are interested in the size of the drug market. However, often both the origin and the veracity of estimates made in this area are unclear. To help understand this topic, this chapter summarizes the findings from a literature review of studies that have attempted to produce an estimate of the size of the drug market. Different methodological approaches and the challenges inherent in estimating the size of drug markets are discussed. The greatest attention is given to demand side approaches as they have been most commonly used; however, the supply side and some more recent innovative approaches are also considered. The chapter concludes by making some recommendations for future studies intended to improve the evidence base in this area.

This article describes the application of a recently proposed framework for deploying wastewater-based epidemiology (WBE) to monitor illicit drug use within festivals (Benaglia et al., 2019). The festival under study was a week-long music festival in Switzerland (Swiss Festival) which attracted around 50,000 people daily. Wastewater sampling was performed during its 2014 and 2015 editions. As the Swiss Festival's wastewater is conveyed to the sewage treatment plant (STP) of the nearby city, to assess illicit drug use when there is no festival (i.e. the background consumption) wastewater sampling was also carried out during an off-festival week in 2015. During the 2014 and 2015 editions of the Swiss Festival, WBE highlighted that the most consumed illicit drugs were cannabis, MDMA, cocaine and amphetamine. Excluding cannabis, the means per capita loads of all illicit drugs were not statistically different between both editions of the Swiss Festival. The results were then compared to those of an Australian festival which had also been subject of a quantitatively assessed illicit drug use study (Lai et al., 2013). This comparison confirmed that MDMA is highly prevalent, as well as amphetamine, although to a lesser extent. Consumption of cocaine (in Switzerland) and methamphetamine (in Australia) is also high, but their use seems to be related to their availability (i.e. to the country where the festival takes place). Furthermore, it was observed that MDMA and amphetamine are more consumed during the festival compared to normal times, when there is no festival. This might suggest that their availability is increased and therefore, that a market for these substances potentially exists during the festival. This last hypothesis was assessed by consulting drug seizures made by the police during the 2015 Swiss Festival. Despite very limited data, police records suggested that most of the drugs were purchased at the festival, which supports the previous hypothesis. Results validate, on the one hand, WBE as a useful indicator to monitor illicit drug use within festivals and on the other hand, the suggested framework for deploying WBE in such environment. In addition, this study suggests the need for prevention and harm reduction measures targeted on MDMA and amphetamine during the Swiss Festival, such as drug checking laboratories.

Background: Most comparative drug policy analyses utilise measures of drug use, often from general population surveys (GPS). However, the limitations of GPS are well-recognised, including the small numbers of people who use illicit drugs sampled. Web surveys offer a potential solution to such issues. Therefore EMCDDA conducted a study to assess the potential for using such surveys to supplement information obtained from GPS. Methods: The European Web Survey on Drugs (EWSD) asked about use of cannabis, amphetamines, cocaine and MDMA in 14 countries from 2016 to 2018. Each participant country translated the questionnaire as necessary and devised its own sampling strategy. Individuals aged 18 +, resident in the participant country, who had used one or more of the drugs covered by the survey in the past 12 months were included in the analysis. Participation was anonymous and voluntary. Results: More than 40,000 people completed the survey, with recruitment mostly through social media. Larger samples of users of all drug types than found in GPS were generally obtained. However, the respondent profiles differed markedly between countries, e.g. the proportion aged 18-24 ranged from 30% to 80%. The results relating to use showed both inter-country similarities and differences, e.g. mean daily amounts of cocaine used varied between countries but increases in amounts used with increased frequency of use were similar. Price data showed good external validity. Conclusion: Web surveys offer the possibility of collecting information from large numbers people who use illicit drugs quickly and cheaply and can fill important gaps in our knowledge of patterns of use, particularly by recreational users. However, they also have limitations. Standardising questionnaires and approaches to data cleaning and analysis facilitates comparisons between countries but obtaining comparable samples may be challenging. Multinational surveys need to balance standardisation of methods with responsiveness to differing country contexts; our collaborative model does this.

Members and partners of the Sewage analyses CORe group Europe - (SCORE) measured five illicit drug residues in wastewater 2011-2017 (every year one week). The data set covers in total 143 wastewater treatment plants in 120 cities from 37 countries, which were monitored at least once.

AbstractBackground and aimsWastewater‐based epidemiology is an additional indicator of drug use that is gaining reliability to complement the current established panel of indicators. The aims of this study were to: (i) assess spatial and temporal trends of population‐normalized mass loads of benzoylecgonine, amphetamine, methamphetamine and 3,4‐methylenedioxymethamphetamine (MDMA) in raw wastewater over 7 years (2011–17); (ii) address overall drug use by estimating the average number of combined doses consumed per day in each city; and (iii) compare these with existing prevalence and seizure data.DesignAnalysis of daily raw wastewater composite samples collected over 1 week per year from 2011 to 2017.Setting and ParticipantsCatchment areas of 143 wastewater treatment plants in 120 cities in 37 countries.MeasurementsParent substances (amphetamine, methamphetamine and MDMA) and the metabolites of cocaine (benzoylecgonine) and of Δ9‐tetrahydrocannabinol (11‐nor‐9‐carboxy‐Δ9‐tetrahydrocannabinol) were measured in wastewater using liquid chromatography–tandem mass spectrometry. Daily mass loads (mg/day) were normalized to catchment population (mg/1000 people/day) and converted to the number of combined doses consumed per day. Spatial differences were assessed world‐wide, and temporal trends were discerned at European level by comparing 2011–13 drug loads versus 2014–17 loads.FindingsBenzoylecgonine was the stimulant metabolite detected at higher loads in southern and western Europe, and amphetamine, MDMA and methamphetamine in East and North–Central Europe. In other continents, methamphetamine showed the highest levels in the United States and Australia and benzoylecgonine in South America. During the reporting period, benzoylecgonine loads increased in general across Europe, amphetamine and methamphetamine levels fluctuated and MDMA underwent an intermittent upsurge.ConclusionsThe analysis of wastewater to quantify drug loads provides near real‐time drug use estimates that globally correspond to prevalence and seizure data.

Tobacco smoking is the major cause of many chronic diseases, especially lung cancer. Knowledge about population-wide tobacco use and exposure is essential to characterise its burden on public health and evaluate policy efficacy. Obtaining such knowledge remains challenging with current methods (e.g., surveys, biomonitoring) but can be achievable with wastewater analysis, a promising tool of retrieving epidemiology information. This study examined population-wide exposure to tobacco toxicants and carcinogens through wastewater analysis and explored relationships among these chemicals. Cotinine, trans -3′-hydroxycotinine, anabasine, anatabine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) were analysed in samples from Greece, Switzerland and Belgium, where tobacco control policies are different. Measured per-capita mass loads were ranked as: nicotine biomarkers ≫ tobacco markers > carcinogens. Relationships between nicotine biomarkers and tobacco markers implied substantial use of non-tobacco nicotine items besides tobacco products. Geographic profiles of tobacco markers revealed higher levels in Geneva and Athens than Geraardsbergen and Ninove. Environmental third-hand smoke led to NNK detection, with elevated levels observed in Athens where indoor smoking is widespread, posing potential health risks to the population. Our novel outcomes are relevant for public health authorities as they provide indications about external exposure and can thus be used to plan and evaluate tobacco control policies.

This study shows the efficiency of passive sampling to reveal industrial and agricultural pollution trends. Two practical applications for nonpolar and polar contaminants are presented. Low-density polyethylene (LDPE) samplers were deployed for one year in the Venoge River (VD) to monitor indicator PCBs (iPCBs, IUPAC nos. 28, 52, 101, 138, 153 and 180). The results showed that the impact of PCB emissions into the river is higher in summer than in other seasons due to the low flow rate of the river during this period. Polar organic chemical integrative samplers (POCIS) were deployed for 4 months in the Sion-Riddes canal (VS) to investigate herbicides (terbuthylazine, diuron and linuron). Desisopropylatrazine-d5 (DIA-d5) was tested as a performance reference compound (PRC) to estimate aqueous concentration. The results showed an increase of water contamination due to the studied agricultural area. The maximal contamination was observed in April and corresponds to the period of herbicide application on the crops.