Rapid Assessment of Drug Abuse: Smart City Tools (R41/R42 - Clinical Trial Optional)

Background

Given the prevalence of drug abuse and the epidemic level of opioids misuse, there is a growing need for a comprehensive approach to assess trends in drug use and drug abuse, understand the effectiveness of prevention and treatment programs, and compare usage data across cities and/or states. However, many current methods of the drug use surveillance (e.g. surveys, data on overdose incidence, crime data) have a two-year lag before data are available making challenging reactive operation to shift drug diversion, abuse, and overdose. The other limitations of widely used data sources include lack of geographic resolution, coverage of the selected population, exclusion of the large portion of drug-using community, and involvement of multiple stakeholders.

Municipal wastewater testing is a relatively new strategy that can overcome such limitations by providing a more rapid and objective measure of drug use than traditional methods. A panel of experts from Mathematica’s symposium (Washington , DC, 2017)  recommended wastewater testing methods for substance use monitoring because they are readily scalable and anonymous, they can eliminate self-reporting surveys, map drug consumption, and can provide an early warning in the ever-changing landscape of substance abuse for proactive responses. Currently technologies can detect various drugs including opioids in the wastewater stream and can differentiate between drugs that were discarded and drugs that were metabolized. These approaches can be adopted to address practical questions and dynamic monitoring of illicit drugs use. Specifically, wastewater analysis can reveal the collective drug habits of communities, providing a more accurate picture than self-reported surveys or traditional methods of drug use statistics. It can also alert communities about raising problems in their earlier stage instead of relying on grim emergency-room statistics and overdose deaths.

Large-scale coordinated studies using wastewater methods have already been successfully conducted in Europe.  Within the US, a few pilot wastewater-based studies were initiated in few states including Nebraska, Nevada, New York, South Carolina, Utah, and Wisconsin. The studies demonstrated that the appropriate handling of both samples and data is key to making wastewater testing a routine process. However, the current methodologies require labor-intensive sample collection and multiple resources for sample analysis, involve calibration complexities, and lack multi-indicator monitoring and alert systems. There is the unmet need to address these technological deficiencies and translate wastewater testing into practical insights.

The goal of this Funding Opportunity Announcement (FOA) is to improve the utilization of wastewater testing for illicit drugs and obtain more systematic and comprehensive use of data by developing “Smart city tools”, namely a series of novel technologies with a broad spectrum of drug sensitivity. These technologies could assist public health surveillance programs addressing the needs of dynamic practice for monitoring drug use and abuse.

New wastewater testing technologies could provide a widespread and objective picture of drug use that would be consistent, scalable, cost-effective, and complement other epidemiological studies. This could benefit multiple stakeholders (e.g. municipal and state public health organizations; police departments; educational, prevention and reinforcing programs; health care/treatment centers) provide opportunities to identify emerging drug threats, examine temporal trends, identify geographic hotspots of drug use where more resources may be needed, test effectiveness of new programs and reinforce use of the best practices. Overall, new technologies could translate the wastewater science into practical insights and add the value of wastewater testing to improve public health and safety.

Research Objectives:

This FOA aims to support small businesses to advance knowledge and address technological gaps to adopt wastewater testing for routine monitoring of illicit drugs. Some examples of studies to be conducted, include, but are not limited to:

Because of the multidisciplinary nature of this emerging field, involving technological, environmental, health and social aspects, applicants should consider working with both the end user and the purchaser as part of the Phase I application. This includes demonstration of a clear value proposition of a technology to both the end user (e.g. local, state, or national communities) and the purchaser. At the end of Phase I activities, applicants should be able to demonstrate both technical and commercial feasibility.   

See Section VIII. Other Information for award authorities and regulations.

1. • Improving existing technologies or developing new sensing devices that can consistently detect drug use or/and abuse in wastewater;
   • Optimizing sample collection for wastewater testing addressing variability challenges such as across-day sampling, within-day sampling, flow error, analytical error, and population estimates;
   • Increasing the wastewater signal specificity and sensitivity for highly potent illicit drugs, including opioids such as fentanyl or its other synthetic derivatives;
   • Determining the stability of many of the new synthetic opioids to assess whether these samples can be detected in wastewater;
   • Testing device placement at upstream sewer pipes where different subcatchment areas merge;
   • Developing models to determine operational feasibility of working collaboratively with existing infrastructure and community stakeholders;
   • Designing new methods for wastewater data analytics and predictive modeling. Building practical and dynamic tools to summarize and visualize drug use patents by community and drug type.

   • Because of the multidisciplinary nature of this emerging field, involving technological, environmental, health and social aspects, applicants should consider working with both the end user and the purchaser as part of the Phase I application. This includes demonstration of a clear value proposition of a technology to both the end user (e.g. local, state, or national communities) and the purchaser. At the end of Phase I activities, applicants should be able to demonstrate both technical and commercial feasibility.   

     See Section VIII. Other Information for award authorities and regulations.