Something in the water

What drugs are local residents abusing? A researcher’s solution to that vexing problem suggests just how much our sewage knows about us

By Paul Kix
August 21, 2011

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IN 1980, THE cooks making drugs for motorcycle gangs roving the West Coast discovered something amazing. If they swapped out a key chemical in amphetamines for an ingredient found in over-the-counter cold remedies, they could make a new drug that was twice as potent and endlessly abundant. Because the drug included a molecular structure known as a methyl group, the cooks called their drug methamphetamine, or crystal meth.

Its use spread quickly. By the early 1980s Mexican drug cartels had muscled their way into the trade, and in the 1990s the drug went nationwide. By the following decade the drug had ravaged entire families, entire towns, in many states.

Around 2005, amid the grim accumulation of reports on the totality of meth’s destruction, Jennifer Field began to think about how she might help. Field is an environmental chemist at Oregon State University, and Oregon had become one of those meth-ravaged states: One-third of all drug-treatment admissions were for meth, according to a Department of Justice study. Meth, Governor Ted Kulongoski said, factored in 85 percent of the state’s property and identity thefts. But like many drugs, meth proved difficult for officials to track; they couldn’t provide objective figures on who exactly was using the drug.

Field didn’t know much about drugs. But she knew that their chemical components appeared almost everywhere: in hair follicles, in blood, and, of course, in urine. That led to her a-ha moment. What if she could track the use of meth across the state by detecting it in waste water? After all, whatever we put in our bodies ends up as chemical components in our streams of refuse. Everything is in there. So what if everything were detectable?

Field started at home: a sewage-treatment plant in Corvallis, Ore., the city in which OSU is located. Corvallis is an affluent town; methamphetamine, in the public perception at least, is a drug of the poor. Field thought that if she could find and measure meth in Corvallis, she could measure it anywhere. The city’s waste-water-management team agreed to let her and a colleague take a few samples from the plant. Sure enough, they found chemical evidence of meth in the waste water.

The data intrigued her, but Field needed someone familiar with drug policies and surveillance to help her put it in context. So she went online, found drug experts, and began cold-calling them. A couple scoffed and said they weren’t interested in evaluating urine and feces. But then Field found a drug epidemiologist in Seattle, Caleb Banta-Green, a research scientist at the University of Washington who also sat on a work group that followed drug use in major cities for the National Institute on Drug Abuse. When Field phoned him, Banta-Green couldn’t believe what he was hearing. In the subjective, unreliable world of tracking drugs, Field had just found a way to quantify results with hard science. “It was the gold standard,” Banta-Green said. He told Field that of course he would work with her.

They published their first paper in 2009, which duplicated Field’s Corvallis finding: Her instruments, it appeared, could detect meth in waste water anywhere. Field and Banta-Green are now finishing the research on a subsequent paper, which will examine patterns in cities’ drug abuse over a year.

What Field and Banta-Green have happened upon is a way around one of the oldest impediments to effective drug enforcement and treatment: knowing who’s using, where, and how much. Though it is still in the early stages, their work offers the prospect of a new epoch, an age where cities’ - or even nations’ - drug habits can be tracked by the day, or even the hour. The implications don’t stop at meth, or even at illegal drugs. Because almost everything we consume will ultimately be found in our waste water, the more refined this new field becomes, the more it can be used to expose deception, of all sorts, from all comers.

Beneath Field and Banta-Green’s research lies a simple but often overlooked truth about any system, from a car to an entire society: If you want to know what’s truly happening inside, you can get a pretty good idea from looking at its waste. And the power of that insight also means that as Field and Banta-Green’s work grows in influence, it will also start to raise difficult new questions about privacy. What may look like a much-needed truth meter to an epidemiologist may also look a lot like a new kind of surveillance camera. When you can find almost everything in sewage, there is almost nothing you can’t know.

Tracking drug use is a frustrating art. Drugs cross borders in secret; drug sales don’t come with receipts. Modern drug epidemiology relies on the self-reports of users, and on hospital admissions that can’t provide all the context, and on police arrests that omit the same, and on halfway homes and homeless shelters that can tell a researcher how many abusers each facility houses, but not how many more refuse to seek shelter. “We have really crappy tools,” Banta-Green said, by way of explaining his exasperation with his craft.

It is a reactive science, in other words. But by nature epidemiologists like Banta-Green yearn to be proactive - to find ways to intercede before abusers become offenders and neighborhoods wastelands. Drug-monitoring agencies spanning continents trade what new insights they have: the National Institute on Drug Abuse here in the States for the last 40 years, and the European Monitoring Centre for Drugs and Drug Addiction in the European Union for nearly 20. But the field is constrained by the limits of its data.

Jennifer Field’s insight came from a different world entirely. The measuring of waste is its own industry. In fact it’s many industries. Stick a probe in a car’s tailpipe to test the emissions and you’ll have a sense for how clean the engine is; stick a sensor in a smokestack and you’ll know how dirty and old a power plant is. This is how environmental chemistry works, and Field’s advancement was that you could take these tools and use them not just to determine what was being emitted into the environment, but to learn things about the people producing the waste.

On March 4, 2008, Field and Banta-Green and other colleagues initiated a single-day study. Ninety-six Oregon municipalities agreed to take part in the research. They were large and small, rural and urban, representing 65 percent of the state’s population. The researchers took a portion of the daily flow from local water-treatment facilities and headed back to the lab, where they injected 2 millimeters of the sewage onto Field’s instrument and scanned it for meth, cocaine, and ecstasy. The same rigor that scientists apply to a new employee or an athlete taking a drug test, Field and Banta-Green were now applying to raw sewage. The results were very clear: The components of ecstasy appeared in less than half the treatment plants, cocaine’s components in 80 percent of them. The molecules of meth, though, were in all of them. The researchers published the study in 2009 in the journal Addiction to much academic fanfare.

The study sought to prove only that the testing could work, and it did: The results clearly corresponded with the expected distribution of those drugs in the state. But the continued prevalence of meth was a piece of unhappy news. Since passing stricter controls on cold medicines, Oregon had reported a drop in meth-related deaths, and a plunge in the rate of meth-lab busts indicated a huge decrease in local production. Banta-Green and Field’s results, however, raised an uncomfortable truth: Meth was still being used everywhere.

That one-day study, and knowing that much about cities and towns that quickly, “was like manna from heaven,” Banta-Green said, but Field shrugs off the notion that it was any great insight on her behalf. The work was simply a matter of applying ever-stronger technology to a new problem, she says. (Indeed, before publishing her paper Field learned that Italian researchers had already tried something similar, detecting cocaine in river water.)

There were limits to the study. The testing couldn’t extend to rural areas that relied on septic tanks instead of public pipes. And at the time of its release, the study could provide only a snapshot of drug use; it couldn’t say with any specificity how many people in the town were using the drug, or when they were using it.

Still, Field and Banta-Green’s paper offers the prospect of a profound change in drug policy. Drug arrests and even decreases in drug production don’t tell the full story of how drug use is spread through a population. Sifting through waste water, however, could.

Field and Banta-Green’s ambition is now to gather the data they need to develop the test into a more sensitive tool, taking their research to every city and town that will accept it. As the technique improves, it will be possible to sample waste water every week, every day, every hour. Then, in theory, researchers could reverse engineer the results, figure out the time that people in the community used the drug the most, and thereafter step up police patrols appropriately, or ER doctors on call.

Enough sampling could one day allow police and drug-abuse agencies to make predictions: If epidemiologists tracking Town A see a spike in meth use at the end of year one, and then a spike in crime six months later, the researchers following the similarly sized Town B can alert officials to be aware of a spike in crime six months after a spike in meth shows up in its sewage pipes.

The notion of combing through sewage might seem distasteful, but in a sense this is how we understand all human history - archaeology, after all, is the study of what we leave behind. In different ways, the waste stream has been just as powerful a tool for investigators and, quite literally, muckrakers. The Dallas pastor Ole Anthony, for example, helped bring down the deceitful, multimillionaire televangelist Robert Tilton in the 1980s by digging through his trash.

Our own lives, too, reveal themselves in our waste. Robin Nagle, an anthropology professor at New York University who has a joint appointment with New York’s sanitation department, studies how trash documents the life of a city. She says that garbage handlers have intimate knowledge of the people whose trash they haul away. When people get married, have kids, get a promotion, take up a new hobby - their trash collectors know. In fact, “It surprises me when people are surprised by that,” Nagle said.

Accordingly, Field and Banta-Green don’t want to contain their research to drugs. Field, as the environmental chemist, is interested in which other chemicals might appear in waste water, like mercury. The technique could say a lot about the food we eat. The more you know, the more targeted a problem you can treat, and the more ambitious you can be in solving it.

That ambition could become obtrusive, too. Taking their research “upstream,” Banta-Green said, could start to identify the neighborhoods where meth is used, and even the homes. It would become expensive and laborious, but such work could be done. For all his ambitions, Banta-Green sees this as a step too far, a violation of privacy.

It would also raise thorny new civil liberties questions, says Harvard Law School professor Philip Heymann: The Supreme Court has ruled that picking through someone’s trash on the street is not a crime, but moving into someone’s home to confiscate drugs is. “You’re someone right in the middle with this,” Heymann said. What you do in the privacy of your own bathroom cannot be held against you, but what you flush through sewage pipes into a public treatment plant is very much in the public domain. “You could argue either side,” Heymann said.

For now, Field and Banta-Green simply want to see what patterns emerge from testing waste water repeatedly. One of their studies, likely to be published in the next six months, follows 20 cities in the Northwest every week over one year. Still more experiments will look at the fluctuations of drug use by the hour.

Some cities in the Sun Belt and Midwest aren’t waiting for the results: They’ve contacted Field to measure their waste water for meth. A spokeswoman for the Massachusetts Water Resources Authority said the Commonwealth’s waste water plants would be open to testing, but it has not yet been approached. (In 2007, the MWRA did test for pharmaceuticals and personal care products in its waters. The agency has not done testing for any illegal drugs.)

What Field and Banta-Green want to do next is set up nationwide baselines - norms of drug use for all communities of various sizes and demographics, so new results have something to be measured against. Doing that work will be less a question of scaling Field’s technology than acquiring grant money, for which they’re applying.

If it seems like a breach of dignity to be looking at waste, it’s also possible that someday, when waste is commonly seen as information, that that perception will change. In a passage from one of Robin Nagle’s favorite science fiction books, a distant planet employs people whose job it is to sift through waste water. They know the habits of everyone in their world, in close to real time. In the book, Nagle said, “It’s a job that only the most revered people have.”

Paul Kix is a general editor at ESPN: The Magazine.