Utilizing a National Wastewater Monitoring Program to Address the U.S. Opioid Epidemic: A Focus on Metro Atlanta, Georgia

The opioid epidemic has continued to be an ongoing public health crisis within Metro Atlanta for the last three decades. However, estimating opioid use and exposure in a large population is almost impossible, and alternative methods are being explored, including wastewater-based epidemiology. Wastewater contains various contaminants that can be monitored to track pathogens, infectious diseases, viruses, opioids, and more. This commentary is focusing on two issues: use of opioid residue data in wastewater as an alternative method for opioid exposure assessment in the community, and the adoption of a streamlined approach that can be utilized by public health officials. Opioid metabolites travel through the sanitary sewer through urine, fecal matter, and improper disposal of opioids to local wastewater treatment plants. Public health officials and researchers within various entities have utilized numerous approaches to reduce the impacts associated with opioid use. National wastewater monitoring programs and wastewater-based epidemiology are approaches that have been utilized globally by researchers and public health officials to combat the opioid epidemic. Currently, public health officials and policy makers within Metro Atlanta are exploring different solutions to reduce opioid use and opioid-related deaths throughout the community. In this commentary, we are proposing a new innovative approach for monitoring opioid use and analyzing trends by utilizing wastewater-based epidemiologic methods, which may help public health officials worldwide manage the opioid epidemic in a large metro area in the future.