America Is Doubling Down on Sewer Surveillance

Like viruses, illicit and prescription drugs leave behind traces in the country’s wastewater systems.

By Helen Ouyang
Illustration by Ben Kothe / The Atlantic
August 26, 2024, 8 AM ET

Not long ago, tracking the spread of a virus by sampling wastewater counted as a novelty in the United States.
Today, wastewater monitoring offers one of the most comprehensive pictures anyone has of 
COVID-19’s summer surge. 
This type of surveillance has been so effective at forecasting the risks of the virus’s rise and fall 
that local governments are now looking for other ways to use it. 
That has meant turning from tracking infections to tracking illicit and high-risk drug use.

Monitoring wastewater for viruses works because infected people excrete tiny bits of viral matter; similarly, someone who’s taken a drug expunges biomarkers from their body. 

• Because drugs tend to show up in sewage before overdoses rise, city officials can discover when, say, a potent fentanyl supply is likely being mixed with other drugs, and alert residents. One town began an aggressive prescription-opioid-disposal campaign after discovering the drugs in abundance in its wastewater. Other communities have used wastewater tracking to allocate Narcan and study the effectiveness of programs funded by opioid settlements.

Wastewater monitoring for drug use has been routine in Europe and Australia for at least a decade but is quickly spreading across the United States. 

Biobot Analytics, a biotechnology company that was one of the CDC’s go-to labs for COVID wastewater tracking, now has federal funding. . .