NATIONAL WASTEWATER

DRUG MONITORING PROGRAM

REPORT 5, AUGUST 2018
 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

CONTENTS
CEO FOREWORD.............................................................................................................................4
SNAPSHOT......................................................................................................................................6
INTRODUCTION..............................................................................................................................8
RESEARCH FINDINGS...................................................................................................................15
1: EXECUTIVE SUMMARY...........................................................................................................17
2: INTRODUCTION.......................................................................................................................19
2.1: Preamble..............................................................................................................................19
3: METHODS ................................................................................................................................20
3.1: Participating wastewater treatment plants (WWTPs)..........................................................21
3.2: Sample collection and preparation......................................................................................22
3.3: Presentation of data and interpretation of graphs..............................................................22
4: RESULTS....................................................................................................................................25
4.1 Individual site comparison of drug use in April 2018............................................................25
4.2 Temporal changes in drug consumption estimates by jurisdiction.......................................39
4.3 Drug profile for each state and territory...............................................................................59
5: INTERNATIONAL COMPARISON OF DRUG USE...................................................................63
5.1 Stimulant use........................................................................................................................63
5.2 Nicotine and alcohol use.......................................................................................................65
6: ACKNOWLEDGEMENTS..........................................................................................................67
7: REFERENCES............................................................................................................................68
8: APPENDICES............................................................................................................................70
Appendix 1: Drug-specific parameters for analytical reporting and usage calculations.............70
Appendix 2: Number of sites assesed in each report..................................................................71
Appendix 3: Further information on WWTPs..............................................................................72
Appendix 4: Percentage of samples above LOD (%) for each drug and period assessed............74
CONCLUSIONS..............................................................................................................................75

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 CEO FOREWORD

The Australian Criminal Intelligence Commission has a national responsibility to provide

information and intelligence on criminal activity. Much of the harm Australians suffer at the
hands of organised crime is due to the trade in illicit substances and abuse of licit substances.
Serious and organised crime groups profit from importing, trafficking, manufacturing and
selling drugs.
This National Wastewater Drug Monitoring Program report is the fifth in a series of nine
public reports that will detail the findings of the program until the end of 2019. This report
provides statistically valid datasets of drug use and distribution patterns across a large
number of sites in capital cities and regional areas.
Wastewater analysis is widely applied internationally as a tool to measure and interpret drug
use within national populations, with the current national program in Australia representing
world best practice. Wastewater analysis provides a measure of one important aspect of
national health—the demand for a range of licit and illicit drugs. An understanding of this
behaviour allows governments to effectively direct resources to priority areas and monitor
the progress of demand and supply reduction strategies.

EVOLUTION OF THE PROGRAM

This report includes wastewater data from all states and territories and covers both capital
city and regional sites, enabling the program to provide a national picture of drug use. In
April 2018, 47 wastewater sites were monitored nationally. Based on 2016 Census data,
these sites cover 54.8 per cent of the Australian population—around 12.8 million people.
This report contributes further data to permit the identification of changes in usage patterns
and to build a comprehensive and increasingly detailed picture of national drug consumption.
In future reports the Australian Criminal Intelligence Commission will test for cannabis
consumption, one of the most used illicit drugs, both domestically and internationally. This
exemplifies the continuing evolution of the program and we are grateful to our partners at
the University of Queensland and the University of South Australia for extending the existing
program in this manner.

TRENDS IDENTIFIED DURING THIS REPORTING PERIOD

Of the drugs monitored by the program, consistent with previous reports, alcohol and
nicotine continue to be the most consumed drugs in Australia. Although the population-
weighted average consumption of methylamphetamine decreased in both capital city and
regional sites from December 2017 to April 2018, it remains the most consumed illicit
drug of those tested. The consumption of other drugs monitored by the program remains
considerably lower.
While there is variation in consumption levels both within and across states and territories,
there has been an overall decrease in the population-weighted average consumption of many
of the drugs measured by the program from December 2017 to April 2018. Of note and concern
this reporting period is the increase in fentanyl consumption, particularly in regional sites, with

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the population-weighted average consumption of fentanyl in April 2018 in both capital city
and regional sites the highest recorded since the program began. While fentanyl consumption
measured by the program reflects both licit and illicit use, increased consumption is of concern
as the high potency of fentanyl greatly increases the risk of overdose.
This report also includes updated SCORE data, which provide international consumption
comparisons for a number of drugs monitored by the program. Of the 23 countries with
comparable reported data, Australia ranks second highest after the United States of America
—where only one site was tested—for total estimated stimulant consumption. When comparing
individual drugs, Australia ranks highly for methylamphetamine consumption, with medium
MDMA consumption and relatively low cocaine consumption.
In addition to placing Australian drug use in context with other countries, for the first time this
report includes ‘bubble maps’, which provide a visual representation of average consumption
in capital city and regional sites. These maps enable users to readily see and compare national
consumption averages, and European consumption averages where available, for individual
drug types.

ADDITIONAL INSIGHTS GAINED FROM WASTEWATER ANALYSIS

Wastewater analysis provides a measure of the demand for a range of licit and illicit drugs.
Analysis of wastewater data offers opportunities to address emerging problems, identify
previously unknown drug threats and consumption patterns, and assists to measure the
effectiveness of harm reduction initiatives and supply disruption strategies.
Following on from the national consumption estimates for methylamphetamine, cocaine,
MDMA and heroin derived from the program and included in Report 4, this report includes
a further breakdown of these figures to the state and territory level. This again reinforces
that population size is not the sole influencing factor on drug consumption and highlights the
variation in drug use that exists between the individual states and territories. Understanding
these differences is important in the development and delivery of tailored responses to suit
the specific needs of individual jurisdictions. In the future we will also look to calculate annual
consumption estimates for the second and third year of the program. This longitudinal data
will provide valuable insights, enabling the ready comparison of data across reporting periods
and assist in identifying changes in drug consumption across the life of the program.
I would like to thank the Australian Government for contributing the funding which made
this initiative possible and to acknowledge the Australian Criminal Intelligence Commission
officers who contributed to the project. I also acknowledge the valuable support and
specialist expertise of the University of Queensland and the University of South Australia, who
undertook the data collection and analysis which underpins this report.

Michael Phelan APM

Chief Executive Officer
Australian Criminal Intelligence Commission

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Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

SNAPSHOT

Alcohol and nicotine

54%
remain the highest
consumed substances
and methylamphetamine
continues to be the most
consumed illicit drug tested.

The April 2018 collection Increased fentanyl use is of concern,

covers 54.8 per cent of with April 2018 capital city and regional
Australia’s population—about average consumption at the highest
12.8 million Australians. levels recorded by the program.

Capital city cocaine

and heroin average
consumption
exceeded regional
consumption.
Regional nicotine, alcohol, methylamphetamine,
MDMA, MDA, oxycodone and fentanyl average
consumption exceeded capital city consumption.

SCORE INTERNATIONAL COMPARISONS

Of the 23 countries with comparable reported Australia ranks second
data for the four common stimulants for methylamphetamine
considered (MDMA, cocaine, amphetamine consumption, with median
and methylamphetamine), Australia has the MDMA consumption and
second highest total estimated consumption relatively low cocaine
overall after the United States of America. consumption.

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 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

ACT 80.4 kg
Methylamphetamine

NSW 2,298.4 kg
NT 65.5 kg
Qld 1,277.9 kg
SA 1,005.3 kg
Tas 92.0 kg
Vic 2,039.2 kg 8,387 kg
WA 1,528.3 kg
National

ACT 67.8 kg
NSW 1,814.6 kg
NT 19.5 kg
Qld 323.8 kg
Cocaine

SA 108.8 kg
Tas 15.5 kg
Vic 681.5 kg 3,075 kg
WA 43.8 kg
National

ACT 28.9 kg
NSW 471.9 kg
NT 38.2 kg
Qld 223.3 kg
MDMA

SA 58.7 kg
Tas 32.1 kg
Vic 326.5 kg 1,280 kg
WA 101.3 kg
National

ACT 16.1 kg
NSW 239.9 kg
NT 1.1 kg
Qld 75.7 kg
Heroin

SA 38.6 kg
Tas 2.1 kg
Vic 348.8 kg 765 kg
WA 42.5 kg
National

Estimated state and territory annual consumption of methylamphetamine, cocaine, MDMA and heroin
(based on NWDMP data for August 2016 to August 2017).

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Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

INTRODUCTION
This is the fifth in a series of nine National Wastewater Drug Monitoring Program reports to
be publicly released by the Australian Criminal Intelligence Commission. The program aims
to deliver on the recommendations of the Final Report of the National Ice Taskforce. It is
the first program to provide leading-edge, coordinated national research and intelligence on
illicit and licit drugs, with a specific focus on methylamphetamine and 11 other substances.
In 2016, the Australian Criminal Intelligence Commission received $3.6 million in funding
under the Proceeds of Crime Act to deliver the National Wastewater Drug Monitoring
Program over three years. The program provides a measure, rather than an estimate, of the
use of a number of illicit drugs, as well as licit drugs including nicotine, alcohol and some
pharmaceuticals. It gives us valuable insight into the trends and emerging issues of drug
consumption across Australia and can identify new sources of threat.
The findings presented in the nine reports will give law enforcement, policy, regulatory and
health agencies additional and more objective data on the use of methylamphetamine and
other drugs. This data creates opportunities to shape the response to both the demand and
the supply side of the illicit drug market, particularly in high-use areas.

IMPLEMENTATION
The Australian Criminal Intelligence Commission has contracted the University of
Queensland, and through it the University of South Australia, to deliver the program.
Relationships have been built between the universities and the operators of wastewater
facilities across Australia to permit the collection and analysis of samples.
In this report, wastewater analysis from the National Wastewater Drug Monitoring Program
measured the presence1 of the following substances:

ƒƒ methylamphetamine
ƒƒ amphetamine
ƒƒ cocaine
ƒƒ 3,4-methylenedioxymethylamphetamine (MDMA)
ƒƒ 3,4-methylenedioxyamphetamine (MDA)
ƒƒ heroin
ƒƒ mephedrone
ƒƒ methylone
ƒƒ oxycodone
ƒƒ fentanyl
ƒƒ nicotine
ƒƒ alcohol.

1 The contract recognises that threshold levels are substance dependent and will vary accordingly. Refer to
the research findings for further information on detection levels, and whether it was possible to measure all
substances.

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 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

The first five substances are widely recognised illicit stimulants. Heroin is an illicit
depressant. The next two substances, mephedrone and methylone, are illicit synthetic
stimulants and are described as new psychoactive substances (NPS).2 Oxycodone and
fentanyl are opioid pharmaceuticals with therapeutic application, but are also diverted to
the illicit market. Nicotine and alcohol are licit drugs. The Australian Criminal Intelligence
Commission will continue to review the appropriateness of the monitored substances with
its partners, stakeholders and the universities.
Both contracted universities will monitor wastewater at approximately 50 sites across
Australia until the end of 2019. It is the intention of the program that capital city sites
cover all state and territory capital cities, with the remaining sites covering regional cities
and towns. Capital city sites will be monitored for the duration of the program, while the
remaining sites will be re-assessed periodically. Sites were selected to permit the Australian
Criminal Intelligence Commission to provide data on major population areas, sites of actual
or potential concern from a drug use perspective, and sites where the local authorities have
established relationships with the two universities. In April 2018, 47 wastewater treatment
plants participated nationally.
The breakdown of sites by jurisdiction for April 2018 is as follows:

2
11
6
9
7
6 1
5

2 From Report 4, the two synthetic cannabinoids JWH-018 and JWH-073 are no longer monitored by the
National Wastewater Drug Monitoring Program as they had not been detected since monitoring commenced
in August 2016.

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Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

The Australian Criminal Intelligence Commission will continue engaging with all states
and territories in an attempt to secure their ongoing participation in sampling for future
reports. Participation from all states and territories is vital to informing our understanding
of the national picture of drug use and demand. In the event that one or more states and
territories decide not to participate in the national program in the future, the Australian
Criminal Intelligence Commission will identify replacement sites from participating states
and territories to ensure that the largest possible segment of the national population is
sampled. Accordingly, the location of sites within and between states and territories may
change over the three years of the contract.

REPORTING
National Wastewater Drug Monitoring Program reports will be published as comprehensive
public reports three times a year, as per the program contract. In accordance with current
wastewater analysis conventions, the terms of the contract, and to protect the integrity
of the program, the exact locations of wastewater treatment plants will not be publicly
released by the Australian Criminal Intelligence Commission.
To maintain the confidentiality of the participating sites, each site was allocated a unique
code so that results could be de-identified. However, trends in particular states and
territories are still able to be identified. The public reports will incorporate a discussion
of trends in drug use where distinct trends are seen—for example, between regional
areas and capital cities, or between states and territories and nationally—and will include
comparisons with testing from previous years where that data is available.
In order to inform appropriate responses, stakeholders in law enforcement, health and
other relevant policy agencies may be provided with classified information identifying actual
sampling locations.

EXPLOITATION OF THE NATIONAL WASTEWATER DRUG MONITORING

PROGRAM DATA
The Australian Criminal Intelligence Commission intends that the findings of the National
Wastewater Drug Monitoring Program analysis will be fundamental to the development
of government policy and decision making, as the reports will provide a regular, timely,
unambiguous and detailed measure of the level of demand for the listed commodities
in the Australian population, complementing other drug datasets published in Australia.
The fifth National Wastewater Drug Monitoring Program report measures drug use by
approximately 54.8 per cent of the Australian population.3 It is hoped that wastewater data
will be used with other available data sources to obtain a more comprehensive and accurate
understanding of drug markets nationally and in the respective states and territories.
The Australian Criminal Intelligence Commission continues to engage with academic
institutions, industry and public sector agencies concerning potential uses for data
generated by the National Wastewater Drug Monitoring Program. Discussions have centred
upon focusing responses in particular high risk areas, measuring drug use in particular local
areas, estimating the size of specific illicit markets, comparing wastewater data with

3 The April 2018 population estimate is based on the Australian Bureau of Statistics 2016 Census data and
catchment data supplied by the operators of the wastewater facilities and service providers.

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 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

other drug-related data and exploring options for monitoring the effectiveness of existing
demand, supply and harm reduction initiatives. The advantage the National Wastewater
Drug Monitoring Program offers in all these contexts is that the data is collected on an ongoing
basis, is reported regularly and can be shaped to accommodate changing circumstances.
Making the National Wastewater Drug Monitoring Program data available to the public
and to stakeholder agencies enriches understanding and informs the national conversation
on drug trends and related demand. Because the collection and analysis protocols are
similar, it is also possible to compare domestic drug consumption with international
drug consumption. This report includes a comparison of national methylamphetamine,
amphetamine, cocaine and MDMA consumption data with recent Sewage analysis CORe
group Europe (SCORE) consumption data for a number of European countries and the
United States of America. This again illustrates the variation that exists in drug preferences
within and between countries and may stimulate further discussions on alternative
responses to the threat posed by drug use.

Wastewater has been identified as offering an important, unified and consistent guiding
tool in developing holistic drug responses. The National Wastewater Drug Monitoring
Program is based on a well-established and internationally recognised methodology which
has been applied to varying extents by many other nations. Australia is one of the few
countries in the world where the program is funded by a national government, with the
scope of sampling in Australia generating data which will help governments at both a state
and national level to formulate appropriate responses.

ESTIMATED NATIONAL CONSUMPTION

The Australian Criminal Intelligence Commission used wastewater data collected between
August 2016 and August 2017 to estimate the annual weight of methylamphetamine,
MDMA, cocaine and heroin consumed nationally (see Table 1). While the estimates are
conservative, they provide valuable insight into Australia’s demand for illicit drugs that
could not have been gained without the program. Also included in the table is the weight of
amphetamines, cocaine, MDMA and heroin seized nationally in 2016–17.
Table 1: Estimated annual national methylamphetamine, cocaine, MDMA and heroin
consumption between August 2016 and August 2017 and national seizures for 2016–17.

Drug Estimated consumption Weight of national seizures

(kilograms) (kilograms)
Methylamphetamine 8,387 3,821a
Cocaine 3,075 4,623
MDMA 1,280 1,426
Heroin 765 224
a Granularity within drugs categorised as amphetamine-type stimulants is determined by available data. At this
time it is not possible at a national level to provide a further breakdown of drugs within the amphetamines
category. Amphetamines include amphetamine, methylamphetamine, dexamphetamine and amphetamines
not elsewhere classified. Based on available data, methylamphetamine accounts for the greatest proportion of
amphetamines seized nationally.

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Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

To put the size of the Australian methylamphetamine market into context, the total
combined estimated weight of cocaine, MDMA and heroin consumed annually equates to
around 60 per cent of the estimated weight of methylamphetamine consumed annually.
This data also illustrates the variation in the size of these markets, with the estimated
weight of methylamphetamine consumed annually being 6½ times that of MDMA and the
estimated weight of cocaine consumed annually being four times that of heroin.
In addition to providing insight into how use of the different drugs in the program compare,
when compared with the national seizure data as reported in the Illicit Drug Data Report
2016–17:
ƒƒ The weight of amphetamines seized nationally equated to 45.6 of the total estimated
weight of methylamphetamine needed to meet national demand.
ƒƒ The weight of cocaine seized nationally was one and a half times the total estimated
weight of cocaine needed to meet national demand (150.3 per cent).
ƒƒ The weight of MDMA seized nationally exceeded the total estimated weight of MDMA
needed to meet national demand (111.4 per cent).
ƒƒ The weight of heroin seized nationally equated to 29.3 per cent of the total estimated
weight of heroin required to meet national demand.

ESTIMATED STATE AND TERRITORY CONSUMPTION

The Australian Criminal Intelligence Commission used wastewater data collected between
August 2016 and August 2017 to estimate the annual weight of methylamphetamine,
MDMA, cocaine and heroin consumed in each Australian state and territory (see Table 2).4
While the estimates are conservative, they provide valuable insight into Australia’s demand
for illicit drugs that could not have been gained without the program.

Table 2: Estimated annual state and territory methylamphetamine, cocaine, MDMA and
heroin consumption.

State / Estimated drug consumption (kilograms per annum)

territory Methylamphetamine Cocaine MDMA Heroin Total
ACT 80.4 67.8 28.9 16.1 193.2
NSW 2,298.4 1,814.6 471.9 239.9 4,824.8
NT 65.5 19.5 38.2 1.1 124.3
Qld 1,277.9 323.8 223.3 75.7 1,900.7
SA 1,005.3 108.8 58.7 38.6 1,211.4
Tas 92.0 15.5 32.1 2.1 141.7
Vic 2,039.2 681.5 326.5 348.8 3,396.0
WA 1,528.3 43.8 101.3 42.5 1,715.9
National 8,387 3,075 1,280 765

4 State and territory consumption estimates were calculated using data from the first year of the program
and provide further insight into the breakdown of the previously provided national consumption estimates
for methylamphetamine, cocaine, MDMA and heroin. When the data is available, annual consumption
estimates will be calculated for the second and third year of the program to enable comparison and the
identification of any changes across the three year program.

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 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

While it is not unexpected that that the larger jurisdictions generally consume more drugs,
population size is not the only influencing factor on drug use, as illustrated by the variation
in consumption across the four drug types. This becomes more evident when the same data
is presented as a proportion of the weight of drugs consumed (see Table 3). By expressing
annual consumption estimates derived from the program as a proportion of the total weight
of methylamphetamine, cocaine, MDMA and heroin consumed in each state and territory
we are more readily able to see the variation that exists.

Table 3: Estimated annual methylamphetamine, cocaine, MDMA and heroin consumption,

as a proportion of the total weight consumed per state and territory.

Estimated annual consumption

State / territory (proportion of state/territory total consumption)
Methylamphetamine Cocaine MDMA Heroin
ACT 41.6% 35.1% 15.0% 8.3%
NSW 47.6% 37.6% 9.8% 5.0%
NT 52.7% 15.7% 30.7% 0.9%
Qld 67.2% 17.0% 11.7% 4.0%
SA 83.0% 9.0% 4.8% 3.2%
Tas 64.9% 10.9% 22.7% 1.5%
Vic 60.0% 20.1% 9.6% 10.3%
WA 89.1% 2.5% 5.9% 2.5%
Highest consumption in Australia (as a proportion of state / territory consumption) per drug type
Second highest consumption in Australia (as a proportion of state / territory consumption) per drug type

While methylamphetamine is the most consumed illicit drug measured by the National
Wastewater Drug Monitoring Program in all states and territories, there is variation in drug
preferences within and between the individual states and territories. Understanding these
preferences is important in the development and delivery of tailored responses to suit the
specific needs of individual jurisdictions. Demand for these drugs remains robust and a
shared approach that targets supply, demand and harm reduction is critical to addressing
drug use in Australia. Drug consumption estimates derived from wastewater data, when
used in combination with other data—such as seizure, arrest, price, purity, health and
self-report data—provide greater insight into the related markets and the potential impact
of supply, demand and harm reduction strategies.

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Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

EVOLUTION OF THE PROGRAM

The Australian Criminal Intelligence Commission will continue to work with the participating
universities to enhance the program. Since its launch, the program has explored and
implemented various enhancements that contribute to the delivery of better data and building
a better and more granular understanding of drug consumption in Australia. These enhancements
include the ability to compare Australia’s drug consumption with measured consumption in
different countries, and the inclusion of additional substances in the monitoring program as
new methodologies are developed and endorsed by the scientific community. Discussions also
include whether it may be possible to use alternative metabolites of some substances to more
precisely measure their consumption in the community.
The fifth National Wastewater Drug Monitoring Program report continues to provide valuable
insight into drug consumption in Australia. In addition to placing Australian drug use in
context with other countries, this report incorporates ‘bubble maps’5 which provide a visual
representation of average capital city and regional consumption. These maps facilitate the
interpretation of consumption patterns at a glance for the individual drug types in relation to
national consumption averages and European consumption averages when available.
As the report evolves, so too does the program of work, with cannabis to be included as
one of the drugs monitored by the National Wastewater Drug Monitoring Program from
Report 6 in December 2018. This will provide further insight into one of the largest illicit drug
markets in Australia.
Wastewater data is an important part of the suite of datasets available to increase our
understanding of drug consumption, demand and supply in Australia. The Australian Criminal
Intelligence Commission is working to ensure the broadest possible range of stakeholders are
engaged throughout the life of the program, consulting with stakeholders through existing drug
forums and direct discussions with agencies. This includes working with industry to increase
our understanding of drug markets in Australia.

RESULTS FROM THE INITIAL COLLECTION

This fifth report of the National Wastewater Drug Monitoring Program builds on national drug
consumption data contained in the preceding four public reports to identify drug use patterns
across states, territories and the nation. It provides data on capital city and regional drug use and,
where possible, comparisons with previous levels of use in sites across Australia and internationally.
This, and future reports, will contribute further data to identify trends, changes in patterns of use
and emerging issues, building a comprehensive and increasingly detailed picture of national drug
consumption. Benefits of longitudinal wastewater data include the identification of emerging trends
and patterns of use. This concept is best illustrated by the fentanyl data. The weighted average
consumption of fentanyl in both capital city and regional sites increased from December 2017 to
April 2018 and are both currently the highest recorded levels since the program began.
Reported results reflect per capita use in all locations and, with the exception of MDA (for
which a reliable dose figure is not available), are expressed in terms of both the number
of doses and the weight or volume per capita of the respective substances, to facilitate
comparison between substances.

5 Bubble maps display graduated symbols showing different magnitudes of drug use derived from consumption
estimates.

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RESEARCH FINDINGS
Prepared by the University of Queensland (B Tscharke, R Mackie,
J O’Brien, S Grant, J Mueller) and University of South Australia
(M Ghetia, H Aghera, R Bade, C Gerber, J White)

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Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

LIST OF ABBREVIATIONS:
ABS Australian Bureau of Statistics
ACIC Australian Criminal Intelligence Commission
ACT Australian Capital Territory
DASSA Drug and Alcohol Services South Australia
LC-MS/MS Liquid chromatography tandem mass spectrometry
LOD Limit of detection
LOR Limit of reporting
MDA 3,4-methylenedioxyamphetamine
MDMA 3,4-methylenedioxymethylamphetamine
NPS New psychoactive substances
NSW New South Wales
NT Northern Territory
NWDMP National Wastewater Drug Monitoring Program
Qld Queensland
SA South Australia
SPE Solid phase extraction
Tas Tasmania
Vic Victoria
WA Western Australia
WWTP Wastewater Treatment Plant

TERMINOLOGY:
Methylamphetamine is also commonly known as methamphetamine. In this report, consistent
with the preferences of the Australian Criminal Intelligence Commission, methylamphetamine
is used.
MDMA is commonly known as ecstasy.
Alcohol consumption in this report refers to ethanol consumption, but the more general term
alcohol is used throughout.
Nicotine consumption has replaced tobacco consumption in this report as the target metabolites
may also be derived from nicotine replacement products, such as gums and patches.

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 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

1: EXECUTIVE SUMMARY
Wastewater analysis has become a standard method for measuring population-scale
use of a range of different chemical compounds. The underlying concepts involved in
wastewater analysis were demonstrated in the first national Australian report released in
March 2017. Estimates of drug usage in a population were back-calculated from measured
concentrations of drug metabolites (excreted into the sewer system after consumption) in
wastewater samples. Spatial and temporal trends in drug use have now been included using
this approach for several sites across Australia. The National Wastewater Drug Monitoring
Program (NWDMP) for the Australian Criminal Intelligence Commission (ACIC) monitors
selected substances of concern in most populated regions of Australia. The study now
focuses on twelve licit and illicit drugs, including nicotine, alcohol, methylamphetamine,
cocaine, MDMA (ecstasy) and heroin. Trends in estimated drug consumption are being
established over the three-year project. Wastewater treatment plants (WWTPs) located
across capital cities and regional Australia, covering all states and territories, have been
invited to participate in this program. An additional graph set has been included for the
first time in this report, comparing aggregated consumption estimates per jurisdiction on
a bubble map of Australia. Additionally, this report has included updated international
comparisons, comparing recent Australian results to the Sewage analysis CORe group
Europe (SCORE) dataset for sites involved in the 2017 SCORE study.
For this fifth report, wastewater samples were collected during weeks of February and
April 2018. Twenty-four-hour composite wastewater samples were collected using
time-proportional or flow-proportional autosamplers at the influent of each WWTP by
plant operators. Samples were collected for up to seven consecutive days. Concentrations
of drug metabolites were determined in the wastewater using liquid chromatography-
tandem mass spectrometry (LC-MS/MS) analytical methods. Drug consumption estimates
for each catchment population were calculated from these measured concentrations using
flow volumes and estimates of the catchment population size by evaluating census data
vs catchment maps, together with excretion and dose data obtained from the scientific
literature. A total of 20 WWTPs in capital cities and a further 27 regional sites participated
in the project for the April 2018 period, covering a population of more than 12 million
Australians. To maintain treatment plant confidentiality, each site was allocated a unique
code and site names are not included in this report. Data from this report equates to
coverage of approximately 48 per cent and 55 per cent of Australia’s population for
February and April, respectively. A total of 2,284 individual daily samples have been
assessed since the beginning of the program, with new results from 445 additional samples
added in this report. The collected samples provide relatively comprehensive,
Australia-wide baseline data against which subsequent results can continue to be
compared to ascertain both spatial and temporal trends.

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National Wastewater Drug Monitoring Program—Report 5, August 2018

The estimated drug usage across the 47 sites (April 2018) was consistent with previous
reports. After normalising the amount of drug measured in wastewater for population size
and average dose consumed, alcohol and nicotine were consistently the highest consumed
drugs in all states and territories. Estimated consumption of nicotine was generally higher
in regional areas compared to capital cities. In the case of alcohol, the difference was less
pronounced. The Northern Territory had the highest consumption of nicotine and alcohol,
but with only two participating sites the results may not be representative of the Territory
as a whole. In other parts of Australia alcohol consumption was similar for the most part,
except for regional South Australia, where it was relatively low. Nicotine use across the
nation was fairly consistent.
Methylamphetamine remains the highest of the illicit drugs included in the report, both
in capital cities and regional sites and shows no tendency to decline. The highest
methylamphetamine levels were seen in Northern Territory (capital city) and Western
Australia (regional).
Amphetamine is a metabolite of methylamphetamine and measured amphetamine
concentrations across the sites were consistent with the observed levels being primarily
related to methylamphetamine metabolism rather than sourced from direct consumption.
Compared to methylamphetamine, estimated usage of other stimulants was generally
much lower, although no consistent pattern (profile) of usage for these other drugs could
be observed between states and territories. Cocaine consumption in Australia is mostly
centred in New South Wales across several capital city and regional sites, with high levels of
consumption also recorded in the Australian Capital Territory. At sites elsewhere around the
country usage was low in comparison. MDMA usage was similarly low across most sites with
a few site-specific exceptions.
Oxycodone and fentanyl, which are both prescription pharmaceutical substances with abuse
potential, had elevated consumption levels at several regional sites. Regional areas had
average oxycodone use well above capital city sites in many states. Consumption of heroin
varied widely, with minimal amounts detected in the Northern Territory and high levels
recorded in Victoria.
After removing the proportion of MDA attributable from MDMA metabolism, use of
the drug appeared variable across the nation. For the other drugs included in this study,
methylone and mephedrone concentrations were generally at or below detection levels at
all participating sites.
The collection of wastewater samples at regular intervals allowed for the temporal
comparison of consumption data. While small overall changes were evident at both a site
and a state or territory level, more data are required to draw longer term conclusions. The
recent declines in methylamphetamine use in South Australia and Western Australia are
clear reversals in longer term trends.

18
 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

2: INTRODUCTION
2.1 PREAMBLE
Wastewater analysis is a technique for delivering population-scale consumption of
substances. The University of Queensland and University of South Australia have been
commissioned to provide drug consumption data to ACIC for a period of three years,
beginning in August 2016. Wastewater treatment sites are assessed bimonthly in the case
of capital city sites and every four months for regional sites. The aim is to acquire data on
the population-scale use of substances that cause potential harm, either through addiction,
health risks, or criminal and anti-social behaviour. The intention is to establish baseline data
of substance use across Australia. This fifth NWDMP report compares consumption data
from the first four reports with results obtained subsequently from February and April 2018.
Compounds of concern include nicotine from nicotine intake (cigarettes, gum, patches,
e-cigarettes, etc.), ethanol from alcohol intake, pharmaceutical opioids with abuse
potential, illicit substances such as methylamphetamine, MDMA, cocaine and heroin as
well as a number of new psychoactive substances (NPS). The compounds amphetamine
and MDA were measured but not included in the initial reports. Amphetamine is a by-
product of methylamphetamine pyrolysis and is also one of its metabolites. We found
the levels of amphetamine to correspond consistently with the expected values from the
excretion of methylamphetamine. MDA is a metabolite of MDMA, but since the proportion
of MDA derived from MDMA is known, the difference between measured MDA and
MDMA metabolite has now been included in the current report. The amount of MDA was
calculated by subtracting 1.65 mg of MDA for every 100 mg of MDMA consumed
(Pizarro et al. 2002; Khan & Nicell 2011). The report presents patterns of substance use
across Australia, showing differences in levels between capital cities and regional centres,
within states and territories, and nationally.

19
Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

3: METHODS
The method underlying wastewater based monitoring of drug use in a given population is
based on the principle that any given compound that is consumed (irrespective of whether
it is swallowed, inhaled/smoked or injected) will subsequently be excreted (either in the
chemical form it is consumed and/or in a chemically modified form that is referred to as
a metabolite). The excreted compound or metabolite will eventually arrive in the sewer
system. The drugs and their metabolites of interest in this study are given in the first
NWDMP report (available at www.acic.gov.au), as well as an in-depth description of the
methodologies involved.6 Collectively, waste products in the sewer system arrive at a WWTP
where wastewater samples are collected over a defined sampling period. Measuring the
amount of target compound in the wastewater stream allows for a back-calculation factor
to be applied to determine the amount of drug that was used over the collection period
(Figure 1). The method is non-invasive and is done on a population-scale level, so individuals
are not targeted and privacy is respected.
Figure 1: Schematic of the population catchment area and methodology employed to
convert measured concentration of substances in wastewater to mass loads or doses
consumed per day per normalised population.

DOSES OF DRUG CONSUMED/1000 PEOPLE

(calculated)
(number of doses of drug consumed on average by 1000 people
in the catchment in 24 hours)

Divide by the mass of

Community drug typically
consumed in one go
(i.e. the standard dose)

MASS OF DRUG CONSUMED/1000 PEOPLE

(calculated)
(grams of drug consumed on average by 1000 people
in the catchment in 24 hours)
Community-wide facilities Divide by excretion rate i.e.
e.g. shopping malls/ the mass of metabolite
hotels/events/ Community excreted for every unit of drug
consumed, and multiply by the
offices/ services
CATCHMENT difference in molecular weight
industry e.g. hospitals/ between the drug and its’
POPULATION universities/ metabolite
prisons MASS OF METABOLITE EXCRETED/1000 PEOPLE
(calculated)
(grams of metabolite excreted on average by 1000 people
in the catchment in 24 hours)
CONCENTRATION OF EXCRETED
METABOLITE Divide by catchment
(measured) Autosampler at population
(wastewater entering the WWTP is sampled over a (thousands of people)
24 hour period. The average concentration of
WWTP
metabolite is measured, inlet
i.e. grams of metabolite per litre of wastewater) TOTAL MASS OF METABOLITE EXCRETED
(calculated)
Wastewater Multiply concentration by total volume (total grams of excreted metabolite that reaches
treatment plant of wastewater flowing into WWTP the WWTP from the catchment in 24 hours)
over 24 hours
(WWTP)

To obtain an estimate of drug use, representative samples are collected over a given period
(typically 24 hours) using autosamplers that collect time or flow proportional samples.
Wastewater treatment plant operators provide assistance with collecting the samples from
the influent autosampler (where the wastewater enters the treatment plants). Details of the
calculation methods are given in Report 1.

6 Information in relation to heroin appears in Report 3.

20
 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Collected wastewater samples were analysed at the University of South Australia and the
University of Queensland laboratories. The steps routinely performed in our laboratories
are based on filtration of the samples followed by an enrichment/concentration step where
the concentrated sample is injected, or (for chemicals with sufficiently high concentrations)
direct injection of samples into the analytical instruments. The instrumental analysis
consists of chromatographic separation and subsequent compound specific detection.
A summary of the extraction and analytical methods is given in Report 1. An updated
excretion and dose table including the heroin specific metabolite, 6-monoacetylmorphine,
can be found in Appendix 1.

3.1 PARTICIPATING WASTEWATER TREATMENT PLANTS (WWTPS)

Forty-seven WWTPs across Australia participated in this study for the April 2018 collection
(Figure 2). Of these, 20 sites were located in capital cities and a further 27 were regional
sites, covering a wide range of catchment population sizes. Sites were selected by the
ACIC. The number of participating sites for February and April 2018 is listed in Table 4 and
Appendix 2. A complete list of participating sites, number of samples and relative catchment
sizes are listed in Appendix 3. To maintain the confidentiality of the participating sites, all
sites were allocated a unique code to de-identify their results. Only site codes are presented
in the results sections.
Figure 2: Participating WWTPs in April 2018, showing the number of capital city and
regional plants by state and territory. The colours in this figure are matched with others in
Participating WWTPs per State/Territory
the remainder of the report to identify results relating to individual states and territories.

1C
1R 3C
3C
8R
3R
4C
5R
3C
4R
1C
C = Capital city WWTP
R = Regional WWTP 2C
3C 4R
2R
21
Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Table 4: Number of participating WWTPs for the periods covered in this report. Every
second collection period aims to collect data from both regional (R) and capital city (C)
sites (April), while the in-between collection periods (February) aim to collect data from
capital city sites only.

Feb–18 Apr–18
State/territory C R C R
ACT 1 - 1 -
NSW 3 - 3 4
NT - - 1 1
Qld 3 - 3 8
SA 4 - 4 5
Tas 3 - 3 2
Vic 2 - 2 4
WA 3 - 3 3
Population (millions) C & R 11.2 - 11.2 1.6
Total population (millions) 11.2 12.8
% of Australian population 47.9% 54.8%
Estimates have been rounded to the nearest 0.1 million. 2016 Census population used for population percentage
estimates.

3.2 SAMPLE COLLECTION AND PREPARATION

Daily composite samples were collected by treatment plant staff on seven consecutive
days, or where seven days was not feasible, across as many consecutive days as possible.
Regional sites in South Australia provided weekend samples for the first time, which should
be considered when interpreting historical results—see Appendix 3. Samples were stored at
4oC or were frozen prior to transport to Adelaide or Brisbane. Further details of the sampling
protocol and relevant quality controls are included in Irvine et al. (2011), Lai et al. (2011),
Lai et al. (2015) and Tscharke et al. (2016). All other descriptions of calculations, extractions
and analytical methods are outlined in Report 1 (available at www.acic.gov.au).

3.3 PRESENTATION OF DATA AND INTERPRETATION OF GRAPHS

Reported averages: All averages for state/territory or Australia-wide drug consumption
data are presented throughout this report as population weighted averages. The number
of people in the catchment population is used as the weighting for the respective drug
consumption data for that population. For example, to calculate the population weighted
average of capital city methylamphetamine consumption, the methylamphetamine
consumption data for each WWTP was multiplied by the respective population number,
all data were then summed and divided by the total population across all capital city sites.
Reported average values are therefore not skewed towards usage data from small,
non-representative populations.

22
 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Per capita consumption: The per capita consumption estimates presented in this report
are calculated using the total estimated catchment population (which includes children).
For example, per capita alcohol consumption has previously been reported by the Australian
Bureau of Statistics (ABS) based on population numbers for people aged 15 and over. The
consumption values presented in the current report will be under-estimated compared to
those determined for an adult-only population. For consistency, data from other studies
included in this report were recalculated where necessary using estimated total population.
Graphical presentation of data: An overview of how the data is presented in the graphs
for the individual sites and bubble maps is given in Figure 3. This includes information
on interpreting the consumption data presented on the vertical axes in all graphs in this
report. In some graphs the values plotted in the graph can be read as either mass of drug
consumed (left axis), or doses of drug consumed (right axis). For the specific case of MDA,
the amount of MDA excreted following MDA consumption is not known, and therefore for
this drug we can only express the results as how much drug was excreted into the sewer
network, e.g. the mg excreted per 1,000 people per day.
Figure 3: Explanation of the graphical representation of data for individual sites and
bubble maps.

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23
Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Figure 3 (continued): Explanation of the graphical representation of data for individual

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Instrumental method limits of detection and limits of reporting: Since the wastewater
samples contain very low quantities of particular drugs, the limit of detection (LOD) was
determined analytically as the lowest concentration of that drug that could be determined
in the sample (using the methods described in Report 1). A drug may be present at a
concentration below the LOD. However, trace quantities may be present at undetectable levels.
The limit of reporting (LOR) is a concentration (higher than the LOD), above which we have high
confidence that the concentration measured on the analytical instrument is accurate. Above
the LOD but below the LOR there may be some uncertainty as to the actual concentration.
To be conservative (a drug may be present but there is uncertainty as to its concentration)
and in line with current practise, for back calculations to estimate per capita consumption, a
concentration below the LOD is included as a value of LOD. A concentration above the LOD but
below LOR, is included at the midpoint between the LOD and LOR (i.e. (LOD + LOR)/2).
Weekly pattern of drug use: The pattern of drug use over the sampling week for the sites in
this report cannot be elucidated from the data included in the current report since the start
of collection weeks did not always correspond for every plant. We present only maximum,
minimum and average (for the individual sites) and only average (or population weighted
average, see above) values for all other graphs. Consistent patterns of drug use in Australia
from previous wastewater-based epidemiology studies indicate that some illicit drugs such
as cocaine, MDMA, mephedrone and methylone have high variation in weekly consumption
rates, with higher consumption on weekends. Other drugs such as methylamphetamine,
oxycodone and fentanyl appear to have lower daily variation suggesting that their
consumption is consistent throughout the week (Lai et al. 2015; Tscharke et al. 2016).

24
 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

4: RESULTS
Estimated drug consumption data are presented in several different ways in the following
sections to allow comparisons of drug use at the individual site level (section 4.1), between
states and territories (section 4.2) and within each state and territory (section 4.3).
We recommend exercising caution when comparing results between sites as some plants
provided samples for fewer days than others and the collection week did not correspond in
all instances. A list of the detection frequency for each drug can be found in Appendix 4.
This report retained the current population estimates introduced in Report 4 by integrating
the specific wastewater catchment areas against the high-resolution population data
recently released from the 2016 Census. The uncertainties in individual population
estimates have less impact when data are averaged, for example when broader comparisons
at the state/territory or international level are undertaken. The uncertainties in population
numbers are particularly evident in smaller regional communities or sites where short-term
population changes occur due to employment opportunities, tourism or festival events.

4.1 INDIVIDUAL SITE COMPARISON OF DRUG USE IN APRIL 2018

4.1.1 NICOTINE AND ALCOHOL
Consumption of tobacco was estimated by measuring two nicotine metabolites. Since the
method does not distinguish between nicotine intake from tobacco or electronic cigarettes
and nicotine replacement therapies such as patches and gums, the estimate is reported
as nicotine in this report. Nicotine consumption varied significantly between sites and
regions (Figure 4). Sites in regional areas across all states and territories showed noticeably
higher per capita consumption levels during April 2018 than capital city precincts. This was
evident from the regional vs capital city averages for the sampling period (red horizontal
and dotted blue lines, Figure 4). Capital city sites in Northern Territory and Tasmania had
the highest weekly consumption, while some regional New South Wales, Northern Territory,
Queensland and Tasmania sites had well above average levels.
Figure 4: Estimated nicotine consumption for April 2018 in mass of nicotine consumed
per day (left axis) and number of cigarettes per day (right axis) per thousand people.
from 5-7. Average
The number of collection days varied Average Average

6000
Nicotine
4500

5000 4000
(Cigarettes / 1000 People / Day)

Dose
(mg Nicotine / 1000 People / Day)

1.25
Estimated Consumption

3500
4000
Estimated Consumption

3000

2500
3000

2000

2000
1500

1000
1000
500

0 ** * * * * * * * * * * * 0
009
003
006
008
021
071
016
025
040
051
068
081
115
010
085
078
002
005
011
012
020
024
028
029
033
039
092
077
007
013
027
059
017
022
063
076
117
119
004
019
041
018
038
048
058
001
067
037
046
061
062
066
114
101
103
104
102
116
118
120

ACT NSW NT Qld SA Tas Vic WA

All Site Capital Regional
Capital Regional * No Data
Average Average Average

ƒƒ High regional average ƒƒ Variable weekly levels

25
Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Alcohol was measured using a specific metabolite of ethanol. The capital city average
was lower than the regional centre alcohol consumption, but the difference was less
pronounced than for nicotine (Figure 5). Many sites showed a wide range over the
collection week. Alcohol consumption in some regional areas of Western Australia and
South Australia were well below the national average. The Northern Territory, capital sites
of Tasmania and a couple of Western Australian sites were above the national capital city
and regional averages.
Figure 5: Estimated alcohol consumption for April 2018 in volume consumed per day
(left axis) and standard drinks per day (right axis) per thousand people. The number of
collection days varied from 5-7.

80
Alcohol
6000 Dose
10000mg
70

(Standard Drinks / 1000 People / Day)

5000
60
(Litres of Ethanol / 1000 People / Day)

Estimated Consumption
50 4000
Estimated Consumption

40
3000

30
2000
20

1000
10

0 ** * * * * * * * * * * * 0
009
003
006
008
021
071
016
025
040
051
068
081
115
010
085
078
002
005
011
012
020
024
028
029
033
039
092
077
007
013
027
059
017
022
063
076
117
119
004
019
041
018
038
048
058
001
067
037
046
061
062
066
114
101
103
104
102
116
118
120
ACT NSW NT Qld SA Tas Vic WA
All Site Capital Regional
Capital Regional * No Data
Average Average Average

ƒƒ Capital city averages higher than regional ƒƒ Relatively high level in the Northern Territory
ƒƒ Wide weekly spread

The same information can be represented in a pictorial way by showing the relative scale of
use of nicotine (Figure 6) and alcohol (Figure 7) as capital city or regional ‘bubbles’ for each
state and territory.

26
 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Figure 6: Estimated nicotine consumption per jurisdiction for April 2018 in number of
cigarettes per day per thousand people. The number of collection days varied from 5-7.

Capital Regional

Nicotine consumption
(Cigarettes/1000 People/Day)
877–1438
1438–1620

1620–1983

1983–2617

2617–4406

Average nicotine consumption for comparison

Europe
All site Capital Regional

Figure 7: Estimated alcohol consumption per jurisdiction for April 2018 in number of standard
drinks per day per thousand people. The number of collection days varied from 5-7.

Capital Regional

Alcohol consumption
(Standard Drinks/1000 People/Day)
502–1025
1025–1177

1177–1306

1306–1605

1605–3542

Average alcohol consumption for comparison

Europe
All site Capital Regional

27
Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

4.1.2 STIMULANTS
The relative estimated consumption levels across the participating sites for four stimulants,
methylamphetamine, cocaine, MDMA and MDA are described in more detail below.
4.1.2.1 METHYLAMPHETAMINE
Estimated mass loads of methylamphetamine were high compared to other illicit
substances. Unlike previous reports, the average regional loads were well above capital city
consumption levels (Figure 8). However, large site differences were still evident, particularly
in regional areas. The high variability in consumption was observed across all states.
Differences in mass loads between capital cities were less obvious in April 2018 than in
previous periods. The highest regional levels appeared at sites in Queensland, Victoria and
Western Australia. Some sites showed a wide range in levels over the sampling week, which
is unusual for a habitually used substance.
Figure 8: Estimated methylamphetamine consumption for April 2018 in mass consumed
per day (left axis) and doses per day (right axis) per thousand people. The number of
collection days varied from 5-7.

4500
Methylamphetamine Dose
30

140
4000

120
3500

(Doses / 1000 People / Day)

(mg / 1000 People / Day)
Estimated Consumption

Estimated Consumption
3000 100

2500
80

2000
60
1500
40
1000

20
500

0 ** * * * * * * * * * * * 0
009
003
006
008
021
071
016
025
040
051
068
081
115
010
085
078
002
005
011
012
020
024
028
029
033
039
092
077
007
013
027
059
017
022
063
076
117
119
004
019
041
018
038
048
058
001
067
037
046
061
062
066
114
101
103
104
102
116
118
120

ACT NSW NT Qld SA Tas Vic WA

All Site Capital Regional
Capital Regional * No Data
Average Average Average

ƒƒ Regional averages higher than capital cities ƒƒ Highest mass load in a regional Victoria site
ƒƒ Capital city levels relatively similar ƒƒ Variable across sites

4.1.2.2 AMPHETAMINE
The concentration of amphetamine observed in the August 2016 and December 2017
samples strongly correlated with the methylamphetamine concentrations, with approximately
7 times higher methylamphetamine measured than amphetamine for both periods (see
Appendix 4 of Report 1) which is consistent with the reported amphetamine excretion
range following methylamphetamine consumption (Gracia-Lor et al. 2016). Therefore, we
assumed that the levels of amphetamine measured were predominantly metabolites of
methylamphetamine. It is possible that some of the amphetamine measured could be a result
of amphetamine ingestion. But, due to the much higher methylamphetamine consumption
and excretion profile, this cannot be confirmed by our present data.

28
 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

4.1.2.3 COCAINE
Cocaine was measured using its specific metabolite, benzoylecgonine. Unlike
methylamphetamine, capital city areas on average had higher cocaine use than regional
centres (Figure 9). Tasmania, South Australia and Western Australia had relatively low
consumption in both regional and capital city areas. In contrast, capital city New South
Wales showed the highest levels nationwide, while consumption in regional parts of the
state were also higher than the national average. Nevertheless, the scale of cocaine use in
Australia remained noticeably lower than methylamphetamine levels.
Figure 9: Estimated cocaine consumption for April 2018 in mass consumed per day per
thousand people (left axis) and doses per day (right axis). The number of collection days
varied from 5-7.

4000
Cocaine 40 Dose
10

3500 35

3000 30

(Doses / 1000 People / Day)

(mg / 1000 People / Day)
Estimated Consumption

Estimated Consumption
2500 25

2000 20

1500 15

1000 10

500 5

0 ** * * * * * * * * * * * 0
051

092

048

116
009
003
006
008
021
071
016
025
040
068
081
115
010
085
078
002
005
011
012
020
024
028
029
033
039
077
007
013
027
059
017
022
063
076
117
119
004
019
041
018
038
058
001
067
037
046
061
062
066
114
101
103
104
102
118
120
ACT NSW NT Qld SA Tas Vic WA
All Site Capital Regional
Capital Regional * No Data
Average Average Average

ƒƒ High levels in city sites ƒƒ Regional consumption low

4.1.2.4 MDMA (3,4-METHYLENEDIOXYMETHYLAMPHETAMINE)

In comparison with other illicit substances, estimated consumption of MDMA was low
across the country (Figure 10). Sites in capital city Northern Territory and New South Wales
had relatively high levels on across the week. In general, capital city levels were comparable
across the nation. The regional average was slightly higher than capital city sites. A direct
comparison of regional and capital city sites in some regions (e.g. Tasmania) may be
inappropriate as a few regional sites did not sample on weekends when MDMA consumption
is typically higher.

29
Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Figure 10: Estimated MDMA consumption for April 2018 in mass consumed per day (left
axis) and doses per day (right axis) per thousand people. The number of collection days
varied from 5-7. Average Average Average

1600
MDMA 16

1400 14
Dose
100
1200 12

(Doses / 1000 People / Day)

(mg / 1000 People / Day)
Estimated Consumption

Estimated Consumption
1000 10

800 8

600 6

400 4

200 2

0 ** * * * * * * * * * * * 0
009
003
006
008
021
071
016
025
040
051
068
081
115
010
085
078
002
005
011
012
020
024
028
029
033
039
092
077
007
013
027
059
017
022
063
076
117
119
004
019
041
018
038
048
058
001
067
037
046
061
062
066
114
101
103
104
102
116
118
120
ACT NSW NT Qld SA Tas Vic WA
All Site Capital Regional
Capital Regional * No Data
Average Average Average

ƒƒ Low use across the country ƒƒ Wide weekly spread indicates higher weekend use

4.1.2.5 MDA (3,4-METHYLENEDIOXYAMPHETAMINE)

MDA previously had low overall detection frequency using a direct injection method. In
this latest report, the compound was detected after concentrating the sample using solid
phase extraction (SPE) prior to analysis to improve the sensitivity of the method. Data is
not available in the scientific literature for the proportion of MDA that is eliminated after
MDA consumption. However, data is available detailing the proportion of MDA eliminated
after MDMA consumption. Therefore, the proportion of MDA attributable from MDMA
metabolism was subtracted from the total measured amount of MDA for each site. Data
for MDA is expressed as mg excreted per 1,000 people per day and cannot be expressed as
consumption due to the lack of metabolic information of MDA elimination following MDA
consumption. Although the dosage of MDA is not known, it is likely to be similar to that of
MDMA, of around 100 mg. The daily mass loads for regional sites were on average higher
than capital cities (Figure 11). Sites 25 in New South Wales and 28 in Queensland had very
high levels on some sampling days compared to other sites in the states and elsewhere.
Since the parent drug is measured in wastewater, disposal of unused drug into the sewer
system may result in unusually high values being recorded. Tasmania generally had the
highest levels of MDA in capital city cites.

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 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Figure 11: Estimated MDA consumption for April 2018 in mass consumed per day per
thousand people. The number of collection
Average days varied
Averagefrom 5-7.
Average

MDA DECIDE ON DOSES

Dose
100 100 3

90 90

80 80

(mg / 1000 People / Day)

Estimated Consumption
(mg / 1000 People / Day)

70 70
Estimated Consumption

60 60

50 50

40 40

30 30

20 20

10 10

0 ** * * * * * * * * * * * 0
009
003
006
008
021
071
016
025
040
051
068
081
115
010
085
078
002
005
011
012
020
024
028
029
033
039
092
077
007
013
027
059
017
022
063
076
117
119
004
019
041
018
038
048
058
001
067
037
046
061
062
066
114
101
103
104
102
116
118
120
ACT NSW NT Qld SA Tas Vic WA
All Site Capital Regional
Capital Regional * No Data
Average Average Average

ƒƒ Higher regional average ƒƒ Tasmania capital city levels highest

ƒƒ Very high levels on some days at sites 25 and 28

The scale of use of each stimulant is showed as bubble graphs. Regional and capital city
use of methamphetamine (Figure 12), cocaine (Figure 13), MDMA (Figure 14) and MDA
(Figure 15) are all represented to reflect the proportion of drug use across the country.
The popularity of cocaine on the eastern seaboard is apparent. Compared to European
levels, methamphetamine use is the clear exception, being much more prominent in
Australia. All the other stimulants were below European averages.

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Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Figure 12: Estimated methylamphetamine consumption per jurisdiction for April 2018 in
mg consumed per day per thousand people. The number of collection days varied from
5-7. The Europe population-weighted average is from the SCORE dataset, March 2017.

Capital Regional

Methylamphetamine consumption
(mg/1000 People/Day)
77–676
676–891

89–1136

1136–1274

1274–1735

Average methylamphetamine consumption for comparison

Europe All site Capital Regional

Figure 13: Estimated cocaine consumption per jurisdiction for April 2018 in mg consumed
per day per thousand people. The number of collection days varied from 5-7. The Europe
population-weighted average is from the SCORE dataset, March 2017.

Capital Regional

Cocaine consumption
(mg/1000 People/Day)
35–63
63–254

254–345

345–506

506–1011

Average cocaine consumption for comparison

Europe All site Capital Regional

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 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Figure 14: Estimated MDMA consumption per jurisdiction for April 2018 in mg consumed
per day per thousand people. The number of collection days varied from 5-7. The Europe
population-weighted average is from the SCORE dataset, March 2017.

Capital Regional

MDMA consumption
(mg/1000 People/Day)
41.7–65.9
65.9–86.5

86.5–95.4

95.4–139.2

139.2–411.9

Average MDMA consumption for comparison

Europe All site Capital Regional

Figure 15: Estimated MDA consumption per jurisdiction for April 2018 in mg consumed
per day per thousand people. The number of collection days varied from 5-7.

Capital Regional

MDA consumption
(mg/1000 People/Day)
1.3–3.8
3.8–5.3

5.3–7.2

7.2–9.2

9.2–21.0

Average MDA consumption for comparison

All site Capital Regional

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Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

4.1.3 OPIOIDS
Two pharmaceutical opioids were measured, as well as heroin, an illicit drug.
4.1.3.1 PHARMACEUTICAL OPIOIDS
Oxycodone and fentanyl are legally prescribed pharmaceuticals with abuse potential.
Although wastewater analysis cannot be used to differentiate between prescribed and
illicit use, the relative scale of use of these substances remain of interest. The metabolism
and excretion of both compounds are well characterised. The major metabolite of each
compound was measured to estimate drug consumption.
Consumption of oxycodone in regional sites was well above capital city levels, with the regional
national average being substantially higher than that of the capital cities (Figure 16). Regional
Victoria and capital city sites of Tasmania were amongst the highest overall users of oxycodone.
Figure 16: Estimated oxycodone consumption for April 2018 in mass consumed per day
(left axis) and doses per day (right axis) per thousand people. The number of collection
days varied from 5-7. Average Average Average

800
Oxycodone 40
Dose
20
700 35

600 30

(Doses / 1000 People / Day)

(mg / 1000 People / Day)

Estimated Consumption
Estimated Consumption

500 25

400 20

300 15

200 10

100 5

0 ** * * * * * * * * * * * 0
009
003
006
008
021
071
016
025
040
051
068
081
115
010
085
078
002
005
011
012
020
024
028
029
033
039
092
077
007
013
027
059
017
022
063
076
117
119
004
019
041
018
038
048
058
001
067
037
046
061
062
066
114
101
103
104
102
116
118
120

ACT NSW NT Qld SA Tas Vic WA

All Site Capital Regional
Capital Regional * No Data
Average Average Average

ƒƒ Higher and variable regional average ƒƒ Highest capital sites in Tasmania

The extent of fentanyl use was very variable across the nation. The regional average
exceeded the capital city by a large margin, mainly because of some regional centres
in New South Wales, Queensland and South Australia increasing the national average
(Figure 17). Tasmania was the exception. Rates of fentanyl use in capital cities across
Australia were of comparable levels, apart from high levels in Tasmania and a few sites
in other states with very low measured amounts.

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 Australian Criminal Intelligence Commission
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Figure 17: Estimated fentanyl consumption for April 2018 in mass consumed per day
(left axis) and doses per day (right axis) per thousand people. The number of collection
days varied from 5-7. Average Average Average

10
Fentanyl 30

9
25 Dose
8 0
(mg / 1000 People / Day)

(Doses / 1000 People / Day)

7
Estimated Consumption

Estimated Consumption
20
6

5 15

4
10
3

2
5
1

0 ** * * * * * * * * * * * 0
051

092

048

116
009
003
006
008
021
071
016
025
040
068
081
115
010
085
078
002
005
011
012
020
024
028
029
033
039
077
007
013
027
059
017
022
063
076
117
119
004
019
041
018
038
058
001
067
037
046
061
062
066
114
101
103
104
102
118
120
ACT NSW NT Qld SA Tas Vic WA
All Site Capital Regional
Capital Regional * No Data
Average Average Average

ƒƒ Higher and variable regional average

ƒƒ Regional sites in New South Wales, Queensland and South Australia unusually high
−− Raises regional average

4.1.3.2 HEROIN
Heroin is metabolised by users and excreted in low amounts as the unique metabolite,
6-monoacetylmorphine (6-MAM). A method to detect heroin by 6-monoacetylmorphine was
described in a paper by Tscharke et al. (2016). Since 6-MAM is characteristic of heroin use, it
can be used to distinguish heroin from other opioids such as morphine and codeine. Heroin
consumption in Australia in April 2018 was relatively low, with regional centres having lower
consumption on average compared to capital cities (Figure 18). Some capital city areas of New
South Wales and Victoria recorded the highest levels of all measured locations.
The relative scale of oxycodone and fentanyl use is apparent when results are presented
in bubble graph form. Oxycodone consumption in capital cities and Western Australia are
noticeably lower (Figure 19), while fentanyl use in regional centres is high compared to
capital cities (Figure 20). The elevated heroin consumption in the south eastern parts of the
country is clearly evident from the bubble graph (Figure 21).

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Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Figure 18: Estimated heroin consumption for April 2018 in mass consumed per day (left axis)
and doses per day (right axis) per thousand people. The number of collection days varied
from 5-7. Average Average Average

600
Heroin 30

Dose
500 25 20

(Doses / 1000 People / Day)

Estimated Consumption
(mg / 1000 People / Day)

400 20
Estimated Consumption

300 15

200 10

100 5

0 ** * * * * * * * * * * * 0
009
003
006
008
021
071
016
025
040
051
068
081
115
010
085
078
002
005
011
012
020
024
028
029
033
039
092
077
007
013
027
059
017
022
063
076
117
119
004
019
041
018
038
048
058
001
067
037
046
061
062
066
114
101
103
104
102
116
118
120
ACT NSW NT Qld SA Tas Vic WA
All Site Capital Regional
Capital Regional * No Data
Average Average Average

ƒƒ Lower regional use ƒƒ High consumption in Victoria Site 67

Figure 19: Estimated oxycodone consumption per jurisdiction for April 2018 in mg
consumed per day per thousand people. The number of collection days varied from 5-7.

Capital Regional

Oxycodone consumption
(mg/1000 People/Day)
29–60
60–78

78–114

114–165

165–246

Average oxycodone consumption for comparison

All site Capital Regional

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 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Figure 20: Estimated fentanyl consumption per jurisdiction for April 2018 in mg consumed
per day per thousand people. The number of collection days varied from 5-7.

Capital Regional

Fentanyl consumption
(mg/1000 People/Day)
0.63–0.99
0.99–1.42

1.42–1.71

1.71–2.73

2.73–3.63

Average fentanyl consumption for comparison

All site Capital Regional

Figure 21: Estimated heroin consumption per jurisdiction for April 2018 in mg consumed
per day per thousand people. The number of collection days varied from 5-7.

Capital Regional

Heroin consumption
(mg/1000 People/Day)
5.4–10.7
10.7–28.9

28.9–44.1

44.1–73.8

73.8–140.3

Average heroin consumption for comparison

All site Capital Regional

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Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

4.1.4 NEW PSYCHOACTIVE SUBSTANCES

The compounds included under the NPS class in this study were methylone and mephedrone.
Limited information is available on the human metabolism and excretion of these drugs.
Therefore, the parent compound was measured. It is probable that a significant proportion of
the ingested drug is converted into different metabolites. There were a number of instances
of mephedrone detections in New South Wales and Queensland, but methylone use appeared
to be largely confined to New South Wales. The measured levels were mostly below the limits
of reporting. Sites that showed the presence of the two compounds are qualitatively listed in
Table 5 for the April 2018 period. Detections in April 2018 are almost exclusively confined to
the eastern states (Figure 22).
Table 5: The number and code of sites per state and territory where mephedrone and methylone
were detected in April 2018. The total number of daily samples that were assessed was 319.
Number of detections Apr 2018 Sites detected Apr 2018
State/territory Mephedrone Methylone Mephedrone Methylone
NT 0 0
ACT 0 0
NSW 5 6 006, 008, 068 003, 008, 016,
025, 068
Qld 5 1 005, 011, 024 028
SA 0 0
Tas 0 0
Vic 0 0
WA 0 1 129
Total 10 8 6 sites 7 sites

Figure 22: Estimated percentage positive detections per jurisdiction for mephedrone and
methylone for April 2018. This is the number of detections as a percentage of the total
number of samples analysed per jurisdiction. The number of collection days varied from 5-7.

Capital Regional

Mephedrone percentage detections

per jurisdiction
2.2–5.0
5.0–10.0

10.0–14.3

Average mephedrone detections for comparison

All site Capital Regional

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 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Figure 22 (continued): Estimated percentage positive detections per jurisdiction for

mephedrone and methylone for April 2018. This is the number of detections as a
percentage of the total number of samples analysed per jurisdiction. The number of
collection days varied from 5-7.

Capital Regional

Methylone detections per jurisdiction

0.0–2.7

2.7–10.7

10.7–14.33

Average methylone detections for comparison

4.2 TEMPORAL CHANGES IN DRUG CONSUMPTION ESTIMATES BY

All site Capital Regional
JURISDICTION
The total level of each drug outlined in the preceding reports per state or territory was
compared with subsequent collection periods included in the current report. Every effort
was made to assess the same sites for each period. However, as the individual sites and
the number of sites used to generate the population-weighted averages may have changed
between periods, comparing between time points should be done with caution. This
would be most evident for the regional averages, which had more variation in participation
between each period (see Appendix 3 for a comprehensive list of participating sites and
number of days assessed per sampling campaign).
Note: the lines on each graph representing averages are the cumulative average across all
sampling time points.
4.2.1 NICOTINE AND ALCOHOL
Average nicotine consumption in samples collected from regional sites were generally
higher when compared to the capital cities (see section 4.2.5, Figure 26). In most states,
nicotine consumption remained steady over the total collection periods. Western Australia
continued to show an overall decrease for both capital city and regional areas, while regional
Tasmania is on the rise.

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Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

In the case of alcohol, the difference between overall capital city and regional centre
consumption within each state or territory was minimal, except for South Australia where
regional use remained at almost half that of the capital city (see section 4.2.5, Figure 27).
This finding was interesting. Usually consumption of alcohol is elevated on the weekend.
The April 2018 collection period was the first time regional South Australia centres provided
weekend samples. However, alcohol consumption remained similar to historical levels. For the
most part national consumption levels remained steady, with no apparent trend in terms of
changes in use over time within each region, Western Australia being the obvious exception.
4.2.2 ILLICIT DRUGS
The trend in methylamphetamine use was variable in many parts of the country
(see section 4.2.5, Figure 28). Consumption in the Australian Capital Territory, New South
Wales, Tasmania and Victoria remained largely stable. Western Australia had the highest
regional levels of methylamphetamine. However, both in Western Australia and South
Australia, consumption declined dramatically after December 2017. These were the
states where use was historically highest in the nation. Capital city Northern Territory and
Queensland were the only areas where levels continued to rise.
When plotted against historical levels recorded in the three regions, the sudden drop-off
in use of methylamphetamine use in South Australia was striking (Figure 23). While not
as dramatic, decreased use in Western Australia was evident. Levels in Queensland and
Victoria remained essentially steady over the current and historical periods.
Figure 23: Change in methylamphetamine consumption for sites with historical data.

Estimated Methylamphetamine Consumption

Estimated Methylamphetamine Consumption

3000 100
WA: Perth (average of 101, 103, 104)

2400 80

[Doses / 1000 people / day]

[mg / 1000 people / day]

1800 60

1200 40

600 20

No Data
0 0
'09 '10 '11 '12 '13 '14 '15 Aug Oct Dec Feb Apr Jun Aug Oct Dec Feb Apr
'16 '16 '16 '17 '17 '17 '17 '17 '17 '18 '18
Estimated Methylamphetamine Consumption
Estimated Methylamphetamine Consumption

3000 100
SA: Adelaide (average of 007, 013, 027 & 059)
[Doses / 1000 People / Day]

2400 80
[mg / 1000 People / Day]

1800 60

1200 40

600 20

0 0
'09 '10 '11 '12 '13 '14 '15 Aug Oct Dec Feb Apr Jun Aug Oct Dec Feb Apr
'16 '16 '16 '17 '17 '17 '17 '17 '17 '18 '18

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 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Figure 23 (continued): Change in methylamphetamine consumption for sites with

historical data.

Estimated Methylamphetamine Consumption

Estimated Methylamphetamine Consumption

1800 60
QLD: Regional (012)

[Doses / 1000 People / Day]

[mg / 1000 People / Day]

1200 40

600 20

N/A N/A N/A N/A N/A

0 0
'09 '10 '11 '12 '13 '14 '15 Aug Oct Dec Feb Apr Jun Aug Oct Dec Feb Apr
'16 '16 '16 '17 '17 '17 '17 '17 '17 '18 '18

Estimated Methylamphetamine Consumption

Estimated Methylamphetamine Consumption

1800 60
QLD: Regional (033)

[Doses / 1000 People / Day]

[mg / 1000 People / Day]

1200 40

600 20

N/A N/A N/A N/A N/A

0 0
'09 '10 '11 '12 '13 '14 '15 Aug Oct Dec Feb Apr Jun Aug Oct Dec Feb Apr
'16 '16 '16 '17 '17 '17 '17 '17 '17 '18 '18
Estimated Methylamphetamine Consumption
Estimated Methylamphetamine Consumption

1800 60
VIC: Melbourne (067) One or two weeks assessed per year
[Doses / 1000 People / Day]
[mg / 1000 People / Day]

1200 40

600 20

No Data
0 0
'09 '10 '11 '12 '13 '14 '15 Aug Oct Dec Feb Apr Jun Aug Oct Dec Feb Apr
'16 '16 '16 '17 '17 '17 '17 '17 '17 '18 '18

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Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Figure 23 (continued): Change in methylamphetamine consumption for sites with

historical data.

Estimated Methylamphetamine Consumption

Estimated Methylamphetamine Consumption

1800 60
VIC: Melbourne (001) One or two weeks assessed per
year

[Doses / 1000 People / Day]

[mg / 1000 People / Day]

1200 40

600 20

No Data
0 0
'09 '10 '11 '12 '13 '14 '15 Aug Oct Dec Feb Apr Jun Aug Oct Dec Feb Apr
'16 '16 '16 '17 '17 '17 '17 '17 '17 '18 '18

The consumption of cocaine in capital city sites in New South Wales remained high for
the duration of the monitoring period compared to other Australian regions (see section
4.2.5, Figure 29). The upward trend in consumption observed in the previous report for
the Australian Capital Territory stalled after December 2017. Small increases were evident
in other states, but these are from a very low base. Regional consumption was noticeably
lower than in capital cities in every state and territory, except Queensland. Western
Australia and Tasmania remained well below the national average.
MDMA use in Australia appeared to be on the decline or steady in all states and territories
(see section 4.2.5, Figure 30). The Northern Territory remained high compared to other
parts of the country. Regional centres showed levels slightly above the capital city locations.
Regional South Australia sites provided weekend samples for the first time in April 2018, but
the overall levels for that state remained unchanged.
MDA use, corrected for the proportion derived from MDMA (Khan 2011), showed that levels
in regional Queensland were dropping from initial highs to amounts found elsewhere in
regional Australia (see section 4.2.5, Figure 31). South Australia and capital city New South
Wales were at levels below average. The regional and overall national averages were skewed
somewhat by the high MDA levels detected at site 012 in Queensland in August 2017.

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 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

4.2.3 OPIOIDS
The average levels of oxycodone use were higher in regional areas of several states
(see section 4.2.5, Figure 32). Since the first report in March 2017, which contained analysis
of samples collected in August 2016, consumption of oxycodone declined in some regions,
for example, capital city New South Wales, South Australia and Western Australia. A similar
decline was only evident in regional Tasmania, with other regional areas remaining either flat
or slightly on the increase. The variation in participating rural sites (and hence the sampled
populations) may also influence the observed trend of the population-weighted averages.
Fentanyl use in regional Australia remains high in comparison to capital cities (see section
4.2.5, Figure 33). In Queensland and Victoria, fentanyl use is on the increase. This is also the
case in regional Western Australia.
The state and territory comparison of the use of heroin show that consumption was highest
in Victoria (see section 4.2.5, Figure 34). In general, regional areas of each state had lower
levels of heroin consumption. The extent of heroin consumption has been measured in
capital city South Australia since 2013. Together with the current reporting period, levels of
heroin consumption for the region have been slightly declining (Figure 24).
Figure 24: Change in heroin consumption for South Australia.
200
SA: Adelaide (average of 007, 013, 027 & 059)
175
Estimated Heroin Consumption

Estimated Heroin Consumption

[Doses / 1000 People / Day]
6
[mg / 1000 People / Day]

150

125
4
100

75

50 2

25

0 0
'13 '14 '15 '16 Aug Oct Dec Feb Apr Jun Aug Oct Dec Feb Apr
'16 '16 '16 '17 '17 '17 '17 '17 '17 '18 '18

ƒƒ The ‘16 bar represents the average of Feb, Apr and Jun

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Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

4.2.4 NEW PSYCHOACTIVE SUBSTANCES (NPS)

Methylone and mephedrone were only detected sporadically and at very low levels
compared to other substances included in the report (April mephedrone and methylone
results are shown in Table 5).
The temporal changes in detections per state/territory (number of samples above LOD) is
shown in Figure 25 and section 4.2.5, Figure 35. It is evident that the number of detections
of these two substances has decreased since the start of the project in August 2016.
Methylone detections peaked in April 2017 and have declined steadily since then.
Figure 25: The percentage of all samples where mephedrone and methylone were detected.

Total detections by sampling period

50 Aug 2016 Oct 2016
Dec 2016 Feb 2017
Apr 2017 Jun 2017
Percentage detection of all samples (%)

Aug 2017 Oct 2017

40 Dec 2017 Feb 2018
Apr 2018

30

20

10

0
Mephedrone Methylone

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 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

4.2.5 ESTIMATED AVERAGE CONSUMPTION FIGURES

Estimated Nicotine Consumption

Estimated Consumption
(Cigarettes / 1000 People / Day)
3500

3000

2500

2000

1500

1000

500

0
Apr 2018
Dec 2017
Aug 2017
Figure 26: Estimated average consumption of nicotine by state/territory, where 1 cigarette provides 1.25 mg of nicotine.

Apr 2017
Dec 2016

WA
Aug 2016

ƒƒ Increasing use in Tasmania and declining use in Western Australia

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016

Vic
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016

Tas
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Nicotine

Dec 2016
Aug 2016

SA
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Qld

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
NT

Apr 2018
Dec 2017
Aug 2017
ƒƒ Mostly small overall changes in consumption

Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
NSW

Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
ACT

Aug 2017
Apr 2017
Dec 2016
Aug 2016
1500
4500

4000

3500

3000

2500

2000

1000

500

(mg Nicotine / 1000 People / Day)

Estimated Consumption

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Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Estimated Consumption
Estimated Alcohol Consumption
(Standard Drinks / 1000 People / Day)

3500

3000

2500

2000

1500

1000

500

0
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016

WA
Aug 2016
Apr 2018
Dec 2017
Aug 2017

ƒƒ No weekend sampling in regional Tasmania

Apr 2017
Dec 2016
Aug 2016
Figure 27: Estimated average consumption of alcohol by state/territory. A standard drink is 10.0 g or 12.5 mL.

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016

Vic
Apr 2018
Dec 2017

may cause underestimation

Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016

Tas
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Alcohol

Aug 2016

SA
Apr 2018
Dec 2017
Aug 2017
Apr 2017

ƒƒ Mostly small changes in consumption over the year, except Western Australia
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Qld

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
ƒƒ Northern Territory high capital city and regional values

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
NT

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
NSW

Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
ACT

Aug 2017
Apr 2017
Dec 2016
Aug 2016
50

40

30

20

10

(Litres Ethanol / 1000 People / Day)

Estimated Consumption

46
47
Estimated Consumption
(mg / 1000 People / Day)
0
500
1500
2000
2500
3000

1000

Aug 2016 -
Aug 2016
Dec 2016 -
Dec 2016
Apr 2017 -
Apr 2017
Aug 2017 -
Aug 2017
ACT
ACT

Dec 2017 -
Dec 2017
Apr 2018 -
Apr 2018
Aug 2016 -
Aug 2016
Dec 2016 -
Dec 2016
Apr 2017 -
Apr 2017
Aug 2017 -
Aug 2017
Dec 2017 -
Dec 2017
Apr 2018 -
Apr 2018
Aug 2016 -
Aug 2016
NSW

Dec 2016 -
NSW

Dec 2016
Apr 2017 -
Apr 2017
Aug 2017 -
Aug 2017
Dec 2017 -
Dec 2017
Apr 2018 -
Apr 2018
Capital

Aug 2016 -
Aug 2016
Dec 2016 -
Dec 2016
Apr 2017 -
Apr 2017
Aug 2017 -
Aug 2017
Dec 2017 -
Dec 2017
Apr 2018 -
Apr 2018
NT

Aug 2016 -
Aug 2016
NT

Dec 2016 -
Dec 2016
Apr 2017 -
Apr 2017
Aug 2017 -
Aug 2017
Dec 2017 -
Dec 2017
ƒƒ Large decreases in South Australia and Western Australia Apr 2018 -
Apr 2018
Aug 2016 -
Aug 2016
Dec 2016 -
Regional

Dec 2016
Apr 2017 -
Apr 2017
Aug 2017 -
Aug 2017
Dec 2017 -
Dec 2017
Apr 2018 -
Apr 2018
Qld
Aug 2016 -
Aug 2016
QLD
Dec 2016 -
Dec 2016
Apr 2017 -
Apr 2017
Aug 2017 -
Aug 2017
Dec 2017 -
Dec 2017
Apr 2018 -
Apr 2018
Aug 2016 -
Aug 2016
Dec 2016 -
Dec 2016
Apr 2017 -
Apr 2017
Aug 2017 -
Aug 2017

All Site
Dec 2017 -
Dec 2017

Average
Apr 2018 -
Apr 2018

SA
Aug 2016 -
Aug 2016

SA
Dec 2016 -
Dec 2016
Apr 2017 -
Apr 2017
Aug 2017 -
Aug 2017
Dec 2017 -
Dec 2017
Apr 2018 -
Apr 2018
Aug 2016 -
Aug 2016
Dec 2016 -
Dec 2016
Apr 2017 -
Figure 28: Estimated average consumption of methylamphetamine by state/territory.

Apr 2017
Aug 2017 -
Aug 2017
Methylamphetamine

Dec 2017 -
Dec 2017
Apr 2018 -
Apr 2018

Capital
Tas
Aug 2016 -
Aug 2016

TAS

ƒƒ Small variations elsewhere

Average
Dec 2016 -
Dec 2016
Apr 2017 -
Apr 2017
Aug 2017 -
Aug 2017
Dec 2017 -
Dec 2017
Apr 2018 -
Apr 2018
Aug 2016 -
Aug 2016
Dec 2016 -
Dec 2016
Apr 2017 -
Apr 2017
Aug 2017 -
Aug 2017
Dec 2017 -
Dec 2017
Apr 2018 -
Apr 2018

Vic
Aug 2016 -
Aug 2016

VIC
Dec 2016 -
Dec 2016
Apr 2017 -
Apr 2017
Aug 2017 -
Aug 2017

Average
Dec 2017 -

Regional
Dec 2017
Apr 2018 -
Apr 2018
Aug 2016 -
Aug 2016
Dec 2016 -
Dec 2016
Apr 2017 -
Apr 2017
Aug 2017 -
Aug 2017
Dec 2017 -
Dec 2017
Apr 2018 -
Apr 2018
Aug 2016 -
Aug 2016

WA
WA
Dec 2016 -
Dec 2016
Apr 2017 -
Apr 2017
Aug 2017 -
Aug 2017
Dec 2017 -
Dec 2017
Apr 2018 -
Apr 2018

0
10
20
30
40
50
60
70
80
90
100
(Doses / 1000 People / Day)
Estimated Consumption
National Wastewater Drug Monitoring Program—Report 5, August 2018
Australian Criminal Intelligence Commission
Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Estimated Consumption

Estimated Consumption
(Doses / 1000 People / Day)

12
14

10

0
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016

WA
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017

ƒƒ Low overall use outside of New South Wales

Apr 2017
Dec 2016
Aug 2016

Vic
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016

Tas
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Cocaine

Dec 2016
Aug 2016

SA
Apr 2018
Dec 2017
Aug 2017
Figure 29: Estimated average consumption of cocaine by state/territory.

Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Qld

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
NT

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
NSW

Aug 2016
ƒƒ Levelling off in most capital cities

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
ACT

Aug 2017
Apr 2017
Dec 2016
Aug 2016
1200
1400

1000

800

600

400

200

(mg / 1000 People / Day)

Estimated Consumption

48
 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Estimated Consumption

Estimated Consumption
(Doses / 1000 People / Day)
12

10

0
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016

WA
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016

Vic
Apr 2018
Dec 2017
Aug 2017
Apr 2017

ƒƒ Declining rates of use in many areas

Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016

Tas
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
MDMA

Aug 2016

SA
Apr 2018
Dec 2017
Aug 2017
Figure 30: Estimated average consumption of MDMA by state/territory.

Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Qld

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
ƒƒ Large variations amplified by relatively low consumption
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
NT

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
NSW

Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
ACT

Aug 2017
Apr 2017
Dec 2016
Aug 2016
400
1200

1000

800

600

200

(mg / 1000 People / Day)

Estimated Consumption

49
Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Number of detections
Number of detections
EstimatedExcretion
Estimated Excretion
100
100 (mg / 1000 People / /Day)
(mg / 1000 People Day)

80

60

40

20
80

60

40

20

0
0
Apr 2018
Apr Dec
20182017
Dec Aug
20172017
Aug Apr
2017
20172017
Apr Dec
20162016
Dec Aug

WA
Aug 20162016

WA
Apr Apr
20182018
Dec Dec
20172017
Aug Aug
20172017
Apr Apr
20172017
Dec Dec
20162016
Aug Aug
20162016
Apr Apr
20182018
Dec 20172017
Dec
Aug Aug
20172017
Apr Apr
20172017
Dec Dec
20162016
Aug Aug
20162016

Vic
Vic
Apr Apr
20182018
Dec Dec
20172017
Aug Aug
20172017
Apr Apr
20172017
Dec Dec
20162016
Aug Aug
20162016
Apr Apr
20182018
Dec Dec
20172017
Aug Aug
20172017
Apr Apr
20172017
Dec Dec
20162016
Aug Aug
20162016

Tas
Tas
Apr Apr
20182018
Dec Dec
20172017
Aug 2017
Apr Aug
20172017
Dec Apr
20162017
Aug Dec
20162016
Aug 2016
Apr 2018
Dec Apr
20172018
Aug Dec
20172017
Apr Aug
20172017
Dec Apr
20162017
Aug Dec
20162016

SA
MDA

Apr Aug
20182016

SA
MDA

Dec Apr
20172018
Aug Dec
20172017
Apr Aug
20172017
Dec Apr
20162017
Figure 31: Estimated average consumption of MDA by state/territory.

Aug Dec
20162016
Apr Aug
20182016
Dec Apr
20172018
Aug Dec
20172017
Apr Aug
20172017
Dec Apr
20162017
Aug Dec
20162016
Qld

Apr Aug
20182016
Qld

Dec Apr
20172018
Aug Dec
2017
20172017
Apr Aug
20162017
Dec Apr
Aug 20162017
Dec 2016
Apr Aug
20182016
Dec 2017
Aug Apr
20172018
Apr Dec
20172017
Dec Aug
20162017
Aug Apr
20162017
NT

Dec 2016
Apr Aug
2018
Dec 20172016
NT

Aug Apr
20172018
Apr Dec
20172017
Dec Aug
20162017
Aug Apr
20162017
Apr Dec
20182016
Dec Aug
20172016
Aug Apr
20172018
ƒƒ Declining use in regional Queensland

Apr Dec
20172017
Dec Aug
20162017
NSW

Aug Apr
20162017
Apr Dec
20182016
NSW

Dec Aug
20172016
Aug Apr
20172018
Apr Dec
20172017
Dec Aug
20162017
Aug Apr
20162017
Apr Dec
20182016
Dec Aug
20172016
ACT

Aug 2017
Apr Apr
20172018
Dec Dec
20162017
ACT

Aug Aug
20162017
Apr 2017
Dec 2016
Aug 2016
100100

80 80

60 60

40

20

0
40

20

(mg / 1000 People / Day)

(mg Estimated Excretion
/ 1000 People / Day)
Estimated Excretion

50
 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Estimated Consumption

Estimated Consumption
(Doses / 1000 People / Day)

20

15

10

0
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016

WA
Aug 2016

ƒƒ Capital city consumption trending downwards except Queensland

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016

Vic
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016

Tas
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Oxycodone

Aug 2017
Apr 2017
Dec 2016
Aug 2016

SA
Figure 32: Estimated average consumption of oxycodone by state/territory.

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Qld

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
NT

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
ƒƒ High regional use declining or levelling off

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
NSW

Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
ACT

Aug 2017
Apr 2017
Dec 2016
Aug 2016
150
450

400

350

300

250

200

100

50

(mg / 1000 People / Day)

Estimated Consumption

51
Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Estimated Consumption

Estimated Consumption
20 (Doses / 1000 People / Day)

15

10

0
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016

WA
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017

ƒƒ Small overall annual changes in capital cities

Aug 2017
Apr 2017
Dec 2016
Aug 2016

Vic
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016

Tas
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Fentanyl

Dec 2016
Aug 2016

SA
Apr 2018
Dec 2017
Figure 33: Estimated average consumption of fentanyl by state/territory.

Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Qld

Apr 2018
Dec 2017
Aug 2017
Apr 2017
ƒƒ Consistently higher regional use in many states and territories
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
NT

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
NSW

Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
ACT

Aug 2017
Apr 2017
Dec 2016
Aug 2016
4.0

3.5

3.0

2.5

2.0

1.5

1.0

0.5

0.0

(mg / 1000 People / Day)

Estimated Consumption

52
 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Estimated Excretion

Estimated Consumption
(Doses / 1000 People / Day)

12

10

0
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016

WA
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016

Vic
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016

ƒƒ Consumption in Victoria highest

Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016

Tas
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Heroin

Aug 2016

SA
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Figure 34: Estimated average consumption of heroin by state/territory.

Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Qld
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
NT

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
NSW

Aug 2016
Apr 2018
Dec 2017
ƒƒ Much lower regional average

Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
ACT

Aug 2017
Apr 2017
Dec 2016
Aug 2016
250

200

150

100

50

(mg / 1000 People / Day)

Estimated Consumption
Estimated Alcohol Consumption

53
Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016

WA
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016

Vic
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016

Tas
Mephedrone detections

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Figure 35: The percentage of all samples where mephedrone and methylone were detected.

Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016

SA
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016

Qld
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
NT

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
NSW

Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
ACT

Aug 2017
Apr 2017
Dec 2016
Aug 2016
80

20
90

70

60

50

40

30
100

10

capital or regional area by jurisdiction (%)

Percentage detections within each

54
 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016

WA
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016

Vic
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Figure 35 (continued): The percentage of all samples where mephedrone and methylone were detected.

Aug 2017
Apr 2017
Dec 2016
Aug 2016

Tas
Apr 2018
Methylone detections

Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016

SA
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016

Qld
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
NT

Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
NSW

Aug 2016
Apr 2018
Dec 2017
Aug 2017
Apr 2017
Dec 2016
Aug 2016
Apr 2018
Dec 2017
ACT

Aug 2017
Apr 2017
Dec 2016
Aug 2016
100

40
90

80

70

60

50

30

20

10

capital or regional area by jurisdiction (%)

Percentage detections within each

55
Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

4.2.6 CAPITAL CITY AVERAGES

For the purposes of determining representative population trends for the collective
catchments included in the report over the total sampling period, the averaged capital
city and regional site populations were expressed as the total capital or regional average
consumption of illicit stimulants (Figure 36). A complication with this type of analysis
was that fewer sites were sampled in between August 2016 and December 2017, so the
contributing population was smaller between these dates. Some approximations had to be
made to account for the absence of some densely populated regions (e.g. October 2016
for capital city New South Wales, and Queensland). For the total population included in
the report, methylamphetamine appeared to show a steady decline from October 2016
to June 2017, with an increase to October 2017, followed by another downward trend.
MDMA levels declined overall over the first part of the project, after which regional areas
increased slightly. Since detected levels are very low, the result may not be significant.
Cocaine consumption showed some short-term variations. In terms of legal substances with
abuse potential, alcohol and nicotine consumption remained largely unchanged over the
reporting period (Figure 37). The two pharmaceutical opioids included in the study showed
contrasting trends. Fentanyl in regional areas have been on the increase, while oxycodone
use has declined. Capital city fentanyl and oxycodone levels have remained largely stable.
Figure 36: The population-weighted average of all sites for methylamphetamine, MDMA
and cocaine.
Weighted average consumption of methylamphetamine

Estimated methylamphetamine consumption

Estimated methylamphetamine consumption

1800 60

[Doses / 1000 People / Day]

[mg / 1000 People / Day]

1200 40

600 20

0 0
Aug 16 Oct 16 Dec 16 Feb 17 Apr 17 Jun 17 Aug 17 Oct 17 Dec 17 Feb 18 Apr 18

All capital sites All regional sites Capital data estimated for Qld and NSW

56
 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Figure 36 (continued): The population-weighted average of all sites for methylamphetamine,

MDMA and cocaine.
Weighted average consumption of MDMA
300 3.0

250 2.5
Estimated MDMA consumption

Estimated MDMA consumption

[Doses / 1000 People / Day]
[mg / 1000 People / Day]

200 2.0

150 1.5

100 1.0

50 0.5

0 0.0
Aug 16 Oct 16 Dec 16 Feb 17 Apr 17 Jun 17 Aug 17 Oct 17 Dec 17 Feb 18 Apr 18

All capital sites All regional sites Capital data estimated for Qld and NSW

Weighted average consumption of cocaine

900 9

800 8
Estimated cocaine consumption

Estimated cocaine consumption

[Doses / 1000 People / Day]
700 7
[mg / 1000 People / Day]

600 6

500 5

400 4

300 3

200 2

100 1

0 0
Aug 16 Oct 16 Dec 16 Feb 17 Apr 17 Jun 17 Aug 17 Oct 17 Dec 17 Feb 18 Apr 18

All capital sites All regional sites Capital data estimated for Qld and NSW

As Queensland and New South Wales capital city sites were not sampled in October 2016, their average
consumption in August and December 2016 was used to provide the overall October estimate. Regional areas
were only sampled every second collection period.

57
Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Figure 37: The population-weighted average of all sites for nicotine, alcohol, oxycodone
and fentanyl.
Weighted average consumption of nicotine
2800
3200
2400
Estimated nicotine consumption

Estimated nicotine consumption

[Cigarettes / 1000 People / Day]
2800
[mg / 1000 People / Day]

2000
2400

2000 1600

1600
1200
1200
800
800
400
400

0 0
Aug 16 Oct 16 Dec 16 Feb 17 Apr 17 Jun 17 Aug 17 Oct 17 Dec 17 Feb 18 Apr 18

All capital sites All regional sites Capital data estimated for Qld and NSW

Weighted average consumption of alcohol

30
28

[Standard Drinks / 1000 People / Day]

2100
26
Estimated alcohol consumption

Estimated alcohol consumption

24
[Litres / 1000 People / Day]

1800
22
20
1500
18
16 1200
14
12 900
10
8 600
6
4 300
2
0 0
Aug 16 Oct 16 Dec 16 Feb 17 Apr 17 Jun 17 Aug 17 Oct 17 Dec 17 Feb 18 Apr 18

All capital sites All regional sites Capital data estimated for Qld and NSW

Weighted average consumption of oxycodone

300
14
Estimated oxycodone consumption

Estimated oxycodone consumption

250
12
[Doses / 1000 People / Day]
[mg / 1000 People / Day]

200 10

8
150

6
100
4

50
2

0 0
Aug 16 Oct 16 Dec 16 Feb 17 Apr 17 Jun 17 Aug 17 Oct 17 Dec 17 Feb 18 Apr 18

All capital sites All regional sites Capital data estimated for Qld and NSW

58
 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Figure 37 (continued): The population-weighted average of all sites for nicotine, alcohol,
oxycodone and fentanyl.

Weighted average consumption of fentanyl

3.0
14
Estimated fentanyl consumption

Estimated fentanyl consumption

2.5
12

[Doses / 1000 People / Day]

[mg / 1000 People / Day]

2.0 10

8
1.5

6
1.0
4

0.5
2

0.0 0
Aug 16 Oct 16 Dec 16 Feb 17 Apr 17 Jun 17 Aug 17 Oct 17 Dec 17 Feb 18 Apr 18

All capital sites All regional sites Capital data estimated for Qld and NSW

Weighted average consumption of heroin

150 7.5

125
Estimated heroin consumption

Estimated heroin consumption

6.0

[Doses / 1000 People / Day]

[mg / 1000 People / Day]

100
4.5

75

3.0
50

1.5
25

0 0.0
Aug 17 Oct 17 Dec 17 Feb 18 Apr 18

All capital sites All regional sites Capital data estimated for Qld and NSW

As Queensland and New South Wales capital city sites were not sampled in October 2016, their average
consumption in August and December 2016 was used to provide the overall October estimate. Regional areas
were only sampled every second collection period.

4.3 DRUG PROFILE FOR EACH STATE AND TERRITORY

To compare the scale of use of different types of drugs within the same region (for example,
within a state or territory), drug consumption was reported as the number of doses
consumed. When the amount of drug measured in wastewater was normalised for population
size and average dose consumed (conversion factors listed in Report 1, and in Appendix 1),
alcohol and nicotine remained consistently the highest consumed drugs in all states and
territories. For example, the national average consumption of nicotine and alcohol per 1,000
people per day were approximately 1,300 cigarettes per 1,000 people (Figure 4) and 1,200
standard drinks per day per 1,000 (Figure 5), whereas for methylamphetamine, the national
average consumption was closer to 35 doses per 1,000 people per day (Figure 8).

59
Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

In agreement with previous reports, methylamphetamine consumption remained the highest

amongst the measured illicit drugs and opioids in this report, across all regions of Australia
(Figure 38). This trend was consistent for both capital cities and regional sites. Based on the
consumption profiles of other drugs detected in this study (cocaine, MDMA, oxycodone and
fentanyl), no other consistent patterns of usage within the different states and territories
were observed. Oxycodone and fentanyl use were very similar within almost all states and
territories, with the relative proportions favouring regional over capital city areas.
Figure 38: Profile of average drug consumption by state or territory. Consumption is
shown as the number of doses per 1,000 people per day to allow comparison of drugs of
different types within the same region (state or territory).
Australian Capital Territory (ACT)
80
Capital Average
Regional Average (None)
70
National Capital Average
Estimated Consumption(Doses / 1000 people / D
National Regional Average
60
(Doses / 1000 People / Day)
Estimated Consumption

50

40

30

20

10

0
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Methylamphetamine Cocaine MDMA Oxycodone Fentanyl Heroin

Noroxycodone
Norfentanyl
New South Wales (NSW) JWH_018
80 JWH_073
Mephedrone
Capital Average Methylone
Tobacco
70 Regional Average Ethanol_Std_p

National Capital Average Ethanol_Std_1

Ethanol_L_100
National Regional Average
60
(Doses / 1000 People / Day)
Estimated Consumption

50

40

30

20

10

0
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-
Aug 2016-
Dec 2016-
Apr 2017-
Aug 2017-
Dec 2017-
Apr 2018-

Methylamphetamine Cocaine MDMA Oxycodone Fentanyl Heroin

60
 Estimated Consumption Estimated Consumption Estimated Consumption
(Doses / 1000 People / Day) (Doses / 1000 People / Day) (Doses / 1000 People / Day)

0
10
20
30
40
50
60
70
80

0
10
20
30
40
50
60
70
80
90
100
0
10
20
30
40
50
60
70
80
Aug 2016- Aug 2016- Aug 2016-
Dec 2016- Dec 2016- Dec 2016-
Apr 2017- Apr 2017- Apr 2017-
Aug 2017- Aug 2017- Aug 2017-
Dec 2017- Dec 2017- Dec 2017-
Apr 2018- Apr 2018- Apr 2018-
Aug 2016- Aug 2016- Aug 2016-
Dec 2016- Dec 2016- Dec 2016-
Apr 2017- Apr 2017- Apr 2017-
Aug 2017- Aug 2017- Aug 2017-
Dec 2017- Dec 2017- Dec 2017-
Apr 2018- Apr 2018- Apr 2018-

Methylamphetamine
Methylamphetamine
Methylamphetamine
Aug 2016- Aug 2016- Aug 2016-
Dec 2016- Dec 2016- Dec 2016-
Apr 2017- Apr 2017- Apr 2017-
Aug 2017- Aug 2017- Aug 2017-
Dec 2017- Dec 2017- Dec 2017-
Apr 2018- Apr 2018- Apr 2018-
Aug 2016- Aug 2016- Aug 2016-
Dec 2016- Dec 2016- Dec 2016-

Cocaine
Cocaine
Cocaine
Apr 2017- Apr 2017- Apr 2017-
Aug 2017- Aug 2017- Aug 2017-
Dec 2017- Dec 2017- Dec 2017-
Apr 2018- Apr 2018- Apr 2018-
Aug 2016- Aug 2016- Aug 2016-
Dec 2016- Dec 2016- Dec 2016-
Apr 2017- Apr 2017- Apr 2017-
Aug 2017- Aug 2017- Aug 2017-
Dec 2017- Dec 2017- Dec 2017-
Apr 2018- Apr 2018- Apr 2018-
Aug 2016- Aug 2016- Aug 2016-
Dec 2016- Dec 2016- Dec 2016-

MDMA
MDMA
MDMA
Apr 2017- Apr 2017- Apr 2017-
Aug 2017- Aug 2017- Aug 2017-
Dec 2017- Dec 2017- Dec 2017-
Apr 2018- Apr 2018- Apr 2018-
Aug 2016- Aug 2016- Aug 2016-
Dec 2016- Dec 2016- Dec 2016-

Queensland (Qld)
Apr 2017- Apr 2017- Apr 2017-
Aug 2017- Aug 2017- Aug 2017-

South Australia (SA)

Dec 2017- Dec 2017- Dec 2017-
Apr 2018- Apr 2018- Apr 2018-
Northern Territory (NT)

Aug 2016- Aug 2016- Aug 2016-

Dec 2016- Dec 2016- Dec 2016-
Apr 2017- Apr 2017- Apr 2017-

Oxycodone
Oxycodone
Oxycodone

Aug 2017- Aug 2017- Aug 2017-

Dec 2017- Dec 2017- Dec 2017-
Apr 2018- Apr 2018- Apr 2018-
Aug 2016- Aug 2016- Aug 2016-
Dec 2016- Dec 2016- Dec 2016-
Apr 2017- Apr 2017- Apr 2017-
Aug 2017- Aug 2017- Aug 2017-
Dec 2017- Dec 2017- Dec 2017-
Apr 2018- Apr 2018- Apr 2018-
Aug 2016- Aug 2016- Aug 2016-
Dec 2016- Dec 2016- Dec 2016-

Fentanyl
Fentanyl
Fentanyl

Apr 2017- Apr 2017- Apr 2017-

Aug 2017- Aug 2017- Aug 2017-
Dec 2017- Dec 2017- Dec 2017-
Apr 2018- Apr 2018- Apr 2018-
Aug 2016- Aug 2016- Aug 2016-
Capital Average

Capital Average
Capital Average

Dec 2016- Dec 2016- Dec 2016-

Regional Average

Regional Average
Regional Average

Apr 2017- Apr 2017- Apr 2017-

Aug 2017- Aug 2017- Aug 2017-
Figure 38 (continued): Profile of average drug consumption by state or territory.

Dec 2017- Dec 2017- Dec 2017-

Consumption is shown as the number of doses per 1,000 people per day to allow

Apr 2018- Apr 2018- Apr 2018-

comparison of drugs of different types within the same region (state or territory).

Aug 2016- Aug 2016- Aug 2016-

National Capital Average

National Capital Average

National Capital Average

Heroin
Heroin
Heroin

Dec 2016- Dec 2016- Dec 2016-

National Regional Average

National Regional Average

National Regional Average

Apr 2017- Apr 2017- Apr 2017-

Aug 2017- Aug 2017- Aug 2017-
Dec 2017- Dec 2017- Dec 2017-
Apr 2018- Apr 2018- Apr 2018-
National Wastewater Drug Monitoring Program—Report 5, August 2018
Australian Criminal Intelligence Commission

61
62
Estimated Consumption Estimated Consumption Estimated Consumption
(Doses / 1000 People / Day) (Doses / 1000 People / Day) (Doses / 1000 People / Day)

0
10
20
30
40
50
60
70
80
0
10
20
30
40
50
60
70
80
0
10
20
30
40
50
60
70
Aug 2016- Aug 2016- Aug 2016- 80
Dec 2016- Dec 2016- Dec 2016-
Apr 2017- Apr 2017- Apr 2017-
Aug 2017- Aug 2017- Aug 2017-
Dec 2017- Dec 2017- Dec 2017-
Apr 2018- Apr 2018- Apr 2018-
Aug 2016- Aug 2016- Aug 2016-
Australian Criminal Intelligence Commission

Dec 2016- Dec 2016- Dec 2016-

Apr 2017- Apr 2017- Apr 2017-
Aug 2017- Aug 2017- Aug 2017-
Dec 2017- Dec 2017- Dec 2017-
Apr 2018- Apr 2018- Apr 2018-

Methylamphetamine
Methylamphetamine
Methylamphetamine
Aug 2016- Aug 2016- Aug 2016-
Dec 2016- Dec 2016- Dec 2016-
Apr 2017- Apr 2017- Apr 2017-
Aug 2017- Aug 2017- Aug 2017-
Dec 2017- Dec 2017- Dec 2017-
Apr 2018- Apr 2018- Apr 2018-
Aug 2016- Aug 2016- Aug 2016-
Dec 2016- Dec 2016- Dec 2016-

Cocaine
Cocaine
Cocaine
Apr 2017- Apr 2017- Apr 2017-
Aug 2017- Aug 2017- Aug 2017-
Dec 2017- Dec 2017- Dec 2017-
Apr 2018- Apr 2018- Apr 2018-
Aug 2016- Aug 2016- Aug 2016-
Dec 2016- Dec 2016- Dec 2016-
National Wastewater Drug Monitoring Program—Report 5, August 2018

Apr 2017- Apr 2017- Apr 2017-

Aug 2017- Aug 2017- Aug 2017-
Dec 2017- Dec 2017- Dec 2017-
Apr 2018- Apr 2018- Apr 2018-
Aug 2016- Aug 2016- Aug 2016-
Dec 2016- Dec 2016- Dec 2016-

MDMA

MDMA
MDMA
Apr 2017- Apr 2017- Apr 2017-
Aug 2017- Aug 2017- Aug 2017-

Victoria (Vic)
Dec 2017- Dec 2017- Dec 2017-
Tasmania (Tas)

Apr 2018- Apr 2018- Apr 2018-

Aug 2016- Aug 2016- Aug 2016-
Dec 2016- Dec 2016- Dec 2016-
Apr 2017- Apr 2017- Apr 2017-
Aug 2017- Aug 2017- Aug 2017-
Dec 2017- Dec 2017- Dec 2017-
Apr 2018- Apr 2018- Apr 2018-

Western Australia (WA)

Aug 2016- Aug 2016- Aug 2016-
Dec 2016- Dec 2016- Dec 2016-
Apr 2017- Apr 2017- Apr 2017-

Oxycodone
Oxycodone
Oxycodone
Aug 2017- Aug 2017- Aug 2017-
Dec 2017- Dec 2017- Dec 2017-
Apr 2018- Apr 2018- Apr 2018-
Aug 2016- Aug 2016- Aug 2016-
Dec 2016- Dec 2016- Dec 2016-
Apr 2017- Apr 2017- Apr 2017-
Aug 2017- Aug 2017- Aug 2017-
Dec 2017- Dec 2017- Dec 2017-
Apr 2018- Apr 2018- Apr 2018-
Aug 2016- Aug 2016- Aug 2016-
Dec 2016- Dec 2016- Dec 2016-

Fentanyl
Fentanyl
Fentanyl

Apr 2017- Apr 2017- Apr 2017-

Aug 2017- Aug 2017- Aug 2017-
Dec 2017- Dec 2017- Dec 2017-
Apr 2018- Apr 2018- Apr 2018-
Aug 2016- Aug 2016- Aug 2016-

Capital Average
Capital Average
Capital Average

Dec 2016- Dec 2016- Dec 2016-

Regional Average
Regional Average
Regional Average

Apr 2017- Apr 2017- Apr 2017-

Aug 2017- Aug 2017- Aug 2017-
Figure 38 (continued): Profile of average drug consumption by state or territory.

Dec 2017- Dec 2017- Dec 2017-

Consumption is shown as the number of doses per 1,000 people per day to allow

Apr 2018- Apr 2018- Apr 2018-

comparison of drugs of different types within the same region (state or territory).

Aug 2016- Aug 2016- Aug 2016-

National Capital Average

National Capital Average
National Capital Average

Heroin
Heroin
Heroin

Dec 2016- Dec 2016- Dec 2016-

National Regional Average

National Regional Average
National Regional Average

Apr 2017- Apr 2017- Apr 2017-

Aug 2017- Aug 2017- Aug 2017-
Dec 2017- Dec 2017- Dec 2017-
Apr 2018- Apr 2018- Apr 2018-
 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

5: INTERNATIONAL COMPARISON OF DRUG USE

5.1 STIMULANT USE
When comparing stimulant use in Australia with international levels, it should be
recognised that cultures have different drug preferences and availability of drugs may differ
between countries. Throughout many parts of Europe amphetamine is more commonly
used than methylamphetamine, while the opposite is true in Australia. Therefore, to
make international comparisons, the four common stimulants were added together and
expressed as doses per day per normalised population (Figure 39). Latest international data
for Europe and the United States of America (USA) were used as reported by SCORE (2018).
Figure 39: The total amount of stimulant consumed (as doses per 1,000 people per day)
by a country as a population weighted average of the number of reported sites (given in
brackets after country name).
Estimated stimulant consumption by country
(population-weighted average of (n) sites)
MDMA
80 Cocaine
Estimated Total Consumption

Amphetamine
(Doses / 1000 People / Day)

(Meth metabolism subtracted)

Methylamphetamine
60
Australia

40

20

0
U Sw lan 7)

)
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ze Be nd )
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ak (1)

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an )

Li ug 2)

)
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G ub (7)

e 7)

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at )

an (4)
et al (1)

la (1)

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Sl ny )

Po rus )

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d erla (3

el (4
gd (5

ch lg (2

nl (1

(1
Sp (1

(1

ro (2

us (1

yp (4

ua (3

re (1
a (2
(4

(
ov (1
s
in nd

Ic in

ia

Fi ria

e
Fr d
N nia

C ia

A ly
us ca

om

G nd
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C ce

th al

Po ia
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ni itz d
A eri

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rt
N tr

m
m

ep
r
A

K
of

te
s
te

C
a
St
d
te
ni
U

Note: the European estimates are based on data of a few WWTPs per country only and, therefore, may not
represent the national per capita consumption for a given analyte in a given country. The number of reported
cities is given in brackets after country name. European and USA data are from SCORE (2018) and various
excretion factors applied are reported in Appendix 1. SCORE reports measured raw loads in sewers and doses
were calculated for the purposes of this report in the same way as for Australia. All SCORE data were from March
2017. Australian data is from April 2018.

Comparing these drugs individually between Australia and other countries, Australia’s ranking
in Figure 39 is driven by its high methylamphetamine consumption. Methylamphetamine
levels are the second highest compared to the other reported countries. It must be noted that
the other countries in the world with reasonably high methylamphetamine use, in Asia and
other parts of North America, are not necessarily represented here. Compared to European
drug usage patterns, Australian cocaine consumption is relatively low, while MDMA is at
median levels (Figure 40).

63
64
Estimated consumption U
U ni
ni (mg / 1000 People / Day) te
te
d d
K St Estimated consumption
U i at
es (mg / 1000 People / Day)
ni Sw ng
d

0
200
400
600
800
1000
1200
1400
1600
1800
2000
2200
2400
te of
d itz om
A
St er
la (1) m

0
200
400
600
800
1000
1200
1400
1600
1800
at
C A er
i
es nd u
of S pa (5)
ze st ca
ch ra (1
A R ia ) l
N me in ( ep (4
et 4 u 7
Australian Criminal Intelligence Commission

he ric )
rla a ( Sl blic )
1 ov
Sl nd ) a (2)
ov s ( N kia
en 3) or (
Ic ia w 2)
el (1 C ay
B and ) yp (1
consumed on a per capita basis.

el Li ru )
gi (2 th s
um ) ua (2
n )
Ita (7) Fi ia
Sw nl (1
F ly itz and )
e
National Wastewater Drug Monitoring Program—Report 5, August 2018

G ran (1)
er c G rla (4)
m e( er nd
an 4) m
A y( an (5)
us 17 y
t ) Sp (17
C ria ai )
ro (1
N n
Po ati )
a et I (4
he taly )
A rtug (1) rla (1
us
tr l ( a n )
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N ia ( gi (3)
or 4 u
7 G m
Sl wa ) re (7
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ak 1) ni
te Au e (
G ia d s 1
C re (2 K tri )
in a

(population-weighted average of (n) sites)

ze Lit ece ) gd (1
(population-weighted average of (n) sites)

Australia

Estimated cocaine consumption by country

ch hu ( o )
R ani 1) Po m
ep a l (1
ub (1 Po and )
) rt
Fi lic
Estimated methylamphetamine consumption by country

nl (2 ug (1)
Methylamphetamine

an ) al
d (3
Not detected

Cocaine )
Australia
(4
)
0
10
20
30
40
50
60

0
2
4
6
8
10
12
14
16
18
20
22
24
United States of America and Australia for methylamphetamine, cocaine and MDMA
Figure 40: National population weighted average consumption for cities in Europe, the

(Doses / 1000 People / Day) (Doses / 1000 People / Day)

Estimated consumption Estimated consumption
 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Figure 40 (continued): National population weighted average consumption for cities in

Europe, the United States of America and Australia for methylamphetamine, cocaine and
MDMA consumed on a per capita basis.
Estimated MDMA consumption by country
(population-weighted average of (n) sites)
800 8
MDMA
700 Australia 7

(Doses / 1000 People / Day)

(mg / 1000 People / Day)

600 6
Estimated consumption

Estimated consumption
500 5

400 4

300 3

200 2

100 1

0 0
B ny 1)
Po um )

Fr gal )
ze F nc (3)

lic )
us ai )

Li rw (1)

C kia )
es P pru 2)
A an )
in nia )

er t )

Ita (1)
R lan (4)

lo nia )
ni S an )

C om )

N tria )

)
A ia ( )

ic )
Ic nd )

ec )
gi 17

u (7

va (1

of ol s (2
2

G roa (1

ua (1
1

ub (4
A Sp (2

(1
al 4

er (1
la (3
el (5

re (1
a (

(
d ve (
gd (

us 4
tr n (
el (
m ia
te lo d

c h in e
ep d

e
th ay

m d
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G ly
itz nd

a
Sw erla

rt

y
o

S
h

K
et
N

at
C
U

St
d
te
ni
U

Note: the European estimates are based on data of a few WWTPs per country only and, therefore, may not
represent the national per capita consumption for a given analyte in a given country. The number of reported
cities is given in brackets after country name. European and USA data are from SCORE (2018) and various
excretion factors applied are reported in Appendix 1. SCORE reports measured raw loads in sewers and doses
were calculated in the same way as for Australia. All SCORE data were from March 2017. Australian data is from
April 2018.

5.2 NICOTINE AND ALCOHOL USE

In the case of nicotine and tobacco, Australian consumption was compared with countries
for which wastewater-based data are available (Figure 41). Although the periods in which
the international studies were conducted are not matched, Australia ranks well below the
European countries in terms of nicotine consumption, while alcohol use is slightly more
towards the European average.

65
Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Figure 41. National population weighted average consumption for studies outside
Australia and Australia for nicotine and alcohol consumed on a per capita basis.
Estimated nicotine consumption by country
(population-weighted average of (n) sites)

5500 Nicotine 7000

Australia 6500
5000

Estimated cigarette consumption

Estimated Nicotine consumption

6000

(Cigarettes / 1000 People / Day)

4500 5500
(mg / 1000 People / Day)

4000 5000

3500 4500
4000
3000
3500
2500 3000
2000 2500

1500 2000
1500
1000
1000
500 500
0 0
h)

s)

n)

7)
o)

)
l)

n)

n)

n)

1)

a)
)
(8

ht

(6
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to
el

(4
(1

el
ric

lo
sl

ila

bo
ge
ec
y

c
lic
ris
ss

st
(O

el

ia
l

na

i
ha
Zu

is
Ita

l
tr

ub

po
ub
t

(B
ru

al
(
as

(L
(U
ay

hi
en
(

ly

tr
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ep

om
ep
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(C

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Sw orw

Ita

us
s

op
an

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R
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ai

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l
Sp
itz

Po
k
r

ov
ze
he
el

ar

go
C

Sl
B

m
et

tia
en
N

an
D

(S
n
ai
Sp

Estimated alcohol consumption by country

(population-weighted average of (n) sites)
45 3500
Alcohol
(Litres of Alcohol / 1000 People / Day)

(Standard Drinks / 1000 People / Day)

40 Australia 3000
35

Estimated consumption
Estimated consumption

2500
30

25 2000

20 1500

15
1000
10
500
5

0 0
)

)
)

3)
n)

)
o)

t)

n)
l)

n)

o)
(2

47
(8

ls

(2
ch
on

al
to

ch
(

sl
ge

lo

la

an
e

g
(
a

n
um any

i
d

is
ss

ur
(O

i
e

l
nd

ia
ad

M
ai
ha

te

ug
on

tr
r

or
(Z
(B
ru

al

(
Sp

as
(U
ay
an

rla
en

(L
(L

ly
tr

(P
(B

nd
er

(C
d
w

Ita
C

us
op

s
he

nd
d

an

nd
G

or
an

la

n
ad
A
et
(C

la
gl
N

er

ai
rla
gl

er
gi

lm
En

Sp
itz
k

En

he
el

e
ar

itz
A
Sw
Th
B
m

et

Sw
en

N
D

Note: the study estimates are based on data from available scientific publications. The number of reported cities is
given in brackets after country name. Various excretion factors applied are reported in Appendix 1. Reported mass
loads in sewers have been collated on a population weighted basis per city where applicable and doses calculated
in the same way as for Australia. Nicotine data are from 2011 (Portugal), 2012 (Italy), 2014 (Czech Republic,
Slovak Republic), average of 2012-2014 (Spain) and 2015 (China) (Lopes et al. 2014, Rodriguez-Alvarez et al. 2014,
Castiglioni et al. 2015, Mackulak et al. 2015, Wang et al. 2016) and for remaining sites from Baz-Lomba et al.
(2016). Results for alcohol are from samples collected in 2015 (Ryu et al. 2016). Norway, Spain, Belgium,
United Kingdom, Netherlands, Italy, Switzerland and Denmark results are from Baz-Lomba et al. (2016).

66
 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

6: ACKNOWLEDGMENTS
The project team sincerely thank the numerous WWTP operators involved in sample
collection and WWTP management agencies for providing flow volumes and other site
information. The cooperation of the plants and management agencies is critical to the
ongoing success of this project.
The University of South Australia would like to thank our funding partners, the Drug and
Alcohol Services South Australia (DASSA) for their permission to use historical and current
data from South Australia, as well as the Western Australia Police Force for permission to
use data from Western Australia. We would also like to acknowledge the efforts of other
team members at the University of South Australia, including Lynn Nguyen for assistance
with logistics and analytical methods.
The University of Queensland thanks Geoff Eaglesham for his contributions to the analytical
work for this study. We also thank the members of the Emerging Environmental Health Risks
research group at QAEHS (incorporating the former Entox) for assistance with preparing and
shipping over 1,000 sampling bottles to the various plants, and those members, past and
present, who helped establish this field at the university.
We also would like to acknowledge the wider wastewater-based epidemiology field
which includes addiction specialists, analytical chemists, environmental engineers,
forensic scientists, pharmacologists, policy advisors and sewer engineers for their ongoing
contributions to knowledge, willingness to share both methodology and data, critical review
and for advancing wastewater analysis research.
The symbols/images used in Figure 1 in the report were provided courtesy of the Integration
and Application Network, University of Maryland, Center for Environmental Science
(ian.umces.edu/symbols/).

67
Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

7: REFERENCES
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Causanilles, A., Hernandez, F., Kasprzyk-Hordern, B., Kinyua, J., McCall, A-K., van Nuijs, A.,
Ort, C., Plósz, B.G., Ramin, P., Reid, M., Rousis, N.I., Ryu, Y., de Voogt, P., Bramness, J. and
Thomas, K. (2016). Comparison of pharmaceutical, illicit drug, alcohol, nicotine and caffeine
levels in wastewater with sale, seizure and consumption data for 8 European cities.
BMC Public Health 16:1035. DOI: 10.1186/s12889-016-3686-5.

Boerner, U., Abbott, A., and Roe, L. (1975). The metabolism of morphine and heroin in man.
Drug metabolism reviews 4(1): 39-73.

Castiglioni, S., Senta, I., Borsotti, A., Davoli, E. and Zuccato, E. (2015). A novel approach for
monitoring tobacco use in local communities by wastewater analysis. Tob Control 24(1):
38-42. DOI: 10.1136/tobaccocontrol-2014-051553.

Gracia-Lor, E., Zuccato, E. and Castiglioni, S. (2016). Refining correction factors for back-
calculation of illicit drug use. Sci Total Environ 573: 1648-1659.
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Irvine, R.J., Kostakis, C., Felgate, P.D., Jaehne, E.J., Chen, C. and White, J.M. (2011).
Population drug use in Australia: a wastewater analysis. Forensic Sci Int 210(1-3): 69-73.
DOI: 10.1016/j.forsciint.2011.01.037.

Khan, U. and Nicell, J.A. (2011). Refined sewer epidemiology mass balances and their
application to heroin, cocaine and ecstasy. Environment International 37: 1236-1252.

Khan, U. and Nicell, J.A. (2012). Sewer epidemiology mass balances for assessing the illicit
use of methamphetamine, amphetamine and tetrahydrocannabinol. Sci Total Environ
421-422: 144-162. DOI: 10.1016/j.scitotenv.2012.01.020.

Lai, F.Y., Ort, C., Gartner, C., Carter, S., Prichard, J., Kirkbride, P., Bruno, R., Hall, W.,
Eaglesham, G. and Mueller, J.F. (2011). Refining the estimation of illicit drug consumptions
from wastewater analysis: Co-analysis of prescription pharmaceuticals and uncertainty
assessment. Water Research 45(15): 4437-4448. DOI: 10.1016/j.watres.2011.05.042.

Lai, F.Y., Anuj, S., Bruno, R., Carter, S., Gartner, C., Hall, W., Kirkbride, K.P., Mueller, J.F.,
O’Brien, J.W., Prichard, J., Thai, P.K. and Ort, C. (2015). Systematic and day-to-day effects of
chemical-derived population estimates on wastewater-based drug epidemiology.
Environ Sci Technol 49(2): 999-1008. DOI: 10.1021/es503474d.

Lalovic, B., Kharasch, E., Hoffer, C., Risler, L., Liu-Chen, L.Y. and Shen, D.D. (2006).
Pharmacokinetics and pharmacodynamics of oral oxycodone in healthy human subjects:
role of circulating active metabolites. Clin Pharmacol Ther 79(5): 461-479.
DOI: 10.1016/j.clpt.2006.01.009.

Lopes, A., Silva, N., Bronze, M.R., Ferreira, J. and Morais, J. (2014). Analysis of cocaine and
nicotine metabolites in wastewater by liquid chromatography-tandem mass spectrometry.
Cross abuse index patterns on a major community. Sci Total Environ 487: 673-680.
DOI: 10.1016/j.scitotenv.2013.10.042.
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 Australian Criminal Intelligence Commission
National Wastewater Drug Monitoring Program—Report 5, August 2018

Mackulak, T., Birosova, L., Grabic, R., Skubak, J. and Bodik, I. (2015). National monitoring of
nicotine use in Czech and Slovak Republic based on wastewater analysis.
Environ Sci Pollut Res Int 22(18): 14000-14006. DOI: 10.1007/s11356-015-4648-7.

Pizarro, N., Ortuño, J., Jarré, M., Hernández-López, C., Pujadas, M., Llebaria, A., Joglar, J.,
Roset, P.N., Mas, M., Segura, J., Camí, J. and De la Torre, R. (2002). Determination of MDMA
and its metabolites in blood and urine by gas chromotography-mass spectrometry and
analysis of enantiomers by capillary electrophoresis. Journal of Analytical Toxicology 26(3):
157-165.

Rodriguez-Alvarez, T., Rodil, R., Rico, M., Cela, R. and Quintana, J. B. (2014). Assessment of
local tobacco consumption by liquid chromatography-tandem mass spectrometry sewage
analysis of nicotine and its metabolites, cotinine and trans-3’-hydroxycotinine, after
enzymatic deconjugation. Anal Chem 86(20): 10274-10281. DOI: 10.1021/ac503330c.

Rossi, S. (2016). Australian Medicines Handbook, (internet). Adelaide, Australia,

Australian Medicines Handbook, Pty. Ltd.

Ryu, Y., Barcelo, D., Barron, L.P., Bijlsma, L., Castiglioni, S., de Voogt, P., Emke, E., Hernandez, F.,
Lai, F.Y., Lopes, A., de Alda, M.L., Mastroianni, N., Munro, K., O’Brien, J., Ort, C., Plosz, B.G.,
Reid, M.J., Yargeau, V. and Thomas K.V. (2016). Comparative measurement and quantitative
risk assessment of alcohol consumption through wastewater-based epidemiology:
An international study in 20 cities. Sci Total Environ 565: 977-983.
DOI: 10.1016/j.scitotenv.2016.04.138.

Sewage Analysis CORe group Europe (SCORE) (2018). Wastewater analysis and drugs –
a European multi-city study. Available at
http://www.emcdda.europa.eu/topics/pods/waste-water-analysis_en

Sullivan, M. A., Vosburg, S. K. and Comer, S. D. (2006). Depot naltrexone: antagonism of the
reinforcing, subjective, and physiological effects of heroin. Psychopharmacology 189(1): 37-46.

Tscharke, B.J., Chen, C., Gerber, J.P. and White, J.M. (2016). Temporal trends in drug use in
Adelaide, South Australia by wastewater analysis. Sci Total Environ 565: 384-391.
DOI: 10.1016/j.scitotenv.2016.04.183.

Wang, D. G., Dong, Q. Q., Du, J., Yang, S., Zhang, Y. J., Na, G. S., Ferguson, S. G., Wang, Z.
and Zheng, T. (2016). Using Monte Carlo simulation to assess variability and uncertainty of
tobacco consumption in a city by sewage epidemiology. BMJ Open 6(2): e010583.
DOI: 10.1136/bmjopen-2015-010583.

Zuccato, E., Chiabrando, C., Castiglioni, S., Bagnati, R. and Fanelli, R. (2008). Estimating
community drug abuse by wastewater analysis. Environ Health Perspect 116(8): 1027-1032.
DOI: 10.1289/ehp.11022.

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8: APPENDICES
APPENDIX 1: DRUG-SPECIFIC PARAMETERS FOR ANALYTICAL REPORTING
AND USAGE CALCULATIONS
Analyte levels of detection, levels of reporting, highest detection, excretion factors and
standard doses from the literature.

Level of Level of Standard

Excretion
Analyte detection reporting dose pure
factor
(LOD) [ng/L] (LOR) [ng/L] drug (mg)

Amphetamine 12 16 0.394a 30b

Cocaine 17 50 0.075b 100b
Cotinine 33 100 0.3c 1.25c
Norfentanyl 0.1 0.1 0.3d 0.2d
JWH-018 1 14 n.a. n.a.
JWH-073 10 20 n.a. n.a.
MDA * 1 4 n.a. n.a.#
MDMA 1.5 2 0.225b 100b
Mephedrone 0.4 0.8 n.a. n.a
Methylamphetamine 33 100 0.39g 30b
Methylone 0.01 0.1 n.a. n.a.
Hydroxycotinine 17 50 0.44c 1.25c
Noroxycodone 0.1 1 0.22f 20d
Ethyl sulphate 167 500 0.00012e 10ge
Benzoylecgonine 33 100 0.35g 100b
6-monoacetylmorphine 0.5 1.0 0.013h 20i

n.a. = data not available; a = (Khan and Nicell 2012); b = (Zuccato et al. 2008); c = (Castiglioni et al. 2015);
d = (Rossi 2016); e = (Ryu et al. 2016); f = (Lalovic et al. 2006); g = (Lai et al. 2011); h = (Boerner et al. 1975);
i =(Sullivan et al. 2006).
* Data is not available in the scientific literature for the proportion of MDA that is eliminated after MDA
consumption. However, data is available detailing the proportion of MDA eliminated after MDMA consumption.
Therefore, our MDA estimate of mg excreted per day per 1,000 people is the amount of MDA excreted from the
population after considering the metabolic fraction excreted from MDMA.
#
It is likely that the dose for MDA is similar to that of MDMA, of 100 mg.

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 APPENDIX 2: NUMBER OF SITES ASSESSED IN EACH REPORT
Number of sites assessed in each state and territory for each report and total populations assessed.
C = capital city wastewater treatment plant, R = regional wastewater treatment plant
Report 1 Report 2 Report 3 Report 4 Report 5
Aug-16 *Oct-16 Dec-16 *Feb-17 Apr-17 *Jun-17 Aug-17 *Oct-17 Dec-17 *Feb-18 Apr-18
State/territory C R C R C R C R C R C R C R C R C R C R C R
ACT 1 - - - 1 - 1 - 1 - 1 - 1 - 1 - 1 - 1 - 1 -
NSW 5 5 - - 3 3 3 - 3 2 3 - 5 7 3  - 3 5 3  - 3 4
NT 1 1 - - - - - - - - - - 1 1 - - 1 - 0 - 1 1
Qld 3 9 - - 2 8 3 - 3 8 3 - 3 7 3  - 3 6 3  - 3 8
SA 4 4 4 - 4 5 4 - 4 5 4 - 4 5 4 - 4 5 4 - 4 5
Tas 3 4 - - - - - - - - - - 3 3 3  - 3 2 3 -  3 2
Vic 2 5 2 - 2 3 2 - 2 2 2 - 2 6 2 - 2 4 2 - 2 4
WA 3 1 3 - 3 3 3 - 3 3 3 - 3 3 3  - 3 3 3  - 3 3
Population
11.5 1.6 6.5 -  10.6 1.3 11.1 -  11.1 1.2 11.1 -  11.5 1.7 11.2  - 11.2 1.5 11.2  - 11.2 1.6
(millions) C & R
Total Population
13.1 6.5 11.9 11.1 12.3 11.1 13.2 11.2 12.7 11.2 12.8
(millions)
% of Australian
55.9% 27.8% 50.9% 47.4% 52.4% 47.4% 56.3% 47.9% 54.3% 47.9% 54.8%
population
* Every second time-point aims to sample from only capital city sites. Census 2016 population used for population percentage estimates. Estimates have been rounded to the nearest
0.1 million. Note: catchment populations have been refined, and so population totals and percentages may have changed accordingly.
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APPENDIX 3: FURTHER INFORMATION ON WWTPS
Sampling details of each wastewater treatment plant.
# Samples
Site Code Capital/Regional Aug 16 Oct 16 Dec 16 Feb 17 Apr 17 Jun 17 Aug 17 Oct 17 Dec 17 Feb 18 Apr 18 Population Category
ACT: 009 Capital 7 - 7 7 7 7 7 7 7 7 7 >150,000
NSW: 003 Capital 7 - 7 4 7 7 7 7 7 7 7 >150,000
NSW: 006 Capital 7 - 7 7 7 7 7 7 7 7 7 >150,000
NSW: 008 Capital 6 - 7 7 7 7 7 7 7 7 7 >150,000
NSW: 021 Capital 7 - - - - - 7 - - - - 30,000 to 150,000
Australian Criminal Intelligence Commission

NSW: 071 Capital 7 - - - - - 7 - - - - >150,000

NSW: 016 Regional 5 - 7 - - - 5 - 7 - 7 30,000 to 150,000
NSW: 025 Regional 7 - - - - - 7 - 7 - 7 30,000 to 150,000
NSW: 040 Regional 7 - - - - - 7 - - - - <30,000
NSW: 051 Regional 7 - - - - - 7 - - - - <30,000
NSW: 068 Regional 1 - 4 - 7 - 7 - 7 - 7 >150,000
National Wastewater Drug Monitoring Program—Report 5, August 2018

NSW: 081 Regional - - - - - - 7 - 7 - - <30,000

NSW: 115 Regional - - 7 - 7 - 7 - 7 - 7 30,000 to 150,000
NT: 010 Capital 7 - - - - - 7 - 7 - 7 30,000 to 150,000
NT: 078 Regional 7 - - - - - 7 - - - 7 <30,000
Qld: 002 Capital 7 - 6 6 7 7 7 7 7 7 7 >150,000
Qld: 005 Capital 7 - - 7 7 7 6 6 7 6 7 >150,000
Qld: 011 Capital 7 - 7 6 7 7 6 7 7 7 7 >150,000
Qld: 012 Regional 5 - 7 - 7 - 7 - 6 - 7 >150,000
Qld: 020 Regional 7 - - - - - - - - - - <30,000
Qld: 024 Regional 7 - 7 - 7 - - - - - 7 30,000 to 150,000
Qld: 028 Regional 7 - 7 - 7 - 7 - - - 7 30,000 to 150,000
Qld: 029 Regional 7 - 7 - 7 - 7 - 7 - 7 30,000 to 150,000
Qld: 033 Regional 7 - 7 - 7 - 7 - 7 - 6 30,000 to 150,000
Qld: 039 Regional 7 - 7 - 7 - 7 - 7 - 7 <30,000
Qld: 053 Regional 7 - 3 - 5 - 7 - 5 - 6 <30,000
Qld: 077 Regional 7 - 7 - 7 - 7 - 7 - 7 <30,000
SA: 007 Capital 5 7 7 7 7 7 7 7 7 7 7 >150,000
SA: 013 Capital 5 7 7 7 7 7 7 7 7 7 7 >150,000
SA: 027 Capital 5 7 7 7 7 7 7 7 7 7 7 30,000 to 150,000
SA: 059 Capital 5 7 7 7 7 7 7 7 6 7 7 >150,000
 Sampling details of each wastewater treatment plant (continued).
# Samples
Site Code Capital/Regional Aug 16 Oct 16 Dec 16 Feb 17 Apr 17 Jun 17 Aug 17 Oct 17 Dec 17 Feb 18 Apr 18 Population Category
SA: 017 Regional 5 - 4 - 4 - 4 - 4 - 7 <30,000
SA: 022 Regional 5 - 4 - 4 - 4 - 4 - 7 <30,000
SA: 063 Regional 5 - 4 - 5 - 4 - 4 - 7 <30,000
SA: 076 Regional 5 - 4 - 4 - 4 - 4 - 7 <30,000
SA: 119 Regional - - 4 - 4 - 4 - 4 - 7 <30,000
Tas: 004 Capital 7 - - - - - 5 5 5 5 5 <30,000
Tas: 019 Capital 7 - - - - - 5 5 5 5 5 <30,000
Tas: 041 Capital 7 - - - - - 4 5 5 5 5 <30,000
Tas: 018 Regional 7 - - - - - 5 - 7 - 7 <30,000
Tas: 038 Regional 7 - - - - - - - - - - <30,000
Tas: 048 Regional 7 - - - - - 5 - 5 - 5 <30,000
Tas: 058 Regional 7 - - - - - 5 - - - - <30,000
Vic: 001 Capital 7 7 7 7 7 7 7 7 7 7 7 >150,000
Vic: 067 Capital 7 7 7 7 7 7 7 7 7 7 7 >150,000
Vic: 037 Regional 7 - 7 - - - 7 - 7 - 7 >150,000
Vic: 046 Regional 7 - - - - - 7 - - - - 30,000 to 150,000
Vic: 061 Regional 7 - 7 - 7 - 7 - 7 - 7 30,000 to 150,000
Vic: 062 Regional 7 - - - - - 5 - - - - <30,000
Vic: 066 Regional 6 - 7 - 7 - 7 - 7 - 7 30,000 to 150,000
Vic: 114 Regional - - - - - - 5 - 7 - 7 30,000 to 150,000
WA: 101 Capital 7 7 7 7 7 7 7 7 7 7 7 >150,000
WA: 103 Capital 7 7 7 7 7 7 7 7 7 7 7 >150,000
WA: 104 Capital 7 7 7 7 7 7 7 7 7 7 7 >150,000
WA: 102 Regional 7 - 7 - 7 - 7 - 7 - 7 30,000 to 150,000
WA: 118 Regional - - 7 - 7 - 7 - - - - <30,000
WA: 120 Regional - - 7 - 7 - 7 - 7 - 7 30,000 to 150,000
WA: 129 Regional - - - - - - - - 7 - 7 <30,000
  Total Days 329 63 236 107 236 112 342 126 288 126 319
  Total Sites 51 9 37 16 36 16 54 19 45 19 47
  Total Capital 22 9 15 16 16 16 22 19 20 19 20
  Total Regional 29 0 22 0 20 0 32 0 25 0 27
 Total samples: 329 Total samples: 406 Total samples: 690 Total samples: 414 Total samples: 445 Grand total number of
Report 1; Report 2; Report 3; Report 4; Report 5; samples: 2,284
Aug 2016 Oct & Dec 2016, Feb 2017 Apr, Jun & Aug 2017 Oct & Dec 2017 Feb & Apr 2018 Report 1-5
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APPENDIX 4: PERCENTAGE OF SAMPLES ABOVE LOD (%) FOR EACH DRUG AND PERIOD ASSESSED.
The proportion of samples that each drug was detected above LOD for Report 1 to 5. Note: regional sites are only sampled every second period.

Drug detections % (above LOD) Report 1–5

Aug Oct Dec Feb Apr Jun Aug Oct Dec Feb Apr
2016 2016 2016 2017 2017 2017 2017 2017 2017 2018 2018
Methylamphetamine Capital 100 100 100 100 100 100 100 100 100 100 100
Methylamphetamine Regional 100 - 100 - 100 - 100 - 100 100 100
Cocaine Capital 97 97 96 96 97 96 90 90 95 99 97
Australian Criminal Intelligence Commission

Cocaine Regional 45 - 52 - 53 - 53 - 56 100 82

MDMA Capital 100 100 100 100 100 96 100 100 100 100 100
MDMA Regional 95 - 96 - 100 - 98 - 100 - 98
MDA Capital 98 92 100 100 100
National Wastewater Drug Monitoring Program—Report 5, August 2018

MDA Regional 86 - 95 - 95
Oxycodone Capital 100 100 100 100 100 100 100 100 100 100 100
Oxycodone Regional 100 - 100 - 100 - 100 - 100 - 100
Fentanyl Capital 100 97 100 99 100 100 100 100 100 100 96
Fentanyl Regional 96 - 94 - 99 - 100 - 100 - 100
Heroin Capital 83 92 84 85 76
Heroin Regional 37 - 59 - 22
Alcohol Capital 100 100 100 100 100 100 100 100 100 100 100
Alcohol Regional 100 - 100 - 100 - 100 - 100 100 100
Nicotine Capital 100 100 100 100 100 97 100 100 100 100 100
Nicotine Regional 100 - 100 - 100 - 100 - 100 100 100
Mephedrone Capital 2 - - - - 1 - 1 24 3 4
Mephedrone Regional - - 3 - 3 - 1 - 12 - 3
Methylone Capital 45 19 47 28 79 7 28 46 59 10 2
Methylone Regional 41 - 14 - 9 - 22 - 22 - 3
CONCLUSIONS

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CONCLUSIONS
For the fifth report of the National Wastewater Drug Monitoring Program, wastewater analysis
was conducted in February and April 2018. The program has identified variations in patterns
of drug consumption, both over time and within and between jurisdictions. Consistent with
previous reports, findings show that of the substances monitored, nicotine and alcohol are the
most consumed drugs in Australia.7 While there have been decreases in methylamphetamine
consumption this reporting period from the previous reporting period, it remains the most
consumed illicit drug, with estimated consumption significantly exceeding that of other
monitored illicit drugs.

METHYLAMPHETAMINE
When comparing data from April 2017 and April 2018, population-weighted averages for
methylamphetamine consumption in capital city and regional sites increased.
The population-weighted average consumption of methylamphetamine for both capital city
and regional sites decreased from December 2017 to April 2018. Of note this reporting period
are the decreases in average capital city and regional methylamphetamine consumption
recorded in both South Australia and Western Australia. The regional average consumption
of methylamphetamine continues to exceed capital city average consumption. The Northern
Territory had the highest estimated average capital city consumption of methylamphetamine in
April 2018, with Western Australia having the highest estimated average regional consumption.

AMPHETAMINE
Amphetamine is a metabolite of methylamphetamine consumption. While the program measured
amphetamine consumption, measured consumption was not reported separately as levels
measured were consistent with observed levels related to methylamphetamine consumption.

COCAINE
When comparing data from April 2017 and April 2018, population-weighted averages for cocaine
consumption in capital city sites decreased, while consumptions in regional sites increased.
The population-weighted average consumption of cocaine for both capital city and regional
sites decreased from December 2017 to April 2018 . The capital city average consumption
of cocaine was almost double the regional average. New South Wales continues to have the
highest estimated average capital city and regional consumption of cocaine in Australia.

3,4-METHYLENEDIOXYMETHYLAMPHETAMINE (MDMA)
When comparing data from April 2017 and April 2018, population-weighted averages for MDMA
consumption in capital city sites decreased, while consumption in regional sites increased.
The population-weighted average consumption of MDMA for both capital city and regional
sites decreased from December 2017 to April 2018. The regional average consumption of
MDMA was higher than capital city average consumption. The Northern Territory had the
highest estimated average capital city consumption of MDMA in April 2018, with New South
Wales having the highest estimated average regional consumption, closely followed by Victoria.

7 Throughout this report, all comparisons on the consumption of different drugs are based on doses consumed
rather than drug mass.

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3,4-METHYLENEDIOXYAMPHETAMINE (MDA)
MDA is a metabolite of MDMA. As the proportion of MDA derived from MDMA is known,
it has been possible from Report 3 to estimate MDA consumption rather that its presence
solely as a metabolite of MDMA use. The regional average consumption of MDA exceeds
capital city average consumption. While in previous reporting periods Site 12 in Queensland
was identified as a site of particular concern given the very high consumption levels
reported, this is no longer the case. Tasmania had the highest estimated average capital city
consumption of MDA in April 2018, with New South Wales having the highest estimated
average regional consumption.

HEROIN
The population-weighted average consumption of heroin in capital city sites remained
relatively stable, while consumption in regional sites decreased from December 2017 to
April 2018. The capital city average consumption of heroin was more than double the
regional average. Victoria had the highest estimated capital city and regional average
consumption of heroin in April 2018.

MEPHEDRONE
Consistent with previous reporting periods, mephedrone was mostly detected below
the level at which it could be reliably quantified. The number of national detections of
mephedrone more than halved this reporting period, from 23 in December 2017 to 10 in
April 2018. The number of sites where mephedrone was detected remained stable at six
this reporting period, with mephedrone detected in New South Wales and Queensland in
April 2018.

METHYLONE
Consistent with previous reporting periods, methylone was mostly detected below the level
at which it could be reliably quantified. The number of national detections of methylone
decreased considerably this reporting period, from 65 in December 2017 to eight in April
2018. Methylone was detected at seven sites in April 2018, a decrease from the 17 sites
in December 2017. While methylone was detected in New South Wales, Queensland and
Western Australia in April 2018, use appears to be largely concentrated in New South Wales.

OXYCODONE
When comparing data from April 2017 and April 2018, population-weighted averages for
oxycodone consumption remained relatively stable in capital city sites and increased in
regional sites.
The population-weighted average consumption of oxycodone decreased in capital city sites
and increased in regional sites from December 2017 to April 2018. The regional average
consumption of oxycodone continues to be almost double the capital city average. In April
2018, Tasmania had the highest estimated average capital city consumption of oxycodone,
with Victoria having the highest estimated average regional consumption.

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FENTANYL
When comparing data from April 2017 and April 2018, population-weighted averages for
fentanyl consumption in capital city and regional sites increased, with regional consumption
in April 2018 more than double that of April 2017.
The population-weighted average consumption of fentanyl increased in both capital city and
regional sites from December 2017 to April 2018, with related consumption currently the
highest recorded since the program began. The regional average consumption of fentanyl
was more than double the capital city average. Tasmania and the Australian Capital Territory
had the highest estimated average capital city consumption of fentanyl in April 2018, with
New South Wales the highest estimated average regional consumption.

NICOTINE8
When comparing data from April 2017 and April 2018, population-weighted averages for
nicotine consumption in capital city and regional sites decreased.
Nicotine remains one of the most consumed drugs in Australia. The population-weighted
average consumption of nicotine in capital city sites increased from December 2017 to
April 2018, with regional average consumption remaining relatively stable. The regional
average consumption of nicotine exceeded capital city average consumption. The Northern
Territory9 had the highest estimated average capital city and regional consumption of nicotine in
April 2018.

ALCOHOL
When comparing data from April 2017 and April 2018, population-weighted averages for
alcohol consumption in capital city sites decreased and increased in regional sites.
Alcohol remains one of the most consumed drugs in Australia. The population-weighted
average consumption of alcohol remained relatively stable in regional sites from December
2017 to April 2018, while consumption in capital city sites decreased. The regional average
consumption of alcohol was higher than capital city average consumption. The Northern
Territory had the highest estimated average capital city and regional consumption in
April 2018, with consumption levels well above the national average.

INTERNATIONAL COMPARISONS (SCORE)

There are a number of factors that influence drug consumption, including but not limited
to different drug preferences and drug availability. This concept is illustrated in the SCORE
data and the notable differences in stimulant drug preferences. Of the 23 countries with
comparable reported data for MDMA, cocaine, amphetamine and methylamphetamine,
Australia ranks second highest after the USA for total estimated stimulant consumption,
although the USA figure is based on testing at one site only. In comparing the individual
drug components, Australia ranks highly compared to other reported countries for
methylamphetamine consumption, with medium MDMA consumption and relatively low
cocaine consumption.

8 For accuracy, estimates have been changed from tobacco in Report 1 and 2 to nicotine from Report 3 due
to the inability to distinguish between nicotine intake from tobacco or electric cigarettes and nicotine
replacement therapies such as patches and gum.
9 As the Northern Territory only had two participating sites, results may not be representative of the Territory
as a whole.

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NEXT REPORT
The sixth report of the National Wastewater Drug Monitoring Program is scheduled to be
publicly released in December 2018. Cannabis is to be included in the drugs monitored by
the National Wastewater Drug Monitoring Program, with related analysis to be incorporated
for the first time in Report 6.

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© Commonwealth of Australia 2018