Dr. Sabo-Attwood’s Research

Tackling the Opioid Epidemic 

Drug-involved overdoses took the lives of more than 100,000 people last year in the United States bringing the 2-decade mortality total to nearly 1 million people. These deaths are largely attributable to synthetic opioids, namely illicitly manufactured fentanyl, that is knowingly and unknowingly consumed. Treatment and prevention are critical to addressing this crisis, which rely on knowledge of specific types, quantities, and consumption patterns of substances. Traditional surveillance methods (e.g., surveys, fluid testing) have limitations in scope and timing. They provide informational facets but are not designed to inform on community-level drug trends as they are emerging. Wastewater-based epidemiology (WBE) is an innovative yet mature approach that can identifydrug use trends rapidly on a community scale. By measuring human excreted chemicals or biological metabolites that enter wastewater streams, WBE provides information using biomarkers of health in a defined population. Community-level drug trends have been determined from wastewater for drugs of current concern (e.g., fentanyl); however, implementation of WBE as a holistic framework that contributes reliable, consistent, and trusted data to stakeholders is urgently needed. Our goal is to enhance the rigor and robustness of WBE as an “early warning system” to effectively drive response in impacted communities through innovative approaches, including first-time harmonization of wastewater and health data streams from across the U.S. and disseminating data that is informed and adopted by key stakeholders. We are also integrated with the National Drug Early Warning System Coordinating Center (NDEWS) which provides the field with timely and salient information on emerging substance use trends.  

We have also used WBE to identify positive cases of SARS-COV-2 and in new work are quantifying pesticides in wastewater in agricultural communities as a surrogate for understanding worker exposure and health. 


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