| The structure of drug in China was dominated by synthetic drugs,followed by opioids,and other drugs,such as cocaine(COC),were the last.Ketamine(KET)was one of the most abused synthetic drugs in China.In recent years,a new alternative to ketamine has appeared on the market-2-fluorodes-chloroketamine(2F-DCK),and in order to avoid been arrested,the criminals mixed it into KET and sold it,2F-DCK had not yet been listed,which had increased the difficulty of drug control,the abuse of COC in China had gradually increased with the increase of international exchanges,and there were few studies on its abuse in China.Therefore,this study selected 25 major cities on the nationwide,collected 34 sewage plant inlet samples,used gas chromatography-mass spectrometer to analyze the concentration of KET and COC,and analyzed the consumption of KET and COC by wastewater-based epidemiology,predicted the total annual abuse,drug users and prevalence of KET,analyzed it’s spatial distribution,temporal trends,and influencing factors of KET.In addition,supplementary sampling was carried out in the provinces and surrounding cities where 2F-DCK seizures have been reported in China.A total of 23 wastewater treatment plant samples,municipal sewer samples and Yongjiang River samples were collected.Establishing a solid-phase extraction-based gas chromatography-mass spectrometry method to analyze its stability and abuse.The concentration range of KET was <LOD-97.9 ng/L,the average was 27.1 ± 23.3 ng/L.The metabolite of KET is norketamine with a concentration range was <LOD-49.8 ng/L,the average was 5.51 ± 10.53 ng/L.Only Qamdo,Changzhi and Chongqing had detected COC metabolite benzoylecgonine,the concentration range was <LOD-41.6 ng/ L,the average was3.50 ± 8.91 ng/L.According to the back calculation,the consumption of KET and COC in 2018 were 35.3 ± 65.2 mg/d/1000 inh,3.28 ± 7.10 mg/d/1000inh(the consumption of COC in most Chinese cities and overall remains low).The annual consumption of KET was predicted to be20.4 t,the drug users was 847,000,and the prevalence was 0.05%.Spatial distribution analysis found there was no significant difference in the consumption of KET between the cities in the north and south of China and the cities in the east and west.Among the seven geographic regions,East China,Central China,and South China,where the economy is relatively developed,are more severely abused.Temporal changes analysis found that compared with2014,the consumption of KET decreased significantly(p <0.05)in 2016 and 2018,and there was no significant change in 2016 compared with 2018.Statistical analysis showed economy is the main factor affecting the abuse of KET.2F-DCK showed high stability in acidified wastewater and natural wastewater at normal or freezing conditions;2F-DCK was detected in the sewage of Guangzhou,Shenzhen,Nanning and Quanzhou,with a concentration range of <LOD-43.9 ng/L ng/L and an average of 6.07 ± 13.74 ng/L,the abuse of 2F-DCK had not caused pollution to the natural environment of Yongjiang River,and the abuse of 2F-DCK was not as widespread as KET,but this rapidly growing new psychoactive substance still requires great attention.Wastewater-based epidemiology can comprehensively and objectively assess the abuse of KET and COC across the country in real time,analyze the spatial distribution characteristics and temporal changes of substances,and monitor the distribution of abuse of drug substitutes.The abuse of COC,KET and their substitute(2F-DCK)in China is not very serious,but longterm monitoring is still needed to provide a scientific basis for smart drug control. |
PDF Full Text Request