ArticleThe Science of the total environment2023
Occurrence of Z-drugs, benzodiazepines, and ketamine in wastewater in the United States and Mexico during the Covid-19 pandemic.
Article in The Science of the total environment, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- Presence of Benzodiazepines in Aquatic Environments: A Systematic Review of the Literature.Drug safety · 2026Pooled it
- Interpol review of forensic drug chemistry, 2022-2025.Forensic science international. Synergy · 2026Review
- High temporal resolution monitoring of illicit drug consumption across England via wastewater analysis.Addiction (Abingdon, England) · 2026Article
- Discovery and quantification of novel diazepam metabolites BP-246 and BP-271 in freshwater fish using HRMS and UPLC-MS/MS.Scientific reports · 2026Article
- Public Awareness and Acceptance of Wastewater Surveillance in the United States, June 2024.Public health reports (Washington, D.C. : 1974) · 2026Article
- Dispersive micro-solid-phase extraction coupled to UHPLC-Q-TOF-MS and UHPLC-QqQ-MS for suspect and target screening of illicit drugs and pharmaceuticals in wastewater.Analytical and bioanalytical chemistry · 2026Article
- Recent Advances in Adsorption-Photocatalytic Removal of Pharmaceuticals From Water Using Hybrid Ion-Adsorbent Photocatalyst.Water environment research : a research publication of the Water Environment Federation · 2026Review
- Z-Drugs in the Environment: A Review.Molecules (Basel, Switzerland) · 2026Review
- The Real-World Safety Profile of Temazepam: A 20-Year Pharmacovigilance Analysis Based on the Large-Scale FAERS Database.CNS neuroscience & therapeutics · 2026Article
- Targeted LC-MS/MS method for quantifying respiratory pharmaceuticals in wastewater.Environmental science : water research & technology · 2026Article
- Public Opinions from Malawian and Malawi Refugee Camp Residents of Wastewater and Environmental Surveillance.The American journal of tropical medicine and hygiene · 2025Article
- Integrating community perspectives to enhance the utility of wastewater-based epidemiology for addressing substance use in the United States.Current opinion in psychiatry · 2025Review
- Determination of 14 Benzodiazepine Multiresidues in Aquaculture Environment by Ultra-High-Performance Liquid Chromatography-Tandem Mass Spectrometry.Molecules (Basel, Switzerland) · 2025Article
- Ketamine use in a large global sample: Characteristics, patterns of use and emergency medical treatment.Journal of psychopharmacology (Oxford, England) · 2025Article
- Potentiation of the depressant effect of alcohol by flunitrazepam in rats: an electrocorticographic, respiratory and electrocardiographic study.Naunyn-Schmiedeberg's archives of pharmacology · 2024Article
- Abusive use of Zolpidem as a Result of COVID-19 and Perspectives of Continuity of the Problem in the Post-Pandemic Period.Current neuropharmacology · 2024Review
- Microplastics and other emerging contaminants in the environment after COVID-19 pandemic: The need of global reconnaissance studies.Current opinion in environmental science & health · 2023Review
- Community-level exposomics: a population-centered approach to address public health concerns.Exposome · 2023Article
- Characterization of Extended-Release Lorazepam: Pharmacokinetic Results Across Phase 1 Clinical Studies.Journal of clinical psychopharmacologyArticle
Corrections and comments
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Authors and funding
17 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Z-drugs, benzodiazepines and ketamine are classes of psychotropic drugs prescribed for treating anxiety, sleep disorders and depression with known side effects including an elevated risk of addiction and substance misuse. These drugs have a strong potential for misuse, which has escalated over the years and was hypothesized here to have been exacerbated during the COVID-19 pandemic. Wastewater-based epidemiology (WBE) constitutes a fast, easy, and relatively inexpensive approach to epidemiological surveys for understanding the incidence and frequency of uses of these drugs. In this study, we analyzed wastewater (n = 376) from 50 cities across the United States and Mexico from July to October 2020 to estimate drug use rates during a pandemic event. Both time and flow proportional composite and grab samples of untreated municipal wastewater were analyzed using solid-phase extraction followed by liquid chromatography-tandem mass spectrometry to determine loadings of alprazolam, clonazepam, diazepam, ketamine, lorazepam, nordiazepam, temazepam, zolpidem, and zaleplon in raw wastewater. Simultaneously, prescription data of the aforementioned drugs were extracted from the Medicaid database from 2019 to 2021. Results showed high detection frequencies of ketamine (90 %), lorazepam (87 %), clonazepam (76 %) and temazepam (73 %) across both Mexico and United States and comparatively lower detection frequencies for zaleplon (22 %), zolpidem (9 %), nordiazepam (<1 %), diazepam (<1 %), and alprazolam (<1 %) during the pandemic. Average mass consumption rates, estimated using WBE and reported in units of mg/day/1000 persons, ranged between 62 (temazepam) and 1100 (clonazepam) in the United States. Results obtained from the Medicaid database also showed a significant change (p < 0.05) in the prescription volume between the first quarter of 2019 (before the pandemic) and the first quarter of 2021 (pandemic event) for alprazolam, clonazepam and lorazepam. Study results include the first detections of zaleplon and zolpidem in wastewater from North America.
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