Piloting wastewater-based monitoring on a university campus to inform public health surveillance and response for opioids and other high-risk substances.

This study demonstrates the use of wastewater monitoring for opioids and other high-risk substances on a university campus, intended to inform public health surveillance and response efforts for youth and transitional age youth. Over a 14-week campaign, we collected 54 grab samples from three campus manholes, including one that isolated flows from a student housing complex, and analyzed them for 24 parent compounds and metabolites using LC-MS/MS. Heroin and its metabolite 6-acetylmorphine were among several opioid-related detections, illustrating how campus wastewater monitoring can capture actionable use events for targeted public health interventions. Fentanyl, norfentanyl, and xylazine were consistently below their method reporting limits across all 54 samples, consistent with recent declines in national overdose and wastewater datasets. The highest detection frequencies were associated with methamphetamine (22-50%), amphetamine (39-83%), and a THC metabolite (50-100%). This study also highlights the implications of sample type (grab vs. composite) and day of week for wastewater-based epidemiology (WBE). Considering that the use of opioid-related WBE as an actionable public health surveillance tool is still relatively new, additional case studies are needed to explore the potential of this emerging tool and increase confidence in deploying public health interventions in response to wastewater data.