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A nationwide wastewater monitoring pilot to identify legal and illegal substances and enable future substance use research

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Wastewater-based epidemiology has been proposed as a faster, near real-time window into community substance use, but national-scale implementation in the United States has been elusive. A National Institute on Drug Abuse-funded pilot with Biobot Analytics spanning 76 sites across 41 states demonstrates that harmonized, near-real-time wastewater surveillance of opioids and adulterants is not only feasible but actionable, offering public health officials data weeks or months ahead of traditional reporting systems.

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Fig. 1: Population weighted, locally estimated scatterplot smoothing (LOESS)-smoothed trends in benzoylecgonine, methamphetamine, naloxone, norfentanyl and xylazine wastewater concentration averages across four regions of the United States during the programme period (October 2023–September 2024).
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Authors and Affiliations

  1. Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Peter R. Chai

  2. Biobot Analytics, Inc. https://biobot.io/

    Kaitlyn Hess, Marisa A. P. Donnelly & Mariana Matus

Authors

  1. Peter R. Chai
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  2. Kaitlyn Hess
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  3. Marisa A. P. Donnelly
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  4. Mariana Matus
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Corresponding author

Correspondence to
Peter R. Chai.

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Competing interests

P.R.C. is funded by DP2DA056107, M.M. is co-founder and CEO of Biobot Analytics, and K.H. and M.A.P.D. are employees of Biobot Analytics. M.M. and the work described in this manuscript is funded by 75N95023P00170-0-0-1.

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Chai, P.R., Hess, K., Donnelly, M.A.P. et al. A nationwide wastewater monitoring pilot to identify legal and illegal substances and enable future substance use research.
Nat Water (2026). https://doi.org/10.1038/s44221-026-00660-7

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  • DOI: https://doi.org/10.1038/s44221-026-00660-7

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