National Wastewater-Based Surveillance of Nitazenes and Xylazine in Australia: Emerging Trends

Wastewater analysis has been used as a tool to monitor the use of novel psychoactive substances to understand public health impacts and identify contaminants of emerging concern. Due to their activity at low biological concentrations, determining their occurrence in wastewater is critical to identifying potential risks to human and environmental health. To date, there has been no sustained wastewater surveillance of nitazenes or xylazine in Australia. This work addresses that gap by providing nationally relevant data crucial for human and environmental health monitoring of nitazene and xylazine trends. This study applied wastewater analysis to detect nitazenes and xylazine in samples collected across Australia over a one-year period. Nitazenes and xylazine were detected in all of the states and territories in Australia. Nitazenes were recorded in all collections, fluctuating between a 6 and 16% detection frequency across the sampling year. Ongoing monitoring is critical to inform people who use drugs, public health, law enforcement, and policy makers about the extent of nitazene use in the population. The detection of these substances in wastewater underscores the need for further investigation into their possible impacts to human and environmental health.