The White House Office of National Drug Control Policy (ONDCP) recently released a report on wastewater testing, marking the federal government’s full embrace of this innovative approach to tracking evolving trends in drug use.
As people excrete substances––such as in toilets and showers––this material makes its way to local treatment plants, where it is tested for the presence of various substances. This approach can test for drugs as well as diseases such as COVID-19 and measles. ONDCP’s report mentioned that the program measures more than 20 drugs and can detect the presence of more than 500.
Wastewater testing enables detection of local variations in the drug supply. For example, the report noted that fentanyl’s highest concentrations were in Washington State, cocaine’s highest concentrations were in Texas, and methamphetamine’s highest concentrations were in Colorado and Nevada. In turn, interventions and awareness campaigns can be targeted to these regions.
An additional advantage of wastewater testing is that it provides results that are timelier and more affordable than traditional toxicology testing. While the most recent final statistics for drug overdose deaths go through 2024, wastewater testing can provide results in a matter of days. The CDC said that “from toilet flush to results only takes about 5 to 7 days.”
The report also pointed to medetomidine, para-fluorofentanyl, carfentanil, and acetyl fentanyl as “potential emerging and re-emerging threats.” This approach can detect local changes in the drug supply before they become nationwide crises.
ONDCP Director Sara Carter said, “wastewater testing provides near real-time data to guide and shape a proactive approach to illicit drug threats,” adding that “by implementing wastewater testing, we are identifying new drug trends and responding to them rapidly.”
Wastewater testing is a central component of the 2026 National Drug Control Strategy, which outlined that ONDCP will prioritize “the establishment of new data systems to monitor drug consumption in real-time, through a national wastewater-based monitoring system and biosurveillance.”