Wastewater tests for drug residues conducted in Tallinn and Tartu in October 2023, indicate an increase in the use of cannabis and cocaine in both cities. The results also show a rise in the use of amphetamines in Tartu, while in Tallinn, the concentration of amphetamines in wastewater has remained at a stable level over the years, according to the National Institute of Health Development (TAI)

Concentrations of methamphetamine and MDMA, or ecstasy, in wastewater have decreased in both Tallinn and Tartu in recent years. Overall, illicit drug levels in wastewater were slightly higher in Tallinn than in Tartu. Methamphetamine proved an exception. While only small amounts were detected in Tartu wastewater, levels were still higher than in Tallinn.

In 2022, the average amount of cannabis products (THC-COOH) detected in wastewater per 1,000 inhabitants in Tallinn was 8,639 mg. In 2023, this had risen to 9,915 mg. In Tartu, the average was 4,278 mg in 2021 and 5,492 mg in 2023. When those cannabis amounts are converted into doses to provide a clearer picture, an average of 38,064 doses of cannabis were consumed daily in Tallinn and 4,390 doses in Tartu.

"In the context of the ongoing debates in Europe regarding the legalization of cannabis and the [associated] legislative changes in some countries, there is no reason to be surprised by the growing interest in cannabis. Estonia will also face the challenge of dealing with increasing use of cannabis and its harmful consequences. Ensuring access to support and treatment for both minors and adults will become a major concern," said Katri Abel-Ollo of the National Institute of Health Development's (TAI) drugs and addiction department.

The average cocaine residue levels per 1,000 inhabitants in Tallinn was 40 percent higher in 2023 than in 2022 (464 mg vs. 650 mg). In Tartu, cocaine use was 2.6 times higher than in 2021 (157 mg vs. 410 mg). Cocaine use was highest in both Tallinn and Tartu during the period between Saturday night and Sunday (October 7 to October 8), with a daily usage level of 1,320 mg per 1,000 of the population in Tallinn (6,336 doses per day) and 814 mg per 1,000 of the population in Tartu (810 doses per day).

"The rapid spread of cocaine in Europe is due to a number of factors, including improved availability, falling prices over the years and increased purity," explained Abel-Ollo.

He added, that cocaine is a highly addictive substance, and that continuous use requires increasing the amount consumed in order to achieve the desired effects. Cocaine addiction is also associated with a number of physiological and mental health issues, which puts Europe's healthcare systems under severe strain.

Concentrations of MDMA in wastewater have been relatively low in recent years. Studies over the last two years have shown that the average daily intake per 1,000 inhabitants is around 40 mg. In both Tallinn and Tartu, MDMA concentrations in wastewater were highest during the period from Saturday to Sunday (October 7 to October 8), with MDMA use on weekdays lower than one dose per 1,000 of the population. This suggests that MDMA use is mostly recreational.

Amphetamine concentrations in Tallinn wastewater have remained stable in recent years, averaging 350 mg per 1,000 inhabitants per day. In Tartu, methamphetamine use has increased to an average of 339 mg per 1,000 inhabitants per day from 250 mg in 2021, according to the study.

According to Abel-Ollo, there are amphetamine users in Estonia, and the drug is taken either by injection or other means. On top of the amount consumed by daily users and people who are addicted to the drug, there is also a significant amount added due to recreational use of amphetamines,  Abel-Ollo said.

Among the new substances detected in the 2023 study was α-PVP (alpha-pyrrolidinovalerophenone). A synthetic cathinone, α-PVP, has been available on the Estonian drug market since around 2017 or 2018. Traces of the highly dangerous synthetic opioid protonitase and the herbal drug mitragynine were also found in Tallinn's wastewater for the first time. Traces of α-PVP and mitragynine were also found in Tartu's wastewater.

 "The discovery of nitazenes in the wastewater confirms the ability of the wastewater testing methods to detect new dangerous trends on the drug market," said Abel-Ollo.

In previous years, wastewater studies have shown an increase in weekend drug use in Estonia's major cities. The results of the 2023 Tallinn wastewater analysis also show a rise in the use of recreational drugs (amphetamines, MDMA, cocaine) at weekends.

"The increasing use of drugs for recreational purposes, as well as the mixed use of several drugs, has led to a growing need for harm reducing activities in the context of nightlife. Such activities aim to prevent and reduce the harm caused by both alcohol and drug use in nightclubs, music events and festivals, as well as to raise people's awareness of the dangers of drugs while also providing reliable support without passing judgement on anyone," said Abel-Ollo.

The 2023 Tallinn and Tartu wastewater study was carried out between October 3 and October 10.

The wastewater analysis focused on the metabolic residues of drugs, alcohol and tobacco. In the case of amphetamine, methamphetamine and MDMA, the wastewater was analyzed for traces of the pure substance rather than the metabolic residues (which may also include residues, which have not passed through the human body).

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