New European Study by the “Gaia” Laboratory of Environmental and Engineered Water Processes and Systems Reveals Significant Findings on Drug Use

A research collaboration between the Gaia Laboratory of Environmental and Technical Processes and Water Systems of the Faculty of Engineering at the University of Cyprus and the Cyprus National Addictions Authority.

Understanding the habits and trends of a population is no longer based solely on questionnaires and statistical surveys. One of the most innovative applications in public health, wastewater epidemiology, utilizes a source of information that until recently was considered merely waste: urban wastewater.

Through its analysis, scientists can extract valuable data on the use of pharmaceuticals, the consumption of illicit substances, as well as the presence or spread of diseases across entire populations.

The process is based on sampling wastewater at the inflows of treatment plants, where substances excreted naturally by the human body after use or consumption, along with their metabolites, are detected. In this way, a representative chemical profile of the daily life of a city emerges. Urban wastewater thus acts as a highly revealing mirror of society, capturing collective consumption patterns, behaviors, and lifestyles of residents in a region, a city, or even an entire country.

The most recent results from the largest European program in the field of urban wastewater analysis and epidemiology are presented in the report titled “Wastewater analysis and drugs — a European multi-city study.” The report is published today by the SCORE network (SCORE Network – Bringing together experts and knowledge on wastewater-based epidemiology) in collaboration with the European Union Drugs Agency (EUDA). The 2025 wastewater analysis study covered 115 cities across 25 countries, including Norway and Turkey.

Samples were collected over 24-hour periods and analyzed for the detection of amphetamine, methamphetamine, cocaine, MDMA, ketamine, and cannabis. The findings show that drug use exhibits strong geographical variations across European cities. From 2024 to 2025, the load of the cocaine metabolite in wastewater increased overall by 22%, with the highest levels recorded in Western and Southern Europe. In contrast, amphetamine and methamphetamine levels remained generally stable, although notable regional variations were observed. At the same time, in some cities in Central and Northern Europe, indications of a gradual increase in use are emerging.

The SCORE research team has been conducting annual monitoring of urban wastewater in European cities since 2011, aiming to record patterns of drug use at the population level. SCORE is the European network of scientists and organizations that coordinates and standardizes wastewater analysis for studying drug use. Its full name is Sewage Analysis CORe group Europe, and it was established to harmonize sampling, analysis, and data interpretation methods so that results from different cities and countries are comparable.

Cyprus has been actively participating in the network since 2012 through the Gaia Laboratory of the Department of Civil and Environmental Engineering and the Nireas International Water Research Center of the University of Cyprus, under the supervision and coordination of Professor Dr. Despo Fatta-Kassinos.

Within this framework, samples are collected and analyzed from the largest urban areas of the country (Nicosia, Limassol, Larnaca, Paphos, Ayia Napa/Paralimni) for substances such as amphetamine, methamphetamine, MDMA (ecstasy), benzoylecgonine (the main human metabolite of cocaine), ketamine, cannabis, and others. These data provide valuable insights into drug consumption patterns in Cyprus and, with the support of the Cyprus National Addictions Authority (Dr. Christos Mina, Ms. Maria Savvidou), the research has now become systematic, creating a comprehensive national profile.

Sampling follows the common SCORE protocol: daily influent wastewater samples are collected for one week each year. Analysis is carried out using advanced techniques such as ultra-high-performance liquid chromatography coupled with tandem mass spectrometry (UHPLC-MS/MS). The detected concentrations are then converted, using specialized algorithms, into estimates of substance consumption per 1,000 inhabitants, providing an accurate picture of drug use trends at the real population level.

The Gaia Laboratory team participating in the research includes Dr. Magda Psychoudaki, Ms. Rafaela Panayiotou, Dr. Costas Michael, and Dr. Despo Fatta-Kassinos.

The research is conducted in collaboration with Dr. Christos Mina (Chairman of the Cyprus National Addictions Authority) and Ms. Maria Savvidou (Monitoring Department Officer of the Cyprus National Addictions Authority).

Key Findings 2025

MDMA:
Between 2024 and 2025, Europe shows an overall decrease of nearly 16% in MDMA loads detected in urban wastewater. The highest levels are mainly found in cities in Belgium (≈350–450 mg/day/1,000 inhabitants), the Netherlands (≈400–500 mg/day/1,000 inhabitants), and Spain (≈200–300 mg/day/1,000 inhabitants). In Cyprus, regional variations are observed: the largest decrease is recorded in Limassol (63.2%), with 2.5 mg/day/1,000 inhabitants in 2025 compared to 6.8 in 2024, while the largest increase is recorded in Larnaca (157.1%), with 3.6 mg/day/1,000 inhabitants in 2025 compared to 1.4 in 2024. It is worth noting that MDMA levels in Cyprus remain very low compared to other European cities, approximately 100–150 times lower than those recorded in cities with the highest loads.

Cocaine:
At the European level, cocaine use is more pronounced in cities of Western and Southern Europe, particularly in Belgium, the Netherlands, and Spain. From 2024 to 2025, the loads of the cocaine metabolite (BE) in European wastewater increased by 22%. In Cyprus, regional differences are observed: in Limassol, a significant decrease (65.9%) is recorded, with 33.2 mg/day/1,000 inhabitants in 2025 compared to 97.3 in 2024, while in most other areas an increase is recorded, with the largest in Larnaca (92.5%), from 38.8 to 74.7 mg/day/1,000 inhabitants. Compared to European cities with the highest loads, Cyprus shows significantly lower values, about 20–75 times lower.

Amphetamine:
The highest levels of amphetamine in Europe are mainly found in cities in Northern and Central Europe, such as Norway, Sweden, Denmark, Belgium, the Netherlands, and Germany. Compared to these countries, concentrations recorded in Cyprus remain significantly lower, approximately 10–40 times lower. At the local level, increases are recorded in several areas, with the largest in Limassol (261.2%), from 6.7 to 24.2 mg/day/1,000 inhabitants, followed by Ayia Napa (258.8%), from 8.0 to 28.7 mg/day/1,000 inhabitants.

Methamphetamine:
Methamphetamine use in Europe remains generally limited and historically concentrated mainly in the Czech Republic and Slovakia, although it is also detected in other countries, including Cyprus. Compared to regions with higher levels, values in Cyprus remain low—several tens of times lower. For 2025, the largest increase is observed in Ayia Napa (286.4%), with 17.0 mg/day/1,000 inhabitants compared to 4.4 in 2024, followed by Larnaca (115.7%), with 35.8 compared to 16.6. In contrast, other areas show a declining trend, with Limassol recording the largest decrease.

Ketamine:
In Europe, ketamine loads in wastewater increased by 41% from 2024 to 2025, with the highest concentrations recorded in cities in Belgium, Germany, and the Netherlands. Compared to these countries, levels in Cyprus remain significantly lower—several tens of times lower—although use in Cyprus is comparable to several Central European countries. At the local level, the largest decrease is observed in Limassol (62.9%), with 2.6 mg/day/1,000 inhabitants in 2025 compared to 7.0 in 2024, while in Larnaca an increase of 277.8% is recorded, from 0.9 to 3.4 mg/day/1,000 inhabitants.