Nantucket’s sewer water reveals secret the islanders were trying to keep to themselves
It’s common in the movies for people to flush things do the toilet that they don’t want others to see, but even the sewer shares more than a foul odor.
Nantucket began a wastewater monitoring program last summer to help officials respond to health risks associated with “high-risk substances and opioids in the community.” What they found over the following eight months on the summer retreat off the coast of Cape Cod that is a favorite of the powerful, rich, and famous was jaw-dropping.
While the level of fentanyl and other opioids in the sewer water was below the national and regional average, cocaine was consistently higher, according to the data presented in the city’s report. During two spikes, one in mid-October and another a few days before Christmas, the level reached “dangerous amounts” that were nearly three times higher than the national average, and even more when compared to the regional average.
Nantucket’s sewers flush out islanders’ secrets
While the two spikes in the presence of cocaine were similar in amounts, there were differences between the two. During the October surge, there was an absence of a similar surge in benzoylecgonine (BZE), which is the primary metabolite produced by the body when cocaine is consumed.
The city’s report notes that this “signals that some portion of the cocaine entering the sewer system did not come from typical human metabolism.” Such a divergent pattern between the amount of the two substances “often appears when unconsumed cocaine is dumped or disposed of into the wastewater system” without being consumed.
Why Nantucket used wastewater to collect data
Nantucket city officials said that they began the wastewater surveillance as their community, like others across the nation, “is not immune to the growing public health crisis of substance misuse and overdose.” However, in the case of the island, the seasonal population “can quadruple in the summer,” presenting a “unique challenge of managing behavioral health risks.”
The program “aims to support the efforts of local health professionals, first responders, and recovery services through timely, community-wide data.” Using wastewater testing gives the city a “valuable and cost-effective way” to collect “data that reflects island-wide trends” in near real-time and with fewer biases. At the same time, “without identifying individuals or neighborhoods, thereby preserving community privacy while maximizing insight.”
The town plans to use this data in order to be able to “coordinate educational outreach, screening efforts, or peer-led recovery support tailored to that substance.”
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