Challenges and Perspectives in Environmental Monitoring Used in the Study of Illicit Drugs Consumption in Brazil: A Literature Review

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Thus, this article reviews the literature on the consumption, distribution, and main environmental impacts of illicit drugs in Brazil and analyzes the III National Survey on Drug Use by the Brazilian Population. The literature review is based on articles published in national and international journals between 2018 and 2023. This review consists of two analyses, the first of which addresses publications from the last six years on the monitoring of illicit drugs in Brazil and a second analysis based on the III National Survey on Drug Use that addresses the different possibilities of contact with drugs. The results revealed that the Southeast region of Brazil has the highest number of studies on the subject, especially in the state of São Paulo, while the North and Northeast regions have the lowest number of studies. The Midwest regions only have studies in the federal capital city, Brasília, while no studies were found in states bordering countries that produce illicit drugs, such as Paraguay and Bolivia. Analytical methods that use the concept of miniaturization, green chemistry, and the adoption of acceptance methods are frequent in most articles. Chemometric and statistical tools are widely used for the analysis, development, and conclusion of identification and quantification methods. In general, the most used analytical technique is LC-MS/TS, but other techniques have gained ground for the analysis of illicit drugs, such as GC-MS associated with sample preparation and analysis techniques like SPE, TV-LVI, LDI, MALDI, and FTIR, among others. Furthermore, the data show that the consumption of illicit drugs is increasing in Brazil, especially among young people. Thus, there is an urgent need to monitor the levels of illicit drugs in water bodies in different regions of the country to assess epidemiology and environmental contamination and gather indicators for social policies that curb the consumption of these drugs in the Brazilian population. Wastewater-Based Epidemiology Abused Drugs Cocaine Cannabis Amphetamines-type stimulants Figures Figure 1 Figure 2 Figure 3 Introduction The consumption of illicit drugs, which are psychoactive substances prohibited in several countries, has increased in various age groups over the years. According to the United Nations Office on Drugs and Crime (UNODC), approximately 200 million people, or 4 % of the world's population, used cannabis in 2019. Moreover, an estimated 20 million individuals used cocaine, 62 million used opioids, and 27 million used amphetamine-type stimulants in the same year. The statistics are alarming, with nearly 50,000 people succumbing to opioid overdoses in the United States in 2019, and the highest number of drug-related deaths recorded in Europe in 2018, totaling around 8,300 fatal victims (United Nations Office on Drugs and Crime) Illicit drugs are psychoactive substances that induce alterations in cognitive processes, affecting perception, consciousness, mood, or emotions (Drug Enforcement Administration 2017, 2020). The distinction between licit and illicit substances hinges on factors such as the degree of dependence, side effects, and withdrawal symptoms. In this context, the medicinal use of illicit drugs is considered illegal under both national and international laws and encompasses substances such as cannabis, amphetamine-type stimulants (ATS), opioids, cocaine, and their derivatives (World Heath Organization 2023). Cannabis and cocaine have become the most prevalent drugs in Brazil and have displayed a significant surge since 2008 (United Nations Office on Drugs and Crime) Moreover, Brazil serves as a major consumer and a crucial drug trafficking conduit to Europe, Asia, Oceania, and Africa. Given its proximity to the largest producers of cocaine - Colombia, Ecuador, and Venezuela - most trafficking routes cross the major cities of southeastern Brazil, where most illicit drug seizures take place, according to the (GOV.BR). Only in the city of São Paulo, more than 27 thousand kg of cocaine were seized in 2020, which is equivalent to the total amount seized nationwide in 2010. In 2021, the city witnessed the confiscation of 65,000 kg of illicit drugs, ten times more than the corresponding figure in 2010. The proliferation of illegal substances is often linked to psychological factors like loneliness, anxiety, and curiosity (Sciarotta and Hunter 2022) personal factors such as escapism from reality, quest for identity, rebellion against authorities (Carlini and Sanchez 2018; Erbella et al. 2020), and biological factors such as personal predisposition (Wen et al. 2018). Thus, the search for new sensory experiences, novelty-seeking behavior, social influence, deviations in personality, emotional dependence, alienation, and unregulated sales contribute to the upswing in illegal drug usage, which is sourced from various locations in both large and small cities (Drug Enforcement Administration 2020). Other factors, while not conclusive, are also indicated as influential in illegal consumption, such as popular festivals like carnivals(Sodré et al. 2022), the burgeoning tourism industry (Wen et al. 2018), and social isolation (Berardelli et al. 2021; Charlier 2021; Franck et al. 2021) along with its repercussions due to COVID-19 (Fontes et al. 2021; Hahn et al. 2022b). Studies on drugs conducted in Brazil have primarily focused on wastewater (da Silva et al. 2018; Sodré et al. 2018), seawater, and rivers (Fontes et al. 2019; Pisetta et al. 2022; Roveri et al. 2022a), as well as biological samples like blood and oral fluid (Scherer et al. 2020; Leal Cunha et al. 2021), the identification of metabolites, drug characterization (Fett et al. 2020; dos Reis and Romão 2021; Cunha et al. 2023), and statistical surveys in consumption venues such as clubs and electronic music festivals (Carlini and Sanchez 2018), in addition to the assessment of analytical equipment quality for in situ sampling (Scherer et al. 2020). Nonetheless, there remains a dearth of environmental monitoring focused on water across the vast expanse of Brazilian territory, as most research is concentrated in a few regions of the country. Similarly, there is currently no comprehensive literature review centered on research related to illicit drugs in Brazil, thus compiling the primary scientific advancements performed in the region. This literature review highlights the need to recognized progress, environmental repercussions, monitoring methodologies, sampling strategies and solutions related to illicit drugs consumption in Brazil. To this purpouse, two analyses were carried out, one analysis to examine publications from the last six years relating to the monitoring of illicit drugs in Brazil and a other analysis covering global data from the III National Survey on Drug Use and its alignment with articles of literature. Methodology A search for recent publications on illicit drugs in Brazil was conducted in the Web of Science and ScienceDirect (Elsevier) databases from 2018 to 2023. The search used the term “Drugs” as the keyword. Employing Boolean operators "AND" and "OR" with specific keywords. The search was subsequently refined to focus on categories such as "Illicit Drugs and Brazil" (resulting in 1920 hits), "Cocaine and Brazil" (1879 results), "LSD and Brazil" (2111 results), "Illicit Drugs and Brazil and Environmental" (746 results), "Monitoring or Analysis and Brazil and Illicit Drugs" (973 results), and "Analysis and Brazil and Cannabis" (180 results). Keywords were identified in the title, abstract, and keywords of the records. In cases of uncertainty, the full text was thoroughly examined. This process led to 151 eligible articles, from which 37 were selected. The broad spectrum of scientific disciplines that refer to drugs, including medicine, pharmacy, dentistry, and civil engineering, contributed to the extensive search results. However, for this study, dental, medicinal, philosophical, purely social, pedagogical, clinical psychology, engineering, and similar articles that did not align with the study's objective were excluded. No review studies that exclusively focused on substance abuse or illicit drugs conducted in Brazil were found in the existing literature. In addition to the 36 chosen articles, this review incorporated data from the III National Survey on Drug Use by the Brazilian Population (III LNUD), which is a scientific report conducted by the Oswaldo Cruz Foundation (ICICT and FIOCRUZ 2017) a Brazilian governmental institution that gathers data on illicit drugs use. Surprisingly, this report had not been previously discussed in any review. Consequently, this review is divided into two parts: the first delves into the 37 selected articles from the last six years on illicit drugs in Brazil, while the second section encompasses the general findings from the III LNUD and its concordance with the literature articles (which may or may not be included in the 37 selected articles) (see Figure 1). Figure 1. A serious issue with trafficking at the borders. A wide array of psychoactive substances traverses the expansive territory of Brazil, which serves as a pivotal transfer point for major drug producers and exporters, notably of cannabis and cocaine. According to UNODC (United Nations Office on Drugs and Crime) Colombia accounts for 92% of global cocaine production, with Peru contributing 6%. Colombia and Paraguay, neighboring Brazil, also lead in the production of cannabis, primarily consumed in the Americas, and account for constituting approximately 62% of all cannabis seizures worldwide. The trafficking flow of these drugs primarily targets Europe, parts of Africa, and Oceania (Drug Enforcement Administration 2020). Moreover, this market supplies 192 million cannabis users, 34 million users of amphetamines and other stimulants, 34 million opioid users, 21 million ecstasy users, and 18 million cocaine users (United Nations Office on Drugs and Crime). In Brazil, the increase in the consumption and traffic of illicit drugs is notably higher than the reported seizure figures by the Brazilian Federal Police (PF). Only in 2019, seizures hit record numbers, with over 265 tons (T) of marijuana, 104 tons of cocaine, and other substances such as ecstasy (561.0 T), amphetamines (50.0 T), methamphetamine (59.0 T), and LSD (10.0 T) (GOV.BR). The Brazilian states with the highest drug seizures in 2021 were Minas Gerais (11.3 T), Bahia (11.5 T), Mato Grosso (13.3 T), Sergipe (16.1 T), Pernambuco (17.1 T), Rio de Janeiro (36.4 T), Rio Grande do Sul (44.2 T), Santa Catatina (68.2 T), PR (84.4 T), Mato Grosso do Sul (121.1 T), and São Paulo (266.1 T). Brazil emerged as the most frequently cited country of origin for intercepted cocaine in Africa between 2012 and 2017, corroborating the data presented by the PF based on a historical series of illicit drug seizures. This can be attributed to the vast expanse of Brazilian territory combined with its border connections, which establishes it as the primary land route for trafficking to Europe, Africa, and Oceania (see Figure 2). The principal routes in Latin America are situated near Brazil's borders with Peru, Paraguay, and Bolivia, while the route to the United States incorporates countries such as Mexico, Haiti, Guatemala, and Cuba. Figure 2. Brazilian scientific studies on illicit Drugs: insights from modern chemistry and technological advances Among the various studies conducted in Brazil, research emphasizing wastewater and surface water analysis stands out prominently, especially in relation to emerging pollutants, pharmaceuticals, persistent organic compounds, and illicit drugs. Given that these pollutants can find their way into urban effluents through direct disposal or via the excretion of feces and urine, ultimately reaching rivers and lakes used for the water supply of the Brazilian population, the regular monitoring of these substances in wastewater and surface waters is of paramount importance. This rationale underscores the abundance of studies dedicated to these subjects. Out of the 37 selected articles, 15 focused on wastewater, surface waters, rivers, and seas, as detailed in Table 1. Among the compounds studied, cocaine and its derivatives emerged as the most searched class, associated or not with the analysis of pharmaceuticals and emerging pollutants, while the psychotropic class archieved fewer studies. These investigations reveal elevated levels of persistent organic compounds, pharmaceuticals, pesticides, personal hygiene products, industrial compounds, and illicit drugs. These findings are closely linked to increasing rates of urbanization and the abuse of self-medication, followed by an increasing demand for benzodiazepines, coupled with the easy accessibility of drugs. These substances are discharged into the urban sanitation system without undergoing adequate treatment for removal (Fontes et al. 2019; Montagner et al. 2019; Roveri et al. 2022b). Table 1 Fontes et al. (2021) conducted a study assessing the contamination of cocaine and benzoylecgonine in a tropical zone of the state of São Paulo, specifically in the city of Santos. They discovered the presence of both compounds in various environmental compartments of the region. Moreover, their research revealed that in areas frequented by residents, tourists, fishermen, and harvesters, bioaccumulation of cocaine ranging from 0.914 µg kg -1 to 4.58 µg kg -1 was observed in the tissues of mussels in this area. This finding indicates ecological impacts on the aquatic ecosystem due to the levels of contamination (Fontes et al. 2021). Roveri et al. (2022) examined the waters of five rivers in the São Paulo region with an estimated population of 2.0 million inhabitants. The aim was to address the scarcity of studies that identify and quantify substances in Brazilian river waters. In the surface waters of these five rivers, covering a section of 140 km, levels of cocaine and benzoylecgonine were detected, reaching up to 14.93 ng L -1 and 3.22 ng L -1 , respectively. These findings demonstrate the inefficient removal of these compounds in water treatment systems (Roveri et al. 2022a). Pisetta et al. (2022) conducted an analysis of the maritime coastal zone of Santa Catarina in the southern region of the country, specifically in eight estuaries considered of significant importance. This study covered a region of 561 km, with an estimated population of 1.43 million people. Cocaine and benzoylecgonine were detected in 100% of the samples, with concentrations of up to 0.1686 ng L -1 and 1.094 ng L -1 , respectively. The study suggests that the highest source of these compounds was determined in areas with high population density and intense tourist activity. The ecological risk assessment indicated that 44% of the compounds show low and moderate risks for acute effects on the three evaluated trophic levels (Pisetta et al. 2022). Fabregrat-Safont et al. (2021) and Rico et al. (2021) conducted similar studies involving screening and sampling along the Amazon River. They emphasized the lack of basic sanitation in the northern region of Brazil, with most urban waste being discharged into the tributaries that flow through the region, specifically the Rio Negro, Tapajós, and Tocantins rivers. Over 40 compounds were identified in four cities (Manaus, Santarém, Macapá, and Belém), with cocaine and benzoylecgonine found in areas experiencing the highest anthropogenic impact. According to the authors, the effects on the aquatic biosystem are caused by the high chemical load, which could lead to a loss of biodiversity in the region (Fabregat-Safont et al. 2021; Rico et al. 2021). The analysis of illicit drugs in sewage water has been a primary research strategy in Brazil, with the use of wastewater-based epidemiology to estimate concentrations per thousand inhabitants. Sodré et al. (2018) were the pioneering researchers to establish this approach in the Brazilian capital, Brasília (Sodré et al. 2018). Their study indicates that the northern zone of the city exhibits higher consumption rates, reaching up to 1162 mg day -1 inhab -3 , and that consumption on weekends tends to be 50% higher than on weekdays. Additionally, in the same research group, Da Silva et al. (2018) correlated the levels of cocaine, cocaethylene, benzoylecgonine, alcohol, and Carnival (da Silva et al. 2018). They concluded that due to alcohol consumption, the excreted levels of benzoylecgonine may be underestimated due to an excretion inhibition effect. Moreover, the concentration on Carnival Day reached values of 6229 ± 219 mg day -1 inhab -3 for cocaine. In 2019, Sodré and his collaborators also used wastewater-based epidemiology to assess 11-nor-9-carboxy-Δ9-tetrahydrocannabinol (THC-COOH), the main metabolite of tetrahydrocannabinol (THC), during the Carnival holiday(Sodré et al. 2022). They demonstrated that cannabis use is less affected by the occasional effect, whereas cocaine use and its derivatives drastically decreased post-carnival, indicating lower supply and demand. In this regard, Gozalenz-Mariño et al. (2019) employed a liquid chromatography method with ion exchange and alternatives in reverse phase usage. Their results showed that the levels consumed in the Brazilian capital range from 300-1000 mg day -1 inhab -3 , with chemical loads primarily increasing on Sundays, which corroborates the findings of Sodré et al. (2022) (González-Mariño et al. 2019; Sodré et al. 2022). Additionally, the pyrolytic products resulting from crack smoke (e.g., anhydrous methyl ecgonine ester - AEME) remained consistent, indicating that its use is not significantly affected by occasional use, much like marijuana. Wastewater has also been utilized for studies in other Brazilian states. Roveri et al. (2020, 2022) analyzed raw sewage from Guarujá and Ilha de São Vicente in the state of São Paulo. In a sample estimate of over 500 thousand people, they determined the wastewater hydraulic stress and found cocaine and benzoylecgonine in concentrations of up to 30.3 ng L -1 and 278 ng L -1 , respectively, for Guarujá. In Ilha de São Vicente, concentrations reached up to 6.7 ng L -1 and 17.2 ng L -1 , respectively. Both studies demonstrate ecotoxicological risks for aquatic organisms such as algae, crustaceans, and fish, primarily due to the concentration of pharmaceutical products and illicit drugs (Roveri et al. 2020, 2022b). Hahn et al. (2022a, 2022b) developed a method combining passive wastewater sampling using a combined polar organic chemical integrative sampler with SPE-UHPLC-MS/MS to apply wastewater-based epidemiology. Besides establishing a method for quantifying illicit drugs, they monitored a small community in Rio Grande do Sul during the COVID-19 pandemic in 2020. This led to an estimated consumption of THC at 2,369 ± 1037 mg day -1 inhab -3 , followed by cocaine at 353 ± 192 mg day -1 inhab -3 , providing insights into consumption trends over time and demonstrating the impacts of lockdowns on the final obtained concentration (Hahn et al. 2022a, b). Other monitoring strategies for drug identification have been developed in Brazil. Ferrari et al. (2021) investigated, in the context of the Civil Police of the Federal District (PCDF), the presence of illicit and prescribed drugs in post-mortem blood samples (Ferrari Júnior et al. 2021). The highest percentage of analytes found were related to homicides, accidental deaths, and suicides. Cocaine concentrations were quantified at levels of up to 4.07 µg ml -1 . Other compounds, such as benzodiazepines, were predominant in the 111 analyzed samples. Cunha et al. (2021, 2023) developed and validated a rapid and straightforward analysis method for stimulants and synthetic drugs in blood. They quantified amphetamine, methamphetamine, MDA, MDMA, and seven other compounds from the class of synthetic cathinones and amphetamines (da Cunha et al. 2021; Cunha et al. 2023). The method was applied to 50 blood samples and analyzed in a forensic toxicology laboratory, resulting in five positive samples with amphetamine concentrations of up to 389.3 ng ml -1 . The authors also emphasize the use of clobenzorex by truck drivers, who use it as a tool to stay alert. Monitoring this substance can be an asset in investigating cases involving fatal accidents. Further studies within the same research line have recently been published. Franco et al. (2019) developed a method for UHPLC-MS/MS identification of analgesics, benzodiazepines, antidepressants, anticonvulsants, drugs of abuse, and pesticides in blood and urine (Franco de Oliveira et al. 2019). Cunha et al. (2021) collected oral fluid for toxicological analysis in conjunction with a questionnaire at electronic music festivals (da Cunha et al. 2021). They found that ketamine was the most prevalent psychoactive substance, while 3,4-methylenedioxymethamphetamine (ecstasy) was the most frequent, found in 88.5% of the samples. Da Silva et al. (2020) identified cannabis markers in human plasma and conducted a simple assay coupled with sample preparation to quantify THC, THC-COOH, 11-hydroxy-Δ9-tetrahydrocannabinol (11-OH-THC), cannabinol (CBN), and cannabidiol (CBD) in 100 µl of plasma. They found concentrations of up to 36.20 ng ml -1 of 11-nor-9-carboxy-Δ9-tetrahydrocannabinol (da Silva et al. 2020). Another area of research conducted in Brazil focuses on identifying the primary constituents of drugs. A. Leite et al. (2018) and Dos Santos et al. (2019) employed analytical strategies with chromatographic techniques and 1H NMR to identify the main cannabinoids found in marijuana (drug), hashish, flower, and leaf. The results primarily revealed the presence of THC isomers, OH-THC, and CBN (de A. Leite et al. 2018; dos Santos et al. 2019). G. Dos Santos et al. (2022) raised questions about the current use of cannabis extracts for medicinal purposes and analyzed inorganic constituents. As a result, 33% of the national samples from the state of Minas Gerais contained Pb levels above the limit allowed by the US Pharmacopeia, while 14% of the samples from Rio de Janeiro exceeded the limit established by the Brazilian Pharmacopeia (Dos Santos et al. 2022). As an inquiry, it was suggested that greater care be taken in creating the extracts since elevated metal levels were related to environmental contamination and homemade preparation without quality control. De Oliveira et al., (2024) characterized seized pieces of papers in prisons in the state of RJ, identifying new psychoactive drugs during the Covid-19 pandemic. Four compounds were characterized, one of them being 4F-ABUTINACA, an unprecedented report in South America(de Oliveira et al. 2024). In association with the detection of the marijuana plant, Pereira et al. (2020) conducted a study to identify planting patterns using near-infrared hyperspectral imaging (NIR-HSI) and identified spectral bands that could assist in mapping regions to aid in the discovery of drug plantations. Integrating this resource into low-cost airborne systems becomes a strong ally in combating illegal plantations (Pereira et al. 2020). Barreto et al. (2020) and dos Reis & Romão (2021) identified compounds found in cocaine using microfluidic devices on paper and non-contact capacitive coupled conductometric detection (CE-C4D) (Barreto et al. 2020; dos Reis and Romão 2021). They quantified compounds commonly found in the drug, such as cocaine hydrochloride, levamisole, lidocaine, carbonates, borates, chlorides, nitrates, nitrites, and sulfide. Amorim et al. (2021) determined inorganic adulterants in cocaine samples collected from the streets of Espirito Santo. Some samples revealed high concentrations of Al, Ca, Fe, Mg, Mn, and P, indicating adulterants such as gypsum, marble powder, limestone, cement, and others used to increase profits in the illegal market (Amorim et al. 2021). Other studies have also been conducted on the composition and identification of other drugs such as hashish (Souza et al. 2019; Meira et al. 2021) Scherer et al. (2020) verified the analytical reliability of four devices used for the detection of oral cocaine and cannabinoids through comparison with chromatographic techniques (Scherer et al. 2020). The devices showed good reliability for cocaine; however, they showed low confidence in the results for cannabinoid compounds. Distribution of studies conducted in Brazil The spatial distribution of publications in Brazil can be determined by examining the studied compounds and the number of publications per region, as presented in Table 2 and Figure 3. Table 2. Figure 3. States in the North and Northeast regions have the lowest number of studies conducted on illicit drugs in Brazil. The North region, as indicated in the image, accounts for six studies across three states. However, this is primarily due to two publications that covered an extensive territory, including the states of Amazonas, Pará, and Amapá. Meanwhile, the Northeast region only has two isolated studies - two in Sergipe related to psychoactive compounds, and one in Pernambuco related to the composition of inorganic compounds in different parts of the cannabis plant, which was categorized under 'others' in the table. Moving to the Midwest, the only area with research publications is the capital of Brazil, Brasília, in the Federal District. This location has a strong focus on intensive research in wastewater epidemiology, particularly concerning cocaine and its derivatives. However, no studies were found addressing drug use, distribution, and contamination in states like Mato Grosso and Mato Grosso do Sul, which share borders with Paraguay and Bolivia known for producing and distributing illicit drugs. In contrast to the other regions, the Southeast boasts the most balanced distribution of publications among its states. The number of reported studies accounts for over 50% of the articles selected for this review. Generally, the range of analyzed compounds predominantly includes cocaine and its derivatives, as well as cannabis. São Paulo, the largest urban center in Brazil, has the highest number of publications, mainly on cocaine and its derivatives. This is primarily because these compounds are frequently included in studies of emerging pollutants in water. Moreover, other regions in the Southeast are typically associated with the study of illicit drugs in a more specific context. It should be noted that the Southeast is the most developed Brazilian region, which may be linked to the higher circulation of drugs when compared to other regions. The South region has a series of studies conducted in Rio Grande do Sul and Santa Catarina. These works cover a broad range of drug classes, including cocaine and its derivatives, cannabis and its derivatives, and new psychotropic drugs and their derivatives. In general, Brazil still lacks extensive studies covering its vast territory. Many factors have been overlooked in the research conducted so far, such as tourism, border regions, appropriate forms of treatment, and new methods of use. Some articles do not specify the region in which they were conducted, suggesting that they were carried out somewhere in Brazilian territory. For instance, Pereira et al. (2020) state that the samples were obtained in an operation by the Federal Police in the Federal District but do not specify where their research would be applicable (Pereira et al. 2020). III National Survey on Drug Use by the Brazilian Population - Brazilian consumers The III National Survey on Drug Use by the Brazilian Population (ICICT and FIOCRUZ 2017) indicates that the initial use of illicit drugs is more common among men than women. Over 11.5 million men were found to have initiated drug use, in comparison to slightly over 6 million women (see Table 3). This marks a decrease in the disparity between male and female users compared to earlier studies, where the proportion of male users was three times higher than that of females (Abdalla et al. 2014). Moreover, it is estimated that approximately 15 million Brazilians have experimented with illicit drugs at least once in their lifetime. Table 3. Brazilian trends in drug use differ from those observed in countries with extremist religious practices, such as Iraq and Afghanistan, where the proportion of female users is significantly lower compared to males. In contrast, Brazil's pattern aligns with global trends seen in countries like Canada, the United States, and in Europe, where there is no significant gender-based distinction (Al-Hemiery et al. 2017). According to the World Drug Report, men tend to experiment with drugs at an earlier age, while women, after their initial experimentation, are more inclined to use other substances, thus making them more susceptible to developing disorders and drug-related issues (United Nations Office on Drugs and Crime). The high rates of depression, emotional problems, postpartum depression, post-traumatic stress disorder, violence, and sexual abuse worldwide evidently play a significant role in the increasing number of women turning to illicit drug use. Notably, the abuse of non-prescribed anxiolytic benzodiazepine substances such as alprazolam, diazepam, clonazepam, and midazolam often serves as a starting point before progressing to psychotropic drugs, as observed in Brazil (Galduróz et al. 2005; Andrade et al. 2006; Schneider et al. 2015) This notion is supported by the incidence of drug use in the last thirty days, as depicted in Table 3, which shows a higher percentage for the female group. Women also face a greater risk of acquiring diseases like HIV and hepatitis C, with most cases being associated with recent use of injected drugs. Conversely, most drug users worldwide are men. Moreover, approximately four out of every five patients admitted to rehabilitation clinics are men. In countries with stringent religious practices, consumption and prevalence are more common among men and the majority of smugglers and producers of illicit drugs are male (Abdalla et al. 2014; ICICT and FIOCRUZ 2017). While women are more susceptible to developing dependence syndromes, men are at a higher risk of encountering drugs at an earlier age. The criteria influencing initial drug contact are typically linked to the social environment. This is evident in the percentages of men who have experimented with drugs in the last 12 months, a proportion that is three times higher than that of the female group. According to UNODC, men are more likely to use drugs in social settings with friends (United Nations Office on Drugs and Crime). Additionally, Schneider et al. (2015) suggest that Brazilians who frequently engage in alcohol abuse may seek new forms of gratification, which can lead more men to experiment with drugs. In Brazil, alcohol consumption, which is only allowed for individuals over 18 years old, encompasses both positive and negative factors. It should be noted that alcohol is a legal substance and widely integrated into Brazilian culture and social traditions. As such, discussions often underscore the social and economic benefits associated with moderate alcohol consumption, such as promoting social interaction, supporting the beverage industry, and contributing to tourism related to festive events, among other factors. However, the adverse consequences of excessive alcohol consumption should be equally acknowledged. Alcohol abuse and dependence are significant public health concerns and can lead to a range of detrimental outcomes that impact both individuals and society at large. These negative effects include harm to physical and mental well-being, traffic accidents, instances of domestic violence, family issues, and an increase in crime rates, among others. Television frequently airs beer commercials, and the concept of happiness is often directly linked to intoxication, except in the case of the strict zero-tolerance law known as the Dry Law or Lei Seca , in Portuguese, which criminalizes driving under the influence of any amount of alcohol. A study conducted by Pelição et al. (2016) reveals that 44.8% of accidents in Brazil in the region of Vitória, Espírito Santo involved alcohol and drugs, with 46% being caused by men under the influence of some narcotic substance. Moreover, 9% of total accidents were related to a combination with alcohol (Pelição et al. 2016). The use of illicit drugs distributed by age group shows that more than 814,000 adolescents in Brazil initiate drug use before turning 18, a situation that has doubled since the last report in 2012, with an estimated 350,000 adolescents or 0.8% of the sample (Abdalla et al. 2014) (see Table 3). In the major Brazilian cities that have favelas (urban areas with precarious housing and inappropriate infrastructure built on hillsides, mostly resulting from the shortage of government-funded housing in the 21st century) and in cities with high violence rates, where organized crime is predominant, use of underage individuals as scouts and drug couriers have become common (Pelição et al. 2016; da Silva et al. 2021). Entry into this realm is due to the precariousness of education, almost non-existent work opportunities, and the voracious consumerism of the current world combined with the social exclusion of the so-called favela residents. In this regard, trafficking becomes a high-risk, highly profitable activity, albeit with milder consequences among the underage than among adults (Faria and Barros 2011; Sciarotta and Hunter 2022). Logically, the statistics related to individuals under 18 cannot be attributed solely to young people from poor urban communities since only home visits are conducted in this type of survey (see Table 3). Therefore, the numbers may exclude homes where young people and adolescents were absent from their residences for most of the day, which is common in favelas . In this regard, it is impossible to accurately estimate whether this demographic was fully represented in the data. This makes the already high number even more alarming because, in a situation where it is impossible to account for marginalized adolescents, the figures mainly include middle and upper-class teenagers who were present at home during the interview and were interested in using drugs at least once in their lifetime, with marijuana and cocaine being the most common substances. In the 18 to 34-year age group, an estimated 8 million Brazilians have used some illicit drug during their lifetime. The largest population of individuals using prohibited substances is primarily composed of men. In addition to consumption, young people are inherently involved in drug cultivation, manufacturing, production, and trafficking, when they are referred to as "mules", due to the absence of social and economic opportunities and high profits of these activities. Vulnerable individuals are chosen preferentially due to obedience and recklessness associated with their social situation. However, this does not imply that this class is the main consumer; ultimately, the most common destination continues to be venues of consumption such as social gatherings, nights filled with psychoactive compounds, and the new consumerist trend among higher classes, known as "ostentation" (Sciarotta and Hunter 2022). Finally, the 34 to 54 age group, referred to as the Baby Boomers in the US, primarily consists of people who lived through adolescence when drugs were widely popular and accessible, thus increasing the probability of experimentation (United Nations Office on Drugs and Crime). As for the older population up to 65 years old, the time difference between the arrival and popularization of drugs in Brazil is attributed to the "Baby Boomer" effect. In terms of the prevalent consumption in the last 12 months and 30 days, the result is primarily composed of young people, who are more susceptible to excess and experimenting with new sensations. Although it is commonly believed that low-income individuals in vulnerable social situations subjected to crime and violence and low levels of education would have the highest drug use rates, the social group that experimented the most with illicit drugs in their lifetime was people who finished high school or had some university studies. An estimated 14 million adults have used some type of drug, associated with age group classification, which is consistent with the fact that young people who work or attend college as participants in social groups are more susceptible to illicit drug use (Degenhardt et al. 2018; Verovšek et al. 2021a, b). A study conducted with high school and college students in all Brazilian capitals revealed a significant increase in cocaine consumption from 0.7% to 1.9% between 2004 and 2010 (CEBRID 2010). Abdalla et al. (2014) also found that individuals with more than nine years of schooling had the highest rates of cocaine use at least once in their lifetime, as well as the highest prevalence rates. Faria A; Barros V (2011) report that women often interrupt their higher education due to factors related to drug trafficking, pregnancy, and HIV (Faria and Barros 2011). Studies also highlight a notable incidence of illicit drug use within educational institutions, with cannabis, cocaine, and benzodiazepines being the most prevalent substances within academic environments (Montgomery et al. 2021; Verovšek et al. 2021a, b). The statistics related to geographical regions (see Table 3) indicate that primarily the Southeast region, the most developed in Brazilian territory, has the highest number of individuals who have experimented with illicit drugs in their lifetime. Similarly, all five major regions show significant population use in relation to the size of the territory and the number of residents. The Southeast region, where São Paulo, the largest Brazilian metropolis, is located, serves as the central hub for national drug consumption, trafficking, and seizures (GOV.BR). One of its streets is known as cracolândia , a place where a population of individuals, primarily composed of crack cocaine addicts, lived in destitution. However, in 2022, an operation disbanded the area, evacuating and dispersing the drug addicts to other parts of the city, where they formed another cracolândia . Other regions also face perilous situations, such as the Midwest and North, which share borders with Colombia, Venezuela, Ecuador, Paraguay, and Peru, some of the world's largest producers of marijuana and cocaine. These regions grapple with intense drug trafficking that funnels across the border to distribution and consumption cartels (Drug Enforcement Administration 2017, 2020; Sciarotta and Hunter 2022). Studies focused on the major capital, Brasília, indicate weekend consumption of up to 1800 mg day -1 , which is 50% above the city's normal average (Sodré et al. 2017, 2018; da Silva et al. 2018). Conclusion The results of this review reveal that a wide array of techniques are being employed to monitor, analyze, and quantify illicit drugs in various locations, especially in wastewater, rivers, and seas. However, the majority of studies focus on specific regions of Brazil, especially in the Southeast, which does not share borders with major producers of illicit drugs in the Americas, while other regions, such as the Northeast and Midwest, lack research on the subject. This review underscores the significance of robust studies addressing the control and monitoring of illicit drugs and their social and urban impacts in Brazil, as demonstrated by the analysis of the III National Survey on Drug Use correlated with scientific data. Thus, there is an urgent need to monitor the levels of illicit drugs in water bodies in different regions of Brazil as a strategy for estimating local use and environmental contamination and to gather indicators for the implementation of social policies that curb the increasing consumption of these drugs by the Brazilian population. Finally, it is worth noting that the application of wastewater-based epidemiology, focused on monitoring the profile of illicit drugs, can be employed by governments and anti-drug agencies for various countermeasures, such as prevention through education, enforcement, concerted global actions against the consumption of illicit drugs, and prevention of the illegal money involved in drug trafficking. Declarations Ethical Approval No Ethics Committee approval is required. Competing Interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Author Contributions André Luiz Sampaio da Silva Junior - Conceptualization, Data curation, Formal analysis funding acquisition, Investigation, Writing original draft. Gregório Mateus Santana - Project administration, Conceptualization, Investigation. Madson Moreira Nascimento - Validation, Visualization, Writing original draft, Writing-review & editing. Ricardo Leal Cunha - Project administration, Writing-review & editing, Visualization. Paulo Roberto Ribeiro Mesquita - Project administration, Writing-review & editing, Visualization. Raildo Mota de Jesus - Project administration, Formal analysis funding acquisition, Resources, Writing-review & editing. Funding This work was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), 313993/2021-1. References Abdalla RR, Madruga CS, Ribeiro M, et al (2014) Prevalence of Cocaine Use in Brazil: Data from the II Brazilian National Alcohol and Drugs Survey (BNADS). Addictive Behaviors 39:297–301. https://doi.org/10.1016/j.addbeh.2013.10.019 Al-Hemiery N, Dabbagh R, Hashim MT, et al (2017) Self-reported substance use in Iraq: findings from the Iraqi National Household Survey of Alcohol and Drug Use, 2014. 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Supplementary Files Tablecaptions.docx Cite Share Download PDF Status: Published Journal Publication published 20 Jul, 2024 Read the published version in Environmental Science and Pollution Research → Version 1 posted Editorial decision: Major Revision 01 Apr, 2024 Reviewers agreed at journal 01 Mar, 2024 Reviewers invited by journal 01 Mar, 2024 Editor invited by journal 29 Feb, 2024 Editor assigned by journal 22 Feb, 2024 First submitted to journal 16 Feb, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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17:22:50","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":751243,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3894639/v1/f70c6601-2ae3-4555-a9f3-88ddd7886581.pdf"},{"id":52041767,"identity":"1c7512ae-3aa3-476d-9099-d04698a7e51b","added_by":"auto","created_at":"2024-03-05 18:21:13","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":202873,"visible":true,"origin":"","legend":"","description":"","filename":"Tablecaptions.docx","url":"https://assets-eu.researchsquare.com/files/rs-3894639/v1/fe23b2463ea0e172f11c7e40.docx"}],"financialInterests":"","formattedTitle":"\u003cp\u003eChallenges and Perspectives in Environmental Monitoring Used in the Study of Illicit Drugs Consumption in Brazil: A Literature Review\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe consumption of illicit drugs, which are psychoactive substances prohibited in several countries, has increased in various age groups over the years. According to the United Nations Office on Drugs and Crime (UNODC), approximately 200 million people, or 4 % of the world\u0026apos;s population, used cannabis in 2019. Moreover, an estimated 20 million individuals used cocaine, 62 million used opioids, and 27 million used amphetamine-type stimulants in the same year. The statistics are alarming, with nearly 50,000 people succumbing to opioid overdoses in the United States in 2019, and the highest number of drug-related deaths recorded in Europe in 2018, totaling around 8,300 fatal victims (United Nations Office on Drugs and Crime)\u003c/p\u003e\n\u003cp\u003eIllicit drugs are psychoactive substances that induce alterations in cognitive processes, affecting perception, consciousness, mood, or emotions (Drug Enforcement Administration 2017, 2020). The distinction between licit and illicit substances hinges on factors such as the degree of dependence, side effects, and withdrawal symptoms. In this context, the medicinal use of illicit drugs is considered illegal under both national and international laws and encompasses substances such as cannabis, amphetamine-type stimulants (ATS), opioids, cocaine, and their derivatives (World Heath Organization 2023).\u003c/p\u003e\n\u003cp\u003eCannabis and cocaine have become the most prevalent drugs in Brazil and have displayed a significant surge since 2008 (United Nations Office on Drugs and Crime) Moreover, Brazil serves as a major consumer and a crucial drug trafficking conduit to Europe, Asia, Oceania, and Africa. Given its proximity to the largest producers of cocaine - Colombia, Ecuador, and Venezuela - most trafficking routes cross the major cities of southeastern Brazil, where most illicit drug seizures take place, according to the (GOV.BR). Only in the city of S\u0026atilde;o Paulo, more than 27 thousand kg of cocaine were seized in 2020, which is equivalent to the total amount seized nationwide in 2010. In 2021, the city witnessed the confiscation of 65,000 kg of illicit drugs, ten times more than the corresponding figure in 2010.\u003c/p\u003e\n\u003cp\u003eThe proliferation of illegal substances is often linked to psychological factors like loneliness, anxiety, and curiosity (Sciarotta and Hunter 2022) personal factors such as escapism from reality, quest for identity, rebellion against authorities (Carlini and Sanchez 2018; Erbella et al. 2020), and biological factors such as personal predisposition (Wen et al. 2018). Thus, the search for new sensory experiences, novelty-seeking behavior, social influence, deviations in personality, emotional dependence, alienation, and unregulated sales contribute to the upswing in illegal drug usage, which is sourced from various locations in both large and small cities (Drug Enforcement Administration 2020).\u003c/p\u003e\n\u003cp\u003eOther factors, while not conclusive, are also indicated as influential in illegal consumption, such as popular festivals like carnivals(Sodr\u0026eacute; et al. 2022), the burgeoning tourism industry (Wen et al. 2018), and social isolation (Berardelli et al. 2021; Charlier 2021; Franck et al. 2021) along with its repercussions due to COVID-19 (Fontes et al. 2021; Hahn et al. 2022b).\u003c/p\u003e\n\u003cp\u003eStudies on drugs conducted in Brazil have primarily focused on wastewater (da Silva et al. 2018; Sodr\u0026eacute; et al. 2018), seawater, and rivers (Fontes et al. 2019; Pisetta et al. 2022; Roveri et al. 2022a), as well as biological samples like blood and oral fluid (Scherer et al. 2020; Leal Cunha et al. 2021), the identification of metabolites, drug characterization (Fett et al. 2020; dos Reis and Rom\u0026atilde;o 2021; Cunha et al. 2023), and statistical surveys in consumption venues such as clubs and electronic music festivals (Carlini and Sanchez 2018), in addition to the assessment of analytical equipment quality for in situ sampling (Scherer et al. 2020). Nonetheless, there remains a dearth of environmental monitoring focused on water across the vast expanse of Brazilian territory, as most research is concentrated in a few regions of the country. Similarly, there is currently no comprehensive literature review centered on research related to illicit drugs in Brazil, thus compiling the primary scientific advancements performed in the region.\u003c/p\u003e\n\u003cp\u003eThis literature review highlights the need to recognized progress, environmental repercussions, monitoring methodologies, sampling strategies and solutions related to illicit drugs consumption in Brazil. To this purpouse, two analyses were carried out, one analysis to examine publications from the last six years relating to the monitoring of illicit drugs in Brazil and a other analysis covering global data from the III National Survey on Drug Use and its alignment with articles of literature.\u003c/p\u003e"},{"header":" Methodology","content":"\u003cp\u003eA search for recent publications on illicit drugs in Brazil was conducted in the Web of Science and ScienceDirect (Elsevier) databases from 2018 to 2023. The search used the term “Drugs” as the keyword. Employing Boolean operators \"AND\" and \"OR\" with specific keywords. The search was subsequently refined to focus on categories such as \"Illicit Drugs and Brazil\" (resulting in 1920 hits), \"Cocaine and Brazil\" (1879 results), \"LSD and Brazil\" (2111 results), \"Illicit Drugs and Brazil and Environmental\" (746 results), \"Monitoring or Analysis and Brazil and Illicit Drugs\" (973 results), and \"Analysis and Brazil and Cannabis\" (180 results).\u003c/p\u003e\n\u003cp\u003eKeywords were identified in the title, abstract, and keywords of the records. In cases of uncertainty, the full text was thoroughly examined. This process led to 151 eligible articles, from which 37 were selected. The broad spectrum of scientific disciplines that refer to drugs, including medicine, pharmacy, dentistry, and civil engineering, contributed to the extensive search results. However, for this study, dental, medicinal, philosophical, purely social, pedagogical, clinical psychology, engineering, and similar articles that did not align with the study's objective were excluded. No review studies that exclusively focused on substance abuse or illicit drugs conducted in Brazil were found in the existing literature.\u003c/p\u003e\n\u003cp\u003eIn addition to the 36 chosen articles, this review incorporated data from the III National Survey on Drug Use by the Brazilian Population (III LNUD), which is a scientific report conducted by the Oswaldo Cruz Foundation (ICICT and FIOCRUZ 2017) a Brazilian governmental institution that gathers data on illicit drugs use. Surprisingly, this report had not been previously discussed in any review. Consequently, this review is divided into two parts: the first delves into the 37 selected articles from the last six years on illicit drugs in Brazil, while the second section encompasses the general findings from the III LNUD and its concordance with the literature articles (which may or may not be included in the 37 selected articles) (see Figure 1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFigure 1.\u003c/strong\u003e\u003c/p\u003e\n\u003ch3\u003eA serious issue with trafficking at the borders.\u003c/h3\u003e\n\u003cp\u003eA wide array of psychoactive substances traverses the expansive territory of Brazil, which serves as a pivotal transfer point for major drug producers and exporters, notably of cannabis and cocaine. According to UNODC\u0026nbsp;(United Nations Office on Drugs and Crime)\u0026nbsp;Colombia accounts for 92% of global cocaine production, with Peru contributing 6%. Colombia and Paraguay, neighboring Brazil, also lead in the production of cannabis, primarily consumed in the Americas, and account for constituting approximately 62% of all cannabis seizures worldwide.\u003c/p\u003e\n\u003cp\u003eThe trafficking flow of these drugs primarily targets Europe, parts of Africa, and Oceania\u0026nbsp;(Drug Enforcement Administration 2020). Moreover, this market supplies 192 million cannabis users, 34 million users of amphetamines and other stimulants, 34 million opioid users, 21 million ecstasy users, and 18 million cocaine users\u0026nbsp;(United Nations Office on Drugs and Crime).\u003c/p\u003e\n\u003cp\u003eIn Brazil, the increase in the consumption and traffic of illicit drugs is notably higher than the reported seizure figures by the Brazilian Federal Police (PF). Only in 2019, seizures hit record numbers, with over 265 tons (T) of marijuana, 104 tons of cocaine, and other substances such as ecstasy (561.0 T), amphetamines (50.0 T), methamphetamine (59.0 T), and LSD (10.0 T)\u0026nbsp;(GOV.BR). The Brazilian states with the highest drug seizures in 2021 were Minas Gerais (11.3 T), Bahia (11.5 T), Mato Grosso (13.3 T), Sergipe (16.1 T), Pernambuco (17.1 T), Rio de Janeiro (36.4 T), Rio Grande do Sul (44.2 T), Santa Catatina (68.2 T), PR (84.4 T), Mato Grosso do Sul (121.1 T), and São Paulo (266.1 T).\u003c/p\u003e\n\u003cp\u003eBrazil emerged as the most frequently cited country of origin for intercepted cocaine in Africa between 2012 and 2017, corroborating the data presented by the PF based on a historical series of illicit drug seizures. This can be attributed to the vast expanse of Brazilian territory combined with its border connections, which establishes it as the primary land route for trafficking to Europe, Africa, and Oceania (see Figure 2). The principal routes in Latin America are situated near Brazil's borders with Peru, Paraguay, and Bolivia, while the route to the United States incorporates countries such as Mexico, Haiti, Guatemala, and Cuba.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFigure 2.\u003c/strong\u003e\u003c/p\u003e\n\u003ch3\u003eBrazilian scientific studies on illicit Drugs: insights from modern chemistry and technological advances\u003c/h3\u003e\n\u003cp\u003eAmong the various studies conducted in Brazil, research emphasizing wastewater and surface water analysis stands out prominently, especially in relation to emerging pollutants, pharmaceuticals, persistent organic compounds, and illicit drugs. Given that these pollutants can find their way into urban effluents through direct disposal or via the excretion of feces and urine, ultimately reaching rivers and lakes used for the water supply of the Brazilian population, the regular monitoring of these substances in wastewater and surface waters is of paramount importance. This rationale underscores the abundance of studies dedicated to these subjects.\u003c/p\u003e\n\u003cp\u003eOut of the 37 selected articles, 15 focused on wastewater, surface waters, rivers, and seas, as detailed in Table 1. Among the compounds studied, cocaine and its derivatives emerged as the most searched class, associated or not with the analysis of pharmaceuticals and emerging pollutants, while the psychotropic class archieved fewer studies.\u003c/p\u003e\n\u003cp\u003eThese investigations reveal elevated levels of persistent organic compounds, pharmaceuticals, pesticides, personal hygiene products, industrial compounds, and illicit drugs. These findings are closely linked to increasing rates of urbanization and the abuse of self-medication, followed by an increasing demand for benzodiazepines, coupled with the easy accessibility of drugs. These substances are discharged into the urban sanitation system without undergoing adequate treatment for removal\u0026nbsp;(Fontes et al. 2019; Montagner et al. 2019; Roveri et al. 2022b).\u003c/p\u003e\n\u003cp\u003eTable \u0026nbsp;1\u003c/p\u003e\n\u003cp\u003eFontes et al. (2021) conducted a study assessing the contamination of cocaine and benzoylecgonine in a tropical zone of the state of São Paulo, specifically in the city of Santos. They discovered the presence of both compounds in various environmental compartments of the region. Moreover, their research revealed that in areas frequented by residents, tourists, fishermen, and harvesters, bioaccumulation of cocaine ranging from 0.914 µg kg\u003csup\u003e-1\u003c/sup\u003e to 4.58 µg kg\u003csup\u003e-1\u003c/sup\u003e was observed in the tissues of mussels in this area. \u0026nbsp;This finding indicates ecological impacts on the aquatic ecosystem due to the levels of contamination (Fontes et al. 2021).\u003c/p\u003e\n\u003cp\u003eRoveri et al. (2022) examined the waters of five rivers in the São Paulo region with an estimated population of 2.0 million inhabitants. The aim was to address the scarcity of studies that identify and quantify substances in Brazilian river waters. In the surface waters of these five rivers, covering a section of 140 km, levels of cocaine and benzoylecgonine were detected, reaching up to 14.93 ng L\u003csup\u003e-1\u003c/sup\u003e and 3.22 ng L\u003csup\u003e-1\u003c/sup\u003e, respectively. These findings demonstrate the inefficient removal of these compounds in water treatment systems (Roveri et al. 2022a).\u003c/p\u003e\n\u003cp\u003ePisetta et al. (2022) conducted an analysis of the maritime coastal zone of Santa Catarina in the southern region of the country, specifically in eight estuaries considered of significant importance. This study covered a region of 561 km, with an estimated population of 1.43 million people. Cocaine and benzoylecgonine were detected in 100% of the samples, with concentrations of up to 0.1686 ng L\u003csup\u003e-1\u003c/sup\u003e and 1.094 ng L\u003csup\u003e-1\u003c/sup\u003e, respectively. The study suggests that the highest source of these compounds was determined in areas with high population density and intense tourist activity. The ecological risk assessment indicated that 44% of the compounds show low and moderate risks for acute effects on the three evaluated trophic levels (Pisetta et al. 2022).\u003c/p\u003e\n\u003cp\u003eFabregrat-Safont et al. (2021) and Rico et al. (2021) conducted similar studies involving screening and sampling along the Amazon River. They emphasized the lack of basic sanitation in the northern region of Brazil, with most urban waste being discharged into the tributaries that flow through the region, specifically the Rio Negro, Tapajós, and Tocantins rivers. Over 40 compounds were identified in four cities (Manaus, Santarém, Macapá, and Belém), with cocaine and benzoylecgonine found in areas experiencing the highest anthropogenic impact. According to the authors, the effects on the aquatic biosystem are caused by the high chemical load, which could lead to a loss of biodiversity in the region (Fabregat-Safont et al. 2021; Rico et al. 2021).\u003c/p\u003e\n\u003cp\u003eThe analysis of illicit drugs in sewage water has been a primary research strategy in Brazil, with the use of wastewater-based epidemiology to estimate concentrations per thousand inhabitants. Sodré et al. (2018) were the pioneering researchers to establish this approach in the Brazilian capital, Brasília (Sodré et al. 2018). Their study indicates that the northern zone of the city exhibits higher consumption rates, reaching up to 1162 mg day\u003csup\u003e-1\u003c/sup\u003e inhab\u003csup\u003e-3\u003c/sup\u003e, and that consumption on weekends tends to be 50% higher than on weekdays. Additionally, in the same research group, Da Silva et al. (2018) correlated the levels of cocaine, cocaethylene, benzoylecgonine, alcohol, and Carnival (da Silva et al. 2018). They concluded that due to alcohol consumption, the excreted levels of benzoylecgonine may be underestimated due to an excretion inhibition effect. Moreover, the concentration on Carnival Day reached values of 6229 ± 219 mg day\u003csup\u003e-1\u003c/sup\u003e inhab\u003csup\u003e-3\u003c/sup\u003e for cocaine. In 2019, Sodré and his collaborators also used wastewater-based epidemiology to assess 11-nor-9-carboxy-Δ9-tetrahydrocannabinol (THC-COOH), the main metabolite of tetrahydrocannabinol (THC), during the Carnival holiday(Sodré et al. 2022). They demonstrated that cannabis use is less affected by the occasional effect, whereas cocaine use and its derivatives drastically decreased post-carnival, indicating lower supply and demand.\u003c/p\u003e\n\u003cp\u003eIn this regard, Gozalenz-Mariño et al. (2019) employed a liquid chromatography method with ion exchange and alternatives in reverse phase usage. Their results showed that the levels consumed in the Brazilian capital range from 300-1000 mg day\u003csup\u003e-1\u003c/sup\u003e inhab\u003csup\u003e-3\u003c/sup\u003e, with chemical loads primarily increasing on Sundays, which corroborates the findings of Sodré et al. (2022) (González-Mariño et al. 2019; Sodré et al. 2022). Additionally, the pyrolytic products resulting from crack smoke (e.g., anhydrous methyl ecgonine ester - AEME) remained consistent, indicating that its use is not significantly affected by occasional use, much like marijuana.\u003c/p\u003e\n\u003cp\u003eWastewater has also been utilized for studies in other Brazilian states. Roveri et al. (2020, 2022) analyzed raw sewage from Guarujá and Ilha de São Vicente in the state of São Paulo. In a sample estimate of over 500 thousand people, they determined the wastewater hydraulic stress and found cocaine and benzoylecgonine in concentrations of up to 30.3 ng L\u003csup\u003e-1\u003c/sup\u003e and 278 ng L\u003csup\u003e-1\u003c/sup\u003e, respectively, for Guarujá. In Ilha de São Vicente, concentrations reached up to 6.7 ng L\u003csup\u003e-1\u003c/sup\u003e and 17.2 ng L\u003csup\u003e-1\u003c/sup\u003e, respectively. Both studies demonstrate ecotoxicological risks for aquatic organisms such as algae, crustaceans, and fish, primarily due to the concentration of pharmaceutical products and illicit drugs (Roveri et al. 2020, 2022b).\u003c/p\u003e\n\u003cp\u003eHahn et al. (2022a, 2022b) developed a method combining passive wastewater sampling using a combined polar organic chemical integrative sampler with SPE-UHPLC-MS/MS to apply wastewater-based epidemiology. Besides establishing a method for quantifying illicit drugs, they monitored a small community in Rio Grande do Sul during the COVID-19 pandemic in 2020. This led to an estimated consumption of THC at 2,369 ± 1037 mg day\u003csup\u003e-1\u003c/sup\u003e inhab\u003csup\u003e-3\u003c/sup\u003e, followed by cocaine at 353 ± 192 mg day\u003csup\u003e-1\u003c/sup\u003e inhab\u003csup\u003e-3\u003c/sup\u003e, providing insights into consumption trends over time and demonstrating the impacts of lockdowns on the final obtained concentration (Hahn et al. 2022a, b).\u003c/p\u003e\n\u003cp\u003eOther monitoring strategies for drug identification have been developed in Brazil. Ferrari et al. (2021) investigated, in the context of the Civil Police of the Federal District (PCDF), the presence of illicit and prescribed drugs in post-mortem blood samples (Ferrari Júnior et al. 2021). The highest percentage of analytes found were related to homicides, accidental deaths, and suicides. Cocaine concentrations were quantified at levels of up to 4.07 µg ml\u003csup\u003e-1\u003c/sup\u003e. Other compounds, such as benzodiazepines, were predominant in the 111 analyzed samples.\u003c/p\u003e\n\u003cp\u003eCunha et al. (2021, 2023) developed and validated a rapid and straightforward analysis method for stimulants and synthetic drugs in blood. They quantified amphetamine, methamphetamine, MDA, MDMA, and seven other compounds from the class of synthetic cathinones and amphetamines (da Cunha et al. 2021; Cunha et al. 2023). The method was applied to 50 blood samples and analyzed in a forensic toxicology laboratory, resulting in five positive samples with amphetamine concentrations of up to 389.3 ng ml\u003csup\u003e-1\u003c/sup\u003e. The authors also emphasize the use of clobenzorex by truck drivers, who use it as a tool to stay alert. Monitoring this substance can be an asset in investigating cases involving fatal accidents.\u003c/p\u003e\n\u003cp\u003eFurther studies within the same research line have recently been published. Franco et al. (2019) developed a method for UHPLC-MS/MS identification of analgesics, benzodiazepines, antidepressants, anticonvulsants, drugs of abuse, and pesticides in blood and urine (Franco de Oliveira et al. 2019). Cunha et al. (2021) collected oral fluid for toxicological analysis in conjunction with a questionnaire at electronic music festivals (da Cunha et al. 2021). They found that ketamine was the most prevalent psychoactive substance, while 3,4-methylenedioxymethamphetamine (ecstasy) was the most frequent, found in 88.5% of the samples. Da Silva et al. (2020) identified cannabis markers in human plasma and conducted a simple assay coupled with sample preparation to quantify THC, THC-COOH, 11-hydroxy-Δ9-tetrahydrocannabinol (11-OH-THC), cannabinol (CBN), and cannabidiol (CBD) in 100 µl of plasma. They found concentrations of up to 36.20 ng ml\u003csup\u003e-1\u003c/sup\u003e of 11-nor-9-carboxy-Δ9-tetrahydrocannabinol (da Silva et al. 2020).\u003c/p\u003e\n\u003cp\u003eAnother area of research conducted in Brazil focuses on identifying the primary constituents of drugs. A. Leite et al. (2018) and Dos Santos et al. (2019) employed analytical strategies with chromatographic techniques and 1H NMR to identify the main cannabinoids found in marijuana (drug), hashish, flower, and leaf. The results primarily revealed the presence of THC isomers, OH-THC, and CBN (de A. Leite et al. 2018; dos Santos et al. 2019). G. Dos Santos et al. (2022) raised questions about the current use of cannabis extracts for medicinal purposes and analyzed inorganic constituents. As a result, 33% of the national samples from the state of Minas Gerais contained Pb levels above the limit allowed by the US Pharmacopeia, while 14% of the samples from Rio de Janeiro exceeded the limit established by the Brazilian Pharmacopeia (Dos Santos et al. 2022). As an inquiry, it was suggested that greater care be taken in creating the extracts since elevated metal levels were related to environmental contamination and homemade preparation without quality control.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDe Oliveira et al., (2024) characterized seized pieces of papers in prisons in the state of RJ, identifying new psychoactive drugs during the Covid-19 pandemic. Four compounds were characterized, one of them being 4F-ABUTINACA, an unprecedented report in South America(de Oliveira et al. 2024).\u003c/p\u003e\n\u003cp\u003eIn association with the detection of the marijuana plant, Pereira et al. (2020) conducted a study to identify planting patterns using near-infrared hyperspectral imaging (NIR-HSI) and identified spectral bands that could assist in mapping regions to aid in the discovery of drug plantations. Integrating this resource into low-cost airborne systems becomes a strong ally in combating illegal plantations (Pereira et al. 2020).\u003c/p\u003e\n\u003cp\u003eBarreto et al. (2020) and dos Reis \u0026amp; Romão (2021) identified compounds found in cocaine using microfluidic devices on paper and non-contact capacitive coupled conductometric detection (CE-C4D) (Barreto et al. 2020; dos Reis and Romão 2021). They quantified compounds commonly found in the drug, such as cocaine hydrochloride, levamisole, lidocaine, carbonates, borates, chlorides, nitrates, nitrites, and sulfide. Amorim et al. (2021) determined inorganic adulterants in cocaine samples collected from the streets of Espirito Santo. Some samples revealed high concentrations of Al, Ca, Fe, Mg, Mn, and P, indicating adulterants such as gypsum, marble powder, limestone, cement, and others used to increase profits in the illegal market (Amorim et al. 2021). Other studies have also been conducted on the composition and identification of other drugs such as hashish (Souza et al. 2019; Meira et al. 2021)\u003c/p\u003e\n\u003cp\u003eScherer et al. (2020) verified the analytical reliability of four devices used for the detection of oral cocaine and cannabinoids through comparison with chromatographic techniques (Scherer et al. 2020). The devices showed good reliability for cocaine; however, they showed low confidence in the results for cannabinoid compounds.\u003c/p\u003e"},{"header":"Distribution of studies conducted in Brazil","content":"\u003cp\u003eThe spatial distribution of publications in Brazil can be determined by examining the studied compounds and the number of publications per region, as presented in Table 2 and Figure 3.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eTable 2.\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eFigure 3.\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eStates in the North and Northeast regions have the lowest number of studies conducted on illicit drugs in Brazil. The North region, as indicated in the image, accounts for six studies across three states. However, this is primarily due to two publications that covered an extensive territory, including the states of Amazonas, Pará, and Amapá.\u003c/p\u003e\u003cp\u003eMeanwhile, the Northeast region only has two isolated studies - two in Sergipe related to psychoactive compounds, and one in Pernambuco related to the composition of inorganic compounds in different parts of the cannabis plant, which was categorized under 'others' in the table.\u003c/p\u003e\u003cp\u003eMoving to the Midwest, the only area with research publications is the capital of Brazil, Brasília, in the Federal District. This location has a strong focus on intensive research in wastewater epidemiology, particularly concerning cocaine and its derivatives. However, no studies were found addressing drug use, distribution, and contamination in states like Mato Grosso and Mato Grosso do Sul, which share borders with Paraguay and Bolivia known for producing and distributing illicit drugs.\u003c/p\u003e\u003cp\u003eIn contrast to the other regions, the Southeast boasts the most balanced distribution of publications among its states. The number of reported studies accounts for over 50% of the articles selected for this review. Generally, the range of analyzed compounds predominantly includes cocaine and its derivatives, as well as cannabis. São Paulo, the largest urban center in Brazil, has the highest number of publications, mainly on cocaine and its derivatives. This is primarily because these compounds are frequently included in studies of emerging pollutants in water. Moreover, other regions in the Southeast are typically associated with the study of illicit drugs in a more specific context. It should be noted that the Southeast is the most developed Brazilian region, which may be linked to the higher circulation of drugs when compared to other regions.\u003c/p\u003e\u003cp\u003eThe South region has a series of studies conducted in Rio Grande do Sul and Santa Catarina. These works cover a broad range of drug classes, including cocaine and its derivatives, cannabis and its derivatives, and new psychotropic drugs and their derivatives.\u003c/p\u003e\u003cp\u003eIn general, Brazil still lacks extensive studies covering its vast territory. Many factors have been overlooked in the research conducted so far, such as tourism, border regions, appropriate forms of treatment, and new methods of use. Some articles do not specify the region in which they were conducted, suggesting that they were carried out somewhere in Brazilian territory. For instance, Pereira et al. (2020) state that the samples were obtained in an operation by the Federal Police in the Federal District but do not specify where their research would be applicable (Pereira et al. 2020).\u003c/p\u003e"},{"header":"III National Survey on Drug Use by the Brazilian Population - Brazilian consumers","content":"\u003cp\u003eThe III National Survey on Drug Use by the Brazilian Population (ICICT and FIOCRUZ 2017) indicates that the initial use of illicit drugs is more common among men than women. Over 11.5 million men were found to have initiated drug use, in comparison to slightly over 6 million women (see Table 3). This marks a decrease in the disparity between male and female users compared to earlier studies, where the proportion of male users was three times higher than that of females (Abdalla et al. 2014). Moreover, it is estimated that approximately 15 million Brazilians have experimented with illicit drugs at least once in their lifetime.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eTable 3.\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eBrazilian trends in drug use differ from those observed in countries with extremist religious practices, such as Iraq and Afghanistan, where the proportion of female users is significantly lower compared to males. In contrast, Brazil's pattern aligns with global trends seen in countries like Canada, the United States, and in Europe, where there is no significant gender-based distinction (Al-Hemiery et al. 2017). According to the World Drug Report, men tend to experiment with drugs at an earlier age, while women, after their initial experimentation, are more inclined to use other substances, thus making them more susceptible to developing disorders and drug-related issues (United Nations Office on Drugs and Crime).\u003c/p\u003e\u003cp\u003eThe high rates of depression, emotional problems, postpartum depression, post-traumatic stress disorder, violence, and sexual abuse worldwide evidently play a significant role in the increasing number of women turning to illicit drug use. Notably, the abuse of non-prescribed anxiolytic benzodiazepine substances such as alprazolam, diazepam, clonazepam, and midazolam often serves as a starting point before progressing to psychotropic drugs, as observed in Brazil (Galduróz et al. 2005; Andrade et al. 2006; Schneider et al. 2015)\u003c/p\u003e\u003cp\u003eThis notion is supported by the incidence of drug use in the last thirty days, as depicted in Table 3, which shows a higher percentage for the female group. Women also face a greater risk of acquiring diseases like HIV and hepatitis C, with most cases being associated with recent use of injected drugs. Conversely, most drug users worldwide are men. Moreover, approximately four out of every five patients admitted to rehabilitation clinics are men. In countries with stringent religious practices, consumption and prevalence are more common among men and the majority of smugglers and producers of illicit drugs are male (Abdalla et al. 2014; ICICT and FIOCRUZ 2017).\u003c/p\u003e\u003cp\u003eWhile women are more susceptible to developing dependence syndromes, men are at a higher risk of encountering drugs at an earlier age. The criteria influencing initial drug contact are typically linked to the social environment. This is evident in the percentages of men who have experimented with drugs in the last 12 months, a proportion that is three times higher than that of the female group.\u003c/p\u003e\u003cp\u003eAccording to UNODC, men are more likely to use drugs in social settings with friends (United Nations Office on Drugs and Crime). Additionally, Schneider et al. (2015) suggest that Brazilians who frequently engage in alcohol abuse may seek new forms of gratification, which can lead more men to experiment with drugs. In Brazil, alcohol consumption, which is only allowed for individuals over 18 years old, encompasses both positive and negative factors.\u003c/p\u003e\u003cp\u003eIt should be noted that alcohol is a legal substance and widely integrated into Brazilian culture and social traditions. As such, discussions often underscore the social and economic benefits associated with moderate alcohol consumption, such as promoting social interaction, supporting the beverage industry, and contributing to tourism related to festive events, among other factors. However, the adverse consequences of excessive alcohol consumption should be equally acknowledged. Alcohol abuse and dependence are significant public health concerns and can lead to a range of detrimental outcomes that impact both individuals and society at large. These negative effects include harm to physical and mental well-being, traffic accidents, instances of domestic violence, family issues, and an increase in crime rates, among others.\u003c/p\u003e\u003cp\u003eTelevision frequently airs beer commercials, and the concept of happiness is often directly linked to intoxication, except in the case of the strict zero-tolerance law known as the Dry Law or \u003cem\u003eLei Seca\u003c/em\u003e, in Portuguese, which criminalizes driving under the influence of any amount of alcohol. A study conducted by Pelição et al. (2016) reveals that 44.8% of accidents in Brazil in the region of Vitória, Espírito Santo involved alcohol and drugs, with 46% being caused by men under the influence of some narcotic substance. Moreover, 9% of total accidents were related to a combination with alcohol (Pelição et al. 2016). The use of illicit drugs distributed by age group shows that more than 814,000 adolescents in Brazil initiate drug use before turning 18, a situation that has doubled since the last report in 2012, with an estimated 350,000 adolescents or 0.8% of the sample (Abdalla et al. 2014) (see Table 3).\u003c/p\u003e\u003cp\u003eIn the major Brazilian cities that have \u003cem\u003efavelas\u003c/em\u003e (urban areas with precarious housing and inappropriate infrastructure built on hillsides, mostly resulting from the shortage of government-funded housing in the 21st century) and in cities with high violence rates, where organized crime is predominant, use of underage individuals as scouts and drug couriers have become common (Pelição et al. 2016; da Silva et al. 2021). Entry into this realm is due to the precariousness of education, almost non-existent work opportunities, and the voracious consumerism of the current world combined with the social exclusion of the so-called \u003cem\u003efavela\u003c/em\u003e residents. In this regard, trafficking becomes a high-risk, highly profitable activity, albeit with milder consequences among the underage than among adults (Faria and Barros 2011; Sciarotta and Hunter 2022).\u0026nbsp;\u003c/p\u003e\u003cp\u003eLogically, the statistics related to individuals under 18 cannot be attributed solely to young people from poor urban communities since only home visits are conducted in this type of survey (see Table 3). Therefore, the numbers may exclude homes where young people and adolescents were absent from their residences for most of the day, which is common in \u003cem\u003efavelas\u003c/em\u003e. In this regard, it is impossible to accurately estimate whether this demographic was fully represented in the data. This makes the already high number even more alarming because, in a situation where it is impossible to account for marginalized adolescents, the figures mainly include middle and upper-class teenagers who were present at home during the interview and were interested in using drugs at least once in their lifetime, with marijuana and cocaine being the most common substances.\u003c/p\u003e\u003cp\u003eIn the 18 to 34-year age group, an estimated 8 million Brazilians have used some illicit drug during their lifetime. The largest population of individuals using prohibited substances is primarily composed of men. In addition to consumption, young people are inherently involved in drug cultivation, manufacturing, production, and trafficking, when they are referred to as \"mules\", due to the absence of social and economic opportunities and high profits of these activities. Vulnerable individuals are chosen preferentially due to obedience and recklessness associated with their social situation. However, this does not imply that this class is the main consumer; ultimately, the most common destination continues to be venues of consumption such as social gatherings, nights filled with psychoactive compounds, and the new consumerist trend among higher classes, known as \"ostentation\" (Sciarotta and Hunter 2022).\u003c/p\u003e\u003cp\u003eFinally, the 34 to 54 age group, referred to as the Baby Boomers in the US, primarily consists of people who lived through adolescence when drugs were widely popular and accessible, thus increasing the probability of experimentation (United Nations Office on Drugs and Crime). As for the older population up to 65 years old, the time difference between the arrival and popularization of drugs in Brazil is attributed to the \"Baby Boomer\" effect. In terms of the prevalent consumption in the last 12 months and 30 days, the result is primarily composed of young people, who are more susceptible to excess and experimenting with new sensations.\u003c/p\u003e\u003cp\u003eAlthough it is commonly believed that low-income individuals in vulnerable social situations subjected to crime and violence and low levels of education would have the highest drug use rates, the social group that experimented the most with illicit drugs in their lifetime was people who finished high school or had some university studies. An estimated 14 million adults have used some type of drug, associated with age group classification, which is consistent with the fact that young people who work or attend college as participants in social groups are more susceptible to illicit drug use (Degenhardt et al. 2018; Verovšek et al. 2021a, b).\u003c/p\u003e\u003cp\u003eA study conducted with high school and college students in all Brazilian capitals revealed a significant increase in cocaine consumption from 0.7% to 1.9% between 2004 and 2010 (CEBRID 2010). Abdalla et al. (2014) also found that individuals with more than nine years of schooling had the highest rates of cocaine use at least once in their lifetime, as well as the highest prevalence rates. Faria A; Barros V (2011) report that women often interrupt their higher education due to factors related to drug trafficking, pregnancy, and HIV (Faria and Barros 2011).\u003c/p\u003e\u003cp\u003eStudies also highlight a notable incidence of illicit drug use within educational institutions, with cannabis, cocaine, and benzodiazepines being the most prevalent substances within academic environments (Montgomery et al. 2021; Verovšek et al. 2021a, b).\u003c/p\u003e\u003cp\u003eThe statistics related to geographical regions (see Table 3) indicate that primarily the Southeast region, the most developed in Brazilian territory, has the highest number of individuals who have experimented with illicit drugs in their lifetime. Similarly, all five major regions show significant population use in relation to the size of the territory and the number of residents.\u003c/p\u003e\u003cp\u003eThe Southeast region, where São Paulo, the largest Brazilian metropolis, is located, serves as the central hub for national drug consumption, trafficking, and seizures (GOV.BR). One of its streets is known as \u003cem\u003ecracolândia\u003c/em\u003e, a place where a population of individuals, primarily composed of crack cocaine addicts, lived in destitution. However, in 2022, an operation disbanded the area, evacuating and dispersing the drug addicts to other parts of the city, where they formed another \u003cem\u003ecracolândia\u003c/em\u003e.\u003c/p\u003e\u003cp\u003eOther regions also face perilous situations, such as the Midwest and North, which share borders with Colombia, Venezuela, Ecuador, Paraguay, and Peru, some of the world's largest producers of marijuana and cocaine. These regions grapple with intense drug trafficking that funnels across the border to distribution and consumption cartels (Drug Enforcement Administration 2017, 2020; Sciarotta and Hunter 2022). Studies focused on the major capital, Brasília, indicate weekend consumption of up to 1800 mg day\u003csup\u003e-1\u003c/sup\u003e, which is 50% above the city's normal average (Sodré et al. 2017, 2018; da Silva et al. 2018). \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe results of this review reveal that a wide array of techniques are being employed to monitor, analyze, and quantify illicit drugs in various locations, especially in wastewater, rivers, and seas. However, the majority of studies focus on specific regions of Brazil, especially in the Southeast, which does not share borders with major producers of illicit drugs in the Americas, while other regions, such as the Northeast and Midwest, lack research on the subject.\u003c/p\u003e\n\u003cp\u003eThis review underscores the significance of robust studies addressing the control and monitoring of illicit drugs and their social and urban impacts in Brazil, as demonstrated by the analysis of the III National Survey on Drug Use correlated with scientific data. Thus, there is an urgent need to monitor the levels of illicit drugs in water bodies in different regions of Brazil as a strategy for estimating local use and environmental contamination and to gather indicators for the implementation of social policies that curb the increasing consumption of these drugs by the Brazilian population.\u003c/p\u003e\n\u003cp\u003eFinally, it is worth noting that the application of wastewater-based epidemiology, focused on monitoring the profile of illicit drugs, can be employed by governments and anti-drug agencies for various countermeasures, such as prevention through education, enforcement, concerted global actions against the consumption of illicit drugs, and prevention of the illegal money involved in drug trafficking.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical Approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo Ethics Committee approval is required.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAndré Luiz Sampaio da Silva Junior\u003c/strong\u003e - Conceptualization, Data curation, Formal analysis funding acquisition, Investigation, Writing original draft. \u003cstrong\u003eGregório Mateus Santana\u003c/strong\u003e - Project administration, Conceptualization, Investigation. \u003cstrong\u003eMadson Moreira Nascimento\u003c/strong\u003e - Validation, Visualization, Writing original draft, Writing-review \u0026amp; editing.\u0026nbsp;\u003cstrong\u003eRicardo Leal Cunha\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;-\u0026nbsp;\u003c/strong\u003eProject administration, Writing-review \u0026amp; editing, Visualization. \u003cstrong\u003ePaulo Roberto Ribeiro Mesquita\u0026nbsp;\u003c/strong\u003e- Project administration, Writing-review \u0026amp; editing, Visualization. \u003cstrong\u003eRaildo Mota de Jesus\u003c/strong\u003e - Project administration, Formal analysis funding acquisition, Resources, Writing-review \u0026amp; editing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), 313993/2021-1.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAbdalla RR, Madruga CS, Ribeiro M, et al (2014) Prevalence of Cocaine Use in Brazil: Data from the II Brazilian National Alcohol and Drugs Survey (BNADS). 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Data Brief 39:. https://doi.org/10.1016/j.dib.2021.107614\u003c/li\u003e\n\u003cli\u003eVerov\u0026scaron;ek T, Krizman-Matasic I, Heath D, Heath E (2021b) Investigation of drugs of abuse in educational institutions using wastewater analysis. Science of the Total Environment 799:. https://doi.org/10.1016/j.scitotenv.2021.150013\u003c/li\u003e\n\u003cli\u003eWen J, Meng F, Ying T, et al (2018) Drug tourism motivation of Chinese outbound tourists: Scale development and validation. Tour Manag 64:233\u0026ndash;244. https://doi.org/10.1016/j.tourman.2017.08.001\u003c/li\u003e\n\u003cli\u003eWorld Heath Organization (2023) WHO Expert Committee on Drug Dependence Forty-fifth report. Forty-fifth report. \u003cem\u003eavailable in: http://apps.who.int/bookorders. accessed in: September 7, 2023.\u003c/em\u003e\u003cem\u003e \u003c/em\u003e\u003cem\u003eISBN:978-92-4-006873-5\u003c/em\u003e \u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTables 1 to 3 are available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"environmental-science-and-pollution-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"espr","sideBox":"Learn more about [Environmental Science and Pollution Research](https://www.springer.com/journal/11356)","snPcode":"11356","submissionUrl":"https://submission.nature.com/new-submission/11356/3","title":"Environmental Science and Pollution Research","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Wastewater-Based Epidemiology, Abused Drugs, Cocaine, Cannabis, Amphetamines-type stimulants","lastPublishedDoi":"10.21203/rs.3.rs-3894639/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3894639/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBrazil has one of the highest rates of illicit drug consumption and is considered a major corridor for the trafficking of illicit drugs worldwide. Thus, this article reviews the literature on the consumption, distribution, and main environmental impacts of illicit drugs in Brazil and analyzes the III National Survey on Drug Use by the Brazilian Population. The literature review is based on articles published in national and international journals between 2018 and 2023.\u003c/p\u003e \u003cp\u003eThis review consists of two analyses, the first of which addresses publications from the last six years on the monitoring of illicit drugs in Brazil and a second analysis based on the III National Survey on Drug Use that addresses the different possibilities of contact with drugs. The results revealed that the Southeast region of Brazil has the highest number of studies on the subject, especially in the state of S\u0026atilde;o Paulo, while the North and Northeast regions have the lowest number of studies. The Midwest regions only have studies in the federal capital city, Bras\u0026iacute;lia, while no studies were found in states bordering countries that produce illicit drugs, such as Paraguay and Bolivia. Analytical methods that use the concept of miniaturization, green chemistry, and the adoption of acceptance methods are frequent in most articles. Chemometric and statistical tools are widely used for the analysis, development, and conclusion of identification and quantification methods. In general, the most used analytical technique is LC-MS/TS, but other techniques have gained ground for the analysis of illicit drugs, such as GC-MS associated with sample preparation and analysis techniques like SPE, TV-LVI, LDI, MALDI, and FTIR, among others. Furthermore, the data show that the consumption of illicit drugs is increasing in Brazil, especially among young people. Thus, there is an urgent need to monitor the levels of illicit drugs in water bodies in different regions of the country to assess epidemiology and environmental contamination and gather indicators for social policies that curb the consumption of these drugs in the Brazilian population.\u003c/p\u003e","manuscriptTitle":"Challenges and Perspectives in Environmental Monitoring Used in the Study of Illicit Drugs Consumption in Brazil: A Literature Review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-05 18:21:08","doi":"10.21203/rs.3.rs-3894639/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major Revision","date":"2024-04-02T03:45:22+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"","date":"2024-03-01T07:18:47+00:00","index":0,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-03-01T06:27:34+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"Environmental Science and Pollution Research","date":"2024-02-29T19:21:42+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-02-23T04:15:47+00:00","index":"","fulltext":""},{"type":"submitted","content":"Environmental Science and Pollution Research","date":"2024-02-16T08:31:26+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"environmental-science-and-pollution-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"espr","sideBox":"Learn more about [Environmental Science and Pollution Research](https://www.springer.com/journal/11356)","snPcode":"11356","submissionUrl":"https://submission.nature.com/new-submission/11356/3","title":"Environmental Science and Pollution Research","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"529d40cf-63e9-4dd5-a7e3-07fde3a52dda","owner":[],"postedDate":"March 5th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-08-01T16:22:01+00:00","versionOfRecord":{"articleIdentity":"rs-3894639","link":"https://doi.org/10.1007/s11356-024-34183-z","journal":{"identity":"environmental-science-and-pollution-research","isVorOnly":false,"title":"Environmental Science and Pollution Research"},"publishedOn":"2024-07-20 16:13:37","publishedOnDateReadable":"July 20th, 2024"},"versionCreatedAt":"2024-03-05 18:21:08","video":"","vorDoi":"10.1007/s11356-024-34183-z","vorDoiUrl":"https://doi.org/10.1007/s11356-024-34183-z","workflowStages":[]},"version":"v1","identity":"rs-3894639","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3894639","identity":"rs-3894639","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}