Wastewater surveillance for cocaine, fentanyl, methamphetamine, amphetamine, xylazine, and nicotine in the U.S. Virgin Islands from October 2023 to December 2024.

OBJECTIVE

To address limited substance use prevalence and outcome data available for U.S. Virgin Islands (USVI), we analyzed wastewater surveillance data to understand the presence of select parent drugs and their metabolites.

METHODS

The 24-hour composite wastewater samples were collected at wastewater treatment plants across the St. Croix (STX) and St. Thomas/St. John (STT/STJ) Districts, during October 2023-December 2024. A total of 204 samples were analyzed for cocaine (benzoylecgonine), fentanyl (norfentanyl), methamphetamine, amphetamine, xylazine, and nicotine (trans-3'-hydroxycotinine). Consumption estimates and descriptive statistics were calculated. Linear mixed-effects models (LMEM) were used to analyze the effects of tourism season and District on drug consumption.

RESULTS

Cocaine, benzoylecgonine, and trans-3'-hydroxycotinine were detected in 100% of USVI samples tested. STT/STJ exhibited higher consumption of cocaine and nicotine compared with STX, although these differences were significant only during the low tourism season (p < 0.05). There were statistically significant differences in amphetamine and fentanyl consumption between STX and STT/STJ, controlling for tourism (p < 0.05).

CONCLUSION

USVI estimates varied significantly across the two Districts. Higher cocaine and nicotine use for USVI, particularly for STT/STJ, underscores the need for tailored interventions addressing use of illicit stimulants, tobacco, and other nicotine products, including e-cigarettes.