Italian River Yields Info on Drug Use

Yale Medical School professor Dr. Sydney Spiesel, who writes for Slate, tells Alex Chadwick about a study that is teaching Italian authorities a new way to gauge illegal drug use. They're monitoring the Po River.

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MADELEINE BRAND, host:

And now our regular look at the world of medicine. Physician and Yale Medical School professor Dr. Sydney Spiesel writes on interesting medical studies for the online magazine Slate. He spoke with my colleague Alex Chadwick about a little-noticed study from Italy that taught authorities a new way to gauge illegal drug use: follow the river.

ALEX CHADWICK, host:

Syd Spiesel, it's hard for public health authorities to get accurate data on illegal drug use.

Dr. SYDNEY SPIESEL (Slate): Yeah. Well, you know, there are a lot of different ways you could do it. You could ask the police, but they may or may not know, or they might be guessing, or there might be some political benefit in giving one answer or another. You could try to find users and ask them how much they're taking. But have you asked the right people? Have you asked the right questions? So it's very hard to get an objective measurement.

CHADWICK: And so researchers in Milan, Italy, set out to quantify cocaine use in their region, but rather than rely on surveys or any of these methods, they came up with a novel approach which is just amazing to me.

SPIESEL: Just brilliant. What they did was they sampled the water of River Po. Now if you think of Italy as the boot, the River Po is sort of the garter; it runs across the top. And they went to a sight in Pavia near Milan, which is where the research institute is, and they sampled the water. They knew what the flow was. They were able to calculate the amount of not--they didn't use cocaine, but they used something that the body dumps overboard after cocaine is used; it's a metabolite of cocaine. And by knowing both the flow rate, the concentration that they found of the metabolite and of the population, they were able to make a pretty good guess about how much cocaine was used.

CHADWICK: What did they conclude?

SPIESEL: Well, the conclusion was sort of amazing. It was about at least three times as much as anyone thought. What they found was that there's an average of somewhere between two and seven doses per day per thousand people, or if you limit yourself to young adults, people between--in their study, between 15 and 34, there were somewhere between nine and 26 doses per thousand young adults a day that were consumed in the Po River Valley. It means that there's about 4 kilograms of cocaine a day used in that rather poor region; that is about 3,000 pounds a year. If you go back, you calculate it based on the New York street value, which is sort of estimated at $100 a gram, that means that about $150 million a year are being spent on the abuse of this one drug. You know, that's a huge amount of money diverted from the economy.

CHADWICK: Can this method be used to study other kinds of drug use, whether legal or illegal?

SPIESEL: Yeah, that's how this study originated. The people had originally done research--used this method to study both human and veterinary antibiotics flowing into the River Po, and other people used similar things. It really does give you an idea of oth--of what medications and presumably other materials are going into the waters.

CHADWICK: Well, it's a remarkable way to study drug abuse, or at least it's remarkable to me. I never would have thought of that.

Dr. Syd Spiesel writes the Medical Examiner column for the online magazine Slate.

Syd, thanks for joining us again on DAY TO DAY.

SPIESEL: Thank you so much.

BRAND: And that interview by my colleague Alex Chadwick.

NPR's DAY TO DAY continues. I'm Madeleine Brand.

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