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Cocaine consumption is one of the most relevant public health issues in America and Europe. There are different methods to estimate cocaine consumption, with different levels of accuracy. Although surveys is one of the most employed methods, it usually underestimates cocaine consumption. Recent studies have validated the use of wastewater analysis as the method that would provide more accurate results, as it is based on the analysis of residues of illicit drugs and their metabolites that are excreted by human flow through wastewater treatment plants. This study aims to estimate cocaine consumption in the southeast of Spain by wastewater analysis. Samples were analyzed by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). According to this analysis, cocaine consumption has been estimated at 410,6 milligrams per day and per 1000 inhabitants, a higher result than that obtained at other European cities of similar size. Highest consumption occurs during the weekend, which is consistent with cocaine being categorized as a recreational drug. The results of this analysis show that cocaine use is an increasing public health and economic problem. Finally, wastewater analysis offers different options to estimate its use at this region of Spain.
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