The Office of National Drug Control Policy (ONDCP) has released its first-ever wastewater-based drug monitoring newsletter, providing new data on illicit drug trends across communities and offering an additional tool for public health, law enforcement, and community leaders responding to evolving drug threats.
The report, titled Wastewater Analytics: A Powerful Window into Shifting Drug Use Trends, uses wastewater-based drug monitoring to provide near real-time information on substance use patterns. ONDCP’s Wastewater-Based Drug Epidemiology initiative analyzes samples from more than 100 counties, covering approximately 18% of the U.S. population. While the data is not nationally representative, ONDCP describes it as the largest wastewater drug-monitoring effort conducted in the United States to date.
The initiative measures more than 20 drugs quantitatively and detects the presence of more than 500 substances, providing data-driven insight into changing drug trends and emerging substances.
The July 2026 newsletter examines trends involving three major substances — fentanyl, cocaine, and methamphetamine — while also highlighting seven additional substances identified as emerging concerns.
Among the report’s key findings, wastewater data from sampled sites showed national and regional declines in fentanyl, cocaine, and methamphetamine levels between January and April 2026. However, the report found variations at the state and local level, with Washington State recording the highest fentanyl concentrations, Texas recording the highest cocaine concentrations, and Colorado and Nevada recording the highest methamphetamine concentrations in April 2026.
The report also identified several emerging substances across all four U.S. census regions, including medetomidine, para-fluorofentanyl, carfentanil, and acetyl fentanyl.
ONDCP’s analysis shows that fentanyl peaked nationally in 2023 and has declined since then, while cocaine trends fluctuated after peaking in 2023 and methamphetamine levels remained relatively steady since that year.
The newsletter also provides county-level analysis, noting that areas with elevated concentrations varied by substance. The report highlights that wastewater results can help identify localized areas requiring further examination but should not be interpreted as representative of an entire state or county.
Beyond the three major substances, ONDCP examined seven additional drugs and biomarkers, including acetyl fentanyl, carfentanil, ketamine, medetomidine, para-fluorofentanyl, tianeptine, and xylazine. The report found all seven substances across the four census regions in 2026, with ketamine detected in all tested counties and tianeptine detected in 77% of counties tested.
The new wastewater monitoring effort is intended to provide another source of information for communities working to understand changing drug patterns and support timely responses to emerging threats.
