Wastewater monitoring is a community-level approach for monitoring disease or chemical biomarkers that are excreted in human urine and feces and collected in sewers. Overall, from 2017-2022, there was an increase in the rates of drug-related hospital patient encounters, and substance use-related deaths among Boston residents. These increases were largely driven by opioid and cocaine use, which disproportionately affected Black and Latinx residents. Besides, fentanyl, a highly potent opioid, is a major contributor to fatal drug overdoses in Boston and was found to be present in 94% of people who died of opioid-overdose in 2021. Nearly 60% of fentanyl-related deaths were found to be in some combination with other opioids and/or cocaine. Boston residents who use illegal opioids other than fentanyl, cocaine, and/or methamphetamine are still at risk of a fentanyl overdose due to the common presence of fentanyl in the drug supply. Narcan, a medication that rapidly reverses the effects of an opioid or fentanyl overdose, is widely distributed in Boston, but is not effective when overdose involves xylazine, an emerging adulterant of the drug supply. Psychoactive substance wastewater monitoring programs in Montana and Marin County, California have observed increases in the concentration of psychoactive substances prior to emergency calls for overdose. In Cary, North Carolina, monitoring naloxone levels in wastewater across different neighborhoods allowed public health officials to identify areas with presumptive unreported overdoses, which has helped inform public outreach efforts and interventions in communities. Tuesday, 10/24/2023 Questions due by 5:00 PM EDT to: Procurement@bphc.org snair@bphc.org jhart@bphc.org BPHC proposes to conduct a wastewater monitoring pilot for psychoactive substances to address the overdose crisis and substance-use related deaths among Boston residents. Our goal is to implement a pilot monitoring program to help the BPHC prioritize and focus mitigating strategies to support overdose prevention. Substance use metabolites in the wastewater can serve as a near real-time indicator of substance use and thus can be used as a complementary to existing substance use monitoring data. Through this Request for Proposal (RFP), BPHC seeks a partner to conduct psychoactive substance wastewater monitoring. This RFP will be funded through our ARPA funds and therefore may expire by the end of 2026. Our partner would implement a well-documented pilot wastewater monitoring program with state-of-the-art sampling and analytical methods. The partner would utilize robust reproducible approaches and technologies that have been evaluated by federal agencies, non-governmental organizations, wastewater utilities, academic researchers, and industry.
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