The abuse of opioids is affecting communities throughout the nation including Cary. Last year Cary saw a 40% increase in fatal overdoses and a 135% increase in non-fatal overdoses, resulting in a 70% overall increase in overdoses. 

Cary is committed to offering solutions to this pressing health crisis and increasing the public’s understanding of opioid misuse. The Town is planning to pilot a wastewater monitoring project that would generate opioid consumption data by measuring concentrations of opioid metabolites in sewage. Expected to occur over a 12-week period in the spring and summer 2018, this innovative way of collecting and sharing data could provide another useful tool for healthcare officials and educators focused on developing programs that help those at risk in our community. 

How It Works

The Town is working with Biobot Analytics, a company that provides opioid testing and data analytics services. Town staff will install and operate wastewater sampling devices, or robots, within the sewer system. Ten sampling locations have been selected within Cary’s wastewater collection system by a team of public health officials, scientists and utility managers.

The wastewater sampling devices are discreet and do not affect the operation of the sewer system. The opioid consumption data generated will be an aggregate of wastewater collected over a 24-hour period of 4,000 to 15,000 homes. That is equal to collecting 2.5 gallons out of approximately 200,000 to 800,000 gallons of wastewater. Individual homes or residents cannot be identified when monitoring at that level. 

Opioids and opioid metabolites will be monitored and calculated into a consumption rate of a daily dosage per a population of 1,000. The project will estimate total opioid consumption including: Morphine, Hydromorphone, Hydrocodone, Oxycodone, Codeine, Dihydrocodeine, Tramadol, Heroin, Fentanyl.  

Project Benefits

The pilot project will begin the development of a baseline data set that could replace overdoses as the standard metric used to gauge opioid consumption. Counting overdoses relies on damage control instead of the near-real time response wastewater monitoring could provide.

Cary will share aggregate data with public health officials and educators so that effective programs can be deployed and tailored to address those at risk. 

The pilot is also expected to increase the public’s awareness of local opioid usage trends and encourage discussions among families as a pathway to recovery from addiction.

This is an innovative approach as previous efforts around the world have included whole-city sampling at the headworks of water reclamation facilities.


The pilot project will cost approximately $100,000 and will be funded through a grant received from Bloomberg Philanthropies. The funds are a part of the Mayors Challenge program, designed to help city leaders tackle today's toughest problems.