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In Greece, the situation for many people has been dire in recent years: Unemployment is near 30%, and the public sector has been slashed due to austerity measures imposed by the European Union. A new study looking at the Greek capital’s wastewater shows how the public has responded to the societal stress: The use of many legal and illegal substances—particularly antipsychotics and antidepressants—has skyrocketed since the EU bailout plan took effect in 2010 (Environ. Sci. Technol. 2016, DOI: 10.1021/acs.est.6b02417).

Previous studies have measured illicit substances in wastewater before and after music festivals or on holiday weekends as a way to estimate drug use. Nikolaos S. Thomaidis of the University of Athens immediately recognized the opportunity to apply this methodology when the first EU bailout memorandum was signed in 2010. He thought the study would give “a real-time measure of what’s going on in society,” he says. The situation was changing each year—for example, the Greek government cut public health spending in 2012.

Thomaidis led an international team of researchers to analyze wastewater samples collected from Athens’s treatment plant. They collected samples for about a week at the same time each year from 2010 to 2014, except for the first year, when they sampled the water right after the memorandum was signed. Then they used liquid chromatography and mass spectrometry to screen for 148 legal and illegal drugs and their related metabolites.

The team found huge increases in the use of antipsychotics (35-fold), benzodiazepines (19-fold), and antidepressants (11-fold) from 2010 to 2014, correlating with the fall of Greece’s gross domestic product and the climb in unemployment. Other drugs that also increased in use included drugs to treat ulcers, epilepsy, and hypertension. And although use of antibiotics and nonsteroidal anti-inflammatory drugs decreased—likely due to the cuts to health spending—the researchers found a doubling in the use of illegal methamphetamines.

All the findings suggest that the general health of the Greek people got worse during this period—and in particular, their mental health, Thomaidis says. The greater Athens metropolitan area contains about a third of the country’s population. People in cities were hit harder by the financial crisis and austerity measures than people living in the countryside, who can farm and be closer to extended family networks, he adds. The data show a leveling off in the use of some drugs, as the economic situation begins to stabilize.

Kevin V. Thomas of the Norwegian Institute for Water Research says the approach of linking wastewater with a particular societal event is novel and useful. He says that wastewater-based studies haven’t yet been used to examine the response of a community to a rapid change in society—be it an anti-drug program or an economic collapse—but more such studies would be fascinating to do.