Between September 2023 and August 2024, Biobot Analytics monitored 76 locations across 41 states, covering approximately 20 million people. The study analyzed concentrations of fentanyl, methamphetamine, amphetamine, cocaine, xylazine, and naloxone. The data revealed sharp geographical divides: fentanyl and xylazine concentrations remained highest in the Northeast, while methamphetamine levels were most concentrated in the West.

Beyond simple tracking, the project demonstrated its utility in Laredo, Texas. After detecting fentanyl-laced cocaine in local wastewater, officials launched a targeted outreach campaign, distributing naloxone to over 2,000 households. The study highlights a specific lag in traditional surveillance; in one instance, wastewater signals identified a decline in fentanyl use in February 2024, a trend that official fatal overdose reports did not confirm until May 2025. By providing a standardized, centralized repository for substance use data, the NIH-funded initiative aims to bridge a critical gap in American public health infrastructure, offering a privacy-preserving tool to guide community intervention.