Wastewater-based epidemiology (WBE) is a complementary, well-established comprehensive, cost-effective, and rapid technique for monitoring of illicit drugs used in a general population. This systematic review and meta-analysis is the first to estimate the rank and consumption rate of illicit drugs through WBE studies. In the current study, the related investigations regarding the illicit drug consumption rate based on WBE were searched among the international databases including Scopus, PubMed, Science direct, Google scholar, and local database, Magiran from 2012 up to May 2019. The illicit drug consumption rate with 95% confidence intervals was pooled between studies by using random effect model. The heterogeneity was determined using I² statistics. Also, subgroup analyses were conducted to examine the possible effects of year and location of studies on observed heterogeneity. Meta-analysis of 37 articles indicates that the overall rank order of illicit drugs according to their pooled consumption rate can be summarized as tetrahydrocannabinol or cannabis (7417.9 mg/day/1000 people) > cocaine (655.7 mg/day/1000 people) > morphine (384.9 mg/day/1000 people) > methamphetamine (296.2 mg/day/1000 people) > codeine (222.7 mg/day/1000 people) > methadone (200.2 mg/day/1000 people) > 3,4-methylenedioxymethamphetamine (126.3 mg/day/1000 people) > amphetamine (118.2 mg/day/1000 people) > 2-ethylidene-1,5-dimethyl-3, 3-diphenylpyrrolidine (33.7 mg/day/1000 people). The pooled level rate was 190.16 mg/day/1000 people for benzoylecgonine (main urinary cocaine metabolite), 137.9 mg/day/1000 people for 11-nor-9-carboxy-delta9-tetrahydrocannabinol (main metabolite of cannabis), and 33.7 mg/day/1000 people for 2-ethylidene-1,5-dimethyl-3, 3-diphenylpyrrolidine (main metabolite of methadone). The I² values for all selected drugs were 100% (P value < 0.001). The results of year subgroup indicated that the changes of heterogeneity for all selected drugs were nearly negligible. The heterogeneity within studies based on continents subgroup just decreased in America for drugs like 11-nor-9-carboxy-delta9-tetrahydrocannabinol (I² = 24.4%) and benzoylecgonine (I² = 94.1%). The outcome of this meta-analysis can be used for finding the illicit drugs with global serious problem in view of consumption rate (i.e., cannabis and cocaine) and helping authorities to combat them.

基于废水的流行病学（WBE）是一种互补的，行之有效的综合，具有成本效益的，快速的技术，用于监测普通人群中使用的非法药物。这项系统的审查和荟萃分析是第一个通过WBE研究评估非法药物等级和消费率的方法。在当前研究中，从国际数据库中检索了基于WBE的非法药物消耗率的相关调查，这些数据库包括Scopus，PubMed，Science direct，Google Scholar和本地数据库Magiran（从2012年到2019年5月）。使用随机效应模型在研究之间合并具有95％置信区间的比率。使用I ²确定异质性统计。另外，进行了亚组分析以检查研究年份和地点对观察到的异质性的可能影响。对37篇文章的荟萃分析表明，根据合计消费率，非法药物的总体排名可以概括为四氢大麻酚或大麻（7417.9 mg /天/ 1000人）>可卡因（655.7 mg /天/ 1000人）>吗啡（384.9 mg /天/ 1000人）>甲基苯丙胺（296.2 mg /天/ 1000人）>可待因（222.7 mg /天/ 1000人）>美沙酮（200.2 mg /天/ 1000人）> 3,4-亚甲二氧基甲基苯丙胺（126.3毫克/天/ 1000人）>苯丙胺（118.2毫克/天/ 1000人）> 2-亚乙基-1,5-二甲基-3，3-二苯基吡咯烷（33.7毫克/天/ 1000人）。合并水平率为190。苯甲酰芽子碱（主要尿可卡因代谢产物）为16毫克/天/ 1000人，11-nor-9-羧基-δ9-四氢大麻酚（大麻的主要代谢产物）为137.9毫克/天/ 1000人，以及33.7毫克/天/ 1000人用于2-亚乙基-1,5-二甲基-3，3-二苯基吡咯烷（美沙酮的主要代谢物）。的所有选定药物的I ²值均为100％（P值<0.001）。年分组的结果表明，所有选定药物的异质性变化几乎可以忽略不计。在美国，基于大陆亚组的研究中的异质性在美国像11-nor-9-羧基-delta9-四氢大麻酚（I ²  = 24.4％）和苯甲酰芽子碱（I ²  = 94.1％）之类的国家中刚刚下降。这项荟萃分析的结果可用于从消费率（即大麻和可卡因）的角度查找具有全球性严重问题的非法药物，并帮助当局进行打击。