Sewage-based epidemiology: a novel, emerging approach to estimating population-level illicit drug consumption

The disproportionate burdens of morbidity and premature mortality among Aboriginal and Torres Strait Islander (TSI) Australian’s are well documented. Research and clinical practice evaluations are essential in determining if existing programs to reduce this inequality gap will actually be effective. However, methodological rigour appears to be fundamentally lacking in the current evidence base with concerns that the absence of appropriate evaluations alongside these programs may result in implementation of ineffective practices and poor disease management. This article highlights some of the existing barriers for conducting research in collaboration with Aboriginal and TSI Australians and provides options to consider when addressing these issues.