Current methods measuring the consumption of prescription and illicit drugs are often hampered by innate limitations, the data is slow and often restricted, which can impact the relevance and robustness of the associated data. Here, wastewater-based epidemiology (WBE) was applied as an alternative metric to measure trends in the consumption of twelve narcotics within a collegiate setting from January 2018 to May 2018 at a Southwestern U.S. university. The present follow-up study was designed to identify potential changes in the consumption patterns of prescription and illicit drugs as the academic year progressed. Samples were collected from two sites that capture nearly 100% of campus-generated wastewater. Seven consecutive 24-hour composite raw wastewater samples were collected each month (n = 68) from both locations. The study identified the average consumption of select narcotics, in units of mg/day/1000 persons in the following order: cocaine (528 ± 266), heroin (404 ± 315), methylphenidate (343 ± 396), amphetamine (308 ±105), ecstasy (MDMA; 114 ± 198), oxycodone (57 ± 28), methadone (58 ± 73), and codeine (84 ± 40). The consumption of oxycodone, methadone, heroin, and cocaine were identified as statistically lower in the Spring 2018 semester compared to the Fall 2017. Universities may need to increase drug education for the fall semester to lower the consumption of drugs in that semester. Data from this research encompasses both human health and the built environment by evaluating public health through collection of municipal wastewater, allowing public health officials rapid and robust narcotic consumption data while maintaining the anonymity of the students, faculty, and staff.