Current Drug Trends from the Epidemiological State Rep
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Current Drug Trends from the Epidemiological State Rep

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epidemiological presentation from Jim Hall. You will find “The South Florida Report January 2011.”

epidemiological presentation from Jim Hall. You will find “The South Florida Report January 2011.”

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    Current Drug Trends from the Epidemiological State Rep Current Drug Trends from the Epidemiological State Rep Document Transcript

    • Draft as of January 7, 2011 The South Florida Report January 2011 Community Epidemiology Work Group James N. Hall N South Florida Drug ObservatoryNova Southeastern University 2 Santa Holmes Jacks on W n Rosa gto alto Okaloosa hin Gadsden Nas sau n n Escambia as so Calhoun Hamilton W ffer Leon Madis on Bay ia Je Baker Duval mb Liberty Wakulla lu Laf Suwannee Co Taylor rd ay Union St. d fo Franklin ette Clay Gulf Johns B ra Gilchris t Alachua Putnam Dixie Palm Flagler Levy Marion VolusiaFL=18.5 Citrus Lake Seminole Sumter Hernando Orange 1.3 Million Pasco Brev Hillsborough Osceola ard Polk Pinellas Indian River OkMillion Manatee Hardee e ec ho Highlands St. Lucie be Sarasota De Soto e Martin Charlotte Glades Hendry Palm Beach Lee Beach Broward Collier Dade Monroe 1.8 Million Broward 2.5 2 5 Million Miami- US Census Bureau 2009 Population Estimates Dade 1
    • Draft as of January 7, 2011 DATA SOURCES JANUARY 2011• Florida Medical Examiners Commission 2010 Interim Report on Drugs Identified In Deceased Persons by Florida p g y Medical Examiners from Florida Department of Law Enforcement• Emergency department (ED) DAWN weighted estimates from SAMHSA Center for Behavioral Health Statistics and Quality are for 2004-2009 and reported separately for the Miami-Dade and Ft. Lauderdale Divisions of DAWN• Florida Department of Children and Families treatment data from all publicly-funded adult and youth treatment programs for Miami-Dade and Broward Counties primary admissions for all treatment modalities Jan -June 2010.DATA SOURCES JANUARY 2011 (CONT.) • Comparison of Primary Treatment Admissions in Florida as reported to Treatment Episode Data Set p p (TEDS) from SAMHSA Center for Behavioral Health Statistics and Quality for 1999 and 2009 • National Forensic Laboratory Information System (NFLIS), Drug Enforcement Administration (DEA), for January – June 2010 • Florida Youth Substance Abuse Survey 2010, Florida Department of Children and Families. 2
    • Draft as of January 7, 2011 SOUTH FLORIDA TRENDS BETWEEN 2ND HALF 2009 & 1ST HALF 2010• Cocaine Declining : Street Purity Down, Price Up.• Heroin Consequences: Stable and low• Rx Opioids: Consequences Stable at high levels• Increasing Injecting Drug Use of Rx Opioids• Methamphetamine: Low and Stable• Marijuana: Student Use Up Perceived Risks Down• Benzodiazepine: Deaths ED Reports• Emerging Issues: • Role of street purity and price in decline of cocaine • New Injecting Drug Users naïve about infected syringes • Retail network for current and future unregulated synthetic drugs Number of Cocaine Reports Detected AmongDecedents in South Florida: Jan. 2000 - June 2010 300 281 250 201 200 189 182 NUMBER of 160 162 155 149 151 COCAINE 150 144OCCURRENCES 150 157 146 138 Including 138 136 135 “Present” & 100 121 120 “Cause of 94 Death” 80 Miami-Dade 82 50 Broward 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2X 1h10 SOURCE: Florida Medical Examiners Commission Interim Report 2010 3
    • Draft as of January 7, 2011Number of Cocaine Reports Detected AmongDecedents in Florida: Jan. 2000 - June 2010 2,500 1,943 2,052 2,179 2,000 1,702 1,791 1,3071,614 1,462 1,500 1,034 1,105 All Florida 1,000 1 000 1,206 1 206 500 NUMBER of 0 COCAINE 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2X OCCURRENCES 1h10 Including 300 281 “Present” & 250 “Cause of 189 182 201 200 Death” 149 151 160 162 155 144 138 150 150 157 146 100 138 136 135 121 120 94 Miami-Dade 82 50 80 Broward 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 20092X 1h10 SOURCE: Florida Medical Examiners Commission Interim Report 2010 Number of Cocaine Reports Among Deceased Persons by Polysubstance Use Status in Florida: 2001 - 2010 2000 ons # of Cocaine Detectio Among Decedents s 1500 Cocaine Plus 1000 500 Cocaine Only 0 2X 1h 2001 2002 2003 2004 2005 2006 2007 2008 2009 10 Cocaine Plus 801 942 1142 1269 1443 1520 1639 1,367 1,159 490 CocaineOnly 304 365 472 433 500 532 540 424 303 113SOURCE: Florida Dept. of Law Enforcement, Florida Medical Examiners Commission Reports 2001- 2010 4
    • Draft as of January 7, 2011 Number of Cocaine Reports Detected AmongDecedents in South Florida: Jan. 2000 - June 2010 300 281 250 201 200 189 182 NUMBER of 160 162 155 149 151 COCAINE 150 144OCCURRENCES 150 157 146 138 Including 138 136 135 “Present” & 100 121 120 “Cause of 94 Death” 80 Miami-Dade 82 50 Broward 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2X 1h10 SOURCE: Florida Medical Examiners Commission Interim Report 2010 5
    • Draft as of January 7, 2011 NUMBER OF ESTIMATE ED REPORTS BY DRUG IN MIAMI-DADE ANDFT. LAUDERDALE DAWN DIVISIONS: 2009 16,000 tes 14,000 # of ED Report Estimat 12,000 Benzodiazepine 2,900 1,587 10,000 192 820 Opioids 2,899 8,000 3,375 MDMA (Ecstasy) 252 6,000 Marijuana 2,870 459 4,000 4 000 Heroin H i o 6,459 2,000 Cocaine 4,475 0 Miami-Dade Ft. Lauderdale DAWN Divisions SOURCE: SAMHSA-CBHSQ Dawn Estimates 2009 October 5, 2010Rates per 100,000 of Cocaine Emergency Dept. Reports Miami-Dade County: 2004-2009 600 541.1 500Rates per 100,000 397.7 Miami-Dade 407.7 400.5 400 302.5 300 258.3 200R 100 0 2004 2005 2006 2007 2008 2009SOURCE: US Dept HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates. 6
    • Draft as of January 7, 2011Rates per 100,000 of Cocaine Emergency Dept. Reports Miami-Dade County, and USA: 2004-2009 600 541.1 500Rates per 100,000 397.7 Miami-Dade 407.7 400.5 400 302.5 300 183.7 183.5 258.3 200 162.2 163.6 158.4 USAR 100 137.7 0 2004 2005 2006 2007 2008 2009SOURCE: US Dept HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates. Rates per 100,000 of Cocaine Emergency Dept. Reports Broward (2008), Miami-Dade, and USA: 2004-2009 600 541.1 500Rates per 100,000 397.7 Miami-Dade 407.7 400.5 400 302.5 300 258.3 183.7 183.5 Broward 200 162.2 163.6 183.9 158.4 147 USAR 137.7 100 0 2004 2005 2006 2007 2008 2009SOURCE: US Dept HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates. 7
    • Draft as of January 7, 2011 Number of South Florida* Crime Lab Reportsfor Cocaine and All Other Drugs: 2007-Jun ‘10*Miami-Dade, Broward, & Palm Beach Counties Combined Legend Cocaine All Other Drugs 2007 Cocaine 67% 2007 20,913 10,449 2008 Cocaine 65% 2008 19,156 10,083 2009 Cocaine 62% 2009 15,309 9,403 2010 Cocaine 57% 2X1h 10 13,196 10,312 0 10,000 20,000 30,000 40,000 Number of Crime Lab Samples Source: US DEA National Forensic Laboratory Information System Percent of Primary Treatment Admissions by Substance for the State of Florida: 1999 (n= 84,524) Compared to 2009 (n= 77,604) 0.50% Alcohol Only 1999 2009 Alcohol w/drug 3% 1% 6.50% 2% 1% Crack Cocaine 5% 5% Other Cocaine 18% 28% Marijuana 16% Heroin 2% 11% 20% Opioids p 13% 10% Amphetamines 31% 5% 18% Tranquilizers 4% Other/UnknownSOURCE: US Dept. HHS-SAMHSA, CBHSQ: Treatment Episodes Data Set (TEDS) as reported by the Florida Department of Children and Families 09/30/2010 8
    • Draft as of January 7, 2011 Percent of Primary Treatment Admissions by Substance for the State of Florida: 1999 (n= 84,524) Compared to 2009 (n= 77,604) 0.50% Alcohol Only 1999 2009 1% 6.50% Alcohol w/drug 3% 2% 1% Crack Cocaine 5% 5% Other Cocaine 18% 28% Marijuana 16% Heroin 2% 11% 20% Opioids p 13% Amphetamines 31% 10% Tranquilizers 5% 4% 18% Other/UnknownSOURCE: US Dept. HHS-SAMHSA, CBHSQ: Treatment Episodes Data Set (TEDS) as reported by the Florida Department of Children and Families 09/30/2010 PRICE AND PURITY OF ALLUSA LAW ENFORCEMENT COCAINE PURCHASES JANUARY 2006 - JUNE 2009 $200 80 $180 68.65 $174.38 70 $160 61.33 $158.01 60 Price/Pure Gram $140 Percent Pure $120 51.6 50 $116.36 48.6 $100 40 $94.05 $80 30 $60 Price/Pure Gram P 20 $40 Purity $20 10 $0 0 2006 2007 2008 1H 2009 Source: Based on unpublished US DEA System to Retrieve Information from Drug Evidence (STRIDE) Data 9
    • Draft as of January 7, 2011 Percent of Primary Treatment Admissions by Substance for the State of Florida: 1999 (n= 84,524) Compared to 2009 (n= 77,604) 0.50% Alcohol Only 1999 2009 1% 6.50% Alcohol w/drug 3% 2% 1% Crack Cocaine 5% 5% Other Cocaine 18% 28% Marijuana 16% Heroin 2% 11% 20% Opioids p 13% Amphetamines 31% 10% Tranquilizers 5% 4% 18% Other/UnknownSOURCE: US Dept. HHS-SAMHSA, CBHSQ: Treatment Episodes Data Set (TEDS) as reported by the Florida Department of Children and Families 09/30/2010 NUMBER OF HEROIN-INDUCED DEATHS IN MIAMI-DADE & BROWARD COUNTIES, FL: 1996- JUN 2010 eaths 70 Miami-Dade 60# Lethal Heroin De Broward 50 40 30 20 10 10 8 L 0 SOURCE: Florida Medical Examiners Commission Interim Report 2010 10
    • Draft as of January 7, 2011 NUMBER OF HEROIN-INDUCED DEATHS IN FLORIDA: 1996 - JUNE 2010 # Lethal Heroin Deaths 300 Florida 250 Miami Dade Miami-Dade 200 Broward 150 100 50 50 0 SOURCE: Florida Medical Examiners Commission Interim Report 2010 NUMBER OF OPIATE-RELATED DEATHS OPIATE-BY HEROIN OR RX OPIOID IN FLORIDA: 2000-2010 2000- 4500 4000 3,986 Heroin 3 Rx Opioids 3500# of Opiates Detected 3000 3 Rx Opioids mong Decedents The 3 Rx Opioids are 2500 Methadone, 2000 Hydrocodone, and 1500 Oxycodone 869 1000 500 Heroin 0 276 60 O Am SOURCE: Florida Medical Examiners Commission Reports 2000-2010 11
    • Draft as of January 7, 2011 Prescription Opioid Nonmedical Use and Heroin • Rx Opioid frequently misused by heroin users • Not a significant number of Rx Opioid misusers also using heroin… • Increasing Injecting Drug Use among Rx Opioid nonmedical users in their 20s. • Born 1981 to 1990; Entered Adolescence 1994 – 2003 • After major interventions for HIV Injecting Drug Users • Priority Public Health Issue: Infected Syringes - Young Adults Number of Oxycodone Reports Detected Among Decedents in Florida: Jan. 2007 - June 2010 1200 941 1,007 1,117 NUMBER of 1000 869 Oxycodone 800 685 705OCCURRENCES 568 Including g 600 Florida 400 “Present” & 200 “Cause of 0 Death” 1H 07 2H 07 1H 08 2H 08 1H 09 2H 09 1H 10 SOURCE: Florida Medical Examiners Commission Interim Report 2010 12
    • Draft as of January 7, 2011 Number of Oxycodone Reports Detected Among Decedents in Florida: Jan. 2007 - June 2010 1200 1000 1,007 1,117 800 869 941 600 685 705 400 568 Florida NUMBER of 200 Oxycodone 0OCCURRENCES 1H 07 2H 07 1H 08 2H 08 1H 09 2H 09 1H 10 Including 160 Palm Beach 136 “Present” & 140 124 Broward “Cause of 120 96 103 Death” 100 Miami-Dade 88 89 84 77 91 80 88 60 60 70 47 40 49 20 36 30 30 36 33 0 9 16 1H 07 2H 07 1H 08 2H 08 1H 09 2H 09 1H 10 SOURCE: Florida Medical Examiners Commission Interim Report 2010 Percent of Primary Treatment Admissions by Substance for the State of Florida: 1999 (n= 84,524) Compared to 2009 (n= 77,604) Alcohol Only 0.50% 1999 2009 1% 6.50% Alcohol w/drug 2% 1% 3% Crack Cocaine 5% 5% 16% 18% Other Cocaine 28% Marijuana Heroin 2% 11% 20% Opioids 13% Amphetamines 31% 10% 5% Tranquilizers 4% 18% Other/UnknownSOURCE: US Dept. HHS-SAMHSA, CBHSQ: Treatment Episodes Data Set (TEDS) as reported by the Florida Department of Children and Families 09/30/2010 13
    • Draft as of January 7, 2011Number of Primary Addiction Treatment Admissions for Prescription Opioids in Florida by Age: 1999 vs. 2009Numb of Primary Addictio Treatment 3500 dmissions for Prescriptio Opioids 3000 1999 n= 2,165 2500 on 2009 n= 12,103 12 103 on 2000 1500 1000 500 ber Ad 0 12- 18- 21- 26- 31- 36- 41- 46- 51- 56- 61- 66 & 17 20 25 30 35 40 45 50 55 60 65 over yrs yrs yrs yrs yrs yrs yrs yrs yrs yrs yrs 1999 n= 2,165 19 54 160 255 385 437 478 227 93 22 9 6 2009 n= 12,103 424 944 3243 3038 1670 1017 678 569 351 133 24 12 SOURCE: US Dept. HHS-SAMHSA, CBHSQ: Treatment Episodes Data Set (TEDS) as reported by the Florida Department of Children and Families 09/30/2010 Number of Oxycodone Reports Detected Among Decedents by Age Groups in Florida: Jan-Jun 2010 700 orts 600 State of Florida 1,117 1 117 # of Oxycodone Repo 500 423 400 320 300 238 200 131 o 100 1 5 0 <18 yrs. 18-25 yrs. 26-34 yrs. 35-50 yrs. >50 yrs. Source: FDLE Florida Medical Examiners Commission Interim Report 2010 14
    • Draft as of January 7, 2011 Rates per 100,000 of Nonmedical Use Oxycodone Emergency Dept. Reports Miami-Dade, Broward, and USA: 2004-2009 60 52.8 50 Broward 48.4 Rates per 100,000 40 37.8 34.5 30 25.4 21.7 USA 20 17.9 14.2 14 R 8.2 10.2 10 2 10 5.3 8 8.7 Miami-Dade 0 2004 2005 2006 2007 2008 2009 SOURCE: US Dept HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates. . Rates per 100,000 of Oxycodone Nonmedical Use Emergency Department Reports by Age Groups DAWN Ft. Lauderdale Division vs. USA: 2009 180 153 158.1 160Ra per 100,000 140 Broward & Palm Beach 120 106 100 117.3 92.6 80 88.6 USA 80.2 67.9 69.1 60 73.5 61.1 ate 62.9 47.1 40 43 20 0 18-20 yrs.21-24 yrs.25-29 yrs.30-34 yrs.35-44 yrs.45-54 yrs.55-64 yrs. SOURCE: US Dept HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates. 15
    • Draft as of January 7, 2011 Number of Alprazolam Reports Detected Among Decedents in Florida: Jan. 2007 - June 2010 1200 1,035 942 1,021 986 1000 796 838 800 652 600 400 Florida NUMBER of 200 Alprazolam 0OCCURRENCES 1H 07 2H 07 1H 08 2H 08 1H 09 2H 09 1H 10 Including 160 151 Palm Beach 139 “Present” & 140 Broward “Cause of 120 107 106 Death” 100 Miami-Dade 100 80 77 80 69 79 81 60 62 71 52 63 55 40 44 53 44 36 20 38 22 0 1H 07 2H 07 1H 08 2H 08 1H 09 2H 09 1H 10 SOURCE: Florida Medical Examiners Commission Interim Report 2010 Rates per 100,000 of Nonmedical Use Rx Benzodiazepines Emergency Dept. Reports Miami-Dade, Broward, and USA: 2004-2009 120 101.9 100 USA 89.3 95.2 Rates per 100,000 80 74.1 72.5 64.1 75.2 Broward 65.5 61.5 63.4 60 57.6 61.4 49 55.5 Miami-Dade 40 R 20 0 2004 2005 2006 2007 2008 2009 SOURCE: US Dept HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates. . 16
    • Draft as of January 7, 2011 Rates per 100,000 of Marijuana Emergency Dept. Reports Broward (2008-09), Miami-Dade, and USA: 2004-2009 250 215.1 200 Rates per 100,000 177.7 177 7 157.7 Miami-Dade 145.8 150 136.3 123 135 97.3 102.3 122.6 96.1 94.6 96.9 100 94.2 USA Broward R 50 0 0 2004 2005 2006 2007 2008 2009 SOURCE: US Dept HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates.. Percent of Primary Treatment Admissions by Substance for the State of Florida: 1999 (n= 84,524) Compared to 2009 (n= 77,604) Alcohol Only 0.50% 1999 2009 1% 6.50% Alcohol w/drug 2% 1% 3% Crack Cocaine 5% 5% Other Cocaine 16% 18% 28% Marijuana Heroin 2% 11%20% Opioids p 13% Amphetamines 10% Tranquilizers 5% 31% 4% 18% Other/Unknown SOURCE: US Dept. HHS-SAMHSA, CBHSQ: Treatment Episodes Data Set (TEDS) as reported by the Florida Department of Children and Families 09/30/2010 17
    • Draft as of January 7, 2011 Synthetic Cannabinoids•Widely Available•Need for Laboratory Standards - Crime Labs - Urine Drug Tests Rates per 100,000 of MDMA Emergency Dept. ReportsBroward (2008-09). Miami-Dade County and USA: 2004-2009 14 11.9 12 Miami-DadeRates per 100,000 10 8.8 8.6 7.9 Broward 8.3 8 7.7 5.9 7.3 7.4 6 5.6 4.2 5.9 3.8 4 3.5 USAR 2 0 2004 2005 2006 2007 2008 2009SOURCE: US Dept HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates. 18
    • Draft as of January 7, 201165 PERCENT OF BROWARD CRIME LAB ALLEGED ECSTASY IS BZP IN 2010 BZP TFMPP ? Be On ALERT MEPHEDRONE… “Meow Meow” MDPV I-10 from New Orleans Chlorophenylpiperazine - mCPP 19
    • Draft as of January 7, 2011 South Florida Summary JANUARY 2011 Substance Deaths ED Primary Crime Reports Tx Admits Labs Cocaine Heroin Rx Opioids Rx Benzo’s Metham- Metham M th - Low L Low L Low L Low L phetamine Marijuana NA Ecstasy BZP & Miami- Miami-Dade Broward MDMA SOUTH FLORIDA EMERGING ISSUES:• Role of street purity and price in decline of cocaine consequences• New Injecting Drug Users naïve about infected syringes• Retail network for current and future unregulated g synthetic drugs 20
    • Draft as of January 7, 2011 The South Florida Report January 2011 Community Epidemiology Work Group James N. HallSouth Florida Drug Observatory Nova Southeastern University 2 21