NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC ...

data, however, rising from 1.5 percent of all admissions
in 1999 to 2.1 percent (583 admissions) in the
first half of 2004. The number of other opiate/synthetic
admissions reported in the first half of
2004 was 10 percent lower than the number of primary
other opiates/synthetic admissions reported in
the second half of 2003, but nearly identical to the
number of other opiate/synthetic admissions reported
in the first half of 2003 (n=582). Despite the small
overall numbers of admissions, it will be important to
carefully monitor future treatment admissions data,
given the increase in prescription opiate abuse/misuse
in other major CEWG areas. Other opiates/synthetics
admissions were typically male (60 percent), White
non-Hispanic (74 percent), and age 36–50 (52 percent).
Only 1 percent of the primary other opiate/
synthetic admissions were younger than 18. Interestingly,
80 percent administered other opiates/synthetics
orally, but an additional 16 percent reported
smoking. Sixty-one percent of primary other opiate/synthetic
admissions reported no secondary or
tertiary substance use. An additional 12 percent reported
secondary alcohol use, and 7.5 percent reported
secondary cocaine/crack use. Reports of primary
non-prescription methadone admissions continued
to be minimal among Los Angeles County treatment
admissions (47 admissions, 0.2 percent of all
admissions).
In addition to encompassing major substances of
abuse, unweighted data accessed from DAWN Live!
cover pharmaceutical drug categories, such as psychotherapeutic
agents (antidepressants, antipsychotics,
anxiolytics, sedatives and hypnotics, and central
nervous system [CNS] stimulants), CNS agents (analgesics,
anticonvulsants, antiparkinson agents, and
muscle relaxants), respiratory agents, cardiovascular
agents, and anti-infectives. The case types that are of
interest for pharmaceuticals include seeking detoxification,
overmedication, and other. Of the 1,318
pharmaceuticals falling within these three case types
in the first half of 2004 in the Los Angeles division,
164 (12 percent) were opiates/opioids and an additional
169 (13 percent) were other analgesics (exhibit
14). For the opiates/opioids, overmedication was the
most frequently stated case type (43 percent of opiates/opioids),
followed closely by “other” (41 percent)
and more distantly by seeking detoxification
(16 percent). Among other analgesics, 82 percent
(139) of the drugs were reported as overmedication
cases.
Los Angeles County-based California Poison Control
System calls involving exposure to opiates/analgesics
increased from a low of 25 in 2000 to a high of 67 in
2003 (exhibit 8b). In the first half of 2004 alone, 31
opiate/analgesic exposure calls were reported, which
102
EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Los Angeles County
may indicate a stabilizing of the trend line. Between
January 2003 and June 2004, calls involving an exposure
to hydrocodone were more likely than calls involving
an exposure to oxycodone (58 calls vs. 11
calls, respectively).
Approximately 688 of the 54,240 items analyzed and
reported to NFLIS between October 1, 2003, and September
30, 2004, were identified as pharmaceuticals/prescription/non-controlled
non-narcotic medications
(as opposed to illicit substances). Of those, more
than one-half (361 items; 52.5 percent) were found to
be narcotic/other analgesics. The most frequently cited
analgesics were hydrocodone (204 items; 57 percent)
and codeine (62 items; 17 percent). Other analgesics
identified included methadone (35 items), oxycodone
(21 items), and propoxyphene (10 items). To put these
numbers/percentages into perspective, analgesics accounted
for 0.7 percent of all items analyzed by participating
Los Angeles County laboratories.
Efforts are underway throughout Los Angeles to
quantify the extent of pharmaceutical diversion to the
street. One result of this effort is the availability of
expanded prices for diverted opiates/analgesics. According
to LA CLEAR, Vicodin, a member of the
hydrocodone family of opiate pain relievers, continues
to retail for $5 per 5-milligram tablet in Los Angeles
County (exhibit 13). OxyContin, the trade name
for the powerful analgesic oxycodone hydrochloride,
sells on the streets for $1 per milligram. LA CLEAR
reports reveal that OxyContin is “readily available”
in the LA HIDTA. Percocet sells for $5–$10 per 5milligram
tablet; MS Contin sells for $20 per 60milligram
tablet; codeine sells for $5 per tablet; Dilaudid
(hydromorphone) sells for $100 per 4milligram
tablet; fentanyl patches sell for $25–$100
each; and methadone sells for $10 per tablet.
Marijuana
From the first to second half of 2003, the number of
primary marijuana treatment admissions decreased 6
percent (exhibit 3). A reversal of this decreasing trend
was observed in early 2004. From the second half of
2003 to the first half of 2004, primary marijuana admissions
increased 10 percent (from 3,452 admissions
to 3,812 admissions). As a percentage of the total,
marijuana accounted for 13.4 percent of all admissions
reported in January–June 2004. Like many of the other
major drugs of abuse, the user demographics of primary
marijuana admissions were relatively stable in
the first half of 2004. Three out of four primary marijuana
admissions were male, and individuals younger
than 18 constituted 48 percent of these admissions
(exhibit 5). Primary marijuana admissions were most
likely to be Hispanic (48 percent), followed by Black
Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005