NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC ...

(DAWN) that monitors emergency department (ED)
mentions of drug-related episodes.
Approximately 25 million tourists visit South Florida
annually. The region is a hub of international transportation
and the gateway to commerce between the
Americas, accounting for sizable proportions of the
Nation’s trade: 40 percent with Central America, 37
percent with the Caribbean region, and 17 percent with
South America. South Florida’s airports and seaports
remain among the busiest in the Nation for both cargo
and international passenger traffic. These ports of entry
make this region a major gateway for illicit drugs.
Smuggling by cruise ship passengers is an important
trend in South Florida drug trafficking and has apparently
been growing because of airline security increases
after September 11, 2001.
Several factors impact the potential for drug abuse
problems in South Florida, including the following:
• Proximity to the Caribbean and Latin America
exposes South Florida to the entry and distribution
of illicit foreign drugs destined for all regions
of the United States. Haiti remains a major
link with Colombian traffickers.
• South Florida is a designated High Intensity Drug
Trafficking Area and one of the Nation’s leading
cocaine importation centers. It also became a
gateway for Colombian heroin in the 1990s. Millions
of MDMA (“ecstasy,” or “XTC”) tablets
originate in the Benelux countries and often—
more recently—are flown to the Caribbean before
entering the United States in South Florida.
• Extensive coastline and numerous private air and
sea vessels make it difficult to pinpoint drug importation
routes into Florida and throughout the
Caribbean region.
• Lack of a prescription monitoring system in
Florida now makes the State a source for diverted
medications throughout the southeastern
United States.
Data Sources
This report describes current drug abuse trends in
South Florida, using the data sources summarized
below:
• Drug-related mortality data were provided by
the Florida Department of Law Enforcement
(FDLE), Medical Examiners Commission's 2004
Interim Report of Drugs Identified in Deceased
122
EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Miami-Ft. Lauderdale, Florida
Persons by the Florida Medical Examiners’
Commission.
• Emergency department data for Miami-Dade
County and Broward County, Florida, were accessed
primarily through the Drug Abuse Warning
Network (DAWN) Live! restricted-access
online query system, which is administered by
the Office of Applied Studies (OAS), Substance
Abuse and Mental Health Services Administration
(SAMHSA). In Miami-Dade County, 17 of
the 21 eligible hospitals were in the DAWN sample
in 2004; there were 17 EDs in the sample. In
Broward County, the number of eligible hospitals
totaled 27; 22 were in the DAWN sample, with a
total of 22 EDs in the sample. The data in this paper
are for the first half of 2004, with the exception
of methamphetamine reports, which are for
the full 12 months of 2004. All data were accessed
from DAWN Live! on December 7, 2004,
with the exception of the data from the two Broward
County EDs for the first half of 2004. Data
for the first 6 months from Broward County EDs
were accessed by the CEWG representative directly
from the two participating hospitals, since
at least four EDs in an area must report before the
data are accessible through DAWN Live!. The
unweighted data reported in this paper were not
complete. During the first 6 months of 2004, between
8 and 10 EDs in Miami-Dade County reported
data to DAWN; in the last 6 months, 5–10
reported each month. In Broward County, between
two and three EDs reported in the first 6
months, and between four and seven reported over
the last 6 months. Since all DAWN cases are reviewed
for quality control, and may be corrected
or deleted based on the review, the data reported
here are subject to change. The information derived
from DAWN Live! for this paper represents
some case-type data but primarily represents drug
reports in drug-related visits. Reports exceed the
number of ED visits because a patient may report
use of multiple drugs (up to six drugs and alcohol
may be represented in DAWN). These data cannot
be compared with DAWN data from 2002 and before,
nor can these preliminary data be used for
comparison with future data. Only weighted ED
data released by SAMHSA can be used for trend
analysis. A full description of the DAWN system
can be found at the DAWN Web site
.
• Drug treatment data for the first half of 2004
were provided by the Spectrum Programs, Inc.,
and the Broward Addiction Recovery Centers
Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005