NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC ...

EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Miami-Ft. Lauderdale, Florida
within the past 30 days) was reported by 0.9 percent
of 8th graders, 1.7 percent of 10th graders, and 2.3
percent of 12th graders. These percentages reflected
no change for 8th graders from the same survey in
2003, a 0.4-percent increase for 10th graders, and a
0.3-percent increase for 12th graders.
Heroin
The wholesale and retail prices of heroin have declined
locally over the past year as the area has experienced
a diversification of opioid abuse to include
oxycodone, methadone, hydrocodone, heroin, and
other opioids. Frequently, benzodiazepines are involved
as well. Most deaths, ED visits, and addiction
treatment admissions continue to be among older,
White males.
Broward County, along with Palm Beach County, led
the State in the number of heroin-related deaths in the
first half of 2004. South American heroin has been
entering the area over the past decade. Abuse of narcotic
pain medication has fueled opioid consequences.
Polydrug abuse patterns have facilitated
first-time use of opioid drugs, including heroin.
Throughout Florida, there were 110 heroin-related
deaths in the first half of 2004, representing a 6percent
decline from the 117 such deaths in the previous
6 months. Heroin was found to be the most
lethal drug, with 82 percent (n=90) of heroin-related
deaths being caused by the drug in the first 6 months
of 2004, a 10-perent decline from the second half of
2003. Yet deaths from narcotic opiates increased 13
percent over the same period. Polysubstance abuse
was noted in 82 percent of the heroin-related deaths
statewide (exhibit 1). Across Florida, there were 261
heroin-related deaths in 2003, which represented a
20-percent decline from the previous year. During all
of 2002, there were 326 heroin-related deaths, a
slight decline of only 2 cases from 328 such deaths in
2001.
In the first half of 2004, Broward County and Palm
Beach County had the greatest number of heroinrelated
deaths in the State, with 16 cases each. They
were followed by Orlando (15 cases), Miami-Dade
County (12 cases), Sarasota (11 cases), Tampa (11
cases), and St. Petersburg (9 cases).
In Miami-Dade County, heroin was found at a lethal
dose level in all of the 12 deaths in which heroin was
detected. Other drugs were detected in seven (58 percent)
of the cases (exhibit 2). None of the heroinrelated
fatalities was younger than 26; 33 percent
were age 26–34, 50 percent were 35–50, and 17 percent
were older than 50.
The 12 heroin-related deaths in Miami-Dade during
the first half of 2004 reflected a 25-percent decrease
over the number in 2003. In all of 2003, there were 32
heroin-related deaths, compared to the 36 heroinrelated
deaths in 2002 and 32 in 2001. Heroin deaths
peaked in Miami-Dade County in 2000 with 61 deaths.
In Broward County, the 16 deaths in which heroin
was detected included 9 cases (56 percent) in which it
was found at a lethal dose level. Other drugs were
detected in 15 (94 percent) of the cases (exhibit 3).
None of the heroin-related fatalities was younger than
18; 13 percent were age 18–25, 38 percent were 26–
34, 19 percent were 35–50, and 31 percent were older
than 50.
The 16 heroin-related deaths during the first half of
2004 in Broward County reflected a 33-percent decrease
over the 24 such deaths in the previous 6
months. In all of 2003, there were 49 heroin-related
deaths, compared to the 50 heroin-related deaths in
2002 and 41 in 2001. The relatively low number of
24 heroin-related deaths in 2000 was attributed to a
sharp rise in other opioid deaths linked to prescription
narcotics at that time. The increase in heroinrelated
deaths over the past 8 years rose from 9 in
1995 to 49 in 2003.
Based on unweighted data accessed from DAWN
Live! from Miami-Dade County emergency departments
during the first half of 2004, there were a total
of 661 heroin reports, representing 13 percent of all
illicit substance reports (exhibit 4). Males accounted
for 81 percent of these patients, and 49 percent were
non-Hispanic Whites. Blacks represented 27 percent
of the heroin ED patients, and Hispanics accounted
for 25 percent of the patients. There were two patients
younger than 15 and two age 12–17, while 11
percent were age 18–24, 34 percent were 25–34, and
54 percent were older than 34. Among the 218 heroin
patients for whom the route of administration was
included in the medical record, 78 percent injected
the heroin, 21 percent reported snorting, and 1 percent
cited smoking heroin.
Unweighted data for the first half of 2004 from the
Broward emergency departments identified a total of
54 heroin reports, representing 5 percent of all illicit
substance abuse ED reports (exhibit 5). The heroin
ED patients were predominantly older White males
experiencing withdrawal and/or seeking detoxification.
Males accounted for 76 percent of the patients,
and 80 percent were non-Hispanic Whites. Hispanics
accounted for 11 percent of the heroin ED patients,
and Blacks represented 9 percent of the patients.
There were no patients younger than 18, while 7 percent
were age 18–24, 28 percent were age 25–34, and
Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005 125