NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC ...

65 percent were older than 34. The most common
reason for a heroin patient to visit the ED was dependence
and withdrawal or seeking detoxification in
51 percent of the cases.
BARC reported that 15 percent (n=506) of its 3,416
clients in the first half of 2004 were admitted for heroin
addiction. Spectrum Programs reported 3 percent
(22) of the 641 addiction clients served in the first
half of 2004 sought treatment for heroin. Combined,
the two programs had 528 heroin clients or 13 percent
of their 4,057 patients during the first 6 months
of 2004. A majority of clients were older than 35 and
non-Hispanic White.
Heroin accounted for 608 crime lab cases in Miami-
Dade for the 12-month period from October 2003 to
September 2004 according to the NFLIS, representing
4 percent of all drugs tested and a 2-percent increase
over the total for the previous year. There
were 87 heroin cases worked by the Broward Sheriff’s
Office Crime Lab in the first half of 2004, a 51percent
decrease from the 171 heroin cases in the
second half of 2003 and a slight increase from the 85
cases reported in the first half of 2003. The U.S. DEA
Do-mestic Monitoring Program analyzed 39 streetlevel
samples of heroin in South Florida in 2003. All
of the samples were of South American heroin, and
they averaged 25.6 percent pure heroin. The average
price per milligram pure was $0.90. Nationally, there
were 468 South American heroin samples tested by
the program in 2003. The average purity was 41.8
percent heroin, and the average price was $0.89 per
milligram pure.
Colombian heroin is widely available in South Florida
as described by law enforcement officials and
epidemiologists/ethnographers. According to NDIC,
1 kilogram of heroin sells for $45,000–$65,000 in the
region and for $2,500 per ounce; retail prices are
roughly $100–$150 per gram. The top price for heroin
has dropped 19 percent at the kilogram level and
25 percent at the gram level in the past 12 months.
The most common street unit of heroin is a bag of
heroin (roughly 20 percent purity) weighing about
one-tenth of a gram that sells for $10.
In 2003, any lifetime heroin use was reported in results
of the CDC’s Youth Risk Behavior Survey by
2.3 percent of high school students in Broward
County (exhibit 6). This was the lowest proportion in
the region and represented a 30-percent decline from
the 2001 rate of 3.3 percent. Among high school students
in Miami-Dade County, 2.5 percent reported
lifetime heroin use. In Palm Beach County, 3.7 percent
of high school students reported lifetime heroin
use in the same survey. The proportion for the high
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EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Miami-Ft. Lauderdale, Florida
school students in all of Florida and nationwide as
well was 3.3 percent.
Nationally, the 2004 Monitoring the Future Survey
reported that current use of heroin (defined as any use
within the past 30 days) was reported by 0.5 percent
of 8th, 10th, and 12th graders. These percentages
reflected no change for 8th graders from the same
survey in 2003 and a 0.1-percent increase for 10th
and 12th graders.
Other Opiates
Deaths from opiates other than heroin (including hydrocodone,
oxycodone, and methadone) have been
tracked in Florida since 2000. Beginning in 2003,
morphine, propoxyphene, fentanyl, hydromorphone,
meperidine, and other opioids were included in the
Florida Medical Examiners Commission’s surveillance
monitoring program.
Methadone-related deaths statewide increased 32
percent between the last 6 months of 2003 and the
first half of 2004, when they reached 392. This continues
a steady increase of methadone-related deaths
since 2001. Methadone was the cause of death in 67
percent of the methadone cases during the first half of
2004, causing a 50-percent increase in methadoneinduced
deaths compared to the last half of 2003.
The number of oxycodone-related deaths increased 9
percent statewide between the last 6 months of 2003
and the first half of 2004, when they reached 333.
Oxycodone was the cause of death in 50 percent of
the oxycodone cases during the first half of 2004,
causing an 18-percent increase in oxycodone-induced
deaths compared to the last half of 2003.
The number of hydrocodone deaths increased 6 percent
statewide between the last 6 months of 2003 and
the first half of 2004, when they reached 293. Hydrocodone
was the cause of death in 36 percent of the
hydrocodone-related deaths during the first half of
2004, causing a 25-percent increase in hydrocodoneinduced
deaths compared to the last half of 2003.
Additional opiate-related analgesic deaths statewide
in the first half of 2004 included morphine (307),
propoxyphene (184), fentanyl (93), hydromorphone
(42), meperidine (17), and other opioids (106). When
the ME mentions for all opiate analgesics are added
to those for heroin, these opioid-related ME mentions
in Florida during the first half of 2004 total 1,877
cases. This total is even greater than the 1,720 alcohol-related
deaths during the same 6 month period.
Most of the statewide opioid cases were polydrug
episodes, including 88 percent of the oxycodone ME
Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005