NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC ...

ecstasy. MDMA ED mentions may be stabilizing. Although
ED mentions totaled 24 in 1996 and 172 in
2001, the number of mentions declined insignificantly
to 143 in 2002. MDMA is available in tablet, capsule,
and powdered form. A dose sells for about $13 wholesale
and $30 retail.
The number of DAWN deaths involving the category of
club drugs (including MDMA, ketamine, GHB, gamma
butyrolactone [GBL], and Rohypnol) totaled 19 in
2002. Although this number is small, it shows a large
increase from previous years: four in 1999 and five in
2002.
Available as a club drug in New York City, the veterinary
anesthetic ketamine produces hallucinogenic
effects similar to PCP and visual effects similar to LSD.
On the street, the drug is called “Special K,” “K,” “Vitamin
K,” and “Cat Valium,” and sells for approximately
$25–$50 per dosage unit. It comes in liquid,
powdered, or tablet form, and it may be administered
intranasally or injected. While ketamine is not currently
a controlled substance under Federal law, it is listed as
a controlled substance in New York State. The number
of ketamine ED mentions has remained relatively stable
for the last few years, numbering 36 in 2002. It is available
in club settings and has not been reported on the
“street.”
Another club drug of concern is GHB. GHB ED mentions
in New York City remain very low. Although not
generally available on the street, GHB and the analogs
(GBL, BD, GHV, and GVL) can be easily obtained in
many dance clubs. It is also known as liquid MDMA,
“grievous bodily harm,” or “Georgia Homeboy.” It is
usually available in liquid form, and in a club, GHB
may cost $45–$65 for a bottle cap full. A single dose
costs about $20.
LSD is a strong hallucinogen that has not been a major
problem in New York City since the late 1960s and
early 1970s. It is also known as acid, boomer, and yellow
sunshine.
The club drug sellers and users have comparable demographics,
since they tend to interact in special youthdriven
situations. Both sellers and buyers tend to be
young (early twenties or younger to thirties), White,
and disproportionately male, and most are in college or
associate with a college or club-going crowd.
Although these drugs are part of the New York drug
scene, their appeal at this point has been limited to a
small minority of substance abusers. When field researchers
asked their street sources with chronic
histories of substance abuse about these drugs, most
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EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—New York City
indicated that they never used these substances, and did
not know anyone selling or using them.
INFECTIOUS DISEASES RELATED TO DRUG ABUSE
The AIDS epidemic, with its impact on injection drug
users (IDUs), has played a crucial role in shaping the
New York City drug scene over the last two decades.
HIV first entered New York City in the mid- to late-
1970s. AIDS reporting was mandated in 1983, but reporting
of HIV infection began in June 2000. Sixteen
percent of AIDS cases nationwide have been diagnosed
in New York City, and 17 percent of AIDS deaths in
the United States have occurred in New York City.
According to the New York City Department of Health,
a cumulative total of 142,085 adult and pediatric AIDS
cases were reported in New York City as of December
31, 2003. Overall, reports show that 84,808 New Yorkers
have died of AIDS, representing 60 percent of those
who have contracted the disease.
As of December 31, 2003, 88,479 New Yorkers were
diagnosed with HIV or AIDS; 31,163 were living with
HIV (non-AIDS), and 57,316 were living with AIDS.
The true number of persons living with HIV/AIDS
(PLWHA) is actually higher, since the New York City
Department of Health and Mental Hygiene estimates
that 25 percent of persons living with HIV have never
been tested and do not know that they are infected.
AIDS incidence in New York City peaked in 1993,
with 12,649 cases. Mortality dropped sharply beginning
in 1996, but New York City residents continue to die of
HIV. In 2003, 2,394 people with HIV or AIDS died of
all causes, and approximately 1,700 deaths were due to
HIV/AIDS. In 2002, HIV/AIDS was the leading cause
of death in New Yorkers aged 35–44 and the third leading
cause in those aged 25–34.
Of the 88,479 PLWHA in New York City as of December
31, 2003, 65 percent were diagnosed with
AIDS, and 35 percent were diagnosed with non-AIDS
HIV. Sixty-nine percent were male, and 31 percent
were female. In terms of race/ethnicity, 44 percent were
Black, 32 percent were Hispanic, and 22 percent were
White. For transmission risk factors, 27 percent
(23,670) were men who have sex with men, 24 percent
(21,453) had an injection drug use history, 18 percent
reported a heterosexual transmission factor, 3 percent
had a perinatal transmission risk factor, 1 percent had a
transfusion history, and 28 percent had an unknown
risk factor or were under investigation.
In 2003, 4,086 New Yorkers were diagnosed with HIV;
1,029 (25 percent) first learned they were HIV-positive
at the time they learned they had already progressed to
AIDS.
Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005