NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC ...

• Treatment admissions data for programs in
Philadelphia County were provided by the Pennsylvania
Department of Health, Client Information
System, for January 1, 1998, through June 30,
2004. Data for FY 2004 are preliminary and subject
to revision because of the treatment-reporting
schedule, which results in frequent delays between
a treatment admission and the reporting of
that event.
• Mortality data were provided by the Philadelphia
Medical Examiner’s (ME) Office. These
data cover mortality cases with toxicology reports
indicating the detection of drugs in decedents
in Philadelphia. The time period is January
1, 1994, through June 30, 2004. (The cases include
persons who died from the adverse affects
of one or multiple drugs, as well as persons who
exhibited some substance presence but died from
other causes. The Philadelphia ME also distinguishes
between persons who appeared to have a
lethal reaction to what might be considered a
light or moderate amount of drugs and persons
whose toxicology reports showed a high level of
drugs in their systems.) Mortality cases with
positive toxicology reports for alcohol are only
reported in combination with one or more other
drugs.
• Arrestee urinalysis data for booked adults were
derived from reports from the First Judicial District
of Pennsylvania, Adult Probation/Parole Department,
for the period January 1, 2004, through
June 30, 2004.
• Drug price information was provided by the
National Drug Intelligence Center for the period
January 1, 2004, through June 30, 2004.
• Heroin purity data were provided by the Drug
Enforcement Administration (DEA), Domestic
Monitor Program (DMP), through the first half of
2004.
• Acquired immunodeficiency syndrome (AIDS)
data were provided by the Philadelphia Department
of Public Health’s AIDS Activities Coordinating
Office on AIDS cases reported from November
1, 1981, to June 30, 2004.
• Population and demographic data describing
the City of Philadelphia emanated from the U.S.
Census Bureau.
EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Philadelphia
In addition to these sources, this report draws on focus
group and key informant discussions with former
drug users currently enrolled in treatment programs,
as well as outreach workers assigned to homeless
populations, substance abusers, persons with human
immunodeficiency virus (HIV) infection, and law
enforcement officials.
DRUG ABUSE PATTERNS AND TRENDS
The four major drugs of abuse in Philadelphia continue
to be cocaine, heroin, marijuana, and alcohol.
These are frequently used in combination with each
other and with other supplemental drugs. In 2003 and
in the first half of 2004, 92 percent of people entering
treatment identified one of these drugs as their primary
drug of abuse.
Preliminary unweighted data accessed from DAWN
Live! for the first half of 2004 showed 11,251 total
drug reports and 6,538 total cases. Of these, 75 percent
of drug reports (n=8,428) and 72 percent of the
cases (n=4,675) were categorized as “seeking detox,”
“overmedication,” or “other” as the reason for the
hospital emergency department visit. Within these
three case types, the average number of drug reports
was 1.80 per hospital ED episode. Of the 8,428 drug
reports, 66 percent (n=5,555) were classified as “major
substances of abuse. A subset (n=5,270) included
the total reports of the four major drugs of abuse in
Philadelphia: cocaine (n=2,034), alcohol (n=1,468),
heroin (n=1,030), and marijuana (n=738) (exhibit 1).
In the first half of 2004, the average number of drugs
detected in decedents by the ME (3.72) was the highest
on record (exhibit 2). The average over the previous
10-year period (1994 to 2003) was 2.43 drugs per
case. The number of mortality cases with positive
toxicology reports in 2003 (841) was the highest on
record, going back to at least 1970. With the number
of mortality cases totaling 469 in the first half of
2004, the number of cases in 2004 might exceed the
2003 record. Of the 469 deaths in the first half of
2004, adverse reaction to drugs accounted for 32.4
percent, overdose represented 8.5 percent, violence
accounted for 24.1 percent, and “other causes” constituted
35.0 percent (exhibit 3).
In the first half of 2004, African-American male decedents
(n=154) outnumbered White male decedents
(149), while White females (63) outnumbered African-American
females (61). The remaining 42 deaths
were among Hispanics and Asian Americans. Overall,
African-Americans accounted for 45.8 percent of
Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005 183