NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC ...

2000 reported that the average heroin user injects the
drug four or five times per day.
Narcotic Analgesics
Oxycodone
The use of oxycodone products, including OxyContin,
Percocet/Percodan, Roxicet, and Tylox, continues
to appear problematic in Philadelphia.
Oxycodone reports in hospital emergency departments
ranked first among all narcotic analgesics in the unweighted
data accessed from DAWN Live! for the first
half of 2004 (n=400). Among these cases, the plurality
of cases were classified as “overmedication.”
Oxycodone was detected in 369 decedents from 1994
through the first half of 2004 (the ninth most frequently
detected drug during that time period) (exhibit
2). Detections of oxycodone have been rapidly
increasing since 2000. In 2003, oxycodone was present
in 9.6 percent of all drug-positive deaths; in the
first half of 2004, oxycodone was present in 10.9
percent of drug-positive mortality cases.
Focus group participants since spring 2002 reported
the spread of oxycodone use to all racial/ethnic
groups, with an age range of mid-teens to 40, with
the largest user group being people in their twenties.
Hydrocodone
In the unweighted data accessed from DAWN Live!,
hydrocodone ED reports ranked second among all
narcotic analgesics in the first half of 2004 (n=69).
Among these cases, the plurality of cases were classified
as “seeking detox.”
The presence of hydrocodone in mortality cases has
also increased. There were 40 positive toxicology
ME reports for hydrocodone in 2003, 23 reports in
the first half of 2004, and a total of 211 cases in the
10½ -year period from 1994 through June 2004.
Hydrocodone detections now rank 14th among all
deaths with positive toxicology reports.
Opioid Analgesics
Fentanyl
In the spring of 2004, the Pennsylvania State Attorney
General’s Office issued information about the
diversion and nonmedical use of fentanyl citrate. In
particular, Actiq lozenges were cited as being sold on
the streets of Philadelphia for $20 each. Actiq contains
fentanyl citrate and is indicated for patients who
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EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Philadelphia
continue to experience pain while being treated with
synthetic opiates. Actiq resembles a lollipop, as the
medication lozenge is at the end of a small stick and
it is used by rubbing against the inside soft tissue of
the mouth. Locally, users call it “Perca-pop” or
“Narco-pop.” From 1994 through 2003, the ME recorded
35 deaths with the presence of fentanyl. Of
these, seven occurred in the first half of 2003, and
nine occurred in the second half of 2003. There were
14 additional mortality cases with positive toxicology
reports for fentanyl in the spring of 2004, the period
of the State Attorney General’s announcement.
Marijuana
Marijuana continued to be readily available and
widely used in Philadelphia in the first half of 2004.
Unweighted data from DAWN Live! show that marijuana
reports in hospital emergency departments
ranked fourth (behind cocaine, alcohol, and heroin)
among all drugs in cases categorized as “seeking detox,”
“overmedication,” or “other” in the first half of
2004 (n=738) (exhibit 1). Among these patients, 64
percent were male, 47 percent were African-American,
45 percent were White, 4 percent were Hispanic, and 4
percent were not specified. Twenty-one to 24-yearolds
accounted for the plurality of patients with 18
percent. The second largest group was 35–44-yearolds,
representing 17 percent.
The proportion of clients who cited marijuana as the
primary drug of abuse upon entering treatment was
17 percent in 2003 and the first half of 2004 (exhibit
4). Among all admissions in 2003 and the first half of
2004, marijuana was mentioned by an additional 10
percent as a secondary drug. During the same time
periods, marijuana was mentioned as a tertiary drug
by 7 percent and 6 percent, respectively. In 2003,
among primary marijuana admissions, males accounted
for 78 percent; African-Americans accounted
for 63 percent, Whites accounted for 21 percent, Hispanics
accounted for 13 percent, and Asians and others
accounted for 3 percent. In the first half of 2004,
the comparable figures were 78 percent male, 63 percent
African-American, 24 percent White, 10 percent
Hispanic, and 2 percent Asian and other. Among
primary marijuana treatment admissions in 2003, the
average number of drugs of abuse noted upon entering
treatment was 1.63. The average in the first half
of 2004 was 1.65.
Urinalysis data of booked arrestees from Philadelphia’s
APPD in the first half of 2004 showed that
18.3 percent (n=4,610) of the 25,178 tested arrestees
in the sample were positive for marijuana or marijuana
metabolites. Marijuana was the most frequently
detected drug by APPD.
Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005