NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC ...

for this drug, making olanzapine the 22nd most frequently
detected drug.
Urinalysis data of booked arrestees from Philadelphia’s
APPD in the first half of 2004 showed that 6
percent (n=1,507) of the 25,178 tested arrestees in the
sample were positive for benzodiazepines, making
this class of drugs the fourth most frequently detected
drug by APPD.
Other Prescription Drugs of Note
Prescription drugs are most frequently detected
among decedents in combination with other drugs of
the same type and/or in combination with cocaine,
heroin, or alcohol. ME mentions for the most frequently
detected prescription drugs among decedents
in the first half of 2004 (not already discussed) included
diphenhydramine (n=74), codeine (n=62), and
methadone (n=57) (exhibit 2). With 435 detections
from 1994 through the first half of 2004, codeine
ranked as the sixth most frequently detected drug
during that period. Methadone ranked seventh
(n=404) and diphenhydramine ranked eighth
(n=392). Regarding codeine and diphenhydramine,
each of which is an ingredient in numerous over-thecounter
medications that are abused in Philadelphia,
negative consequences appear most markedly among
decedents in combination with other drugs.
Deaths with the presence of fluoxetine (Prozac) began
to increase in the late 1990s. With 171 positive
toxicology reports for fluoxetine from 1994 through
the first half of 2004, fluoxetine ranked as the 17th
most frequently detected drug.
Dextromethorphan is a common ingredient in numerous
cough and cold medications. Key informants indicated
that its use is increasing among people age 30–
40, particularly in combination with alprazolam and
diazepam. The Philadelphia ME detected dextromethorphan
in 40 cases in 2003 and in an additional
35 cases in the first half of 2004. There were a total of
122 dextromethorphan-positive cases from 1994
through mid-2004, thus ranking dextromethorphan as
the 25th most frequently detected drug.
Quetiapine (Seroquel), an antipsychotic, has only
been on the market for 3–4 years. Twenty of the total
46 quetiapine detections by the ME occurred in 2003,
and an additional 13 detections were made in the first
half of 2004.
Methamphetamine/Amphetamines
Methamphetamine and amphetamines remain a relatively
minor problem in Philadelphia. The prelimi-
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EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Philadelphia
nary unweighted data accessed from DAWN Live!
for the first half of 2004 reveal only 19 methamphetamine
reports; 16 were categorized as “other”
and 3 as “seeking detox” (exhibit 1). Amphetamine
reports totaled 52, of which 38 were in the “other”
category, 5 were “overmedication,” 4 each were “suicide
attempt” and “seeking detox,” and one was in
the “malicious poisoning” case type.
There were 90 deaths with the presence of methamphetamine
(ranked 31st) from 1994 through mid-
2004 and 81 deaths with the presence of amphetamine
(ranked 34th) during that same period.
Annual treatment admissions for methamphetamine/
amphetamines as the primary drug of abuse from 1998
to 2003 were 31, 33, 27, 83, 67, and 33, respectively
(exhibit 4). There were 33 such admissions in the first
half of 2004. Methamphetamine/amphetamines are
rarely identified as a secondary or tertiary drug of
choice among treatment admissions in Philadelphia.
Urinalysis data of booked arrestees from Philadelphia’s
APPD in the first half of 2004 showed that 0.2
percent (n=53) of the 25,178 tested arrestees in the
sample were positive for methamphetamines or amphetamines.
This was the lowest result in the APPD
data.
According to the National Drug Intelligence Center,
the retail/street-level price of methamphetamine was
$100 per gram in the first half of 2004.
Key informants, for the first time, indicated a growing
popularity of methamphetamine among men who have
sex with men. Methamphetamine continues to be reported
as difficult to obtain, not usually sold outdoors,
and requiring a connection; reportedly, however, use
has increased since 2001.
Club Drugs
There has been relatively little consequence data for
methylenedioxymethamphetamine (MDMA). The
preliminary unweighted DAWN Live! data for the first
half of 2004 revealed only 40 reports for MDMA in
cases categorized as “seeking detox,” “overmedication,”
or “other.”
MDMA was present in 6 mortality cases in 1999 (the
first year this drug was detected by the ME) and in a
total of 42 from 1999 through the first half of 2004.
MDMA is reportedly used in combination with marijuana
and lysergic acid diethylamide (LSD), which,
along with its users generally ranging in age from
Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005