NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC ...

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Marijuana is widely available in Arizona in quantities up to hundreds of kilograms, unchanged from the previous reporting period. Prices were unchanged from the previous reporting period, as well, according to the Arizona HIDTA, the Arizona Department of Public Safety, Southwest Border Alliance, and the Arizona Drug Enforcement Administration (exhibit 10). Adolescent males, age 15–17, from the communities along the southern border of Arizona are recruited as drivers by trafficking organizations to move marijuana loads. Most are Hispanic males who are U.S. citizens with and without driver’s permits or licenses. Stimulants The drug-related death data revealed a 17-percent decrease in 2002 for methamphetamine-related deaths (n=132) over such deaths in 2001. The downward trend would appear to be continuing during 2003. Methamphetamine/combination deaths totaled 35 in 2001, rose to 44 in 2002, and were projected to increase to 71 for 2003 for a 103-percent increase over 2001. In the 2004 unweighted data from DAWN Live!, there were 1,293 reports of methamphetamine and 774 of amphetamines (exhibit 7). The ADHS/DBHS Bureau for Substance Abuse Treatment and Prevention data revealed 21 percent of Arizona treatment admissions were for methamphetamine use/abuse in FY 2004 (exhibit 8). The growth of methamphetamine as the presenting primary problem in the public behavioral health system is striking. During FY 2002, methamphetamine accounted for just 11 percent of substances identified at admission to treatment, compared with 21 percent in FY 2004. Little variation exists between urban and rural areas, with the exception of Pima County (Tucson), where 11.1 percent of treatment admissions reported methamphetamine as the primary presenting problem. A statistical summary of the TASC Adult Deferred Prosecution Program revealed that 26.9 percent (n=4,298) of the March 1989 through December 2004 treatment admissions were for methamphetamine use/abuse (exhibit 9a). During October–December 2004, 19.5 percent of the juveniles (n=819) who submitted for drug testing at TASC tested positive for methamphetamine/amphetamine (exhibit 9b). Community Bridges detoxification and recovery centers serve the homeless, indigent, and working poor individuals and families in Maricopa County. Thirteen percent of admissions to Community Bridges 198 EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Phoenix and Arizona during FY 2004 reported methamphetamine as the drug of choice. The DEA reported two types of methamphetamine are available throughout Arizona. Mexican methamphetamine is most predominant. It is produced in large volume (kilogram and pound quantities) at super labs located in Mexico and is transported primarily through Sonora, Mexico, into Arizona. Mexico has surpassed California as the major source of methamphetamine moving into Arizona. While small independent labs generate gram and ounce quantities, they are considered a viable threat to Arizona. An Arizona HIDTA summary of methamphetamine and drug-endangered children statistics for calendar years 2000–2004 indicate 1,263 methamphetamine lab-related seizures and 793 methamphetamine lab seizures for reported disposal costs of $3,841,069. There were 250 children in Maricopa County and 362 statewide who were removed from clandestine laboratory locations during the report years. The most significant change in price for methamphetamine was for a pound of crystal methamphetamine (ice) in Tucson. The previous price had been $13,000 for ice, compared to $7,000–$7,500 during FY 2004 (exhibit 10). The drug of choice in Yuma County (in the southwestern region of State, on the border with Mexico) is crystal methamphetamine. It is relatively low cost, and availability is plentiful. The Regional Behavioral Health Authority in this region of the State receives the greatest number of criminal justice referrals for treatment (58 percent). The Maricopa County Sheriff’s Office reports that the packaging of methamphetamine has changed dramatically the past year. Officers report it is nearly impossible to identify the type of methamphetamine that is seized. Laboratory analysis is needed to determine whether it is Mexican or U.S. made. Wrapping of Mexican methamphetamine previously was professional, with markings or insignias of ownership. It is now reported to be sloppily packaged in unmarked plastic bags. Conversely, the locally produced methamphetamine is now packaged using professional wrapping methods. A new slang name for methamphetamine surfaced in the DEA fourth quarter report. “Quick Zip” is unwashed, or not fully processed, methamphetamine. It was first identified by sources within the prison population. The drug allegedly causes increased psychosis when consumed. Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005
Glotell, a new product in the agricultural market, can be added to tanks of anhydrous ammonia, a precursor chemical for methamphetamine production. Glotell is intended to deter thieves and methamphetamine cooks from stealing the ammonia because it produces a visible pink stain when mixed. When used to make methamphetamine, it produces a highly undesirable effect. Locally, an experienced methamphetamine cook became an entrepreneur and earned $25,000 to teach methamphetamine processing methods to interested traffickers. Additionally, the cook charged $10,000 for every 10 pounds of finished product manufactured. Other Drugs The DEA Diversion unit reported the most commonly abused drugs are Vicodin, Lortab, and other hydrocodone products; Percocet, OxyContin, and other oxycodone products; benzodiazepines; methadone; hydromorphone, morphine; Demerol; codeine products; and anabolic steroids. Soma in combination with other analgesic controlled substances, Ultram (Tramadol), and Nubain continue to be highly abused prescription-only substances. Soma sells for $2–$5 per tablet. The unweighted data from DAWN Live! reflect 843 benzodiazepine reports and 243 muscle relaxant reports for pharmaceutical drug misuse in 2004 (exhibit 11). Treatment programs that serve adolescents report anecdotally that gamma hydroxybutyrate (GHB), methylenedioxymethamphetamine (MDMA or ecstasy), lysergic acid diethylamide (LSD), Coricidin HBP, and Soma are still party drugs. INFECTIOUS DISEASES RELATED TO DRUG ABUSE The Arizona Department of Health Services, Division of Public Health Services, Bureau of Epidemiology and Disease Control, Office of HIV/STD Services began to emphasize capacity building measures within the State HIV/AIDS epidemiology programs and to focus on incidence and prevalence estimates. The March 2004 Annual Report is the most recent report and was reported on in the June 2004 CEWG report (exhibits 12a and 12b). According to the March 2004 report, Arizona had 9,652 persons known to be living with HIV disease, of whom 4,402 had a diagnosis of AIDS. The State has an HIV disease prevalence rate of 184.1 per EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Phoenix and Arizona 100,000 persons. Pima County, the State’s second most populous urban county, has the highest prevalence rate of reported HIV disease (212 per 100,000). Pima County, with 16.4 percent of the State’s population, has 19.7 percent of known AIDS prevalence and 18.1 percent of known HIV prevalence. Maricopa County, the State’s most populous urban county, has the second highest prevalence rate of reported HIV Disease (207 per 100,000). With 60 percent of the State’s population, it has 67.8 percent of known AIDS prevalence and 66.7 percent of known HIV prevalence. The predominant reported mode of transmission of HIV in Arizona continues to be men having sex with men, which accounted for 70.3 percent of reported new cases of HIV disease among males (HIV or AIDS) and 62.6 percent of all reported new cases of HIV disease in 2003. After male-to-male sex, injection drug use, with or without male-to-male sex, accounted for 20.1 percent, and heterosexual exposure accounted for 11.1 percent of reported new cases of HIV disease during 2003. SPECIAL REPORT The Correctional Officer/Offender Liaison (COOL) program was established in 1998 to better serve the substance abuse and behavioral health service needs of high-risk offenders on parole. Funding is provided through an Interagency Services Agreement between the Arizona Department of Corrections (ADOC) and Arizona Department of Health Services to ensure rapid access to treatment and recovery support services. In FY 2004, the COOL report revealed referrals and intakes approached but did not surpass FY 2003 figures (exhibit 13). The COOL Program expedites eligibility screening for AHCCCS and provides rapid connections to treatment and other re-entry services. During FY 2004, parole officers referred 5,953 persons leaving prison to the COOL program through 1 of the 5 Regional Behavioral Health Authorities. Seventy-three percent (n= 4,330) of those referred were subsequently enrolled in substance abuse treatment. The ADOC/ADHS collaboration also operates 20 transitional housing beds for homeless offenders in the COOL program in Maricopa County. The housing program also coordinates community services, employment support, substance abuse treatment, and temporary housing to assist in the reintegration of offenders. For inquiries concerning this report, please contact Ilene L. Dode, Ph.D., EMPACT–Suicide Prevention Center, Inc., 1232 East Broadway, Suite 120, Tempe, Arizona 85282, Phone (480) 784-1514, Fax: (480) 967-3528, E-mail: idode@aol.com. Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005 199
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NATIONAL INSTITUTE ON DRUG ABUSE EP
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Foreword This publication includes
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EPIDEMIOLOGIC TRENDS IN DRUG ABUSE
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2 EPIDEMIOLOGIC TRENDS IN DRUG ABUS
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Epidemiology of Drug Abuse: CEWG Ar
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• The city of Atlanta has become
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In the first 6 months of 2004, trea
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eports (exhibit 2), while African-A
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population) than in 2002 (17.2 per
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16 EPIDEMIOLOGIC TRENDS IN DRUG ABU
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data from the Drug Abuse Warning Ne
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than age 18, compared to 4 percent
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More often than not, marijuana use
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Solomon, L.; Flynn, C.; Muck, K.; e
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• Logan International Airport and
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In 2002, heroin/morphine was indica
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The FY 2004 racial distribution for
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• Emergency department (ED) drug
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monly mentioned secondary drug amon
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Between 2001 and 2003, the Illinois
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In the NIHU Study, 20 percent of pa
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Ecstasy remained available in most
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66 and analyzed by the Division of
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ounce in the Denver metropolitan ar
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18 at the time of admission to trea
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Injecting had been the most common
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alcohol; 651 involved alcohol-in-co
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The economy in Hawai'i, after a dec
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Methamphetamine remains the leading
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methamphetamine, representing 76.5
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Of interest in this chart is the ag
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98 weighted DAWN data released by S
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A total of 5,425 cocaine arrests wa
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data, however, rising from 1.5 perc
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According to NDIC, California and M
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and 15 items were identified as pse
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most frequently reported secondary
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esidents are living with advanced H
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112 EPIDEMIOLOGIC TRENDS IN DRUG AB
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(DAWN) that monitors emergency depa
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Beginning in 2003, SAMHSA’s natio
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65 percent were older than 34. The
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the 1,198 drug abuse ED reports in
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“Crystal” or smokeable methamph
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tion was injection (62.9 percent),
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included reports of ED cases involv
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From November 10 to 16, 2004, 18 me
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Page 162 and 163: 156 2003. Anecdotal information on
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Page 170 and 171: ground economy, it was estimated th
Page 172 and 173: According to street interviews, mos
Page 174 and 175: that crack sells for about $28,000-
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Page 190 and 191: the deaths, while Whites constitute
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Page 228 and 229: correspond to decreases in total ad
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Page 246 and 247: The characteristics of other opiate
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The term “lag” refers to the pe
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costs $1,200-$1,500, compared with
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ties. In the DFW area, Mexican mari
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The 2004 secondary school survey re
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nio and two 2-ounce bottles cost $1
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age may be partially due to the fac
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York and Miami (Pach et al. 2002).
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In 2003, heroin was the primary sub
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opolitan Police Department report t
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International Report
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Among GTC patients, marijuana was t
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Others (63.8 percent) were using a
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Panel on Methamphetamine Abuse: NID
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Appendix A New Drug Abuse Warning N
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DAWN LIVE! The new DAWN includes ca
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Participant List National Institute
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Janie B. Dargan, M.S.W. Policy Anal
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Martin P. Paulus, M.D. Associate Pr
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