NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC ...

use has slowly increased over the last 8 years. In rural
areas, methamphetamine appeared regularly in the
treatment data, but methamphetamine has been identified
as a problem in all parts of the State. The urban,
street-level distributors in St. Louis deal in cocaine, so
amphetamine use is not as widespread in the St. Louis
area; this could indicate differences in dealing networks
and access to locally produced drugs (“mom and pop”
local production). However, an increase in availability
and purity of Mexican methamphetamine and a growth
in Hispanic groups in the St. Louis metropolitan area
may change this trend. An increase in treatment admissions
may signal this change. Cocaine and methamphetamine
use have been split along racial lines in
the State. While the number of methamphetamine
treatment admissions was still relatively low in St.
Louis (752 in 2003), in rural treatment programs,
methamphetamine was the drug of choice after alcohol.
The Midwest Field Division of the DEA decreased its
cleanup of clandestine methamphetamine labs after
training local enforcement groups; 2,860 labs were
reported for 2003. The intensity of these law enforcement
efforts is based on the availability of funds
for local police departments to clean up box labs under
Community Oriented Policing Service (COPS)
funding. Thefts of anhydrous ammonia continued to
be identified as an issue in rural areas.
In the new methamphetamine scene, Hispanic traffickers,
rather than the old network of motorcycle
gangs, are the predominant distributors. Shipments
from “super labs” in the Southwest are trucked in via
the interstate highway system. This network is in
contrast to the local “mom and pop” labs that produce
personal quantities for family and friends. These local
labs tend to use the Nazi method of production,
with an output of 60 percent of the quantity of the
starting products. Purity of the drugs produced by
these labs and percent of finished product depends on
the experience/attentiveness of the “cooker.” Most of
the available methamphetamine is produced in Mexico
and trafficked through these Hispanic traffickers.
While much of the resources and personnel are directed
at the local production, the actual quantity of
methamphetamine that is available is through these
Hispanic organizations. As the purity increases
through these groups, less priority may be placed on
local production. Some crystallized methamphetamine
has been noted in the local market, usually indicating
increased purity in the product.
Locally produced methamphetamine purity fluctuated
between 70 and 80 percent, while methamphetamine
from Mexico has historically been only 20–30 percent
pure (exhibit 1b). Increased crystalline product indicates
higher purity, and the term “ice” has been applied
EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—St. Louis
to all methamphetamine with this crystalline appearance.
Methamphetamine sold for $700–$1,300 per
ounce in St. Louis and for as little as $100–$120 per
gram in some areas, reflecting a slight increase in price
over the past year.
Use of methamphetamine and its derivatives has become
more widespread among high school and college
students, who do not consider these drugs as
dangerous as others. Because methamphetamine is so
inexpensive and appeals to a wide audience, it is
likely that its use will continue to spread.
Depressants
The remaining few private treatment programs often
provide treatment for benzodiazepine, antidepressant,
and alcohol abusers. Social setting detoxification has
become the treatment of choice for individuals who
abuse these substances. Since many of the private
treatment admissions are polysubstance abusers, particular
drug problems are not clearly identified.
Hallucinogens
Over the years, lysergic acid diethylamide (LSD) has
sporadically reappeared in local high schools and
rural areas. Blotters sell for $5–$7 per 35-microgram
dose (exhibit 1b). Much of this LSD is imported from
the Pacific coast. DAWN data in 2004 showed a
small number of cases: 19.
Phencyclidine (PCP) has been available in limited
quantities in the inner city and has generally been
used as a dip on marijuana joints. While PCP is not
seen in quantity, it remains in most indicator data,
including ED mentions, police exhibits, and as a secondary
drug in ME data. Most of the users of this
drug in the inner city are African-American. The unweighted
PCP ED reports in 2004 totaled 23.
Club Drugs
Unweighted DAWN ED data for 2004 show few reports
of methylenedioxymethamphetamine (MDMA)
—only 24. Reports of other club drugs were almost
non-existent; two ketamine and two gamma hydroxybutyrate
(GHB) reports were cited in 2004.
While MDMA remained available at dance parties
and cost $20–$30 per tablet, the popularity of the
drug seems to be declining. Most of the reports about
MDMA abuse are anecdotal or are part of a polydrug
user’s history. Public treatment programs reported no
admissions for MDMA. The private treatment programs
that were queried reported MDMA as part of a
polydrug abuser’s history in less than 10 percent of
their treatment admissions.
Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005 215