NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC ...

• Acquired immunodeficiency syndrome (AIDS)
data were taken from the San Diego County
Health and Human Services Agency, “Human
Immunodeficiency Virus (HIV) Surveillance Report.”
In addition, findings from the 2003 Arrestee Drug
Abuse Monitoring (ADAM) program and the 2002
DAWN medical examiner/coroner system are presented
in the discussion below on methamphetamine.
DRUG ABUSE PATTERNS AND TRENDS
At the January 2005 CEWG meeting, members focused
on the abuse of stimulants, primarily methamphetamine
and cocaine. The primary focus of this
paper is methamphetamine abuse, a major problem in
San Diego County.
Methamphetamine
San Diego continues to be one of the epicenters for
methamphetamine abuse in the United States. While
abuse indicators are mixed, they clearly show that
methamphetamine is a major problem in the county.
As noted earlier, the manufacture of methamphetamine
continues to be a problem.
Prior to 1989, there were many small methamphetamine
labs in San Diego, operated by local “cookers”
and outlaw motorcycle clubs. Over the years, however,
the production and abuse of methamphetamine
“waxed and waned.” The Chemical Diversion and
Trafficking Act of 1988 and the Chemical Control
Diversion Act of 1993 helped to curtail access to the
precursors used to make methamphetamine. In addition,
a DEA sting effort, Operation Triple Neck, resulted
in arrests and the closing of stores that supplied
equipment and chemicals to the methamphetamine
cookers. Most methamphetamine indicators
declined for a time, but new sources and distribution
networks emerged so that…
• Mexican nationals and Mexican-Americans, operating
on both sides of the border, began to produce
large quantities of high-purity methamphetamine.
• The already established networks used to distribute
other illicit drugs were used to distribute
methamphetamine.
• The profits from these operations were large.
EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—San Diego County, California
In FY 2004, methamphetamine accounted for 26.7 percent
of all drug items reported by NFLIS; amphetamines
accounted for less than 1 percent (exhibit 2).
Slightly more than one-half (51 percent) of primary
illicit drug admissions in 2004 were for primary
abuse of methamphetamine (exhibit 3). Trend data
from 1987 through 2004 show that methamphetamine
treatment admissions (n=6,973) and total treatment
admissions (18,009) peaked in San Diego in 2002.
The 2003 data provide more detailed information on
primary methamphetamine treatment admissions.
Also, as shown below, major changes have occurred
in the referral patterns and in the demographic composition
of methamphetamine treatment admissions…
• Nearly three-fourths (72.3 percent) of the 6,365
primary methamphetamine abuse treatment admissions
in San Diego County were referred by
the criminal justice system, compared with only
14 percent in 1987.
• The proportion of male methamphetamine treatment
admissions increased, reaching 58 percent
in 2003.
• The median age of methamphetamine admissions
increased, reaching 33 in 2003.
• The percentage of Hispanic methamphetamine
admissions increased from 12 percent in 1991 to
28 percent in 2003. At the same time, White admissions
decreased from 79 percent in 1991 to
55 percent in 2003.
Over the years, a number of factors were associated
with increases in total admissions and those for
methamphetamine, including the following:
• Law enforcement actions in the late 1980s and
early 1990s, such as Operation Triple Neck
• The establishment of the Methamphetamine
Strike Force (MSF)
• The establishment of and increase in the number
of drug courts
• The passage of Proposition 36 in 2000, which
mandated treatment of drug users involved in the
criminal justice system.
Some of these external factors are graphically depicted
in exhibit 4, together with treatment admissions
data. Note that “budget problems” in the State
Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005 221