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EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—San Diego County, California Exhibit 6. Retail Prices for Selected Drugs in San Diego: July–December 2004 Drug Price Unit and Type Powdered Cocaine $60–$80 Gram $25–$35 One-quarter gram Crack $10–$20 Rock Heroin $60–$100 Gram (Mexican brown powder) $10–$15 One-tenth gram (Mexican brown powder) $50–$100 Gram (Mexican black tar) Marijuana $60–$100 Ounce Methamphetamine $60 Gram $20–$25 One-quarter gram $150–$300 One-quarter ounce MDMA $15–$30 Tablet SOURCE: NDIC 226 Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005
EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—San Francisco Bay Area Patterns and Trends of Drug Use in the San Francisco Bay Area John A. Newmeyer, Ph.D. 1 ABSTRACT In January 2005, the author conducted a comprehensive review of indicators of use of illicit substances in the San Francisco Bay area. Cocaine use remains low compared with use in the rest of the United States. Indicators show no clear upward or downward trend over the past 3 years. Heroin use indicators consistently point to a decline in use from the 1999 peak. Injection remains by far the predominant mode of usage. There are strong indications of an upsurge in use of oxycodone and hydrocodone. Methamphetamine use in the bay area is high compared to use in other metropolitan areas; most indicators point to a further increase in usage levels during the past 3 years. Indicators of use of ‘club drugs’ reached peaks in 2001 and then declined in 2002; ED reports and medical examiner mentions remain few compared to those for cocaine, heroin, or ‘speed.’ The prevalence of HIV among heterosexual drug injectors appears to have stabilized at a low level (6 to 10 percent), but HCV appears to be close to full saturation among that population. A recent legislative bill (SB 1159) enables California pharmacies to sell hypodermic equipment without prescriptions. This may have a significant impact upon disease transmission. A recently approved initiative (Oakland’s Measure Z) directs local authorities to create systems for the regulation and taxation of adult marijuana use. INTRODUCTION Area Description The San Francisco Bay area consists of the following counties: San Francisco, San Mateo, Alameda, Contra Costa, and Marin. The population was 4,160,000 as of July 2003. The population is among the most multicultural of any urban region of the United States, with a particularly large, varied, and longestablished Asian-American representation (19 percent of the total). The Hispanic population represents a wide cross-section of persons of Latin American origin. Blacks account for some 11 percent of bay area residents. San Francisco County has long been a mecca for gays: gay men constitute more than 15 percent of the adult male population. The bay area experienced its initial growth during the California gold rush. In the succeeding century and a half, it expanded greatly as a center for shipping, manufacturing, finance, and tourism. In recent years, Pacific Basin trade and high technology such as software and biotechnology development have led to further expansion and to a highly diversified economy. Since 1994, there has been a steep rise in the cost of rental housing in the bay area, especially in San Francisco, Marin, and San Mateo Counties. This has caused significant out-migration of lower income people, which may be exerting downward pressure on local drug-use prevalence. Reverses in hightechnology industries mitigated this pressure during 2001–2003, with unemployment rising from 2 to 6 percent and the overall population slightly declining. In the past year, unemployment rates have decreased and population is once again slowly increasing. Data Sources 1 The author is affiliated with Haight-Ashbury Free Clinics, Inc., San Francisco, California. The sources of data for the drug abuse indicators within this report are described below: • Emergency department (ED) drug data were accessed from the Drug Abuse Warning Network (DAWN) Live!, a restricted-access online query system administered by the Office of Applied Studies (OAS), Substance Abuse and Mental Health Services Administration (SAMHSA). The unweighted data are for three counties of the San Francisco Bay area (San Francisco, Marin, and San Mateo) for 2004. Seventeen of the 18 eligible hospitals in the area are in the DAWN sample. There are 19 emergency departments in the sample. (Some hospitals have more than one ED.) The data for 2004 were incomplete. Over the 12-month period, between 8 and 11 EDs reported data each month, with most reporting data that were basically complete (90 percent or greater). Data are preliminary and are not estimates for the San Francisco area. The DAWN Live! data were accessed 1/10/2005. Since all DAWN cases are reviewed for quality control, and may be corrected or deleted, the data reported here are subject to change. The information derived from DAWN Live! represent drug Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005 227
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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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NFLIS between October 2003 and Sept
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from 12.2 percent in the first half
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156 2003. Anecdotal information on
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Brownsville, and El Paso. African-A
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ground economy, it was estimated th
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According to street interviews, mos
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that crack sells for about $28,000-
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Benloton, X-man, 911, Lean Back, Se
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DAWN ME mentions for marijuana-invo
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ecstasy. MDMA ED mentions may be st
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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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