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