NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC ...

Cocaine-positive tests among arrestees in San Jose
and Sacramento, nearby metropolises which are
ADAM sites, may give some indication of cocaine
use prevalence in San Francisco. During 2003, 13
percent of adult male arrestees in San Jose and 22
percent of those in Sacramento tested positive for
cocaine. The two areas had, respectively, the fourth
and ninth lowest proportions of cocaine-positive arrestees
among all 39 ADAM sites. For adult female
arrestees in San Jose, 10 percent tested positive—the
second lowest proportion among 25 ADAM sites.
There were nearly 3,800 arrests on cocaine-related
charges in San Francisco in 2004.
According to the NDIC, local prices for powder cocaine
in 2004 were $16,000–$21,000 per kilogram,
$530–$800 per ounce, and as low as $10 per quarter
gram. Crack prices were around $600 per ounce and
$20–$50 per “rock.” These prices were up slightly
from 2002.
To summarize, cocaine use in the bay area is low
compared with use in the rest of the United States.
The indicators do not reflect any consistent upward
or downward trend in the past 3 years.
Heroin
According to the unweighted DAWN Live! data, reports
of heroin during 2004 involved patients who
were two-thirds male and nearly two-thirds White.
Thirty-nine percent were older than 45, and only 19
percent were younger than 30. Injection is the overwhelming
preference (93 percent) as the route of use.
The number of treatment admissions for primary heroin
problems in the five-county bay area fell by more
than half between 1999 and 2004 (exhibit 1). As a
proportion of all primary drug admissions excluding
alcohol, heroin constituted 64 percent in 1994, 55
percent in 1999, and only 36 percent in 2003. Injection
remains by far the predominant route of use: 80
percent reported that route, as compared with 14 percent
who reported inhalation as the preferred route.
San Francisco County heroin admissions fell by 9
percent between FYs 2002 and 2004 (exhibit 2).
ME death mentions involving heroin in 2002 were at
their lowest level in 6 years (exhibit 3). The count for
2002 was 43 percent below the average for 1997–
2000. Males accounted for 87 percent of the heroinrelated
death mentions in 2000. The median age of
the decedents was 40.
In the ADAM program in 2003, 3.1 percent of adult
male arrestees in San Jose and 6.9 percent of those in
EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—San Francisco Bay Area
Sacramento tested opiate positive; the median across
the 39 ADAM sites was 5.8 percent. Of female arrestees
in San Jose, 3.4 percent tested positive, well
below the 25-city median of 6.6 percent.
Arrests for heroin-related offenses totaled 6,136 in
2002, 16 percent higher than in 2001 and 3 percent
higher than in 2000. However, in 2003 such arrests
were about 30 percent below, and in 2004 about 55
percent below, the 2002 level.
Because many heroin users support their habits
through property crimes, reported burglaries may be
a good indicator of use. The number of such reports
in San Francisco fell by 49 percent between 1993 and
1999 (11,164 to 5,704). After that low point, the
count rose to 6,706 in 2001, fell to 5,507 in 2003, and
rose again to nearly the 2001 level in 2004. These
changes may reflect the price of heroin more than the
prevalence of users; it is noteworthy that reported
burglaries and the local price of heroin are both
barely one-quarter of what they were 20 years ago.
The DEA’s DMP tested heroin street buys in the San
Francisco area during 2003. The 27 buys were all of
Mexican origin. The 2003 samples averaged 11 percent
pure and $0.98 per pure milligram (exhibit 4).
Of the last 10 years, 2001, 2002, and 2003 were the 3
with the highest average price and lowest average
purity.
Prices of Mexican black tar heroin ranged from
$9,200 to $30,000 per kilogram and from $230 to
$850 per ounce in 2004. Gram prices ranged from
$50 to $75. In 2002, prices were $16,000–$30,000
per kilogram, $450–$850 per ounce, and around $60
per gram.
In summary, most indicators point to a decline in
heroin use in the period from 2000 to 2004.
Other Opiates
Local observers note a significant increase in oxycodone
availability and usage. ME death mentions in
the overall “narcotic analgesics” category fluctuated
within a narrow range in 1997–2000, but then they
dropped in 2001 and 2002 to a level 29 percent below
the 1997–2000 average (exhibit 3). The combined
count of hydrocodone and oxycodone in the unweighted
DAWN Live! ED reports in 2004 was less
than 8 percent that of heroin. For hydrocodone, whose
count was more than twice that of oxycodone, 57 percent
of the reports represented male patients, 71 percent
represented Whites, and 63 percent represented
patients older than 35.
Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005 229