NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC ...

Depressants
The unweighted ED reports of benzodiazepines in
2004 involved mostly patients who were White (77
percent), male (63 percent), and older than 35 (69
percent). ME mentions dropped from a 1999–2001
average of 54 to 34 in 2002 (exhibit 3).
Hallucinogens
The unweighted data accessed from DAWN Live!
show that ED reports for lysergic acid diethylamide
(LSD) were rare during 2004. Reports of phencyclidine
(PCP) were about five times more common. Of
these PCP reports, most patients were male and most
were Hispanic; two-thirds were older than 35.
Club Drugs
The NDIC reports that in 2004, street prices of methylenedioxymethamphetamine
(MDMA or “X”)
were in the range of $15–$40 per “tab.” Unweighted
data accessed from DAWN Live! show that the ED
reports of this drug were predominantly (69 percent)
among people younger than 30. ED reports of gamma
hydroxybutyrate (GHB) were on average older, with
64 percent older than 30. Ketamine ED reports were
very rare. The actual number of club drug reports
remains small compared with ED reports for cocaine
or methamphetamine. The same is the case for ME
mentions (exhibit 3).
INFECTIOUS DISEASES RELATED TO DRUG ABUSE
AIDS
San Francisco County had a cumulative total of
29,508 AIDS cases through September 30, 2004, an
increase of 678 (2.4 percent) from the total reported
through September 30, 2003. Of these cases, 2,108
(7.1 percent) were heterosexual injection drug users
(IDUs), an increase of 83 (4.1 percent) in a year. Another
3,725 AIDS cases (12.6 percent) were men who
had sex with other men (MSM) and also injected
drugs (MSM/IDUs); this number increased by 79 or
2.2 percent in a year. There were just 47 reported
cases among lesbian IDUs, barely one-hundredth the
number among MSM/IDUs. The rates of case reporting
among all of these groups had been decelerating
during the early 2000s, but during the past year those
rates have begun to accelerate. A total of 330 AIDS
cases have been reported for transgender San Franciscans,
an increase of 9.6 percent in the past year.
Among San Franciscans diagnosed in 2003 and 2004,
heterosexual IDUs accounted for 17 percent, up from
10 percent among those diagnosed in 1994–1996, 14
EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—San Francisco Bay Area
percent of those diagnosed in 1997–1999, and 14
percent of those diagnosed in 2000–2002. However,
the overall case numbers in 2003–2004 were far
lower than those of the late 1980s and early 1990s.
As a result, the percentage of heterosexual IDUs
among the cumulative AIDS caseload will probably
not increase significantly from the current level of 7
percent.
The demography of the cumulative heterosexual IDU
caseload with AIDS has changed very little in the
past 14 years. This caseload is 69 percent male, 50
percent Black, 35 percent White, 11 percent Hispanic,
and 2 percent Asian/Pacific Islander. By contrast,
the gay/bisexual IDU caseload is 72 percent
White, 16 percent Black, 10 percent Hispanic, and
1.6 percent Asian/Pacific Islander.
The heterosexual IDU demography is like that of
heroin users except for over-representation of Blacks,
while the gay male IDU demography is similar to that
for male speed users.
Data from the Urban Health Study, which conducts
semiannual surveys, indicate that in 2004 seroprevalence
of heterosexual IDUs in San Francisco remained
within the same 6–10 percent range that has
prevailed for the past 16 years. By contrast, HIV
prevalence among MSM/IDUs had ranged around 40
percent in the late 1980s, dropped to around 25 percent
in the late 1990s, and rose again to the 30–35
percent range in 2004. Recent UHS data show extensive
self-reported past-month injection of cocaine (21
percent) and amphetamines (30 percent) as well as
heroin (68 percent). A surprisingly low proportion (c.
15 percent) of heterosexual HIV-positive IDUs reported
being on drug treatment for their condition.
Passage of SB1159, which enables California pharmacies
to sell hypodermic equipment without prescriptions,
has the potential for significant effects
upon disease transmission. Early in 2005, decisions
will be made as to which pharmacies will opt into
this activity.
Hepatitis B
From 1996 through 2001, reported cases of HBV in
San Francisco County rarely deviated from a pace of
about one per week. The pace dropped in 2002 and
2003 to about one every 9 days, then dropped further
in 2004 to about one every 16 days.
Hepatitis C
UHS data from 2003 disclosed that fully two-thirds
of all IDUs in the sample self-reported HCV sero-
Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005 231