NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC ...

age may be partially due to the fact that inhalant users
drop out of school early and hence are not in
school in later grades to respond to school-based
surveys.
Inhalant abusers represented 0.3 percent of the admissions
to treatment programs in 2004. The clients
tended to be male (63 percent) and Hispanic (82 percent).
The overrepresentation of Hispanics is due to
the fact that TDSHS has developed and funded
treatment programs that were targeted specifically to
this group. Average age was 22. Seventy percent
were involved with the criminal justice system, average
education was 8.9 years, 10 percent were homeless,
and 16 percent had a history injecting drug use.
In 2000, there were 12 deaths involving misuse of
inhalants, compared with 15 in 2001, 8 in 2002, and
13 in 2003. The categorization of inhalant deaths is
difficult and leads to underreporting, but of those
reported in 2003, the average age was 34, 85 percent
were male, 69 percent were White, and 31 percent
were Hispanic.
Street outreach workers in Austin reported the deaths
of two clients in their quarterly report at the end of
2004. Both were homeless Hispanic males, in their
late forties or early fifties, who were “huffers” and
died from inhaling carburetor fluid. One of the clients
had been inhaling since he was 13 years old.
Steroids
The Texas school survey reported that 2 percent of all
secondary students surveyed in 2004 had ever used
steroids and that less than 1 percent had used steroids
during the month before the survey. Although many
steroids are brought across the border, the school
survey found lifetime usage lower among border students
(1.4 percent) than among non-border students
(2.1 percent).
Carisoprodol (Soma)
Poison control centers confirmed exposure cases of
intentional misuse or abuse of the muscle relaxant
carisoprodol (Soma) increased from 83 in 1998 to
235 in 2003, and there were 160 in the first half of
2004. In addition to the abuse and misuse cases,
there were another 329 cases in which the reason for
the call was suicide.
Between 1998 and 2003, 51 percent of these cases
involved males and 83 percent involved persons older
than 19. Some 37 percent of the cases were in the
Houston region, 18 percent were in the Dallas and
Fort Worth region, and 11 percent were in the
272
EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Texas
Beaumont region. Carisoprodol is a substance that
tends to be abused in combination with other substances.
Only 39 percent of the cases involved that
one drug; all the others involved combinations of
drugs (Forrester, 2004).
In 2003, carisoprodol was mentioned on 51 death
certificates. Only 1 of the deaths involved exclusively
carisoprodol. Hydrocodone, propoxyphene, alcohol,
and benzodiazepines were also substances that were
mentioned along with carisoprodol.
DPS lab exhibits of carisoprodol reported to NFLIS
increased from 13 in 1998 to 90 in 1999, 153 in 2000,
202 in 2001, 179 in 2002, 278 in 2003, and 132 in the
first half of 2004.
According to the Dallas DEA Field Division, Soma
sells for $2–$5 per tablet.
INFECTIOUS DISEASES RELATED TO DRUG ABUSE
Hepatitis C
Exhibit 25 shows that 18 percent of the 8,798 tests
for HCV exposure given in 2003 were positive. Some
41 percent of those with positive tests were exposed
through injecting drug use. The rates were higher for
males, for American Indians and Blacks, and for persons
aged 40 and older. The highest HCV positivity
rates were reported by persons tested at sexually
transmitted disease clinics and drug treatment centers
(22 percent each) and field outreach centers and corrections
and probation settings (20 percent each).
Forty-eight percent of the 200 clients in narcotic
treatment programs who were interviewed by the
author as part of NIDA Grant R21 DA014744 said
they were positive for hepatitis C, and 54 percent said
a doctor had told them they had liver problems.
However, only 5 percent reported they were HIV
positive.
HIV and AIDS Cases
In 2003, the percent of AIDS cases involving heterosexual
exposures was greater than the percent of
cases due to injecting drug use (exhibit 26). The proportion
due to heterosexual contact has risen from 1
percent in 1987 to 27 percent in the first half of 2004,
while the proportion attributed to injecting drug use
was 16 percent in the first half of 2004.
In 1987, 3 percent of the AIDS cases were females
older than age 12; in the first half of 2004, 24 percent
were female. In 1987, 12 percent of the adult and
adolescent cases were Black; in 2004, 44 percent
Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005