NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC ...

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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
were Black. As exhibit 27 shows, the proportion of White males has dropped, while the proportion of Blacks and Hispanics has increased. The proportion of adult needle users entering TDSHS-funded treatment programs has decreased EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Texas from 32 percent in 1988 to 22 percent for 2004. Heroin injectors are most likely to be older, and nearly two-thirds are people of color, while injectors of stimulants and cocaine are far more likely to be White (exhibit 28). For inquiries concerning this report, please contact Jane C. Maxwell, Ph.D., Research Professor, Center for Social Work Research, The University of Texas at Austin, Suite 335, 1717 West 6 th Street, Austin, TX 78703, Phone: 512-232-0610, Fax: 512-232-0617, E-mail: jcmaxwell@sbcglobal.net. Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005 273
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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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the deaths, while Whites constitute
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2000 reported that the average hero
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for this drug, making olanzapine th
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ADHS/DBHS reported that more than o
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Marijuana is widely available in Ar
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212 2004. Data from 2000-2002 DAWN
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purity dropped to 14.4 percent in 2
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No recent GHB incidents or deaths w
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Page 228 and 229: correspond to decreases in total ad
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Page 252 and 253: imipramine) are an older class of m
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Page 270 and 271: costs $1,200-$1,500, compared with
Page 272 and 273: ties. In the DFW area, Mexican mari
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Page 298 and 299: In 2003, heroin was the primary sub
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Page 312 and 313: Among GTC patients, marijuana was t
Page 314 and 315: Others (63.8 percent) were using a
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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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