NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC ...

than age 18, compared to 4 percent of secondary intranasal
cocaine users).
Prices for powdered cocaine for the second half of
2004 were reported as $20,000–$32,000 per kilogram
at the wholesale level, $900–$1,200 per ounce at
midlevel, and $20–$200 per gram at the retail level.
Prices for crack cocaine were reported as $20,000–
$26,000 per kilogram at the wholesale level, $600–
$1,200 per ounce at midlevel, and $40–$200 per
gram at the retail level. For powdered cocaine, the
price range at the wholesale kilogram level was unchanged
from the second half of 2003, while the
lower limit for a retail-level gram was less. For crack
cocaine, the lower limit for a wholesale kilogram was
unchanged from the second half of 2003, while the
lower limit for a retail-level gram was less.
Heroin
Heroin indicators for the Baltimore metropolitan area
as a whole generally indicated an increase over 2001
levels (exhibit 1). The rate of heroin ED mentions
(203 per 100,000 population in 2002) represented a
significant 4-percent increase from 195 per 100,000
in 2001. The heroin treatment admission rate increased
from 652 per 100,000 population age 12 and
older in 2001 to 875 per 100,000 in 2003 (exhibit 2).
However, it was projected to decline slightly to 858
per 100,000 in 2004.
Heroin use in the Baltimore metropolitan area is complex.
There are several groups of heroin users differing
by urbanicity, route of administration, age, and race. In
the first half of 2004, the heroin treatment admission
rate was about seven times higher in Baltimore City
than in the suburban counties (exhibit 2).
In Baltimore City, intranasal use was the preferred
route of administration among treatment admissions
(exhibit 2), and the admission rate for intranasal use
was 29 percent higher than for injection. In the suburban
counties, however, the rate for heroin injection
was 63 percent higher than for inhalation.
Exhibit 6 compares the number of treatment admissions
in the first half of 2004 by route of administration,
age, and race. Baltimore has a core of older African-American
heroin users, both injectors and intranasal
users. White users entering treatment for heroin
were younger and were predominantly injectors.
African-American heroin intranasal users made up 40
percent of the heroin-using treatment admissions in
the Baltimore PMSA in the first half of 2004. Most
(85 percent) were treated in Baltimore City. Among
22
EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Baltimore Metropolitan Area
heroin intranasal users in the city (exhibit 7), most
admissions were African-American (91 percent) and
were age 35 and older (74 percent). The proportion of
intranasal users age 25 and younger decreased from 5
percent in 2000 to 3 percent in the first half of 2004.
Almost one-half (47 percent) of the intranasal heroin
users in the city were women. The median age at admission
was 39, and the median duration of use before
first entering treatment was 14 years. Almost
three-quarters (73 percent) reported daily heroin use.
One-third (33 percent) entered treatment through the
criminal justice system, and less than one-third (29
percent) were receiving treatment for the first time.
Almost three-quarters (72 percent) reported use of
other drugs—45 percent smoked cocaine, 11 percent
used cocaine intranasally, 26 percent used alcohol, 10
percent used marijuana, and 2 percent used opiates
other than heroin.
White heroin injectors made up 26 percent of the
heroin-using treatment admissions in the Baltimore
PMSA in the first half of 2004. More than one-half
(61 percent) were treated in the suburban counties.
Among heroin injectors in the suburban counties (exhibit
8), most admissions were White (81 percent).
About one-third (34 percent) of suburban injectors
were age 25 and younger. Sixty percent of the suburban
heroin injectors were male. The median age at
admission was 30, and the median duration of use
before first entering treatment was 7 years. Almost
three-quarters (74 percent) reported daily heroin use.
Less than one in five (19 percent) entered treatment
through the criminal justice system, and one-third (33
percent) were receiving treatment for the first time.
Two-thirds (67 percent) reported use of other drugs—
14 percent smoked cocaine, 29 percent injected cocaine,
20 percent used alcohol, 17 percent used marijuana,
and 8 percent used opiates other than heroin.
African-American heroin injectors made up 21 percent
of the heroin-using treatment admissions in the
Baltimore PMSA in the first half of 2004. Most (85
percent) were treated in Baltimore City. Among heroin
injectors in the city (exhibit 8), the majority of
admissions (64 percent) were African-American and
were age 35 and older (70 percent), although the proportion
of intranasal users age 25 and younger increased
slightly from 9 percent in 2000 to 11 percent
in the first half of 2004. Some 44 percent of the city’s
heroin injectors were women. The median age at admission
was 40, and the median duration of use before
first entering treatment was 17 years. Most (77
percent) reported daily heroin use. Less than onequarter
(23 percent) entered treatment through the
criminal justice system, and less than one in five (22
percent) were receiving treatment for the first time.
Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005