NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC ...

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York and Miami (Pach et al. 2002). The street-level dealing in DC was described as less organized and more free-flowing than the organized networks in these larger cities. Information from NDIC suggests that Colombian drug trafficking organizations continue to play a major role in supplying opiates and cocaine to DC criminal groups of Colombian and Dominican descent. Data Sources A number of sources were used to obtain comprehensive information regarding the drug use trends and patterns in Washington, DC. Data for this report were obtained from the sources shown below. In addition, interviews were conducted with a sample of substance abuse professionals in the fields of criminal justice, public health, and recovery. • Emergency department (ED) drug data were derived for 2004 from the Drug Abuse Warning Network (DAWN) Live!, a restricted-access online query system administered by the Office of Applied Studies (OAS), Substance Abuse and Mental Health Services Administration (SAMHSA). Eligible hospitals in the area totaled 34; hospitals in the DAWN sample totaled 29; EDs in the DAWN sample numbered 30. (One hospital has two EDs.) The data were incomplete, with varying numbers of EDs reporting each month (see exhibit 1a). Tables reflect cases that were received by DAWN as of January 18, 2005, 1:13 P.M. ET. All DAWN cases are reviewed for quality control. Based on this review, cases may be corrected or deleted. Therefore, these data are subject to change. The data are unweighted and are not estimates for the Washington, DC, metropolitan area. Data presented in this paper represent drug reports in drug-related ED visits. Drug reports exceed the number of visits, since a patient may report use of multiple drugs (up to six drugs plus alcohol). These data cannot be compared with DAWN ED data from 2002 and before, nor can they be used for comparison with future data accessed through DAWN Live!. Only weighted data released by SAMHSA can be used in trend analysis. A full description of the DAWN system can be found at the DAWN Web site . • Drug-related death data were derived from DAWN, OAS, SAMHSA, and annual medical examiner (ME) data for 1997 to 2002. • Drug treatment data for 2000–2003 were obtained from the Treatment Episode Data Set (TEDS), OAS, SAMHSA. 290 EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Washington, DC • Arrest, crime, and law enforcement action data were derived from the Metropolitan Police Department (MPD) crime statistics and press releases pertaining to law enforcement action through December 2004, which can be accessed at www.mpdc.dc.gov. • Arrestee urinalysis data were derived from the District of Columbia Pretrial Services Agency for adult and juvenile arrestees for 2000 through the first 8 months of 2004. • Drug prices and trafficking trends were obtained from the NDIC Narcotics Digest Weekly Special Issue: Illicit Drug Prices January 2004- June 2004 and the Washington-Baltimore High Intensity Drug Trafficking Area (HIDTA) Washington/Baltimore Threat Assessment reports released in 2003 and 2004. • General information on drug use was derived from the University of Maryland’s Center for Substance Abuse Research (CESAR), Drug Early Warning System (DEWS) County indicators, DEWS Investigates reports, and CESAR Briefings, available at www.dewsonline.org and www.cesar.umd.edu. Additional information was obtained from the Citywide Comprehensive Substance Abuse Strategy for the District of Columbia, 2003, and the National Poison Control Center, 2000–2003. • Census data for the District of Columbia were derived from the “Council of the District of Columbia; Subcommittee on Labor, Voting Rights and Redistricting; Testimony of the Office of Planning/State Data Center on Bill 14-137, The Ward Redistricting Amendment Act of 2002,” available at http/www.planning.D.C.gov/docu ments/census2002.shtm. • Test results on drug items analyzed by local crime lab(s) were obtained from the National Forensic Laboratory Information System (NFLIS) for Federal fiscal year (FY) 2004. • Regional counts on methamphetamine labs seized were obtained from the El Paso Intelligence Center’s (EPIC) National Clandestine Laboratory Seizure Database for 1999–2003. • Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) data were obtained from the HIV/AIDS Epidemiologic Profile for the District of Columbia, 2004. Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005
DRUG ABUSE PATTERNS AND TRENDS Cocaine/Crack Cocaine, particularly in the form of crack, remains the most serious drug of abuse in the District, accounting for more ED episodes, adult arrestee positive drug tests, and drug-related deaths than any other drug. Only heroin has a higher percentage of treatment admissions. Cocaine is most often sold at openair markets in the poorer parts of the city and is decreasing in price. The NDIC reported that powder cocaine sold for $27,500–$28,000 per kilogram and $60–$100 per gram during the first 6 months of 2004. Crack sells for slightly more: $28,000–$34,000 per kilogram and $80–$100 per gram. NFLIS data for Federal FY 2004 show that analyzed drug items were more likely to test positive for cocaine (39.57 percent) than for any other drug. Cocaine is smuggled into the District from New York, Miami, Los Angeles, or Philadelphia. Unweighted data accessed from DAWN Live! show that cocaine was the most frequently involved substance in reported ED visits (exhibit 1b). Of the 2,728 ED reports involving cocaine in 2004, 61 percent were male, 74 percent were Black, and 20 percent were White. Nearly three-quarters (73 percent) were age 35 or older, 19 percent were age 25 to 34, and 7 percent were between the ages of 18 and 25. Nearly one-quarter (21 percent) of the cases involved patients seeking detoxification, and 3 percent resulted from suicide attempts. The majority of these patients (75 percent) were designated “other” substance abuse cases. Cocaine-involved deaths totaled 58 in 2002, 27 of which were single-drug deaths (exhibit 2). These 58 deaths represent an increase from 2001, when the total was 42, and from 2000, when the total was 54. In 2003, cocaine was the primary substance of abuse among approximately 29 percent of treatment admissions reported to TEDS, with 19 percent reporting smoked cocaine (referred to as “crack” here) (exhibit 3a). The percentage of primary admissions for nonsmoked cocaine (referred to as “powder” here) increased 51 percent from 474 admissions in 2001 to 717 in 2002, while those for crack decreased 19 percent from 1,450 to 1,172 during this time. In 2003, the number of admissions for crack (912) continued to decrease. Admissions for powder cocaine decreased in 2003 for the first time since 2000. Treatment admissions in 2003 with powder cocaine and crack cocaine as the primary drugs of abuse were more likely to be male (65.7 and 64.7 percent, re- EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Washington, DC spectively) than female (exhibit 3b). More than 94 percent of both cocaine admissions groups were Black, and more than one-half were age 36–45. Reports from the DC Pretrial Services Agency indicate that the percentage of adult arrestees testing positive for cocaine has remained about the same since 2000 (exhibit 4a). In the first 8 months of 2004, 37 percent of adult arrestees in DC Pretrial Services tested positive for cocaine; in the first 8 months of 2004, 3.0 percent of juveniles tested positive (exhibit 4b). The percentage of adults testing positive in 2004 appears to be slight increase from 2003. Heroin Heroin is one of the three leading drug problems in the District, along with cocaine and marijuana. The MPD describes crack as a weekend drug but heroin as having a more steady ongoing market. The NDIC reported that heroin sold for $74,000–$110,000 per kilogram and $100–$110 per gram during the first 6 months of 2004. NFLIS data for Federal FY 2004 show that approximately 13 percent of analyzed drug items tested positive for heroin. The number of heroin abusers in the District continued to increase in 2003, with estimates of 14,000 to 18,000 abusers according to the Washington/Baltimore HIDTA. Most heroin is from South America, although Southeast Asian and Southwest African heroin are still distributed by various groups. Purity ranged from 20.8 percent (South American) to 22.7 percent pure (Southeast Asian). Northwest Washington is frequented by White suburban users purchasing high-purity heroin, while eastern Washington is frequented by more well-established sellers and longterm addicts. Eastern Washington experiences higher levels of trafficking and associated violence. Unweighted data from DAWN Live! show approximately 1,442 ED heroin reports in 2004 (exhibit 1b). Nearly two-thirds (65 percent) of these patients were male; 71 percent were Black and 24 percent were White. More than three-quarters (78 percent) were age 35 or older. Nearly one-quarter (21 percent) of the cases involved individuals seeking detoxification, and 1 percent resulted from suicide attempts. The majority of the cases (78 percent) were designated “other” (exhibit 1b). Of the 20 heroin-involved deaths in 2002, 4 were single-drug deaths (exhibit 2). The number of deaths in 2002 was substantially lower than the totals in 1997 to 2000, but it was an increase from 2001. Deaths peaked at 53 in 1998. Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005 291
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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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correspond to decreases in total ad
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228 reports in drug-related visits;
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Marijuana Arrests for marijuana-rel
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positivity. UHS staff believe, on t
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236 are not estimates for the repor
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were evident. Excluding missing dat
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Page 268 and 269: The term “lag” refers to the pe
Page 270 and 271: costs $1,200-$1,500, compared with
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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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Page 333: Appendix A New Drug Abuse Warning N
Page 336 and 337: DAWN LIVE! The new DAWN includes ca
Page 339 and 340: Participant List National Institute
Page 341 and 342: Janie B. Dargan, M.S.W. Policy Anal
Page 343: Martin P. Paulus, M.D. Associate Pr
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