NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC ...

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