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EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Contents San Diego: Drug Abuse Patterns and Trends in San Diego County, California Michael Ann Haight, M.A. .................................................................................................................. 220 San Francisco: Patterns and Trends of Drug Use in the San Francisco Bay Area John A. Newmeyer, Ph.D...................................................................................................................... 227 Seattle: Recent Drug Abuse Trends in the Seattle-King County Area Caleb Banta-Green, T. Ron Jackson, Susan Kingston, Michael Hanrahan, Steve Freng, David H. Albert, Ann Forbes, and Kris Nyrop .................................................................................... 235 Texas: Substance Abuse Trends in Texas, January 2005 Jane Carlisle Maxwell, Ph.D. .............................................................................................................. 260 Washington, D.C.: Patterns and Trends of Drug Abuse in Washington, DC Erin Artigiani, M.A., Margaret Hsu, M.P.H., and Eric Wish, Ph.D.................................................... INTERNATIONAL REPORT Update of the Epidemiological Surveillance System of Addictions (SISVEA) in Mexico: January–June 2004 Roberto Tapia-Conyer, Patricia Cravioto, Pablo Kuri, Mario Cortés, and Fernando Galván.......... 305 PANEL ON METHAMPHETAMINE ABUSE: NIDA-SUPPORTED RESEARCH STUDIES Natural History of Methamphetamine Abuse and Long-Term Consequences Mary-Lynn Brecht, Ph.D...................................................................................................................... 319 Prenatal Exposure to Methamphetamine and Child Development Barry Lester, Ph.D., Linda LaGasse, Ph.D., Lynne M. Smith, M.D., Chris Derauf, M.D., Penny Grant, M.D., Rizwan Shah, M.D., Amelia Arria, Ph.D., Marilyn Huestis, Ph.D.,and Jing Liu, Ph.D. 1 ....................................................................................... 320 Evidence-Based Approaches for Addressing Methamphetamine Use Among Gay Urban Males Cathy J. Reback, Ph.D. ........................................................................................................................ 322 Predicting Relapse in Methamphetamine-Dependent Individuals Martin P. Paulus, M.D. ....................................................................................................................... 324 APPENDIX A New Drug Abuse Warning Network (DAWN) Emergency Department Data and DAWN Live!: Major Features ................................................................................................................ 329 PARTICIPANTS Participant List ................................................................................................................................................. 333 vi 289 Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005
Introduction Moira P. O’Brien, NIDA This publication includes papers based on information and findings on drug abuse that were presented at the January 2005 Community Epidemiology Work Group meeting in Long Beach, California. The papers of the CEWG representatives provide the most recent indicator data on a range of abused drugs from 20 geographically dispersed areas in the Nation, with special attention devoted to the major theme of the January meeting––stimulant abuse. Over several years, CEWG monitoring efforts led to concern about two central nervous system (CNS) stimulants––cocaine and methamphetamine. There were continued reports of increases in methamphetamine abuse in some areas and high levels of cocaine abuse in many CEWG areas. From indicator trends, it was clear that methamphetamine abuse had been prominent in the West and Southwest for many years; from the more recent trends, there appeared to be a gradual spread of methamphetamine abuse into the Midwest and areas further east and south in the United States. Cocaine persisted as a major abused drug, maintaining a prominent position in the drug abuse indicators, including treatment admissions data. Indicators of methylphenidate (Ritalin) appeared infrequently over time. Methylenedioxymethamphetamine (or ecstasy), which may be classified as a hallucinogen, also acts as a CNS stimulant. Indicator data, however, suggest the use of this drug has been declining in most CEWG areas. Given the concern regarding the higher abuse levels of cocaine and methamphetamine compared to other stimulant drugs, CEWG representatives devoted much of their preparation for meeting presentations and papers to data on these two stimulant drugs. In addition, colleagues from Mexico provided a comparative perspective on the problems of cocaine and methamphetamine abuse in Mexico. The contributions of the CEWG members and Mexican researchers on cocaine and methamphetamine abuse are reflected in their papers in this publication. Also in this publication are papers summarizing findings from a special panel on methamphetamine abuse. EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Introduction These papers focus on the natural history of methamphetamine abuse, long-term consequences, effects of prenatal exposure, and issues associated with the treatment of methamphetamine abuse. This panel continued a precedent begun in June 2003, in which a particular emerging/current drug abuse trend is examined in greater depth than is possible through CEWG area reports. The approach draws on NIDA-supported research and complements CEWG findings. Of note to readers is the fact that 15 CEWG members reported emergency room data for the first time from the redesigned Drug Abuse Warning Network (DAWN). Since the inception of the CEWG, DAWN has been an important source of data. The major changes were instituted in DAWN at the beginning of 2003 and altered virtually every feature of DAWN except its name. As a result of the redesign, new DAWN data cannot be compared with DAWN ED data from 2002 and before. Interim national estimates of drug-related emergency department visits from the new DAWN for 2003 have been published (). There are, however, no metropolitan area estimates available for 2003 or 2004. For the papers presented in this publication, CEWG representatives accessed preliminary raw data from the online real-time query system called DAWN Live!, which is limited to authorized users. Accessing DAWN Live! data, CEWG members reported raw and unweighted reports of individual cases from participating hospitals, not populationbased estimates as have been presented in previous CEWG reports. CEWG area representatives have been granted access to DAWN Live! and have been trained in its use. A session during the January 2005 meeting was devoted to a discussion of the potential for meaningfully incorporating data from this realtime, raw data into the CEWG. A brief description of the new DAWN ED system and DAWN Live! is included in Appendix A. In the next section, the roles and functions of the CEWG are described briefly. Papers of the CEWG representatives, the Mexican researchers, and the methamphetamine panel members follow. Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005 1
Page 1 and 2: NATIONAL INSTITUTE ON DRUG ABUSE EP
Page 3: Foreword This publication includes
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Page 11: Epidemiology of Drug Abuse: CEWG Ar
Page 14 and 15: • The city of Atlanta has become
Page 16 and 17: In the first 6 months of 2004, trea
Page 18 and 19: eports (exhibit 2), while African-A
Page 20 and 21: population) than in 2002 (17.2 per
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Page 24 and 25: EPIDEMIOLOGIC TRENDS IN DRUG ABUSE
Page 26 and 27: data from the Drug Abuse Warning Ne
Page 28 and 29: than age 18, compared to 4 percent
Page 30 and 31: More often than not, marijuana use
Page 32 and 33: Solomon, L.; Flynn, C.; Muck, K.; e
Page 44 and 45: • Logan International Airport and
Page 46 and 47: In 2002, heroin/morphine was indica
Page 48 and 49: The FY 2004 racial distribution for
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50 EPIDEMIOLOGIC TRENDS IN DRUG ABU
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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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EPIDEMIOLOGIC TRENDS IN DRUG ABUSE
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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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The characteristics of other opiate
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June 2004 (exhibit 6c). A minority
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Deaths involving depressants were a
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imipramine) are an older class of m
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The term “lag” refers to the pe
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costs $1,200-$1,500, compared with
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ties. In the DFW area, Mexican mari
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The 2004 secondary school survey re
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nio and two 2-ounce bottles cost $1
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age may be partially due to the fac
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York and Miami (Pach et al. 2002).
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In 2003, heroin was the primary sub
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opolitan Police Department report t
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International Report
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Among GTC patients, marijuana was t
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Others (63.8 percent) were using a
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Panel on Methamphetamine Abuse: NID
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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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