NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC ...

Americans, 29 percent of Hispanics, and 50 percent
of Whites. Sniffing was the primary means for 83
percent of African-Americans, 62 percent of Hispanics,
and 43 percent of Whites.
A recent report (Kane-Willis and Schmitz-Bechteler
2004) examined age and race trends among persons
treated for heroin use in Illinois and found that
Whites were far more likely to be age 18–24 (41 percent)
than were African-Americans (2 percent) and
Hispanics (20 percent).
According to the 2003 ADAM report, 25 percent of
adult male arrestees tested opiate positive (exhibit 3).
The proportion of adult female arrestees testing opiate
positive decreased significantly between 2000 and
2003, from 40 to 22 percent, respectively. The June
2004 Chicago CEWG report provides a more complete
discussion of the ADAM data.
According to the 2003 DMP report, availability of
heroin in Chicago, especially South Asian heroin, continued
(exhibit 4). Heroin from other geographic
source areas, including South America and Mexico,
was also available. The purity of street-level heroin
peaked in 1997 at about 31 percent and has since declined.
In 2003, South American heroin exhibits purchased
by DMP in Chicago averaged 15.8 percent
pure, a 23-percent decrease from 2002. However, the
average price per milligram pure remained low for
South American heroin in 2003 at $0.46. Recent ethnographic
reports suggest a new source of heroin on
the south side of Chicago that is thought to offer a
higher purity level. On the street, this heroin has been
referred to as “tornado” for its strength or “retrodope,”
as it reminds older users of “better” heroin from
years ago.
According to ISP, the amount of heroin analyzed in
Cook County decreased slightly from 21 kilograms in
2003 to 18 kilograms in 2004.
Participants in a study of young non-injecting heroin
users reported high availability of heroin on the
streets of Chicago. Sixty-three percent reported “a
lot” (the highest rating) of heroin on the street in the
past 30 days. Use of brand name heroin was reported
by 29 percent of participants. Most (82 percent) paid
$10 per bag in the 30 days prior to interview. Regarding
heroin quality in the past 30 days, only 11 percent
gave the highest quality rating (“very good”); 31 percent
thought the quality was “good” and 49 percent
perceived the heroin quality as “fair.”
Heroin prices have not changed since the June 2003
report. On the street, heroin is commonly sold in $10
and $20 units (bags), though bags for as little as $5
EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Chicago
were available. Prices for larger quantities varied
greatly, depending on the type and quality of heroin,
the buyer, and the area of the city where the heroin
was sold. At outdoor drug markets, purchases of multibag
quantities—versus grams and fractions of
ounces—were the most common means of buying
larger amounts of heroin. Data indicated that buyers
on the West Side could obtain 11–13 $10 bags for
$100 (sometimes called a “jab”). Sunday sales of two
bags for the price of one were also reported. More
detailed price information is available in the June
2003 Chicago CEWG report.
Among Illinois high school students, increases in
heroin use have not yet been evidenced in periodic
representative surveys. The Illinois Youth Survey
indicates that heroin use among Chicago-area students
is still relatively rare. In 2003, 3.7 percent of
students reported lifetime use of heroin, compared
with 2.5 percent in 2001 and 3.1 percent in 1999. The
gender gap among students who have tried heroin
appears to be closing. In both 1999 and 2001, male
students were on average five times as likely to have
used heroin in their lifetime as females. In 2003, the
gap between males and females was nearly threefold.
APORS data indicated that opioid toxicity was decreasing
between 2000 and 2002 among infants
tested for controlled substances, from 22.4 per 10,000
live births to 16.1 per 10,000 live births, respectively.
In 2002, and similarly in 2000 and 2001, most infants
who tested positive to heroin exposure at birth were
born to African-American mothers (69 percent) and
to mothers age 25–34.
Other Opiates
Hydromorphone (Dilaudid), the pharmaceutical opiate
once preferred by many Chicago IDUs, continued
to be available, although in limited quantities (typical
sources are said to be cancer patients). There were
only 10 hydromorphone ED mentions in Chicago in
2002. The drug sells for approximately $25 per tablet.
Street sales of methadone are more common, with the
drug typically costing $0.75–$1.00 per milligram.
Codeine ED mentions steadily increased after 1995
and peaked in 2000 (83), but they decreased in 2002
to 51 mentions; these changes were not statistically
significant. After a 51-percent decrease in codeinerelated
deaths reported from sentinel DAWN ME
sites in the 6-county Chicago area between 2000 and
2001, codeine-related deaths remained level in 2003,
with 41 cases reported. Codeine syrup is reported to
sell for about $30 for 4 ounces. Codeine is often used
by heroin users to moderate withdrawal symptoms or
to help kick a drug habit.
Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005 55