NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC ...

ounce in the Denver metropolitan area. Crack cocaine
prices have remained relatively stable at $650–$1,000
per ounce, while “rock” prices on the street are $20–
$50 in Denver. Prices are slightly higher outside of
the Denver metropolitan area. Purity is approximately
66 percent throughout the front range and between 41
and 91 percent on the western slope. Treatment providers
stated that crack is fairly rare on the western
slope, and its use remains entrenched in the African-
American communities in southern Colorado.
Overall, Colorado has experienced a decrease in the
wholesale price of powder cocaine because these
users have switched to methamphetamine. Treatment
providers indicate this switch is related to cheaper
prices and a longer lasting “high.” Both drugs are
equally available throughout the State.
Heroin and Other Opiates
Heroin and other opiate use poses a considerable
threat to Colorado, although indicators for both were
mixed. Unweighted data accessed from DAWN Live!
show that heroin ED reports in the first half of 2004
totaled 292, representing 17 percent of illicit drug
reports (exhibit 1).
Opiates other than heroin include hydrocodone, hydromorphone,
codeine, and oxycodone. Unweighted
ED reports of opiates/opioids for Denver in the first
half of 2004 totaled 271; of these, 72 (26.6 percent)
were oxycodone reports and 67 (24.7 percent) involved
hydrocodone.
Hospital discharge data for 1997–2003 combined all
narcotic analgesics, including heroin. These discharges
have been steadily increasing, with the rate
almost doubling in 7 years, from 37 per 100,000 in
1997 to 73 per 100,000 in 2003 (exhibit 2). Treatment
providers indicated a rapid rise in the popularity
of abuse of prescription narcotics such as OxyContin
and hydrocodone, and these data may reflect that.
Heroin/morphine-related mortalities for the Denver
PMSA fluctuated from 34 in 1996, to 79 in 1999, to 66
in 2000, to 77 in 2001, and to 64 in 2002 (exhibit 4).
Statewide, opiate-related deaths increased from 141
(36.2 per million population) in 1997 to 182 (45.9 per
million) in 1998. From this peak, such deaths declined
to 142 (35.2 per million) and 147 (34 per million)
in 1999 and 2000, respectively. However, opiate-related
deaths climbed to 160 (36.3 per million)
in 2001 and 164 (36.5 per million) in 2002. Data for
2003 show that opiate-related deaths decreased
slightly to 152, or 33.3 per million population.
68
EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Denver and Colorado
Heroin and other narcotic analgesic-related calls to
the RMPDC peaked in 2003 at 22 and declined
slightly to 18 in 2004 (exhibit 3).
According to recent ADAM data for a sample of
Denver arrestees, in 2001, 5.2 percent of males and
2.4 percent of females tested positive for opiates.
However, in 2002 5.3 percent of females and 4 percent
of males tested positive for opiates. In 2003,
male arrestees again showed a slightly higher percentage
of positive heroin urines (6.8 percent) than
female arrestees (6.1 percent).
Among Colorado treatment admissions (excluding
alcohol), the proportion of clients with heroin as their
primary drug of choice has steadily declined (exhibit
5). In 1997, 16 percent of all drug treatment admissions
identified heroin as their primary substance,
while in 2004 only 8.5 percent did so. It should be
noted that while in 2004 the ADAD expanded the
number of DACODS reports by adding driving under
the influence (DUI) clients into the DACODS database,
figures used in this report exclude DUI clients.
Treatment admissions for clients who stated other
opiates as their primary drug have been consistent at
3–4 percent from 1997 to 2004 (exhibit 5).
The proportion of “new” heroin and other opiate users
who entered treatment within 3 years of initial use
rose from 1997 (18 percent) to 2000 (22 percent) and
then declined to 16 percent in 2003 (exhibit 6). There
was a very slight increase in 2004 to 17 percent. The
majority of heroin users in treatment are long-time
users. According to ADAD’s State FY 2004 data, it
takes heroin clients an average of 13 years from first
use before they enter treatment (exhibit 7).
Opiates (heroin and other opiates combined) ranked
low among all four generations of users, from 2 percent
for the Y generation, to 8 percent for the X generation
and seniors, and 12 percent for the Baby
Boomers (exhibit 9).
In FY 2004, all heroin/other opiate users were older
than 18 at the time of admission; 61 percent were
male; and 71 percent lived in urban settings (exhibit 8).
Sixty-nine percent of heroin and other opiate users
were White, 19 percent were Hispanic, and 8 percent
were African-American in FY 2004. Forty-two percent
had achieved a 12th grade education, and 34 percent
had attended college. Wages were the primary source
of income for 45 percent. Twenty-eight percent had no
prior treatment, while 31 percent had three or more
treatment episodes before this admission.
Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005