CEWG January 09 Full Report - National Institute on Drug Abuse

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Section III. <strong>CEWG</strong> Area Update Briefs and International Presentations Drug Abuse Patterns and Trends in Greater Boston—Update: <strong>January</strong> 20<strong>09</strong> Daniel P. Dooley For inquiries concerning this report, please contact Daniel P. Dooley, Senior Researcher, Boston Public Health Commission, 1010 Massachusetts Avenue, Boston, MA 02118. Phone: 617–534–2360, Fax: 617–534–2442, E-mail: ddooley@bphc.org. Overview of Findings: In Boston, heroin and cocaine remained heavily abused drugs during this reporting period. Heroin continued to dominate as the primary drug in treatment and was cited most often among calls to the substance abuse helpline. Cocaine continued to figure prominently among treatment admissions, drug arrests, and drug lab samples derived from drug arrests. Marijuana, other opiates including oxycodone, and benzodiazepines were present among the indicators at more moderate levels. Methamphetamine abuse remained at low levels overall. Updated Drug Abuse Trends and Emerging Patterns: Cocaine indicators remained mostly stable at very high levels. Close to one of every four treatment admissions (24 percent) reported past-month cocaine (including crack) use in fiscal year (FY) 2008. The proportion of admissions with past-month cocaine use has remained fairly stable, at between 23 and 26 percent, from FY 2001 to FY 2008. The proportion of female cocaine primary treatment admissions increased from 37 percent in FY 2007 to 45 percent in FY 2008. The proportion of cocaine calls to the helpline remained at 18 percent from 2007 to 2008; it has fluctuated between 18 and 22 percent over the 10-year period from 1999 to 2008. The proportion of Class B drug arrests (mainly cocaine) increased slightly from 43 percent in 2006 to 46 percent in 2007. Cocaine drug lab samples remained stable from 2006 to 2007, accounting for one-third of all samples each year. Heroin abuse indicators remained stable at extremely high levels in Boston. In FY 2008, onehalf of all treatment admissions (n=9,325) cited heroin as the primary drug of abuse. After having steadily increased from 35 percent in FY 1998 to 51 percent in FY 2007, the proportion of heroin treatment admissions remained fairly stable at 50 percent in FY 2008. After increasing over 9 years, the proportion of all admissions with past-month heroin use decreased from 48 percent in FY 2007 to 43 percent in FY 2008. The proportion of male heroin and other opiates treatment admissions decreased slightly from 75 percent in FY 2007 to 72 percent in FY 2008. Conversely, the proportion of female admissions increased slightly from 25 to 28 percent during the same period. Although accounting for a small proportion, the number of heroin and other opiate treatment admissions under age 19 more than doubled from 54 in FY 2007 to 121 in FY 2008, reaching the highest level for this age group in 11 years of reported data. Proportions of other age groups remained stable from FY 2007 to FY 2008, but from FY 1998, the proportion of admissions in the age group 19–29 increased by 40 percent (from 29 percent in FY 1998 to 40 percent in FY 2008) while the proportions of admissions age 30–39 and age 40–49 decreased by 25 and 19 percent, respectively. In FY 2008, two-thirds of the heroin and other opiates admissions were White. From FY 1998 to FY 2008, the proportion of White admissions increased by 38 percent, while the proportions of Black and Latino admissions decreased by 53 and 13 percent, respectively. From FY 2007 to FY 2008, the proportion of heroin and other opiates admissions with a criminal justice history decreased from 19 to 12 percent, while the proportion with a mental health services history increased from 16 to 23 percent. After reaching the highest level in 10 years in FY 2007, the proportion of past-year injection drug use among heroin and other opiates admissions remained stable at 71 percent in FY 2008. After peaking at 40 percent in 2003, the proportion of heroin calls to the substance abuse helpline has remained stable at between 32 and 34 percent from 2005 to 2008. Similarly, the levels of Class A drug arrests (mainly heroin) and heroin drug lab samples were stable from 2005 to 2007 at levels lower than Proceedings of the Community Epidemiology Work Group, <strong>January</strong> 20<strong>09</strong> 37
EpidEmiologic TrEnds in drug AbusE: HigHligHTs And ExEcuTivE summAry their peaks in 2000 and 2001. The Drug Enforcement Administration (DEA)’s most recent data (December 2008), revealed that a bag of heroin on the streets of Boston cost between $3 and $50, with an average purity level of between 20 and 30 percent. Indicators for other opiates/opioids were stable at moderate levels. The number of treatment admissions for other opiates increased from 110 in FY 1998 to 761 in FY 2002. Since then, the proportion of primary treatment admissions for other opiates has remained stable at between 3 and 4 percent from FY 2002 to FY 2008. Similarly, the proportion of other opiates helpline calls increased from 6 percent in 1999 to 18 percent in 2004, but has remained stable at between 16 and 17 percent from 2005 to 2008. The proportion of oxycodone drug lab samples remained stable for 6 years (2002 to 2007) at between 2 and 3 percent. Marijuana indicators were mixed at varied levels. The proportion of treatment admissions citing past-month marijuana use increased slightly to 9 percent in FY 2008, after steadily decreasing from 14 percent in FY 1998 to 7 percent in FY 2007. The proportion of female marijuana primary treatment admissions increased from 25 percent in FY 2007 to 35 percent in FY 2008. The proportion of admissions younger than 30 remained stable at 70 percent from FY 2007 to FY 2008. From 2007 to 2008, the proportion of marijuana helpline calls remained at 4 percent. Class D drug arrests (mainly marijuana) accounted for 35 percent of total drug arrests. The proportion has remained stable at between 33 and 37 percent from 2002 to 2007. The proportion of marijuana drug lab samples decreased from 40 percent 2006 to 35 percent in 2007. Methamphetamine abuse levels remained low in Boston, representing less than 1 percent of all treatment admissions. The number of primary admissions for methamphetamine totaled 59 admissions in FY 2008 and 29 admissions in FY 2007. Similarly, methamphetamine calls to the helpline (n=22) accounted for less than 1 percent of all calls in 2008. Methamphetamine drug lab samples totaled 26 in 2007 and 36 in 2006. Benzodiazepine abuse in Boston remained at moderate levels. Calls to the helpline have been fairly stable in number (at between 130 and 188) but have increased in proportion (from 3 to 5 percent) between 2000 and 2008. HIV/AIDS Update: In 2006, there were 214 adult acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) cases who were injection drug users (IDUs), 3 percent who had sex with IDUs, and 29 percent who had an unknown/undetermined risk factor. Data Sources: State-funded substance abuse treatment admissions data for the Boston region comprising the cities of Boston, Brookline, Chelsea, Revere, and Winthrop (Community Health Network Area [CHNA] 19), for FYs 1998 through 2008 (July 1, 1997 through June 30, 2008) were provided by the Massachusetts Department of Public Health (DPH), Bureau of Substance Abuse Services. Helpline data provided information on drug mentions during calls received by the Massachusetts Substance Abuse Information and Education Helpline for the CHNA 19 region for 1999 through 2008. Drug arrest data for the city of Boston for 2002 through 2007 were provided by the Boston Police Department, Drug Control Unit and Offce of Research and Evaluation. For arrest data only, Black and White racial designations included those who identify themselves as Hispanic. A new Massachusetts law decriminalizing possession of less than an once of marijuana took effect <strong>January</strong> 1, 20<strong>09</strong> and will impact future drug arrest indicators. Forensic laboratory data for the Boston region comprising the cities of the CHNA 19 for 1998 through 2007 were provided by the Massachusetts DPH Drug Analysis Laboratory in Amherst, Massachusetts. These Boston area drug sample counts differ from drug sample counts derived from the <strong>National</strong> Forensic Laboratory Information System and do not include samples analyzed at the Worcester County or State Police laboratories. Drug price/ purity information was provided by the DEA’s New England Field Division, December 2008. Adult AIDS and HIV data for 2006 were provided by the Massachusetts DPH AIDS Surveillance Program, October 1, 2008. 38 Proceedings of the Community Epidemiology Work Group, <strong>January</strong> 20<strong>09</strong>
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