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 intentional, unintentional, adverse reaction, other, or unknown. Most of the exposures involve intentional abuse/misuse/suspected suicide, but all were captured in the data set. All exposure cases are for human cases only; animal cases were excluded, as were “confirmed” nonexposure cases. Drug seizure data were provided by the Cincinnati Police Department and the RENU for illicit drugs seized in Hamilton County. Forensic laboratory data were provided by the <strong>National</strong> Forensic Laboratory Information System for FY 2008. Additional qualitative and drug seizure data were provided by the Greater Warren County Drug Task Force. Methamphetamine clandestine lab data were provided by the Ohio Bureau of Criminal Identification and Investigation. Drug Abuse Patterns and Trends in Colorado and the Denver/Boulder Metropolitan Area—Update: <strong>January</strong> 20<strong>09</strong> Bruce Mendelson, M.P.A. For inquiries concerning this report, please contact Bruce Mendelson, M.P.A., Senior Data Consultant, Denver Department of Human Services, Offce of Drug Strategy, 1200 Federal Boulevard, Denver, CO 80204, Phone: 720–944–2158, Fax:720–944– 3083, E-mail: bruce.mendelson@denvergov.org. Overview of Findings: With mostly stable or increasing trends, marijuana continued to be a major drug of abuse in Colorado and the Denver/ Boulder metropolitan area based on treatment admissions, hospital discharges, law enforcement drug testing, emergency department (ED) visits, and adult and juvenile arrests. Likewise, with mostly stable or increasing trends, cocaine continued to be at or near the top of Colorado and Denver/Boulder area indicators, including treatment admissions, hospital discharges, ED visits, drug-related mortality, poison center calls, and law enforcement drug testing. Conversely, among Colorado and Denver/Boulder area indicators, methamphetamine presented more of a mixed picture, with stable or downward treatment admissions, declining lab seizures, and relatively small proportions of ED visits and drug-related mortality. Many heroin abuse indicators decreased over the last several years, while poison calls remained stable. However, it is likely that Denver heroin deaths are under-reported. Statewide and in the Denver/Boulder area, other opiates were a small but increasing percentage of treatment admissions, and were a substantial proportion of ED visits, and drug-related mortality. Beyond abuse of illicit drugs, alcohol remained Colorado’s most frequently abused substance and accounted for the most treatment admissions, ED reports, poison center calls, drug-related hospital discharges, and drug-related mortality. Updated Drug Abuse Trends and Emerging Patterns: Excluding alcohol, marijuana continued to be the primary drug of abuse statewide and in greater Denver. During the first half of 2008, it represented 37 percent of drug treatment admissions in Colorado, an increase from 34 percent during the first half of 2007. Marijuana accounted for 38 percent of Denver area admissions in the first half of 2008, an increase from 36 percent in the first half of 2007. In the first half of 2008, there were 1,200 unweighted marijuana Drug Abuse Warning Network (DAWN) ED reports in greater Denver, representing 25.5 percent of the reports (excluding alcohol) and ranking third behind cocaine and nonheroin opiates. Marijuana ranked second in 2007 Denver County hospital discharges (N=1,050; rate per 100,000=181), but both the number and rate of such discharges declined from the 2006 peak (N=1,188; rate per 100,000=207). Also, cannabis was the second most common drug submitted for testing by local law enforcement in the first half of 2008 (<strong>January</strong>–June) in Denver and Arapahoe Counties, and ranked first in Jefferson County. Federal drug seizures for marijuana across Colorado, after being relatively stable from 2003 (444.1 kilograms) to 2006 (656.8 kilograms), nearly doubled to 1,149.5 kilograms in 2007. Total adult and juvenile marijuana arrests in Denver (both sales and possession) decreased from 3,235 in 2000 to Proceedings of the Community Epidemiology Work Group, <strong>January</strong> 20<strong>09</strong> 43
EpidEmiologic TrEnds in drug AbusE: HigHligHTs And ExEcuTivE summAry 2,110 in 2004, but then climbed steadily to 3,212 by 2007. Methamphetamine, which accounted for the next highest proportion of treatment admissions statewide (excluding alcohol), overtook cocaine admissions in the first half of 2003. Methamphetamine admissions continued to increase until the first half of 2006 (31 percent), remained stable through 2007, but then declined in the first half of 2008 (26 percent). In greater Denver, methamphetamine represented 22 percent of first half of 2006 admissions, increased to 23 percent in the first half of 2007, but then declined to just 19 percent in the first half of 2008. Greater Denver methamphetamine admissions were behind cocaine in all three of these time periods. Methamphetamine ED reports in greater Denver totaled 266 in the first half of 2008, accounting for just 6 percent of unweighted DAWN reports (excluding alcohol). While methamphetamine was not among the most common drugs found in Denver drug-related decedents, it still accounted for 7.1 percent of Denver drug-related mortality in 2005, 5.3 percent in 2006, and 6.3 percent in 2007. Methamphetamine was the third most common drug submitted for testing by local law enforcement in the first half of 2008 in Denver, Arapahoe, and Jefferson Counties. Federal drug seizures for methamphetamine across Colorado increased each year from 2003 (14.8 kilograms) to 2006 (50.3 kilograms), but then declined to only 8 kilograms in 2007. Likewise, methamphetamine lab seizures in Colorado have declined from 345 in 2003 to only 44 in 2007. Cocaine admissions (excluding alcohol) statewide declined slightly from 21 percent in both the first half of 2006 and 2007 to 20 percent in the first half of 2008. Similarly, Denver area cocaine admissions had increased from 23 percent in the first half of 2006 to 24 percent in the first half of 2007, but then decreased slightly to 22 percent in the first half of 2008. In the first half of 2008, there were 1,436 cocaine ED reports, which at 31 percent of greater Denver unweighted DAWN reports, was the highest number of reports among all drugs excluding alcohol. Likewise, excluding alcohol, cocaine was the most common drug reported in substance abuse-related hospital discharges in 2007, a trend extending from calendar year (CY) 2000. Cocaine was also the most common drug found in Denver drug-related decedents in 2005 (48.2 percent), 2006 (50.3 percent), and 2007 (39.7 percent). Likewise, cocaine in combination with other drugs (i.e., morphine, codeine, alcohol, and heroin) was among the most common combinations found in Denver drug-related decedents in the 2005 to 2007 time period. Continuing the scenario of cocaine dominance in the greater Denver area, cocaine was the most common drug submitted for testing by local law enforcement in the first half of 2008 in Denver and Arapahoe Counties, and ranked second after cannabis in Jefferson County. Federal drug seizures for cocaine across Colorado, after decreasing from 65.5 to 36 kilograms from 2003 to 2004, increased substantially in 2005 (131.5 kilograms) and 2006 (135.1 kilograms), but declined sharply in 2007 (44.0 kilograms). In the first half of 2008, heroin ranked fourth in both statewide and greater Denver treatment admissions, representing 7 and 11 percent of admissions (excluding alcohol), respectively. Heroin accounted for 8 percent of unweighted DAWN reports in the first half of 2008 (n=379), ranking fourth behind cocaine, marijuana, and other opiates. Heroin was found in 11.2, 9.5, and 10.1 percent of Denver drugrelated decedents in 2005, 2006, and 2007, respectively. However, it is likely that this percentage was much greater. The marker for heroin, the metabolite 6-monoacetylmorphine, needs to be present to confirm that heroin was related to the cause of death. However, this metabolite has a very short half-life and may be undetectable by the time blood toxicology is done as part of an autopsy. Morphine and codeine almost always are present when heroin is metabolized, but are also abused opiates. Thus, it is sometimes diffcult to determine whether heroin was involved in a drugrelated death. Often, an autopsy report will describe the circumstances surrounding a drugrelated death including information such as 44 Proceedings of the Community Epidemiology Work Group, <strong>January</strong> 20<strong>09</strong>
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NIH Publication No. 09</str
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CEWG January 09 Full Report - National Institute on Drug Abuse

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