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 and Drug Programs (tables produced by the California Department of Alcohol and Drug Programs) using the California Outcomes Measurement System (CalOMS). CalOMS is a statewide client-based data collection and outcomes measurement system for alcohol and other drug (AOD) prevention and treatment services. Submission of admission/ discharge information for all clients is required of all counties and their subcontracted AOD providers, all direct contract providers receiving public AOD funding, and all private-pay licensed narcotic treatment providers. Data for the current report include admissions to San Diego County for the period <strong>January</strong>–June 2008. Note that CalOMS was implemented in early 2006 (replacing the earlier CADDS system); data reported for periods prior to July 2006 may not be comparable to more recent periods. Unweighted ED data for <strong>January</strong>–June 2008 came from the Drug Abuse Warning Network (DAWN) Live!, a restricted access on-line query system administered by the Offce of Applied Studies, Substance Abuse and Mental Health Services Administration. The completeness of data reported by participating EDs varied by month. The first half of 2008 data for San Diego represent reports of major substances of abuse (n=2,281), including illicit drugs and alcohol only reports for patients younger than 21. These data were accessed on <strong>January</strong> 15, 20<strong>09</strong>, and are subject to change due to corrections and/or deletions arising from quality control reviews. Data represent drug reports in drug-related ED visits and may exceed the number of ED visits due to patients reporting multiple drugs. A full description of the DAWN data system can be found at http://dawninfo.samhsa.gov/. Mortality data were obtained from the Emergency Medical Services Medical Examiner Database, which is maintained by the County of San Diego Health and Human Services Agency. Drug Abuse Patterns and Trends in the San Francisco Bay Area—Update: <strong>January</strong> 20<strong>09</strong> John A. Newmeyer, Ph.D. For inquiries concerning this report, please contact John A. Newmeyer, Ph.D., Epidemiologist, Haight- Ashbury Free Clinics, Inc., 2004 Gough Street, San Francisco, CA 941<strong>09</strong>. Phone: 415–931–5420, Fax: 415–776–8823, E-mail: jnewmeyer@aol.com. Overview of Findings: The five-county San Francisco Bay area was hit hard by economic troubles in the last half of 2008. These troubles especially affected the two inland counties (Alameda and Contra Costa), where unemployment rose to 7.2 percent and housing values fell by as much as one-third. The three coastal counties (Marin, San Francisco, and San Mateo) suffered somewhat less, with unemployment at 5.7 percent and housing values down by approximately one-sixth. Recent trends for cocaine and methamphetamine were down for this reporting period, while those for marijuana and prescription painkillers were up. Heroin use was level or up after a long decline. Updated Drug Abuse Trends and Emerging Patterns: Admissions for cocaine were up slightly. However, nearly half of 2008’s emergency department (ED) reports of cocaine were older than 45, and the cost of crack/cocaine at the wholesale and retail level was notably higher. All indicators for heroin were down during the 2004 to 2007 time frame. However, between 2007 and 2008 admissions increased by 9 percent, and the proportion under age 25 among unweighted ED cases rose from 4 to 7 percent. The Heroin Domestic Monitor Program’s (HDMP) local heroin samples for 2007 had the highest price and lowest purity since 2001. Over the most recent 3 years, three indicators for methamphetamine— the share of unweighted ED reports, the reported usage among San Francisco gay men (from ethnographic sources), and the price of the drug at the wholesale and retail levels—all suggest a sharp decline in usage. Unweighted ED data in 2008 Proceedings of the Community Epidemiology Work Group, <strong>January</strong> 20<strong>09</strong> 63
EpidEmiologic TrEnds in drug AbusE: HigHligHTs And ExEcuTivE summAry reflect an aging population based on methamphetamine ED reports, with 28 percent over age 45. Marijuana treatment admissions were up by 15 percent between fiscal years (FYs) 2007 and 2008. There were significant recent increases in the proportions of hydrocodone and oxycodone among unweighted ED reports in the coastal counties but not the inland counties. Phencyclidine (PCP), gamma hydroxybutyrate (GHB), lysergic acid diethylamide (LSD), and ketamine indicators were minimal. HIV/AIDS Update: Acquired immunodeficiency syndrome (AIDS) annual caseload increase is at 2.3 percent among both heterosexual and gay/bisexual male injection drug users over the past reporting period. Data Sources: Treatment admissions data were available for all five bay area counties for FYs 2007 and 2008. These data were compiled by the California Department of Alcohol and Drug Programs. Unweighted ED Drug Abuse Warning Network (DAWN) Live! data from Offce of Applied Studies, Substance Abuse and Mental Health Services Administration were available to report drug mentions in ED visits for 2008, although data for the last few months of the year were incomplete. <strong>Report</strong>s of arrests for drug law violations were provided by the San Francisco Police Department for 2001–2006. Price and purity data came from the Drug Enforcement Administration, HDMP, and referenced heroin “buys” mostly made in San Francisco County. Data for 2007 were compared with those for 2001–2006. Data on traffcking in heroin and other drugs were available from the <strong>National</strong> Drug Intelligence Center and pertained to wholesale, midlevel, and retail prices prevailing in San Francisco in early 2007. AIDS surveillance data were provided by the San Francisco Department of Public Health and covered the period through September 30, 2008. Drug Abuse Patterns and Trends in the Seattle/King County Area—Update: <strong>January</strong> 20<strong>09</strong> Caleb Banta-Green, T. Ron Jackson, Steve Freng, Michael Hanrahan, Mary Taylor, John Ohta, Glenn Baldwin, David H. Albert, Richard Harruff, and Geoff Miller For inquiries concerning this report, please contact Caleb Banta-Green, M.P.H., M.S.W., Ph.D., Research Scientist, Alcohol and Drug Abuse <strong>Institute</strong>, University of Washington, 1107 NE 45th St, Suite 120; Seattle, WA 98105, Phone: 206–685– 3919, Fax: 206–543–5473, E-mail: calebbg@u. washington.edu, Web: http://adai.washington.edu or Ron Jackson, M.S.W., Evergreen Treatment Services, Phone: 206–223–3644, E-mail: ronjack@u. washington.edu. Overview of Findings: No major changes were evident in data available for the Seattle/ King County area for the first half of 2008, compared with prior years, with small numbers and the short time frame precluding trend analyses. Drugs with substantial negative impacts on health and mortality included prescription-type opiates, cocaine, and heroin. Methamphetamine indicators have generally leveled off or declined slightly. Marijuana indoor growing operations are substantial in the Seattle area, and use is common. Alcohol and benzodiazepines continued to be frequently used in combination with other drugs, both among those entering treatment and among those dying from drug overdoses. MDMA is being manufactured in substantial quantities in the adjacent Canadian province of British Columbia and shipped through Washington. MDMA use appeared to continue at moderate levels among young adults in the area. BZP (1-benzylpiperazine) is has emerged as an MDMA-like drug, often sold as MDMA. There is persistent heroin use, mostly in the Seattle area, with increasing prescription opiate use widespread throughout King County. Mortality for heroin is at its lowest point in at least a decade, while prescription-type opiates remained the drugs most commonly identified in fatal overdoses. Updated Drug Abuse Trends and Emerging Patterns: Cocaine was the most common illicit drug identified in unweighted emergency department (ED) reports, with 2,132 reports, double 64 Proceedings of the Community Epidemiology Work Group, <strong>January</strong> 20<strong>09</strong>
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