National Institute on Drug Abuse Community Epidemiology Work Group (CEWG)

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2

National Institute on Drug Abuse Community Epidemiology

Work Group (CEWG)

Established 1976

NIDA Community Epidemiology Work Group

Texas

Cincinnati

Atlanta

Ft. Lauderdale/Miami

St. Louis

ChicagoDetroit

Minneapolis/St. Paul

BostonNew York

PhiladelphiaWashington D.C.

Phoenix

Denver

Seattle

Los Angeles

San Diego

San Francisco

Honolulu

Maine

United States Drug Observatories

3


Texas

Cincinnati

Atlanta


St. Louis

ChicagoDetroit


BostonNew York


Phoenix

Denver

Seattle

Los Angeles

San Diego

San Francisco

Honolulu

Maine


Albuquerque

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Goals:• To Characterize Changes in Drug Use

• To Provide Early Identification of New Patterns and Emerging Drug Abuse issues

2


Texas

Cincinnati

Atlanta


St. Louis

ChicagoDetroit


BostonNew York


Phoenix

Denver

Seattle

Los Angeles

San Diego

San Francisco

Honolulu

Maine


Albuquerque

2


Texas

Cincinnati

Atlanta


St. Louis

ChicagoDetroit


BostonNew York


Phoenix

Denver

Seattle

Los Angeles

San Diego

San Francisco

Honolulu

Maine


Albuquerque

Key FindingsJanuary 2013

2


Texas

Cincinnati

Atlanta


St. Louis

ChicagoDetroit


BostonNew York


Phoenix

Denver

Seattle

Los Angeles

San Diego

San Francisco

Honolulu

Maine


Albuquerque


1. Outbreaks of New Heroin Epidemics among White, young adults (aged 18-30) Rx Opioid Abusers and Addicts

2


Texas

Cincinnati

Atlanta


St. Louis

ChicagoDetroit


BostonNew York


Phoenix

Denver

Seattle

Los Angeles

San Diego

San Francisco

Honolulu

Maine


Albuquerque


2. Cocaine still a major problem but with declining consequences in all areas

Jan-M

ar07

Apr-Ju

n07

Jul-S

ep07

Oct-Dec

07

Jan-M

ar08

Apr-Ju

n08

Jul-S

ep08

Oct-Dec

08

Jan-M

ar09

Apr-Ju

n09

Jul-S

ep09

Oct-Dec

09

Jan-M

ar10

Apr-Ju

n 10

Jul-S

ept10

Oct-Dec

10

Jan-M

ar11

Apr-Ju

n11

Jul-S

ept11

Oct-Dec

11

Jan-M

ar12

Apr-Ju

n12

$0

$50

$100

$150

$200

$250

0.00

20.00

40.00

60.00

80.00

100.00

$97.64

$117.63$128.10

$114.87$122.72$123.91

$181.04

$197.02

$172.66

$173.97$174.49

$191.95

$191.35

$194.45

$174.71

$173.87

$185.57$175.87

$164.86

$166.24

$168.90$175.16

67.1

59.256.8

60.957.3 57.2

46.2 44.547.9 48.3

45.4 45.6 44.6 44.8 45.948.3 48.4 49.1 48.5 49.9 49.6 48.1

Pric

e Pe

r Pur

e G

ram

Purit

y in

Per

cent

67.1 %

All Cocaine Purchases Domestic STRIDE Data

January 2007 – June 2012

* * STRIDE is a database of drug exhibits sent to DEA laboratories from the DEA, FBI, CBP, ICE, USCG, and Washington MPD. STRIDE is not a representative sample of drugs available in the United States, but reflects all evidence submitted to DEA laboratories for analysis. STRIDE data are not collected to reflect national market trends. Nonetheless, STRIDE data reflect the best information currently available on changes in cocaine price and purity.

From January 2007 through June 2012, the price per pure gram of Cocaine increased 79.4%, from $97.64 to $175.16 while the purity decreased 28.3%, from 67.1% to 48.1%.

*During 2nd Qtr. 2012, the number of cocaine samples analyzed for the STRIDE dataset decreased significantly as compared to 1st Qtr. 2012 due to resource limitations.

8

48.1 %

$ 175.16

$ 97.64

2


Texas

Cincinnati

Atlanta


St. Louis

ChicagoDetroit


BostonNew York


Phoenix

Denver

Seattle

Los Angeles

San Diego

San Francisco

Honolulu

Maine


Albuquerque


3. Most drug deaths involve a combination of benzodiazepine (depressant) with opioid (narcotic pain reliever)

Percent of Other Drugs Detected in the 1,185 Lethal Oxycodone Deaths in Florida: 2009

Benzo-di-

azepine

Another Opioid

Carisoprodal Other Drugs No Other Drug0%

10%

20%

30%

40%

50%

60%

70%

80%72%

42%

12% 9% 7%

Source: Analysis of 2009 Florida Medical Examiner Commission Complete Electronic Database by Nova Southeastern University Center for Study & Prevention of Substance Abuse

% D

etec

ted

49.2 46.7 41.5 13.6* 28.7*

22.5 35.1

27.7

41.8

42.9* 0.0*39.2

135.68.0*

17.7*22.221.8

62.2

14.8* 104.237.0

63.9

103.2

144.0

76.395.380.137.9

69.160.4

75.4

14.9

14.8*

14.9

13.7*

19.4

16.8*

63.322.7*

11.5 46.5

11.3*

4.5*

0.0*

118.2

9.0*

24.5

38.215.5*

11.4

17.8*

13.2

42.9

26.8

12.09.5 13.7

10.5*

5.8*

33.1

9.1*

25.5

18.2

15.1

49.2 46.7 41.5 13.6* 28.7*

22.5 35.1

27.7

41.8

42.9* 0.0*39.2

135.68.0*

17.7*22.221.8

62.2

14.8* 104.237.0

63.9

103.2

144.0

76.395.380.137.9

69.160.4

75.4

14.9

*

* Bernalillo County1,521 enrollees96 OD Reversals77 Heroin Deaths

Rio Arriba County279 enrollees166 OD Reversals12 Heroin Deaths

Santa Fe County50 enrollees12 OD Reversals19 Heroin Deaths

Enrollees elsewhere: 79OD Reversals elsewhere: 4Heroin Deaths elsewhere: 55

Top Counties with Opiate Drug Overdose Deaths and DOH Harm Reduction (Naloxone) Efforts, 2010-2011

Source: OMI and DOH Harm Reduction Program.

NOTE: Clients have the opportunity to enroll in the Naloxone Program at state-funded syringe exchange sites and some public health offices. 391 Reversals

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Texas

Cincinnati

Atlanta


St. Louis

ChicagoDetroit


BostonNew York


Phoenix

Denver

Seattle

Los Angeles

San Diego

San Francisco

Honolulu

Maine


Albuquerque


4. Marijuana is ubiquitous! # 1 for rise in “drugged driving”

Current (past 30-day) Marijuana Use Among Broward County Middle and High School Students

2000-2012

Source: Florida Youth Substance Abuse Surveys 2000-2012

2000 2002 2004 2006 2008 2010 201202468

101214161820

17.2

13.9 14.511.4

14 15.3

19

4.5 5.2 5

2.5 3.5 4.3

3.7

High School Middle School

% R

epor

ting

Cur

rent

Use

Percent of high school students having ridden or driven in the past 30 days with or as driver

having used marijuana or alcoholRODE with Driver who had used

marijuana or alcohol

Florida Miami-Dade Broward0

5

10

15

20

25

30

25.4 24.527.0

21.4 20.518.4

Marijuana Alcohol

DROVE after using marijuana or drinking alcohol

Florida Miami-Dade Broward0

5

10

15

20

25

30

11.2 10.8 10.98.1 9

7% R

epor

ting

% R

epor

ting

Source: FL-DCF - 2012 Florida Youth Substance Abuse Survey

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Texas

Cincinnati

Atlanta


St. Louis

ChicagoDetroit


BostonNew York


Phoenix

Denver

Seattle

Los Angeles

San Diego

San Francisco

Honolulu

Maine


Albuquerque


5. Emerging synthetic drugs such as fake marijuana and stimulants may have peaked in mid 2012 with less retail access but more illicit street sales

Methylone isbeta-ketone MDMA

Molly

Molly’sNot Pure MDMA but….

methylone

bk- 3,4 methylenedioxy-methcathinone

96 Crime Lab Cases March – October 2012 in Broward County

276 Crime Lab Cases in Miami-Dade County during 2012

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Texas

Cincinnati

Atlanta


St. Louis

ChicagoDetroit


BostonNew York


Phoenix

Denver

Seattle

Los Angeles

San Diego

San Francisco

Honolulu

Maine


Albuquerque


6. Methamphetamine consequences are stable (low where they have been low and high where they have been high). ? d or l

Taos AliveImproving a Community in Pain By Julie Martinez CPS

DEA Take Back

April 28, 2012 – 20 kg Collected• Taos Police• Tribal Police • Taos County SherriffSeptember 29, 2012 - • Taos Police• Tribal Police• State Police • Taos County Sherriff• Questa Police • Colorado State TroopersApril 27, 2013 Next one.

Permanent Drop Box

Brochure for Prescriptions

Lockyouremeds.org

Environmental Strategies

Prescriber TrainingHospital Opiate Prescribing GuidelinesNon-DEA Take Back

Holy Cross Hospital ER Opiate Prescribing Guidelines

Narcan Project

Modeled on Project Lazarus. to reverse OD and keeping people alive until they can seek treatment.

Also help prevent accidental OD for children or adults taking sedative combinations.

Safecommunity.

net

Substance Abuse Prevention

Integrate Mental Health Care Early Intervention.

Drug Treatment.And Recovery

Reduce AccessTo Drugs

Reduce Inappropriate Rx Use

Improve Poisoning

Interventions

Patient Education

for Narcan

Kit

Prescription Drug Abuse Initiative of Taos Alive

Increase use of PDMP by local

providers

Presentations to High Schools and Senior Centers

What is Project ECHO?

Extension for Community Healthcare OutcomesInitial focus on expanding access to hepatitis C treatmentGoal: Help Primary Care Practitioners in underserved areas to deliver treatment that has previously been provided only by specialists

National Institute on Drug Abuse Community Epidemiology Work Group (CEWG)

Documents

drug deaths

reversals53 deaths

opiate drug overdose

drug use

addicts key findingsjanuary

lethal oxycodone deaths

cocaine price

stride dataset