1 Drug abuse trends in Minneapolis/St. Paul, Minnesota January 2013 update Carol Falkowski Drug Abuse Dialogues Abstract Heroin'related admissions to treatment continued to rise in the Twin Cities in 2012, while admissions related to other opiates fell somewhat. Heroin accounted for a record'high 12.5 percent of all admissions to addiction treatment in 2012 (first half) compared with 10.7 percent in 2011. Other opiates (mostly prescription painkillers) accounted for 9.0 percent of all treatment admissions in 2012 (first half) compared with 9.5 percent in 2011. Combining these, however, 21.5 percent of all treatment admissions in 2012 (first half) were for opiate addiction, second only to admissions for alcohol (46.5 percent). At the same time, indicators related to the treatment of marijuana, methamphetamine and cocaine addiction remained stable. Concern over the use of emerging synthetic substances that are consumed for their stimulant and hallucinogenic drug'like effects continued in 2012. Reported exposures to Hennepin Regional Poison Center for cannabimimetic THC homologs (“synthetic THC” sold as incense,) grew from 28 in 2010, to 149 in 2011, to 157 in 2012. Reported exposures 2C' E and its analogues (sold as “research chemicals,”) were 10 in 2010, 23 in 2011 and 24 in 2012. Reported exposures to synthetic cathinone compounds (sold as “bath salts,”) grew from 5 in 2010, to 144 in 2011, and fell to 87 in 2012. INTRODUCTION This report is produced twice annually for an epidemiological surveillance network of the National Institute on Drug Abuse, and presents the most recent data and information from multiple sources. AREA DESCRIPTION The Minneapolis/St. Paul (“Twin Cities”) metropolitan area includes Minnesota’s largest city, Minneapolis (Hennepin County), the capital city of St. Paul (Ramsey County), and the surrounding counties of Anoka, Dakota, and Washington. The 2010 Census indicates a state population of 5,303,925. The population of the five metropolitan area counties combined is 2,756,950, according to the Minnesota State Demographic Center. In the fiveUcounty metropolitan area, 80.1 percent of the population is White. AfricanUAmericans constitute the largest minority group (9.1 percent,) Asians account for 6.1 percent, American Indians 0.7 percent, and Hispanics of all races 6.0 percent. Outside of the Twin Cities metropolitan area, Minnesota is less densely populated and more rural in character. Illicit drugs are sold and distributed within Minnesota by Mexican drug trafficking organizations, street gangs, independent entrepreneurs, and other criminal organizations. Drugs are typically transported into the Twin Cities metro area and then further distributed throughout the State. Minnesota
A new report on drug trends in the Twin Cities shows heroin use remains a growing problem, while the abuse surrounding of opiate-based pain killers, like methadone and OxyContin, may be slowing.
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Percent of admissions to Twin Cities addiction treatment programs by primary substance problem - 2012 (first half)
SOURCE: Drug and Alcohol Abuse Normative Evaluation System (DAANES), Minnesota Department of Human Serv ices, 2012. Total number of treatment admissions from January through June 2012 = 10,670.
Heroin 12.5%
Other opiates9.0%
Methamphetamine6.9%
Cocaine5.8%
Marijuana16.8%
Alcohol46.5%
Other/Missing2.5%
exhibit 1
Number of Twin Cities treatment admissions with cocaine as the primary substance problem: 2007 through June 2012 (by quarter)
SOURCE: Drug and Alcohol Abuse Normative Evaluation System (DAANES), Minnesota Department of Human Services, 2012.
Characteristics of patients admitted to Twin Cities addiction treatment programs by primary substance problem: 2012 (first half)
SOURCE: Drug and Alcohol Abuse Normative Evaluation System (DAANES), Minnesota Department of Human Services, 2012. Excludes 208 cases (1.9 percent) with "other" primary substance problems, and 57 (0.5 percent) unknown.
Patient gender by primary substance problem among admissions to Twin Cities addiction treatment programs: 2012 (first half)
SOURCE: Drug and Alcohol Abuse Normative Evaluation System (DAANES), Minnesota Department of Human Services, 2012.
32.1
21.6
44.736.6 34.4
47.9
67.9 78.4 55.3 63.4 65.6 52.1
alcohol MJ cocaine meth- heroin other-opiates0%
20%
40%
60%
80%
100%percent of admiss ions
female male
exhibit 4
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3
Patient age by primary substance problem among admissions to Twin Cities addiction treatment programs: 2012 (first half)
SOURCE: Drug and Alcohol Abuse Normative Evaluation System (DAANES), Minnesota Department of Human Services, 2012.
alcohol& MJ cocaine meth heroin other&opiates0%
20%
40%
60%
80%
100%percent of admissions
age 35 plus age 26 - 34 age 18 - 25 age 17 and under
exhibit 5
Patient race/ethnicity by primary substance problem among admissions to Twin Cities addiction treatment programs: 2010 (first half)
SOURCE: Drug and Alcohol Abuse Normative Evaluation System (DAANES), Minnesota Department of Human Services, 2012.
alcohol MJ cocaine meth heroin other.opiates0%
20%
40%
60%
80%
100%percent of admissions
White African Am Am Indian Hispanic Asian Other
exhibit 6
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4
Most frequently identified drugs of total analyzed drug reports in Minneapolis/St. Paul: 2012 (first half)
SOURCE: National Forensic Laboratory Information System (NFLIS), U.S. Drug Enforcement Administration, 12/12/2012. Excludes data from St. Paul Police Department Laboratory after May 2012. These data represent primary, secondary and tert iary drug reports which were identif ied from seized and analyzed drug items from January through June 2012 in the 7-county metro area (counties: Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, and Washington). BZP = 1-benzylpiperazine .
872
817
711
381
112
82
82
72
57
55
882
Marijuana/cannabis
Methamphetamine
Cocaine
Heroin
Acetaminophen
BZP
Oxycodone
Caffeine
6 - Monoacetylmorphine
Acetylcodeine
All other
0 200 400 600 800 1000
21.1%
19.8%
17.2%
9.2%
2.7%
2.0%
21.4%
1.7%
1.4%
1.3%
2.0%
exhibit 7
Number of Twin Cities treatment admissions with heroin and other opiates as primary substance problem: 2007 through June 2012 (by quarter)
SOURCE: Drug and Alcohol Abuse Normative Evaluation System (DAANES), Minnesota Department of Human Services, 2012.
SOURCE: Drug and Alcohol Abuse Normative Evaluation System (DAANES), Minnesota Department of Human Services, 2012. Metro refers to the 7-county metropolitan area of Minneapolis/St. Paul, Minnesota. Non-metro refers to all other Minnesota counties.
Percentage of Minnesota treatment admissions for heroin and other opiates by county of patient residence: 2007 – 2011
SOURCE: Automation of Reports and Consolidated Orders System (ARCOS) , US Drug Enforcement Administration (DEA), 2010
12.6 = Florida 11.8 = Tennessee, Nevada 11.6 = Oregon 10.2 = Delaware 9.8 = Maine 9.7 = Alabama 9.2 = Washington, Oklahoma 9.0 = Kentucky 8.1 = Michigan 7.9 = Ohio 7.5 = Idaho 7.2 = Missouri 6.5 = Wisconsin 6.2 = California 5.5= South Dakota 5.0 = North Dakota 4.6 = Iowa 4.2 = Minnesota 3.9 = District of Columbia 3.7 = Illinois US overall = 7.1
exhibit 10
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SOURCE: Automation of Reports and Consolidated Orders System (ARCOS), U.S. Drug Enforcement Administration, 2012. Prescription painkillers include: codeine, fentanyl, hydrocodone, hydromorphone, meperidine, morphine and oxycodone.
Prescription painkillers sold in Minnesota - 2011 exhibit 11
Up to 2,200 2,201 to 2,800 2,801 to 3,300 3,301 and up
Prescription painkillers sold in Minnesota Percent change 2005 - 2011
SOURCE: Automation of Reports and Consolidated Orders System (ARCOS), U.S. Drug Enforcement Administration, 2012. Prescription painkillers include: codeine, fentanyl, hydrocodone, hydromorphone, meperidine, morphine and oxycodone.
exhibit 12
Up to 19 % 20 to 39% 40 to 49% 50% and higher
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Oxycodone prescriptions sold in Minnesota - 2011
SOURCE: Automation of Reports and Consolidated Orders System (ARCOS), U.S. Drug Enforcement Administration, 2012.
exhibit 13
Up to 600 601 to 999 1,000 to 1,200 1,201 to 1,940
Oxycodone prescriptions sold in Minnesota
Percent change 2005 -2011
SOURCE: Automation of Reports and Consolidated Orders System (ARCOS), U.S. Drug Enforcement Administration, 2012.
exhibit 14
-3% decline 1 to 45% increase 46 to 90% increase 91 to 124% increase
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Exposures to selected drugs reported to Hennepin Regional Poison Center: 2009 - 2012
SOURCE: Hennepin Regional Poison Center, Hennepin County Medical Center, 2013.
2009 2010 2011 2012THC
Homologs 0 28 149 157
Bath Salts 0 5 144 87
2CE and analogues 5 10 23 24
Heroin 41 52 78 127LSD 9 7 15 37
MDMA 42 26 24 19
exhibit 15
Number of Twin Cities treatment admissions with methamphetamine as the primary substance problem: 2007 through June 2012 (by quarter)
SOURCE: Drug and Alcohol Abuse Normative Evaluation System (DAANES), Minnesota Department of Human Services, 2012.