NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC TRENDS IN DRUG ABUSE Volume II

344 Pages·2005·7.62 MB·English

NATIONAL INSTITUTE ON DRUG ABUSE

EPIDEMIOLOGIC TRENDS
IN DRUG ABUSE

Volume II

Proceedings of the Community Epidemiology Work Group

January 2005

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
NATIONAL INSTITUTES OF HEALTH

Division of Epidemiology, Services and Prevention Research
National Institute on Drug Abuse
6001 Executive Boulevard
Bethesda, Maryland 20892
EPIDEMIOLOGIC TRENDS IN DRUG ABUSE

The National Institute on Drug Abuse (NIDA) ac- at the January 2005 CEWG meeting by CEWG repre-
knowledges the contributions made by the members sentatives from 20 areas. A paper was also submitted
of: the Community Epidemiology Work Group by Mexico. In addition, Volume II contains papers by
(CEWG) who have voluntarily invested their time and experts on a panel on methamphetamine abuse.
resources in preparing the reports presented at the
meetings; representatives from agencies that contribute All material in this volume is in the public domain
data and technical knowledge; and other researchers and may be reproduced or copied without permission
who participate in the meetings. This publication was from the Institute or the authors. Citation of the
prepared by MasiMax Resources, Inc., under contract source is appreciated. The U.S. Government does not
number N01-DA-1-5514 from NIDA. endorse or favor any specific commercial product.
Trade or proprietary names appearing in this publica-
This publication, Epidemiologic Trends in Drug Abuse, tion are used only because they are considered essen-
Volume II, contains papers presented and data reported tial in the context of the studies reported herein.

For more information about the Community Epidemiology Work Group and other re-

search-based publications and information on drug abuse and addiction, visit NIDA’s
Web site at: http://www.drugabuse.gov

Both Volumes I and II (available in limited supply) can be obtained by contacting the
National Clearinghouse for Alcohol and Drug Information

by mail: P.O. Box 2345, Rockville, MD 20852-2345

by phone: [phone]
[phone]
by fax: [phone]

National Institute on Drug Abuse
NIH Publication No. 05-5282
Printed October 2005

ii Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005
EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Foreword

Foreword

This publication includes papers presented at the 57th other drugs. Four other researchers presented data
semiannual meeting of the Community Epidemiology from NIDA-supported studies in a panel on metham-
Work Group (CEWG) held in Long Beach, California, phetamine abuse.
on January 26–28, 2005, under the sponsorship of the
National Institutes of Health, National Institute on Three technical experts participated in a panel fo-
Drug Abuse (NIDA). The CEWG is composed of re- cused on Exploring the Internet as a Potential Tool
searchers from 21 sentinel areas in the Nation who for Monitoring Drug Abuse Trends.
meet semiannually to present data on drug abuse pat-
terns and trends in their areas. CEWG members have Also at the meeting, a Canadian researcher reported
extensive knowledge and experience in community recent survey data from Canada’s drug abuse surveil-
research and their local communities. Members are lance system. In addition, an official from the Mexi-
also informed and have extensive knowledge about the can Ministry of Health provided an update on drug
drug literature, drugs of abuse, drug-abusing popula- abuse patterns and trends in Mexico, based on data
tions, the social and health consequences of drug produced by Mexico’s drug abuse surveillance system.
abuse, drug trafficking patterns, and emerging drug
problems within and across communities. Information reported at each CEWG meeting is dis-
seminated to drug abuse prevention and treatment
As part of the CEWG’s monitoring role, members agencies, public health officials, researchers, and poli-
continue their research between meetings, using the cymakers. The information is intended to alert authori-
Internet, conference calls, and mailings to alert one ties at the local, State, regional, and national levels and
another to new issues and to follow up on issues and the general public to current drug abuse patterns and
emerging drug patterns identified at meetings. Issues trends and emerging drug problems so that appropriate
identified are often added to the agenda of the subse- and timely action can be taken. Researchers also use
quent CEWG meeting. this information to develop research hypotheses that
might explain social, behavioral, and biological issues
At the January 2005 meeting, CEWG members pre- related to drug abuse.
sented recent findings on the abuse of stimulants and

Moira P. O’Brien
Division of Epidemiology, Services and Prevention Research
National Institute on Drug Abuse
National Institutes of Health
Department of Health and Human Services
Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005 iii

EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Contents

Contents

Foreword............................................................................................................................................................ iii
Introduction....................................................................................................................................................... 1
CEWG Roles and Functions............................................................................................................................ 2

EPIDEMIOLOGY OF DRUG ABUSE: CEWG AREA PAPERS

Atlanta: Drug Trends in Metropolitan Atlanta
Brian J. Dew, Ph.D., Kathy S. Newton, M.S., Kirk Elifson, Ph.D.,and Claire Sterk, Ph.D................. 7
Baltimore: Drug Use in the Baltimore Metropolitan Area: Epidemiology
and Trends, 2000–2004 (First Half)
Leigh A. Henderson, Ph.D., and Doren H. Walker, M.S...................................................................... 19
Boston: Patterns and Trends in Drug Abuse: Greater Boston
Daniel P. Dooley.................................................................................................................................. 37
Chicago: Patterns and Trends of Drug Abuse in Chicago
Dita Broz, M.P.H., Matthew Magee, Wayne Wiebel, Ph.D.,
and Lawrence Ouellet, Ph.D................................................................................................................ 51
Denver: Patterns and Trends in Drug Abuse: Denver and Colorado
Nancy E. Brace, R.N., M.A................................................................................................................... 64
Honolulu: Illicit Drug Use in Honolulu and the State of Hawaii
D. William Wood, M.P.H., Ph.D.......................................................................................................... 83
Los Angeles: A Semiannual Update of Drug Abuse Patterns and Trends
in Los Angeles County, California
Beth Finnerty, M.P.H........................................................................................................................... 96
Miami: Drug Abuse in South Florida: January–June 2004
James N. Hall and Madeline Camejo, Pharm.D. ................................................................................ 121
Minneapolis/St. Paul: Drug Abuse Trends in Minneapolis/St. Paul
Carol Falkowski .................................................................................................................................. 136
Newark: Drug Abuse in the Newark Primary Metropolitan Statistical Area
Allison S. Gertel-Rosenberg, M.S.. ...................................................................................................... 145
New Orleans: Drug Abuse Indicators in New Orleans
Gail Thornton-Collins.......................................................................................................................... 155
New York City: Drug Use Trends in New York City
Rozanne Marel, Ph.D., John Galea, M.A., and Robinson B. Smith, M.A............................................ 163
Philadelphia: Drug Use in Philadelphia, Pennsylvania
Samuel J. Cutler and Marvin F. Levine, M.S.W................................................................................... 182
Phoenix: Drug Abuse Trends in Phoenix and Arizona
Ilene L. Dode, Ph.D.............................................................................................................................. 194
St. Louis: Patterns and Trends in Drug Abuse in St. Louis
Heidi Israel, Ph.D., R.N., L.C.S.W., and Jim Topolski, Ph.D.............................................................. 211
Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005 v
EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Contents

San Diego: Drug Abuse Patterns and Trends in San Diego County, California
Michael Ann Haight, M.A. .................................................................................................................. 220
San Francisco: Patterns and Trends of Drug Use in the San Francisco Bay Area
John A. Newmeyer, Ph.D...................................................................................................................... 227
Seattle: Recent Drug Abuse Trends in the Seattle-King County Area
Caleb Banta-Green, T. Ron Jackson, Susan Kingston, Michael Hanrahan, Steve Freng,
David H. Albert, Ann Forbes, and Kris Nyrop .................................................................................... 235
Texas: Substance Abuse Trends in Texas, January 2005
Jane Carlisle Maxwell, Ph.D............................................................................................................... 260
Washington, D.C.: Patterns and Trends of Drug Abuse in Washington, DC
Erin Artigiani, M.A., Margaret Hsu, M.P.H., and Eric Wish, Ph.D.................................................... 289

INTERNATIONAL REPORT

Update of the Epidemiological Surveillance System of Addictions (SISVEA) in Mexico:
January–June 2004
Roberto Tapia-Conyer, Patricia Cravioto, Pablo Kuri, Mario Cortés, and Fernando Galván.......... 305

PANEL ON METHAMPHETAMINE ABUSE: NIDA-SUPPORTED RESEARCH STUDIES

Natural History of Methamphetamine Abuse and Long-Term Consequences
Mary-Lynn Brecht, Ph.D...................................................................................................................... 319
Prenatal Exposure to Methamphetamine and Child Development
Barry Lester, Ph.D., Linda LaGasse, Ph.D., Lynne M. Smith, M.D.,
Chris Derauf, M.D., Penny Grant, M.D., Rizwan Shah, M.D., Amelia Arria, Ph.D.,
Marilyn Huestis, Ph.D.,and Jing Liu, Ph.D.1....................................................................................... 320
Evidence-Based Approaches for Addressing Methamphetamine Use Among Gay Urban Males
Cathy J. Reback, Ph.D. ........................................................................................................................ 322
Predicting Relapse in Methamphetamine-Dependent Individuals
Martin P. Paulus, M.D. ....................................................................................................................... 324

APPENDIX A

New Drug Abuse Warning Network (DAWN) Emergency Department Data
and DAWN Live!: Major Features................................................................................................................ 329

PARTICIPANTS

Participant List................................................................................................................................................. 333

vi Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005
EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Introduction

Introduction

Moira P. O’Brien, NIDA

This publication includes papers based on informa- These papers focus on the natural history of metham-
tion and findings on drug abuse that were presented phetamine abuse, long-term consequences, effects of
at the January 2005 Community Epidemiology Work prenatal exposure, and issues associated with the
Group meeting in Long Beach, California. treatment of methamphetamine abuse. This panel con-
tinued a precedent begun in June 2003, in which a par-
The papers of the CEWG representatives provide the ticular emerging/current drug abuse trend is examined
most recent indicator data on a range of abused drugs in greater depth than is possible through CEWG area
from 20 geographically dispersed areas in the Nation, reports. The approach draws on NIDA-supported re-
with special attention devoted to the major theme of search and complements CEWG findings.
the January meeting––stimulant abuse.
Of note to readers is the fact that 15 CEWG members
Over several years, CEWG monitoring efforts led to reported emergency room data for the first time from
concern about two central nervous system (CNS) the redesigned Drug Abuse Warning Network
stimulants––cocaine and methamphetamine. There (DAWN). Since the inception of the CEWG, DAWN
were continued reports of increases in metham- has been an important source of data. The major
phetamine abuse in some areas and high levels of changes were instituted in DAWN at the beginning of
cocaine abuse in many CEWG areas. From indicator 2003 and altered virtually every feature of DAWN
trends, it was clear that methamphetamine abuse had except its name. As a result of the redesign, new
been prominent in the West and Southwest for many DAWN data cannot be compared with DAWN ED
years; from the more recent trends, there appeared to data from 2002 and before. Interim national estimates
be a gradual spread of methamphetamine abuse into of drug-related emergency department visits from the
the Midwest and areas further east and south in the new DAWN for 2003 have been published
United States. Cocaine persisted as a major abused (<http:DAWNinfo.samhsa.gov>). There are, however,
drug, maintaining a prominent position in the drug no metropolitan area estimates available for 2003 or
abuse indicators, including treatment admissions 2004. For the papers presented in this publication,
data. Indicators of methylphenidate (Ritalin) ap- CEWG representatives accessed preliminary raw data
peared infrequently over time. Methylenedioxyme- from the online real-time query system called DAWN
thamphetamine (or ecstasy), which may be classified Live!, which is limited to authorized users.
as a hallucinogen, also acts as a CNS stimulant. Indi-
cator data, however, suggest the use of this drug has Accessing DAWN Live! data, CEWG members re-
been declining in most CEWG areas. ported raw and unweighted reports of individual
cases from participating hospitals, not population-
Given the concern regarding the higher abuse levels based estimates as have been presented in previous
of cocaine and methamphetamine compared to other CEWG reports. CEWG area representatives have
stimulant drugs, CEWG representatives devoted been granted access to DAWN Live! and have been
much of their preparation for meeting presentations trained in its use. A session during the January 2005
and papers to data on these two stimulant drugs. In meeting was devoted to a discussion of the potential
addition, colleagues from Mexico provided a com- for meaningfully incorporating data from this real-
parative perspective on the problems of cocaine and time, raw data into the CEWG. A brief description of
methamphetamine abuse in Mexico. The contribu- the new DAWN ED system and DAWN Live! is in-
tions of the CEWG members and Mexican research- cluded in Appendix A.
ers on cocaine and methamphetamine abuse are re-
flected in their papers in this publication. In the next section, the roles and functions of the
CEWG are described briefly. Papers of the CEWG
Also in this publication are papers summarizing find- representatives, the Mexican researchers, and the
ings from a special panel on methamphetamine abuse. methamphetamine panel members follow.

Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005 1
EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—CEWG Roles and Functions

CEWG Roles, Functions, and Attributes

Role of the CEWG tion is disseminated quickly to alert authorities at the
local, State, regional, and national levels to current and
At semiannual meetings and through ongoing commu- emerging drug problems so that appropriate action can
nication via e-mail, conference calls, and mailings of be taken. Researchers use the information to develop
relevant data, the CEWG serves as a unique epidemi- research hypotheses that might explain social, behav-
ologic surveillance network to inform drug abuse pre- ioral, and biological issues related to drug abuse.
vention and treatment agencies, public health officials,
policymakers, researchers, and the general public about The 21 areas currently represented by the CEWG are
current and emerging drug abuse patterns. The informa- depicted in the map below.

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The Functions of the CEWG Meetings Presentations by each CEWG member include a com-
pilation of quantitative drug abuse indicator data.
The interactive semiannual meetings are a major and Members go beyond publicly accessible data and pro-
distinguishing feature of the CEWG. The meetings vide a unique local perspective gained from both pub-
provide a foundation for continuity in the monitoring lic records and qualitative research. This information is
and surveillance of current and emerging drug prob- typically obtained from local substance abuse treat-
lems and related health consequences. Through the ment providers and administrators, personnel of other
interactive sessions, the CEWG accomplishes the fol- health-related agencies, law enforcement officials, and
lowing: drug abusers. Time at each meeting is devoted to pres-
entations by invited speakers.
• Dissemination of the most up-to-date information
on drug abuse patterns and trends in each CEWG Identification of changing drug abuse patterns is
area part of the interactive discussions at each CEWG
meeting. Through this process, members alert one
• Identification of changing drug abuse patterns and another to the emergence of a potentially new drug
trends within and across CEWG areas of abuse that may spread from one area to another.
In this role, the CEWG has pioneered in identifying
• Planning for followup on identified problems and the emergence of drug epidemics and patterns of
emerging drug abuse patterns abuse, such as those involving abuse of methaqualone
(1979), crack (1983), methamphetamine (1983), and
2 Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005
EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—CEWG Roles and Functions

“blunts” (1993). MDMA abuse indicators were first health consequences of drug abuse; drug traffick-
reported by CEWG members in December 1985. ing and other law enforcement patterns; and
emerging drugs within and across communities
Planning for followup on issues and problems identi-
fied at a meeting is initiated during discussion ses- • Ongoing collaborative relationships with one an-
sions, with post-meeting planning continuing through other and other researchers and experts in the
e-mails and conference calls. Post-meeting communi- field, which allows for both learning about new is-
cations assist in formulating agenda items for a subse- sues and sharing information
quent meeting, and they also raise new issues for
exploration at the following meeting. • The capability to access relevant drug-related data
from the literature, media, and Federal, State,
Attributes of the CEWG community, and neighborhood sources

CEWG members bring the following attributes to the • An understanding of the strengths and limitations
network: of each data source

• Extensive experience in community research, • The skills required to systematically analyze and
which over many years has fostered information synthesize multiple sources of information, and
sharing between members and local agencies interpret findings within the community context

• Knowledge about their local communities, drugs, Major indicators and primary quantitative data sources
and drug-abusing populations; the social and used by CEWG members are cited in their reports.
Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005 3