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Trends in Drug Abuse Trends in Drug Abuse PDF

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SSppeecciiaall TTooppiicc:: TThhee IImmppaacctt ooff SSeepptteemmbbeerr 1111 PULSE CHECK PULSE CHECK TTrreennddss iinn DDrruugg AAbbuussee JJuullyy––DDeecceemmbbeerr 22000011 RReeppoorrttiinngg PPeerriioodd EExxeeccuuttiivvee OOffffiiccee ooff tthhee PPrreessiiddeenntt OOffffiiccee ooff NNaattiioonnaall DDrruugg CCoonnttrrooll PPoolliiccyy AApprriill 22000022 PULSE CHECK Trends in Drug Abuse April 2002 Executive Office of the President Office of National Drug Control Policy Washington, DC 20503 NCJ 193398 ACKNOWLEDGEMENTS ACKNOWLEDGEMENTS The Office of National Drug Control Policy (ONDCP) acknowledges the contributions made by the 75 Pulse Check sources who voluntarily prepared for and participated in the in-depth discussions that are the basis for this report. Their names (unless they requested anonymity) appear in an appendix. Information presented in this publication reflects the views of those sources, and not necessarily those of the Federal Government. Marcia Meth and Rebecca Chalmers of Johnson, Bassin & Shaw, Inc., produce the Pulse Check for ONDCP, under Contract Number 282-98-0011, Task Order Number 10. Anne McDonald Pritchett, Office of Planning and Budget, ONDCP, serves as the project director and editor for Pulse Check. All material in this publication is in the public domain and may be reproduced or copied without permission from ONDCP. Citation of the source is appreciated. The U.S. Government does not endorse or favor any specific commercial product. Trade or proprietary names appearing in this publication are used only because they are considered essential in the context of the information reported. This issue and previous issues of Pulse Check are available online at <www.whitehousedrugpolicy.gov>. CONTENTS CONTENTS Highlights. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Special Topic: The Impact of September 11. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Heroin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Crack Cocaine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Powder Cocaine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Marijuana. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Methamphetamine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Diverted Synthetic Opioids. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Ecstasy and Club Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Appendix 1: Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 Appendix 2: Population Demographics in the 20 PPuullssee CChheecckkSites. . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 Appendix 3: National-Level Data Sources Available in the 20 PPuullssee CChheecckkSites . . . . . . . . . . . . . . . . . . 71 Appendix 4: PPuullssee CChheecckkSources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 Appendix 5: List of Discussion Areas by Source Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 EXHIBITS Highlights Exhibit 1. How serious is the perceived drug problem in the 20 Pulse Check communities (fall 2001)? . . . . . . . . . . . . .1 Exhibit 2. How has the perceived drug problem changed (spring 2001 vs fall 2001)? . . . . . . . . . . . . . . . . . . . . . . . . . .1 Exhibit 3. What are the most serious drug problems in the 20 Pulse Check sites, by type of source? . . . . . . . . . . . . . . .2 Exhibit 4. What are the most serious drug problems in the 20 Pulse Check sites, by number of sources and sites? . . . . .2 Exhibit 5. What new problems have emerged or intensified during fall 2001? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 Exhibit 6. In what other crimes are illicit drug sellers involved across Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . .4 Exhibit 7. How has the perceived drug problem changed (spring 2001 vs fall 2001)? . . . . . . . . . . . . . . . . . . . . . . . . . .5 Pulse Check: April 2002 page iii CONTENTS Special Topic: The Impact of September 11 Exhibit 1. How have availability of and demand for illegal drugs reportedly changed across the 20 Pulse Check th cities since September 11 ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 Heroin Exhibit 1. How available is heroin across the 20 Pulse Check cities (fall 2001)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 Exhibit 2. How has overall heroin availability changed (spring 2001 vs fall 2001)? . . . . . . . . . . . . . . . . . . . . . . . . . .14 Exhibit 3. Which heroin varieties have changed in availability (spring 2001 vs fall 2001)? . . . . . . . . . . . . . . . . . . . . .14 Exhibit 4. What are the prices and purity levels of different types of heroin in 19 Pulse Check cities? . . . . . . . . . . . . .15 Exhibit 5. How is heroin referred to, and what types of heroin predominate, in different regions of the country? . . . .16 Exhibit 6. How likely are heroin sellers to use their own drug? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 Exhibit 7. What other drugs do heroin dealers sell? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18 Exhibit 8. What demographic groups predominate among heroin users, according to different Pulse Check sources? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 Exhibit 9. How do users administer heroin? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22 Crack Cocaine Exhibit 1. How available is crack cocaine across the 20 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25 Exhibit 2. How has crack cocaine availability changed (spring 2001 vs fall 2001)? . . . . . . . . . . . . . . . . . . . . . . . . . . .26 Exhibit 3. What are crack cocaine price levels in the 20 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27 Exhibit 4. How is crack cocaine referred to across different regions of the country? . . . . . . . . . . . . . . . . . . . . . . . . .28 Exhibit 5. What age group is most likely to use crack? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29 Exhibit 6. Which genders are the predominant users of specific drugs in the 20 Pulse Check cities? . . . . . . . . . . . . . .30 Exhibit 7. What racial/ethnic group is most likely to use crack? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31 Powder Cocaine Exhibit 1. How available is powder cocaine across the 20 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33 Exhibit 2. How has powder cocaine availability changed (spring 2001 vs fall 2001)? . . . . . . . . . . . . . . . . . . . . . . . . .34 Exhibit 3. How much do grams and "eightballs" of powder cocaine cost in 15 Pulse Check cities? . . . . . . . . . . . . . . . .34 Exhibit 4. How is powder cocaine referred to across different regions of the country? . . . . . . . . . . . . . . . . . . . . . . . .35 Exhibit 5. What racial/ethnic group is most likely to use specific drugs? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36 Exhibit 6. What other drugs do powder cocaine users take? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38 Marijuana Exhibit 1. How available is marijuana across the 20 Pulse Check cities (fall 2001)? . . . . . . . . . . . . . . . . . . . . . . . . . .39 Exhibit 2. How has marijuana availability changed (spring 2001 vs fall 2001)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39 Exhibit 3. Which marijuana varieties have changed in availability (spring 2001 vs fall 2001)? . . . . . . . . . . . . . . . . . . .40 Exhibit 4. How much does marijuana cost in 19 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41 Exhibit 5. How is marijuana referred to in different regions of the country? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42 Exhibit 6. What age group is most likely to use marijuana? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43 page iv Pulse Check: April 2002 CONTENTS Exhibit 7. Where are drug users most likely to reside? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43 Exhibit 8. How are different drug users referred to treatment? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45 Methamphetamine Exhibit 1. How available is methamphetamine across the 20 Pulse Check cities (fall 2001)? . . . . . . . . . . . . . . . . . . . .47 Exhibit 2. How has methamphetamine availability changed (spring 2001 vs fall 2001)? . . . . . . . . . . . . . . . . . . . . . . .48 Exhibit 3. How much does methamphetamine cost in 14 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49 Exhibit 4. How is methamphetamine referred to in different regions of the country? . . . . . . . . . . . . . . . . . . . . . . . . .49 Diverted Synthetic Opioids Exhibit 1. Where are the diversion and abuse of OxyContin® emerging across the 20 Pulse Check cities? . . . . . . . . . .53 Exhibit 2. How available is diverted OxyContin® across the 20 Pulse Check cities (fall 2001)? . . . . . . . . . . . . . . . . .54 Exhibit 3. How has diverted OxyContin® availability changed (spring 2001 vs fall 2001) . . . . . . . . . . . . . . . . . . . . .55 Exhibit 4. How has the number of novice OxyContin® treatment clients changed (spring 2001 vs fall 2001)? . . . . . .56 Ecstasy and Club Drugs Exhibit 1. Where is ecstasy emerging across the 20 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59 Exhibit 2. How available are ecstasy and GHB across the 20 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . .60 Exhibit 3. Has ecstasy or GHB availability changed across the 20 Pulse Check cities (spring 2001 vs fall 2001)? . . . . .60 Exhibit 4. How are club drugs and club drug combinations referred to across Pulse Check cities? . . . . . . . . . . . . . . . .61 Exhibit 5. How are ecstasy pills labeled in reporting Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .62 Exhibit 6. How much does a pill (one dose) of ecstasy cost in 18 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . .62 Exhibit 7. Has the number of novice ecstasy users in treatment changed (spring 2001 vs fall 2001)? . . . . . . . . . . . . . .64 Exhibit 8. What are club drug prices? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65 Exhibit 9. What are the predominant characteristics of club drug sellers and sales? . . . . . . . . . . . . . . . . . . . . . . . . . .66 Exhibit 10. What are the predominant characteristics of club drug users and use? . . . . . . . . . . . . . . . . . . . . . . . . . . .66 Pulse Check: April 2002 page v This page intentionally left blank. page vi Pulse Check: April 2002 HIGHLIGHTS PULSE CHECK HIGHLIGHTS✛ This report is based on discussions with 75 epidemiologists, ethnographers, law enforcement officials, and methadone and non-methadone treatment providers from 20 Pulse Check sites. Telephone discussions with these individuals, conducted between November 2001 and January 2002, reveal that overall, when comparing spring and fall 2001, the majority of Pulse Check sources believe their communities’ drug abuse problem to be very serious but stable. (Exhibits 1 and 2) Exhibit 1. How serious is the perceived drug problem in the 20 Pulsse The illicit drug situation is characterized by several key features: Checckcommunities (fall 2001)? ➤The September 11 terrorist attacks and subsequent events had varied Percent(N=75) short- and long-term effects on illegal drug availability, trafficking routes 100 and modes, local marketing strategies, and use patterns in 16 of the 20 90 sites. 80 70 ➤Heroin has surpassed crack as the drug associated with the most serious 60 consequences, as perceived by 27 sources in 17 sites. (Exhibits 3 and 4) 50 40 ➤The number of female heroin users has increased in four cities, where 30 sources are increasingly seeing gender equity among a number of chronic 20 drug users. 10 ➤Marijuana remains the most widely abused illicit drug, as reported by 35 0 sources in 18 sites. Sources in two sites report it as the drug with the most Very Somewhat Not Very Serious Serious Serious serious consequences. (Exhibits 3 and 4) Sources: Law enforcement, epidemiologic/ ➤Methamphetamine continues to be reported as an emerging problem in ethnographic, and treatment respondents several sites. (Exhibit 5) Furthermore, 14 sources in 8 cities consider it the drug contributing to the most serious consequences, doubling from Exhibit 2. only 4 cities since the last Pulse Check, and replacing crack in 2 instances. How has the perceived drug (Exhibits 3 and 4) problem changed (spring 2001 vs fall 2001)? ➤Most respondents continue to link methamphetamine sellers to domestic Percent(N=75) violence, more so than with any other drug. (Exhibit 6) 100 90 ➤The emerging diversion and abuse problem involving OxyContin®, a 80 controlled-release formulation of the pharmaceutical opiate oxycodone, 70 has spread to all but two sites and is associated with serious consequences. 60 (Exhibits 5 and 7) 50 ➤OxyContin® abuse and diverted sales continue to emerge in the rave and 40 nightclub scenes in seven cities: Boston, Detroit, Memphis, Miami, New 30 Orleans, Philadelphia, and Sioux Falls. 20 10 ➤“Ecstasy” (methylenedioxymethamphetamine or MDMA) continues to 0 be an emerging problem in the majority of sites. (Exhibit 5) Much Some- Same Less Worse what Serious Worse Sources: Law enforcement, epidemiologic/ ethnographic, and treatment respondents ✛The following symbols appear throughout these Highlights to indicate type of respondent:LLaw enforcement respondent, EEpidemiologic/ethnographic respondent, NNon-methadone treatment respondent, and MMethadone treatment respondent. Pulse Check: April 2002 page 1 HIGHLIGHTS HIGHLIGHTS FROM THE SPECIAL Exhibit 3. What are the most serious drug problems in the 20 Pulsse CChecck TOPIC SECTION: THE IMPACT OF sites, by type of source?* SEPTEMBER 11 Most commonly abused?* Most serious consequences? City L E N L E N M # After September 11, availability of Boston, MA MJ MJ H HCl Crack H Benzos illegal drugs, particularly heroin, stNew York, NY MJ MJ Crack H Crack Crack Crack a declined in 12 cities: Baltimore, hePhiladelphia, PA MJ MJ H H H H H Columbia (SC), Denver, Detroit, ortPortland, ME MJ MJ H H+Pharm. Oxy H Oxy N El Paso, Honolulu, Memphis, opiates Baltimore, MD NR H NR NR H NR Alcohol Miami, New Orleans, New York, Columbia, SC Crack MJ MJ Crack Crack MJ H Seattle, and Sioux Falls. El Paso, TX MJ MJ Cocaine N/A Crack H Cocaine h utMemphis, TN Meth MJ NR Meth Crack NR NR # Because heroin availability declined SoMiami, FL Crack MJ Crack Oxy H Crack Benzos after September 11, heroin users New Orleans, LA Crack Crack Crack H Crack Crack Oxy are increasingly substituting Washington, DC Crack MJ Crack Crack H Crack H prescription drugs for heroin in Chicago, IL Crack MJ H Crack H Crack H Baltimore, Columbia (SC), El Paso, stDetroit, MI MJ MJ Crack H H Crack H e wSt. Louis, MO MJ MJ MJ Crack Crack Meth H and New York. d MiSioux Falls, SD MJ MJ Alcohol Meth Meth Alcohol Meth # Heightened security at U.S. points +MJ +MJ Billings, MT Meth MJ MJ Meth Meth Meth Meth of entry may have changed drug Denver, CO MJ MJ Meth HCl HCl Meth H trafficking modes or routes in stHonolulu, HI MJ Meth NR Meth Meth NR H e seven cities: Denver, Honolulu, W Los Angeles, CA Crack MJ MJ Crack H Meth H Miami, New York, Portland (ME), Seattle, WA MJ MJ MJ Meth H Cocaine H St. Louis, and Seattle. *Heroin is almost always, by definition, the most commonly used drug in methadone programs, # Signs of increased drug abuse so methadone treatment sources are excluded from this question. were described in nine cities: Note: HCl = Powder cocaine; MJ = Marijuana; H = Heroin; Meth = Methamphetamine; Benzos = Benzodiazepines; Oxy = OxyContin®; Cocaine = unspecified whether crack or HCl; Boston, Columbia (SC), Honolulu, NR= nonrespondent Miami, New York, Portland (ME), St. Louis, Seattle, and Washington, Exhibit 4. What are the most serious drug problems in the 20Pulsse CChecck DC. These signs include increases sites, by number of sources and sites? in demand for treatment, requests for services, and attempts to self- Drug Most commonly abused?* Most serious consequences? medicate illicitly for anxiety or No. of sources No. of sites No. of sources No. of sites depression. Heroin 5 5 27 17 Crack 12 8 19 12 # Trafficking shifts in some border Powder cocaine 1 1 5 4 areas, such as Detroit, Portland Marijuana 35 18 1 1 (ME), and El Paso, were only short Methamphetamine 4 4 14 8 term and soon reverted to “busi- Diverted OxyContin® 0 0 5 3 Benzodiazepines 0 0 2 2 ness as usual.” Similarly, short- Alcohol 1 1 2 2 term market effects, such as price gouging, “super sales,” and drug *Methadone treatment sources are excluded from this count. Sources: Law enforcement, epidemiologic/ethnographic, non-methadone treatment, and adulteration, were reported in methadone treatment respondents Boston, Miami, New York, and Washington, DC. page 2 Pulse Check: April 2002 HIGHLIGHTS HIGHLIGHTS BY SPECIFIC Exhibit 5. What new problems have emerged or intensified during fall ILLICIT DRUG 2001? The 75 discussions also yielded key OxyContin® Ecstasy/Club Drugs Methamphetamine findings about heroin, crack, powder Baltimore, MDE Baltimore, MDE Billings, MTN cocaine, marijuana, methamphetamine, Billings, MTL,N Billings, MTN Chicago, ILM,N synthetic opioids, and ecstasy. Boston, MAL,E,N Boston, MAL Columbia, SCL Columbia, SCE,N Chicago, ILL Detroit, MIN HEROIN Denver, COM Denver, COL Memphis, TNE # Availability increased in only seven Detroit, MIE Detroit, MIE New Orleans, LAM sites (Boston, Chicago, Detroit, El El Paso, TXM El Paso, TXE Seattle, WAL Paso, Miami, New Orleans, and Honolulu, HIL,M Honolulu, HIE Sioux Falls, SDE,N Portland [ME]), declined in two Los Angeles, CAM Los Angeles, CAL,E Washington, DCE (Denver and Honolulu), and Memphis, TNL,E Memphis, TNL,E remained stable elsewhere. Miami, FLL,E New Orleans, LAL (Ketamine) Increases generally involve high- New Orleans, LAL New York, NYE,N purity South American New York, NYM Philadelphia, PAL (Colombian) white heroin, which Philadelphia, PAL,M,N Portland, MEL,E remains the most common. Portland, MEL,M Sioux Falls, SDN Mexican black tar still predomi- St. Louis, MOM,N Washington, DCE,N nates in the West. Seattle, WAN Sioux Falls, SDE # Street-level prices are generally sta- ble, except for increases in Denver Other Emerging Drug Problems None and Seattle and declines in El Paso and Washington, DC. Purity levels Benzodiazepines: Los Angeles, CAL; Seattle, WAE Billings, MTE are also generally stable, except for Clonidine (Catapres®): Baltimore, MDM Chicago, ILE increases in Boston, El Paso, and Dextromethorphan (sold as ecstasy): Memphis, TNE Columbia, SCM Portland and declines in Denver, Diverted methadone: Detroit, MIE; Portland, MEE Denver, CON Diverted pharmaceuticals: Boston, MAE Detroit, MIL,M New Orleans, and Seattle. Fentanyl*: Boston, MAE,M El Paso, TXL,N # Drug sales increasingly involve Hallucinogens: Los Angeles, CAL Los Angeles, CAN referrals, beepers, cell phones, Herbal supplements: Memphis, TNE Miami, FL M,N prearranged meeting places, home Heroin: Billings, MTN; Boston, MAE(ODs); New Orleans, LAE,N Denver, COE(young White suburbanite New York, NYL deliveries, and multi-tiered market deaths); Memphis, TNE Portland, MEN structures. Injecting:Sioux Falls, SDN St. Louis, MOL # Use is increasing among younger Khat**: Boston, MAL Seattle, WAM people. Many are suburban PCP: Washington, DCE Sioux Falls, SDL Whites, particularly in areas Washington, DCL,M around Baltimore, Chicago, *Fentanyl is a powerful synthetic opiate often confused with heroin, responsible for overdose Denver, St. Louis, and Washington, deaths, and often found in patch form. DC. **Khat is a natural stimulant from the Catha Edulis plant, found in a flowering evergreen tree or large shrub from East Africa and Southern Arabia. Its leaves contain psychoactive ingredients # Female users are increasing in structurally and chemically similar to d-amphetamine. some cities (Denver, Memphis, New Orleans, and Portland [ME]). Pulse Check: April 2002 page 3

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Check sources who voluntarily prepared for and participated in the in-depth discussions that are the basis for this report. prescription drugs, such as Elavil®. (amitriptyline, an n Honolulu, HIL,E: Law enforcement efforts are
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