Transcript National Institute on Drug Abuse Community

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National Institute on Drug Abuse
Community Epidemiology Work Group
(CEWG)
NIDA Community Epidemiology Work Group
United States Drug Observatories
Maine
Seattle
Minneapolis/St. Paul
Boston
New York
Detroit
Chicago
San Francisco
Philadelphia
Cincinnati
Washington D.C.
St. Louis
Denver
Los Angeles
Phoenix
San Diego
Honolulu
Atlanta
Texas
Ft. Lauderdale/
Miami
Established 1976
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NIDA Community Epidemiology Work Group
United States Drug Observatories
Maine
Seattle
Minneapolis/St. Paul
Boston
New York
Detroit
Chicago
San Francisco
Philadelphia
Cincinnati
Washington D.C.
St. Louis
Denver
Los Angeles
Phoenix
Albuquerque
San Diego
Honolulu
Atlanta
Texas
Ft. Lauderdale/
Miami 3
NIDA Community Epidemiology Work Group
United States Drug Observatories
Maine
Seattle
Minneapolis/St. Paul
Boston
New York
Detroit
Chicago
San Francisco
Philadelphia
Cincinnati
Washington D.C.
St. Louis
Denver
Los Angeles
Phoenix
Albuquerque
San Diego
Honolulu
Atlanta
Texas
Ft. Lauderdale/
Miami 2
Goals:
• To Characterize Changes in Drug Use
• To Provide Early Identification of New
Patterns and Emerging Drug Abuse issues
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NIDA Community Epidemiology Work Group
United States Drug Observatories
Maine
Seattle
Minneapolis/St. Paul
Key Findings
January 2013
Boston
New York
Detroit
Chicago
San Francisco
Philadelphia
Cincinnati
Washington D.C.
St. Louis
Denver
Los Angeles
Phoenix
Albuquerque
San Diego
Honolulu
Atlanta
Texas
Ft. Lauderdale/
Miami 2
NIDA Community Epidemiology Work Group
United States Drug Observatories
Maine
Seattle
Key Findings
January 2013
Minneapolis/St. Paul
Detroit
Boston
New York
Chicago
Philadelphia
Cincinnati
Outbreaks of New Heroin Epidemics
among
San1.Francisco
Denver
Washington D.C.
White, young
adults (aged 18-30)
St. Louis
Rx
Opioid
Abusers
and
Addicts
Los Angeles
Phoenix
Atlanta
Albuquerque
San Diego
Honolulu
Texas
Ft. Lauderdale/
Miami 2
NIDA Community Epidemiology Work Group
United States Drug Observatories
Maine
Seattle
Key Findings
January 2013
Minneapolis/St. Paul
Detroit
Boston
New York
Chicago
Philadelphia
Cocaine still a major problem but Cincinnati
with
San2.Francisco
Denver
Washington D.C.
declining consequences
in all areas
St. Louis
Los Angeles
Phoenix
Atlanta
Albuquerque
San Diego
Honolulu
Texas
Ft. Lauderdale/
Miami 2
**
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.
All Cocaine Purchases
Domestic STRIDE Data
January 2007 – June 2012
$250
67.1 %
$197.02
$194.45
$191.95
$173.97$174.49
$174.71
$191.35
67.1
80.00
$ 175.16
$185.57
$181.04
57.3
56.8
$150
$173.87
$172.66
60.9
59.2
$166.24
$175.87
$175.16
$168.90
$164.86
57.2
46.2
$128.10
47.9
48.3
48.3
45.4
44.5
45.6
44.6
44.8
48.4
49.1
48.5
60.00
49.9
$122.72$123.91
$114.87
$117.63
$100
49.6
45.9
48.1
48.1 %
40.00
$97.64
$ 97.64
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%.
$50
$0
PPG
JulJulJanAprJulOctJanAprJulOctJanAprJulOctJanAprOctJanAprOctJanAprSept1
Sept1
Mar07 Jun07 Sep07 Dec07 Mar08 Jun08 Sep08 Dec08 Mar09 Jun09 Sep09 Dec09 Mar10 Jun 10
Dec10 Mar11 Jun11
Dec11 Mar12 Jun12
0
1
$97.64 $117.6 $128.1 $114.8 $122.7 $123.9 $181.0 $197.0 $172.6 $173.9 $174.4 $191.9 $191.3 $194.4 $174.7 $173.8 $185.5 $175.8 $164.8 $166.2 $168.9 $175.1
Potency 67.13
59.17
56.84
60.89
57.29
57.19
46.16
44.47
47.90
48.28
45.45
45.59
44.56
44.82
45.91
48.34
48.43
49.12
48.48
49.94
49.59
20.00
0.00
48.11
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*During 2nd Qtr. 2012, the number of cocaine samples analyzed for the STRIDE dataset decreased significantly as compared to 1 st Qtr. 2012 due to resource limitations.
Purity in Percent
Price Per Pure Gram
$200
100.00
NIDA Community Epidemiology Work Group
United States Drug Observatories
Maine
Seattle
Key Findings
January 2013
Minneapolis/St. Paul
Detroit
Boston
New York
Chicago
Philadelphia
Cincinnati
Most drug deaths involve a combination
San3.Francisco
Denver
Washington D.C.
of benzodiazepine
(depressant) with
St. Louis
opioid
(narcotic
pain
reliever)
Los Angeles
Phoenix
Atlanta
Albuquerque
San Diego
Honolulu
Texas
Ft. Lauderdale/
Miami 2
Percent of Other Drugs Detected in the
1,185 Lethal Oxycodone Deaths in Florida: 2009
80%
72%
70%
60%
% Detected
50%
42%
40%
30%
20%
12%
10%
9%
7%
Other Drugs
No Other Drug
0%
Benzodiazepine Another Opioid Carisoprodal
Source: Analysis of 2009 Florida Medical Examiner Commission Complete Electronic Database
by Nova Southeastern University Center for Study & Prevention of Substance Abuse
Top Counties with Opiate Drug Overdose Deaths and DOH
Harm Reduction (Naloxone) Efforts, 2010-2011
46.7
13.2
49.2
26.8
33.1
41.5
NOTE: Clients
have the
opportunity to
enroll in the
Naloxone
Program at
state-funded *
syringe
exchange sites
and some
public health
offices.
9.5
35.1 41.8
13.7
14.9
14.9
9.1*
21.8
18.2 22.2
19.4
62.2
25.5
28.7*
42.9*
15.5* 0.0*
0.0*
39.2
12.0
9.0*
27.7
38.2
22.5
16.8*
13.6*
8.0*
4.5*
17.8*
135.6
22.7*
17.7*
14.8*
14.8*
5.8*
104.2
63.3
103.2
42.9
144.0
13.7*
37.0
15.1
63.9
11.3*
60.4
69.1
10.5*
75.4
24.5
11.5
37.9
11.4
80.1
*
Source: OMI and DOH Harm Reduction Program.
118.2
76.3
46.5
95.3
Rio Arriba County
279 enrollees
166 OD Reversals
12 Heroin Deaths
Santa Fe County
50 enrollees
12 OD Reversals
19 Heroin Deaths
Bernalillo County
1,521 enrollees
96 OD Reversals
77 Heroin Deaths
Enrollees elsewhere: 79
OD Reversals elsewhere: 4
Heroin Deaths elsewhere: 55
NIDA Community Epidemiology Work Group
United States Drug Observatories
Maine
Seattle
Key Findings
January 2013
Minneapolis/St. Paul
Detroit
Boston
New York
Chicago
Philadelphia
Cincinnati
Washington D.C.
# 1 for rise in “drugged driving”
St. Louis
Los Angeles
Phoenix
Atlanta
Albuquerque
San Diego
San Francisco
4. MarijuanaDenver
is ubiquitous!
Honolulu
Texas
Ft. Lauderdale/
Miami 2
Current (past 30-day) Marijuana Use Among
% Reporting Current Use
Broward County Middle and High School Students
2000-2012
20
18 17.2
16
14
12
10
8
4.5
6
4
2
0
2000
19
13.9
14.5
14
15.3
11.4
High School
5.2
Middle School
5
2.5
2002
2004
2006
3.5
4.3
3.7
2008
2010
2012
Source: Florida Youth Substance Abuse Surveys 2000-2012
Percent of high school students having ridden
or driven in the past 30 days with or as driver
having used marijuana or alcohol
RODE with Driver who had used
marijuana or alcohol
% Reporting
25
Marijuana
25.4
Alcohol
27.0
24.5
21.4
20
Alcohol
25
20.5
18.4
15
10
20
15
10
5
5
0
0
Florida
Marijuana
30
% Reporting
30
DROVE after using marijuana or
drinking alcohol
Miami-Dade Broward
11.2
10.8
8.1
Florida
9
10.9
7
Miami-Dade Broward
Source: FL-DCF - 2012 Florida Youth Substance Abuse Survey
NIDA Community Epidemiology Work Group
United States Drug Observatories
Maine
Seattle
Key Findings
January 2013
Minneapolis/St. Paul
Detroit
Boston
New York
Chicago
Philadelphia
Cincinnati
Emerging synthetic drugs such as fake
San5.Francisco
Washington D.C.
marijuana andDenver
stimulants may have
St. Louis
peaked
in
mid
2012
with
less
retail access
Los Angeles
but morePhoenix
illicit street sales
Atlanta
Albuquerque
San Diego
Honolulu
Texas
Ft. Lauderdale/
Miami 2
Molly
Methylone is
beta-ketone MDMA
Molly’s
Not 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
NIDA Community Epidemiology Work Group
United States Drug Observatories
Maine
Seattle
Key Findings
January 2013
Minneapolis/St. Paul
Boston
New York
Detroit
Chicago
6. Methamphetamine consequences
are
Philadelphia
Cincinnati
San Francisco
Denver
stable (low
where they have been low
and D.C.
Washington
St. Louis
high where they have been
high). ? d or l
Los Angeles
Phoenix
Albuquerque
San Diego
Honolulu
Atlanta
Texas
Ft. Lauderdale/
Miami 2
Taos Alive
Improving a Community in Pain By Julie Martinez CPS
DEA Take Back
April 28, 2012 – 20 kg Collected
• Taos Police
• Tribal Police
• Taos County Sherriff
September 29, 2012 • Taos Police
• Tribal Police
• State Police
• Taos County Sherriff
• Questa Police
• Colorado State Troopers
April 27, 2013 Next one.
Permanent
Drop Box
Brochure for Prescriptions
Lockyouremeds.org
Environmental
Strategies
Prescriber Training
Hospital Opiate Prescribing Guidelines
Non-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.
Early Intervention.
Drug Treatment.
And Recovery
Reduce Inappropriate
Rx Use
Improve
Poisoning
Interventions
Integrate Mental Substance Abuse
Prevention
Health Care
Safecommunity.net
Reduce Access
To Drugs
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 Outcomes
Initial focus on expanding access to hepatitis
C treatment
Goal: Help Primary Care Practitioners in
underserved areas to deliver treatment that
has previously been provided only by
specialists