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South Florida Report Substance Abuse Patterns and Trends in Southeastern Florida Autumn 2012 James N. Hall
Transcript of South Florida Report - cdn.trustedpartner.comcdn.trustedpartner.com/docs/library...South Florida...
South Florida Report
Substance Abuse Patterns andTrends in Southeastern Florida
Autumn 2012
James N. Hall
MiamiMiami--
DadeDade
BrowardBroward
PalmPalm
BeachBeach
Flagler
HighlandsHardee
Polk
Martin
St. Lucie
Okeechobee
Indian River
PutnamAlachua
Bradford
UnionColumbia
Gilchrist
Levy
Dixie
Suwannee
Hamilton
St.J ohnsClay
Duval
Nas sau
Baker
Pinellas
Pasco
Manatee
Hillsborough
Bre va rd
Osceola
Orange
S eminole
Collier
HendryLee
Glades
De SotoSarasota
Palm Beach
LakeSumterHernando
Citrus
Marion
Taylor
Madison
Jeffe
rson
Wakulla
Leon
Franklin
Liberty
Gadsden
Jacks on
Calhoun
Gulf
BayWashing
ton
Escambia
SantaRosa
Okaloosa
Walton
Broward
Dade
Holmes
Monroe
Volusia
Lafayette
Charlotte
1.7 Million
1.3 Million
2.3 Million
US Census Bureau2008 Population Estimates
18.8Million
US Census Bureau2010 Population Estimates
Multiple Indicators
• Drug-Related Deaths• Drug-Related Emergency Department Reports• Addiction Treatment Admissions by Primary Drug• Crime Lab Reports• 2011 National Survey on Drug Use and Health• Florida Youth Substance Abuse Survey• Poison Information Center – Poison Exposure Calls
Today’s Topics
• Decline of Cocaine Consequences• Rx Non-Medical Misuse Stable at Epidemic Levels• Heroin on the Horizon ?• Youth Gateways to Adult Addiction
– Alcohol– Marijuana
• Fake Drugs: Real Poisons– Synthetic Cannabinmimectics– Synthetic Stimulants
Number of Cocaine Reports DetectedAmong Decedents in Florida: 2000 - 2011
NUMBER ofCOCAINE
OCCURRENCESIncluding
“Present” &“Cause of
Death”
SOURCE: Florida Medical Examiners Commission Interim Report Jan-Jun 2011
144 149 151189
160 162 182
281
201155
198176
80 94121 138 120 136 150 157 146 135 127 108
050
100150200250300
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2X 1h2011
Miami-Dade
Broward
Number of Cocaine Emergency Department ReportsMiami-Dade County: 2004-2010N
umbe
r of C
ocai
ne E
D R
epor
ts
SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates.
Note: Cocaine visits had statistically significant decreases from 2008 to 2010 and again from 2009 to 2010 , althoughno statistical changes were noted for 2004 compared with 2010. Prescription Opioids nonmedical use visits had astatistically significant increase from 2004 to 2010, although no statistical changes were noted for 2008 and 2009compared with 2010. No statistically significant changes were noted for 2004, 2008, and 2009 compared with 2010for the other drugs shown. No significant testing of data for 2005, 2006 and 20067 versus 2010 was available.
Number of Cocaine Emergency Departments Reportsin Broward & Palm Beach Counties, FL: 2008,,2009 & 2010
SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates 2008-2009.
Note: Cocaine and Heroin visits had statistically significant decreases from 2008 to2009. Heroin also had a statistically significant decreases from 2009 to 2010. PrescriptionOpioid nonmedical use visits had statistically significant increases from 2008 to 2010.No statistically significant changes were noted for 2008 or 2009 compared with 2010 forthe other drugs shown.
Percent of Primary Addiction TreatmentAdmissions by Substance 2007-2011: State of Florida
Perc
ent o
f All
Adm
issio
ns
Source: Substance Abuse and Mental Health Services Administration’s Center forBehavioral Health Statistics and Quality: Treatment Episode Data Set asprovided by the Florida Department of Children and Families as of July 9, 2012.
Cocaine
JUST RELEASED• In 2011, the 1.4 million current cocaine users (i.e., used
in the past 30 days) aged 12 or older, comprised 0.5percent of the US population. That is 1 million less thanthe estimate in 2006 of 2.4 million or 1.0 percent.
• The number of past year first time cocaine usersdeclined from 1.0 million in 2002 to 670,000 in 2011.
• The number of initiates of crack cocaine declined duringthis same period from 337,000 to 76,000.
Source: 2011 National Survey on Drug Use and Health
All Cocaine PurchasesDomestic STRIDE Data
January 2007 – June 2011
From January 2007 through June 2011, the price perpure gram of cocaine increased 71%, from $98 to$167, while the purity decreased 27%, from 67% to49%.
Numbers of Substances Identified amongDecedents in Florida: Jan-June 2011
All Rx = 6,287Alcohol +Illicit Drugs = 3,190
Fla gler
High landsHardee
Polk
Ma rtin
St. Lu cie
Oke e c ho be e
Ind ian River
Pu tnamAlachua
Bradfo
r dUnio nColumbia
Gilchris t
Levy
Dix ie
Suwan nee
Ham ilton
St.Jo hnsClay
Duval
Nassau
Bake r
Pine llas
Pasco
Manatee
Hillsborough
Br ev a rd
Osce ola
Orang e
Seminole
Collie r
Hen dryLee
Glades
De SotoSarasota
Palm Beach
La keSumterHe rnando
Citrus
Ma rion
Taylor
Madis onJeffe
rson
Waku lla
Leon
Franklin
Liberty
Gad sden
Jackson
Calho un
Gulf
BayWas hing
ton
Escambia
SantaRosa
Okaloosa
Walto n
Broward
Dade
Holmes
Monroe
Volusia
Lafayette
Charlotte
Source: Florida Department of Law Enforcement:Florida Medical Examiners Commission Interim Report 2011
2,609 individuals died with oneor more prescription drugs in theirsystem. The drugs were at bothlethal and non-lethal levels.
Prescription Drug-Related Deathsin Florida: January – June 2011
Source: Florida Department of Law Enforcement:Florida Medical Examiners Commission Interim Report 2011
Number of Oxycodone Reports Detectedamong Decedents in Florida: Jan 2007 – Jun 2011
Source: FDLE – Drugs Identified In Deceased Persons by Florida Medical Examiners2007 - 2010 Reports and 2011 Interim Report
NUMBER ofOxycodone
OCCURRENCESIncluding
“Present” &“Cause of Death”
2x 1,058
Number of Oxycodone Reports Detectedamong Decedents in South Florida: 2007-2010
NUMBER ofOxycodone
OCCURRENCESIncluding
“Present” &“Cause of Death”
SOURCE: Florida Medical Examiners Commission Report 2010
Number of Emergency Department Reportsby Drug Miami-Dade County: 2004-2010
Rat
es p
er 1
00,0
00
SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates.
Note: Cocaine visits had statistically significant decreases from 2008 to 2010 and again from 2009 to 2010 , althoughno statistical changes were noted for 2004 compared with 2010. Prescription Opioids nonmedical use visits had astatistically significant increase from 2004 to 2010, although no statistical changes were noted for 2008 and 2009compared with 2010. No statistically significant changes were noted for 2004, 2008, and 2009 compared with 2010for the other drugs shown. No significant testing of data for 2005, 2006 and 20067 versus 2010 was available.
Number of Emergency Departments Reportsby Drug in Broward & Palm Beach Counties, FL:
2008,,2009 and 2010
SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates 2008-2009.
Note: Cocaine visits had statistically significant decreases from 2008 to 2009.Prescription Opioid nonmedical use visits had statistically significant increases from2008 to 2010. No statistically significant changes were noted for 2008 or 2009 comparedwith 2010 for Benzodiazepines.
NMU Rx Opioids
Rates per 100,000 of Oxycodone Nonmedical UseE Emergency Department Reports by Age Groups
DAWN Ft. Lauderdale Division vs. USA: 2010
102.6
215.7241.6
142
67.9 79.2
39.864.6
85.3 83.6 71.3 71.1 72.9 47.1
0
50
100
150
200
250
300
18-20 yrs.21-24 yrs.25-29 yrs.30-34 yrs.35-44 yrs.45-54 yrs.55-64 yrs.
Rat
e pe
r 100
,000
SOURCE: US Dept HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates.
Broward & Palm Beach
USA
Source: SAMHSA - Treatment Episode Data Sets Submitted bythe Florida Dept. of Children and Families as of July 9, 2012
Percent of Primary Rx Opioid Addiction TreatmentAdmissions By Age Groups in Florida: 1998 to 2011
0102030405060708090
100
26 to 30 yrs
21 to 25 yrs
18 to 20 yrs
12 to 17 yrs
Source: SAMHSA - Treatment Episode Data Sets Submitted bythe Florida Dept. of Children and Families as of July 9, 2012
Percent of Primary Rx Opioid Addiction TreatmentAdmissions By Age Groups in Florida: 1998 to 2011
Source: SAMHSA - Treatment Episode Data Sets Submitted bythe Florida Dept. of Children and Families as of July 9, 2012
22%
62%
Percent of Primary Addiction TreatmentAdmissions by Substance 2007-2011:
State of Florida
Perc
ent o
f All
Adm
issio
ns
Source: Substance Abuse and Mental Health Services Administration’s Center forBehavioral Health Statistics and Quality: Treatment Episode Data Set asprovided by the Florida Department of Children and Families as of July 9, 2012.
Heroin
Number of Primary Treatment Admissionsby Drug Broward and Miami-Dade Counties:
Jan –Dec 2011
Source: Florida Department of Children and FamiliesNumber of Primary Admissions
66.6%
54.6%
13.8% 12.5% 11.1%
0%
10%
20%
30%
40%
50%
60%
70%
Dealer Sharing/Trading LegitimateMedical Practice
IllegitimateMedical Practice
Theft
Diversion Sources: Primary Opioid
Source:Kurtz,S&Surratt,H:ARSHNovaSoutheasternUniversityJune2012
Number of Alprazolam Reports Detectedamong Decedents in Florida: 2007 – 2010
Source: FDLE – Drugs Identified In Deceased Persons by Florida Medical Examiners2007 - 2010 Reports and 2011 Interim Report
NUMBER ofAlprazolam
OCCURRENCESIncluding
“Present” &“Cause of Death”
2x 950
Number of Alprazolam Reports Detectedamong Decedents in South Florida: 2007- 2010
NUMBER ofAlprazolam
OCCURRENCESIncluding
“Present” &“Cause of Death”
SOURCE: Florida Medical Examiners Commission Report 2010
Number of Emergency Departments Reportsby Drug in Broward & Palm Beach Counties, FL:
2008,,2009 and 2010
SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates 2008-2009.
Note: Cocaine visits had statistically significant decreases from 2008 to 2009.Prescription Opioid nonmedical use visits had statistically significant increases from2008 to 2010. No statistically significant changes were noted for 2008 or 2009 comparedwith 2010 for Benzodiazepines.
Cocaine
NMU Benzodiazepines
NUMBER OF HEROIN-RELATED DEATHSIN FLORIDA: Jan 2000 – Jun 2011
SOURCE: Florida Medical Examiners Commission Reports 2000-2011
40
# Le
thal
Her
oin
Deat
hs
102
Number of Other Substances Detected inHeroin-Related Deaths State of Florida: 2010
SOURCE: Analysis of Florida Medical Examiners Commission Data 2010by Center for Study & Prevention of Substance Abuse, Nova Southeastern Univ.
# of Occurrences
54 of 58 Heroin Deathswith 1 or more other drugs
Number of Primary Heroin Treatment AdmissionsMiami-Dade and Broward Counties, FL: 2009-2011
# of
prim
ary
Trea
tmen
t Adm
issio
ns
SOURCE: Florida Department of Children and Families
Age of Alcohol Onset andAny Lifetime Alcohol Dependency
Aged 18 and Older47% 45%
38%32% 28%
15% 17%11% 9%
0%
10%
20%
30%
40%
50%
13 14 15 16 17 18 19 20 21
Age Began Drinking
Source: National Epidemiologic Survey onAlcohol and Related Conditions Sample = 43,093
% A
lcoh
ol D
epen
dent
Source: 2011 National Survey on Drug Use and Health
Percent of Past Year Drug Dependence or AbuseAmong Adults Aged 18 or Older
By Age of First Marijuana Use: 2011
12.7%
2.2%
0%
2%
4%
6%
8%
10%
12%
14%
Age of First Marijuana Use
% P
ast Y
ear D
epde
nce/
Abu
se
14 Years orYounger
18 or Older
Source: SAMHSA-National Surveys on Drug Use and Health 2011
14 yrs. Or Younger 18 or Older
Number of Primary Treatment Admissions forJuveniles and Adults by Drug in Broward and
Miami-Dade Counties: Jan - Dec 2011
Source: Florida Department of Children and FamiliesNumber of Primary Admissions
Number of Primary Treatment Admissions forJuveniles and Adults by Drug in Broward and
Miami-Dade Counties: Jan - Dec 2011
Source: Florida Department of Children and FamiliesNumber of Primary Admissions
Imitation: Desired Effects ofKnown Drugs
• Synthetic chemicals thatlook to the brain likemarijuana.
• Sprayed onto plant materialfor smoking
• Seeking marijuana-likeeffects
Toxicity: Potency and efficacy
Potency: Low dose – strong effects
Efficacy: Strong maximum effectsMany Cannabinmimetics show higherpotency and higher efficacy than Cannabis
Percent of Florida 9th-12th Graders ReportingHaving Used Synthetic Marijuana
Source: Florida Youth Substance Abuse Survey 2011
Number of CannabinmimeticsPoison Control Exposure Calls
Jan-Dec 2011 and Jan-June 2012
Source: Florida Poison Information Center – Miami1-800-222-1222
CannabinmimeticsPoison Exposure Calls
# of PoisonExposure CallsJan-Dec 2011
# of PoisonExposure CallsJan-June 2012
State of Florida 517 377Broward County 38 25Miami-Dade County 36 36Palm Beach County 29 20
11 Different Cannabinmimetics Jan. – July 2012Florida Crime Lab Reports n= 403
Source: US DEA: National Forensic Lab Information System (NFLIS) 08/24/2012
111 244 816
32
58
AM2233JWH-073JWH-203RCS-4UR-144JWH-250JWH-081JWH-018JWH-122JWH-210AM2201
n=276
68 %
White lighteningZoomCloud 9Cloud 10Red DoveBlue silkMoon dustNRG (4-MEC)
Head tripRadianceIvory WavePower surgeSextasyVanilla Sky
Bath salts Stimulants often have trendy namesand slick packaging
Number of Emerging PsychoactiveSubstance Drug Poison Control Exposure Calls
in Florida: Jan-Dec 2011 and Jan-April 2012
Source:Florida Poison Information Center – Miami 1-800-222-1222
Synthetic DrugCategory
# of PoisonExposure CallsJan-Dec 2011
# of PoisonExposure CallsJan-April 2012
Synthetic Cannabinoids 517 269HallucinogenicAmphetamines
184 64
MDPV & Mephedrone(Bath Salts)
152 28
Other HallucinogensDMT and 5-MeO-DIPT
6 2
8 Different Cathinmimetics Jan. – July 2012Florida Crime Lab Reports n= 76
Source: US DEA: National Forensic Lab Information System (NFLIS) 08/24/2012
1 1 3 3
4
9
22
33
Fluoromethcathinone
Alpha-PBP
3,4-DMMC
Pentylone
Ethylone
Pentedrone
A-PVP
4-MEC
A-PVP
4-MEC
Designer StimulantsUSA: 35 Cathinmimetics andOther Stimulants Oct 2011-April 2012
} Adverse Effects} More dangerous and deadly ever week} Guinea Pig drugs} Very Addictive} Long-term Psychosis} Linked to Violent Behavior} Legal Strategies} Information Dissemination
(DIED)
www.drugfreebroward.org Presentations
Fake Drugs: Real Poisons
Percent of Primary Addiction TreatmentAdmissions by Substance 2007-2011:
State of Florida
Perc
ent o
f All
Adm
issio
ns
Source: Substance Abuse and Mental Health Services Administration’s Center forBehavioral Health Statistics and Quality: Treatment Episode Data Set asprovided by the Florida Department of Children and Families as of July 9, 2012.
Alcohol
All OtherHeroin
South Florida Report
Substance Abuse Patterns andTrends in Southeastern Florida
Autumn 2012
James N. Hall
