The South Florida Report June 2013

Transcription

1 Escambia Santa Rosa Okaloosa Holmes Bay Jacks on Calhoun Gulf Liberty Gadsden Leon Franklin Wakulla Madison Taylor Dixie Hamilton Suwannee Union Gilchrist Alachua Pinellas Levy Citrus Baker Hernando Pasco Hillsborough Manatee Marion Nas sau Clay Putnam Lake Sumter Sarasota Polk Hardee Lee Duval De Soto Charlotte St. Johns Flagler Seminole Orange Osceola Highlands Glades Collier Monroe Volusia Hendry Indian River St. Lucie Martin Palm Beach Broward Dade The South Florida Report June 213 National Institute on Drug Abuse Community Epidemiology Work Group James N. Hall Report # 57 South Florida Drug Observatory Nova Southeastern University Walton Washington Jefferson Lafayette Columbia Bradford 19.3 Million Brevard Okeechobee 1.4 Million 1.8 Million US Census Bureau 212 Population Estimates 2.6 Million Jim Hall upfrontin@aol.com 1

2 Lower HIGH Moderate Data Sources June 213 June 213 Florida Medical Examiners Commission 212 interim Report on Drugs Identified In Deceased Persons by Florida Medical Examiners from Florida Department of Law Enforcement SAMHSA Drug Abuse Warning Network (DAWN) Emergency Department substance specific drug reports Florida Department of Children and Families treatment data from all publicly-funded adult and youth treatment programs for Miami- Dade and Broward Counties primary admissions for all treatment modalities January - December 212. National Forensic Laboratory Information System (NFLIS), Drug Enforcement Administration (DEA), for January December 212 SAMHSA National Survey on Drug Use and Health Substate Estimates of Substance Abuse and Mental Disorders Florida Poison Information Center Miami Poison Exposure Calls for Emerging Synthetic Drugs January 211 to April 213 South Florida Most Recent Indicator Changes June 213 Marijuana: High and Increasing Cocaine: 5-Year Decline Reversing Rx Opioids: Deaths Declining 17-% Benzodiazepines: Deaths Declining 17-% Ecstasy: Mostly Mollys tests as bk-methylone Heroin: Increases related to Rx Opioids crackdown Cannabinmimetics: Types & Problems + Pot Pens Methamphetamine: Low but Returning Key Issue for Gay Males and Heavy Club Druggers Levels of Indicator Intensity: HIGH Moderate Lower Jim Hall upfrontin@aol.com 2

3 Rate per 1, NUMBER of COCAINE OCCURRENCES Including Present & Cause of Death Number of Cocaine Reports Detected Among Decedents in Florida: ,5 2, 1,5 1, ,15 1,37 1,614 1,72 1,943 2,52 2,179 1,791 1,462 State of Florida 1,42 1,444 SOURCE: Florida Medical Examiners Commission Interim Report Jan-Jun 212 1, X 1h Broward X 1h 212 Rate of Cocaine Emergency Department Reports Per 1,, Broward & Palm Beach Counties, and USA: = Significant Difference with Broward & Palm Beach USA SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates Jim Hall upfrontin@aol.com 3

4 # Lethal Heroin Deaths Top 1 Most Frequently Identified Drugs of Total Analyzed Drug Reports from South Florida Crime Labs Reports CY 212 Drug 212 Number 212 % % Δ vs. 211 Cocaine 11, % Down 16 % Marijuana/Cannabis 5, % Up 8 % Rx Opioids % Down 31 % Rx Benzodiazepines % Down 16 % Heroin % Up 21 % Hallucinogen % Up 16 % Methylone (N-Methyl-3,4- Methylenedioxycathinone) % Up 15 % Phenylimidothiazole Iso Undeterm % Down 9 % Caffeine % Down 17 % Methamphetamine 17.7% Up 17 % All Other Analyzed Drugs 2, % Up 5 % Total 23,671 1.% SOURCE: US DEA: National Forensic Laboratory Information System DQS on May 7, 213 NUMBER OF HEROIN-RELATED DEATHS IN FLORIDA: Jan 2 Jun Florida Broward SOURCE: Florida Medical Examiners Commission Reports Jim Hall upfrontin@aol.com 4

5 # of primary Treatment Admissions Number of Primary Heroin Treatment Admissions and Broward Counties, FL: Broward SOURCE: Florida Department of Children and Families In the first three months of 213, Florida Department of Law Enforcement heroin-related charges totaled 948, up 23-% from same three-month period last year, that number was 772. Jim Hall upfrontin@aol.com 5

6 # Cause of Death Occurrences Number of Selected Lethal Rx Opioid Occurrences Among Deceased Persons in Florida Jan 28 to Jun H8 2H8 1H9 2H9 1H1 2H1 1H11 2H11 1H Oxycodone Methadone Morphine Hydrocodone Fentanyl Source: FDLE Drugs Identified In Deceased Persons by Florida Medical Examiners Jan 27 - Jun 212 Reports Number of Oxycodone Reports Detected among Decedents in South Florida: NUMBER of Oxycodone OCCURRENCES Including Present & Cause of Death Palm Beach Broward All 3 Counties x1H12 SOURCE: Florida Medical Examiners Commission Interim Report 212 Jim Hall upfrontin@aol.com 6

7 Rate per 1, Rate per 1, Rate of NMU Rx Opioid Emergency Department Reports Per 1,, Broward & Palm Beach Counties, and USA: Broward & Palm Beach USA = Significant Difference with SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates E Rates per 1, of Oxycodone Nonmedical Use Emergency Department Reports by Age Groups DAWN Ft. Lauderdale Division vs. USA: yrs yrs yrs. USA 3-34 yrs Broward & Palm Beach yrs yrs yrs. SOURCE: US Dept HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates. Jim Hall upfrontin@aol.com 7

8 Top 1 Most Frequently Identified Drugs of Total Analyzed Drug Reports from South Florida Crime Labs Reports CY 212 Drug 212 Number 212 % % Δ vs. 211 Cocaine 11, % Down 16 % Marijuana/Cannabis 5, % Up 8 % Rx Opioids % Down 31 % Rx Benzodiazepines % Down 16 % Heroin % Up 21 % Hallucinogen % Up 16 % Methylone (N-Methyl-3,4- Methylenedioxycathinone) % Up 15 % Phenylimidothiazole Iso Undeterm % Down 9 % Caffeine % Down 17 % Methamphetamine 17.7% Up 17 % All Other Analyzed Drugs 2, % Up 5 % Total 23,671 1.% SOURCE: US DEA: National Forensic Laboratory Information System DQS on May 7, 213 Number of South Florida Rx Opioid Crime Lab Reports 211 vs. 212 Source: US DEA- National Forensic Laboratory Information System (NFLIS) for Miami- Dade, Broward and Palm Beach Counties 211 (5/8/12) and 212 (5/7/13) Prescription Opioids Reports OXYCODONE 1, HYDROCODONE METHADONE BUPRENORPHINE MORPHINE 3 51 CODEINE HYDROMORPHONE TRAMADOL 7 11 OXYMORPHONE 3 1 PROPOXYPHENE 3 FENTANYL 1 BENZYLMORPHINE 1 DIHYDROCODEINE 1 DIHYDRONORMORPHINONE 1 TOTAL OPIOIDS 1, Jim Hall upfrontin@aol.com 8

9 5,233,785 Dose Units in 6 months Percent of those Age 12 & Above Who Report Nonmedical Use of Pain Relievers in Past Year Source: NSDUH 28-1 Substate Data USA 4.87 % Percent Range: 2.96 % to 8.11 % Jim Hall upfrontin@aol.com 9

10 Percent Reporting Past Year Use Florida Substate DCF Regions 5.38 % All Florida 4.22 % 643,726 Floridians Aged 12 and above Nonmedical Use of Pain Relievers in Past Year Source: NSDUH 28-1 Substate Data 2.96 % Broward 3.11 % Percent of Persons Aged 12 and Above Reporting Nonmedical Use of Rx Pain Relievers in the Past Year: USA 3.82 Florida Broward SOURCE: SAMHSA-CBHSQ(212): Substate Estimates from the National Surveys on Drug Use and Health Jim Hall upfrontin@aol.com 1

11 # Cause of Death Occurrences Number of Alprazolam and Diazepam Occurrences Among Deceased Persons in Florida Jan 28 to Jun Alprazolam Diazepam H8 2H8 1H9 2H9 1H1 2H1 1H11 2H11 1H12 Source: FDLE Drugs Identified In Deceased Persons by Florida Medical Examiners Jan 27 - Jun 212 Reports Number of South Florida Rx Benzodiazepine Crime Lab Reports 211 vs. 212 Source: US DEA- National Forensic Laboratory Information System (NFLIS) for Miami- Dade, Broward and Palm Beach Counties 211 (5/8/12) and 212 (5/7/13) Reports for Rx Benzodiazepines ALPRAZOLAM CLONAZEPAM DIAZEPAM LORAZEPAM TEMAZEPAM 4 17 TRIAZOLAM 2 BROMAZEPAM 1 FLURAZEPAM 1 TOTAL 1, Jim Hall upfrontin@aol.com 11

12 Rate per 1, Rate of Marijuana Emergency Department Reports Per 1,, Broward & Palm Beach Counties, and USA: = Significant Difference with Broward & Palm Beach USA SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates Number of Primary Treatment Admissions for Juveniles and Adults by Drug in Broward and Counties: Jan - Dec 212 Marijuana Rx Opioids Alcohol Cocaine/Crack Rx Benzo's Heroin Other/Unknown ,26 1,69 1, ,576 1, Number of Primary Admissions Broward Source: Florida Department of Children and Families Jim Hall upfrontin@aol.com 12

13 The pen is mightier than the pipe? Jim Hall 13

14 Cannabinmimetics Poison Exposure Calls Number of Cannabinmimetics Poison Control Exposure Calls Jan-Apr 213 # of Poison Exposure Calls Jan-Dec 211 # of Poison Exposure Calls Jan-Dec 212 # of Poison Exposure Calls Jan-Apr 213 State of Florida * 78 Broward County County Palm Beach County * The total of 537 includes 271 in Jan-Apr 212 Source: Florida Poison Information Center Miami Number of Cannabinmimetic Poison Control Exposure Calls Jan-Apr 213 Source: Florida Poison Information Center Miami Jim Hall upfrontin@aol.com 14

15 Rate per 1, Number of South Florida Synthetic Cannabinoids Crime Lab Reports 211 vs. 212 Source: US DEA- National Forensic Laboratory Information System (NFLIS) for Miami- Dade, Broward and Palm Beach Counties 211 (5/8/12) and 212 (5/7/13) Synthetic Cannabinoids AM JWH XLR JWH-81 6 UR JWH JWH-25 4 JWH-73 2 RCS-8 2 JWH-23 1 TOTAL Rate of MDMA Emergency Department Reports Per 1,, Broward & Palm Beach Counties, and USA: Broward & Palm Beach USA = Significant Difference with SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates Jim Hall upfrontin@aol.com 15

16 Number of South Florida Synthetic Cathinones Crime Lab Reports 211 vs % Decrease in MDMA Crime Lab Reports 21 (n= 555) vs 21 (n=299) 64-% Decrease in MDMA Crime Lab Reports 211 (n= 299) vs 212 (n=17) Synthetic Cathinones Methylone MEC ,4-METHYLENEDIOXY- DIMETHYLCATHINONE 2 Mephedrone 12 2 TOTAL Source: US DEA-National Forensic Laboratory Information System (NFLIS) for, Broward and Palm Beach Counties 211 (5/8/12) and 212 (5/7/13) Number of Molly Poison Control Exposure Calls Jan-Apr 212 vs. Jan-Apr 213 Molly Poison Exposure Calls # of Poison Exposure Calls Jan- Apr 212 # of Poison Exposure Calls Jan- Apr 213 State of Florida 2 47 Broward County 8 Methylone is beta-ketone MDMA 19 Palm Beach 4 Source: Florida Poison Information Center Miami Jim Hall upfrontin@aol.com 16

17 Rate per 1, Number of South Florida Other New Drugs Crime Lab Reports 211 vs. 212 Source: US DEA- National Forensic Laboratory Information System (NFLIS) for Miami- Dade, Broward and Palm Beach Counties 211 (5/8/12) and 212 (5/7/13) OTHER EMERGING PSYCHOACTIVE SUBSTANCES BZP MEO-DIPT TFMPP MDPV DMT 6 4 2C-B METHOXYMETHAMPHETAMINE 5-MEO-MIPT 2 ALPHA-PVP 2 MMDA 1 ALPHA-METHYLTRYPTAMINE 1 TRYPTAMINE 1 TOTAL Rate of Illicit Stimulant Emergency Department Reports Per 1,, Broward & Palm Beach Counties, and USA: Broward & Palm Beach USA SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates Jim Hall upfrontin@aol.com 17

18 South Florida Key Findings June 213 June 213 # 1 key change is that deaths related to nonmedical misuse of prescription opioids declined 17-pecent in Florida during the first half of 212 which translates to 8 fewer deaths per week across the State attributable to prescription drug overdoses. # 2 key issue is the increase in injecting drug use among new, young adult cohort of prescription opioid injectors, heroin initiates, and methamphetamine users. A public health threat of increased HIV and Hepatitis C transmission is already occurring. Percent of Addiction Treatment Clients Reporting Injecting Drug Use by Primary Drug at Admission: & Broward Counties 212 Treatment Primary Drug % Broward % Prescription Opioid 22 % 58 % Heroin 85 % 9 % Methamphetamine 18 % 25 % Source: Florida Department of Children and Families Jim Hall upfrontin@aol.com 18

19 Lower HIGH Moderate South Florida Most Recent Indicator Changes June 213 Marijuana: High and Increasing Cocaine: 5-Year Decline Reversing Rx Opioids: Deaths Declining Benzodiazepines: Deaths Declining Ecstasy: Mostly Mollys tests as bk-methylone Heroin: Increases related to Rx Opioids crackdown Cannabinmimetics: Types & Problems + Pot Pens Methamphetamine: Low but Returning Key Issue for Gay Males and Heavy Club Drug Users Levels of Indicator Intensity: HIGH Moderate Lower Jim Hall upfrontin@aol.com 19

20 Surveillance Support Committee Jim Hall 2