Community Epidemiology Report November 2014
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1 Community Epidemiology Report November 214 Drug Abuse Trends Update Broward County and South Florida James N. Hall, Epidemiologist Center for Applied Research on Substance Use and Health Disparities Nova Southeastern University Jim Hall 1
2 Flakka Flaca Skinny Flakka Beautiful, elegant woman who charms all Wakka Flakka Hip-Hop DJ Elsewhere called Gravel alpha-pvp a-pyrrolidinovalerophenone Chemical structures of Synthetic Cathinones Pyrrolidinophenone compounds in comparison to MDPV Jim Hall 2
3 South Florida Crime a-pvp Lab Cases: Toxic Effects: Tachycardia, Agitation, Psychosis, Violent behavior, Excited Delirium Hyperthermia Kidney failure Death Top 1 Most Frequently Identified Drugs of Total Reports from South Florida Crime Labs Reports CY Drug 213 % Δ vs. 212 Cocaine 1,147 Down 11 % Marijuana/Cannabis/THC 5,276 Down 2 % Methylone (N-Methyl-3,4- Methylenedioxycathinone) 1,194 Up 28 % Hallucinogen 984 Up 88 % Rx Opioids 933 Down 4 % Heroin 925 Up 33 % Rx Benzodiazepines 849 Down 4 % Methamphetamine 211 Up 24 % Phenylimidothiazole Isomer 154 Down 37 % Caffeine 131 Down 45 % All Other Analyzed Drugs 2,272 Down 18 % Total 23,69 Down 3 % Source: US DEA National Forensic Laboratory Information System as of May 9, 214 Jim Hall upfrontin@aol.com 3
4 Molly Methylone is beta-ketone MDMA Emerging Psychoactive Substances Synthetic Cannabinoids Synthetic Cathinones Other Emerging Synthetics Number of Different Drugs South Florida Crime Labs Reports Synthetic Cannabinoids Synthetic Cathinones Other Emerging Synthetics SOURCE: US DEA: National Forensic Laboratory Information System DQS on May 9, 214 Jim Hall upfrontin@aol.com 4
5 # of Drug Occurrences Drug Trends Update Nov 214 Emerging 169 Synthetic Drug Deaths in Florida Present Cause of Death Cannabinoids Cathinones Other Synthetics Source: FDLE Florida Medical Examiners Commission, November 214 2C Phenethylamines 2C-B Jim Hall upfrontin@aol.com 5
6 Percent of High School Males Reporting Having Used Synthetic Marijuana Florida and Broward County % 18% 16% 14% 12% 1% 8% 6% 4% 2% % 15.1 % Florida Lifetime 12.4 % Broward Lifetime 5.3 % Florida Past 3 Days 3.9% Broward Past 3 Days Source: Florida Youth Substance Abuse Survey 212 Jim Hall upfrontin@aol.com 6
7 Methamphetamine Arrests Broward County, FL: Jan 21 July 214 4% 2% % Percent By Year 38% 1% 17% 17% 18% st H 214 Percent By Age n=168 Percent By Race/Gender 64% 1% 7% 28% 4% 3% 2% 1% % 35% 26% 27% 9% 2% 1% < 2 2's 3's 4's 5's 6's Black Female White Female Black Male White Male Jim Hall upfrontin@aol.com 7
8 Methamphetamine Trends Related Deaths Δ 212 vs. 213 State of Florida Up 16 % Primary Treatment Δ 211 vs. 212 State of Florida 1.6 % 2 % Up 25 % So FL Crime Labs Δ 212 vs SE FL Counties Up 24 % Responding to an Epidemic Rx Nonmedical Use in Florida Jim Hall upfrontin@aol.com 8
9 Ft. Lauderdale Pill Mill.The doctor is in 49 in Florida 25 in Broward County 9,21,731 Dose Units Jim Hall 9
10 # Cause of Death Occurrences Florida s Response July 21 Senate Bill 2272 Legal authority to close Pill Mills and limited practitioner dispensing of CS Schedule II to 3-day supply August 21 Tamper-resistant OxyContin. March 211 Law Enforcement Strike Force July House Bill 795 Comprehensive law bans practitioner dispensing of CS II and new regulations. Permits PDMP to operate. Number of Selected Lethal Rx Opioid Occurrences Among Deceased Persons in Florida 28 to 213 CS-II Dispensing Limits & OxyContin Tamper Resistant Strike Force House Bill Takes effect Oxycodone Methadone Morphine Hydrocodone Source: FDLE Drugs Identified In Deceased Persons by Florida Medical Examiners Jan 28 - Dec 213 Reports Jim Hall upfrontin@aol.com 1
11 Grams of Oxycodone Sold per 1, Number of Unique Patients Identified By Threshold Levels Number of Prescribers and Number of Pharmacies by Quarter , 5 Prescribers & 2,864 5 Pharmacies 51-% Decrease Level ,97 1,415 Level Source: Annual Report Florida s Prescription Drug Monitoring Program (PDMP) Levels 9, 1 15 Level 7 Level Grams of Oxycodone Sales in Florida Per 1, Population 7, 6, 5, 63,325 Grams Sold Per 1, Population # 1 National Rank Among States and Territories 4, 3, 2, 1, 28,88 # 19 21,614 # Source: US Drug Enforcement Administration ARCOS Automation of Reports and Consolidated Orders System Jim Hall upfrontin@aol.com 11
12 # of Deaths Hydromorphone (e.g.., Dilaudid ) 213 ARCOS Grams Sold Per 1/Population STATE TOTAL GRAMS GRAMS/ 1K POP 1 FLORIDA 27, , DELAWARE 1, , VERMONT 6, CONNECTICUT 34, VIRGINIA 67, MONTANA 8, NEW 7 HAMPSHIRE 1, MARYLAND 43, WASHINGTON 48, OREGON 27, Source: US DEA ARCOS 3 Report 4 March 5, Hydromorphone Related-Deaths in Florida Source: Florida Medical Examiners Commission Exhibit 4 Top 1 Most Frequently Identified Drugs of Total Reports from South Florida Crime Labs Reports CY Drug 213 % Δ vs. 212 Cocaine 1,147 Down 11 % Marijuana/Cannabis/THC 5,276 Down 2 % Methylone (N-Methyl-3,4- Methylenedioxycathinone) 1,194 Up 28 % Hallucinogen 984 Up 88 % Rx Opioids 933 Down 4 % Heroin 925 Up 33 % Rx Benzodiazepines 849 Down 4 % Methamphetamine 211 Up 24 % Phenylimidothiazole Isomer 154 Down 37 % Caffeine 131 Down 45 % All Other Analyzed Drugs 2,272 Down 18 % Total 23,69 Down 3 % 1 Data are for January December 213 and include primary, secondary, and tertiary reports. SOURCE: NFLIS, DEA, data retrieved May 9, 214 Jim Hall upfrontin@aol.com 12
13 # Heroin Deaths Number of Heroin Deaths in Florida: Florida Palm Beach Broward Miami-Dade SOURCE: Florida Medical Examiners Commission Reports Jim Hall upfrontin@aol.com 13
14 # Heroin Deaths Number of Heroin Deaths in Florida: Palm Beach Broward 5 46 Miami-Dade SOURCE: Florida Medical Examiners Commission Reports Heroin Trends Related Deaths Δ 212 vs. 213 State of Florida Up 7 % Palm Beach County 6 2 Up 233 % Broward County 9 11 Up 22 % Primary Treatment Δ 211 vs. 212 State of Florida 2.2 % 3.2 % Up 45 % So FL Crime Labs Δ 212 vs SE FL Counties Up 33 % Jim Hall upfrontin@aol.com 14
15 Among Florida Youth Most Don t Drink, Smoke, or Take Drugs Screening, Brief Intervention, Referral to Treatment Jim Hall upfrontin@aol.com 15
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