The Broward Report April PDF Free Download

The Broward Report April 2011 Community Epidemiology Work Group James N. Hall South Florida Drug Observatory Nova Southeastern University 2

TODAY S TOPICS Underage Drinking Cocaine Continuing Signs of Decline Rx Opioids: Deaths Continue Unchecked Injecting Drug Use (IDU) Among Rx Opioid Users Marijuana: Increasing Use, Softening of Attitudes New Unregulated Synthetic Drugs On the Radar: Methamphetamine, GHB

CURRENT (PAST 30-DAY) DRUG USE AMONG BROWARD COUNTY MIDDLE SCHOOL STUDENTS 2000-2010 % Reporting Current Use 30 25 20 15 10 5 0 Alcohol Cigarette Marijuana Inhalants 24 19.8 20.1 18.7 16.8 14.8 8.1 7.8 5.9 5.9 5.4 5.4 5 4.3 4.5 4.7 5.2 5 2.5 3.5 3.7 2.5 2.3 1.5 2000 2002 2004 2006 2008 2010 Source: Florida Youth Substance Abuse Surveys 2000-2010

CURRENT (PAST 30-DAY) DRUG USE AMONG BROWARD COUNTY HIGH SCHOOL STUDENTS 2000-2010 % Reporting Current Use 50 45 40 35 30 25 20 15 10 5 0 44 39.9 36 37.3 34.1 34.1 Alcohol Cigarette Marijuana Inhalants 18.7 17.2 13.9 14.5 14 15.3 11.4 12.9 10 7.8 8.2 2.4 6.2 2.2 2 1.9 2.3 1.4 2000 2002 2004 2006 2008 2010 Source: Florida Youth Substance Abuse Surveys 2000-2010

CURRENT (PAST 30-DAY) DRUG USE AMONG BROWARD COUNTY MIDDLE AND HIGH SCHOOL STUDENTS 2000-2010 % Reporting Current Use 35 30 25 20 15 10 5 0 33.1 3.6 14 11.5 31 30.3 Alcohol Cigarette Marijuana Inhalants 27.1 28.3 25.9 10 10.2 9.4 10.6 7.3 9.2 7.8 5.4 5.6 4.2 4.1 4.6 3.7 3.7 2.4 2000 2002 2004 2006 2008 2010 Source: Florida Youth Substance Abuse Surveys 2000-2010

CURRENT (PAST 30-DAY) BINGE DRINKING AMONG BROWARD COUNTY MIDDLE & HIGH SCHOOL STUDENTS 2000-20010 % Reporting Current Use 25 20 15 10 5 0 22.8 8.9 High School Middle School 20.3 17.2 17 6.9 8.8 5.6 18.8 2000 2002 2004 2006 2008 2010 5 16.8 4.4 Source: Florida Youth Substance Abuse Surveys 2000-2010

CURRENT ALCOHOL USE AMONG BROWARD MIDDLE AND HIGH SCHOOL STUDENTS BY GENDER 2000-2010 % Reporting Use Past 30 Days 34 32 30 28 26 24 30.8 29.6 32.8 28.4 30.3 30.9 Male 28.5 28.8 27.8 26 Female 27 24.8 22 2000 2002 2004 2006 2008 2010 Source: Florida Dept. of Children & Families Florida Youth Substance Abuse Surveys 2000-2010

ALCOHOL AND THE YOUNG BRAIN April Alcohol Awareness Month

FINDINGS OF THE NATIONAL EPIDEMIOLOGIC SURVEY ON ALCOHOL AND RELATED CONDITIONS As illustrated in the graph on the next slide, nearly half (or 47 percent) of the survey s 43,093 participants over the age of 18 who reported an alcohol dependency problem sometime in their lifetime had their first drink of alcohol before the age of 13 years. This survey was conducted for the National Institute on Alcohol Abuse and Alcoholism.

AGE OF ONSET AND ANY LIFETIME ALCOHOL DEPENDENCY 50% 47% 45% 38% AGED 18 AND OLDER % Alcohol Dependent 40% 30% 20% 10% 0% 32% 28% 15% 17% 11% 9% 13 14 15 16 17 18 19 20 21 Age Began Drinking Source: National Epidemiologic Survey on Alcohol and Related Conditions Sample = 43,093

The Brain Continues to Develop into Adulthood The brain undergoes dramatic changes during adolescence. One of the areas still maturing from ages 5 to 20 years is the prefrontal cortex, the part of the brain that enables us to assess situations, make sound decisions, and keep emotions and desires under control. Introducing alcohol or other drugs while the brain is still developing may have profound and long-lasting consequences.

Source: SAMHSA-National Survey on Drug Use and Health 2008

PERCENT OF BROWARD COUNTY HIGH SCHOOL STUDENTS REPORTING ALCOHOL USE BY AGE 13 OR YOUNGER 2000-2010 % Reporting Use by Age 13 45 40 35 30 25 20 15 10 5 0 40.7 38.4 36.9 40.1 31.8 24 8.7 6.5 5.8 5.9 5.5 4.6 2000 2002 2004 2006 2008 2010 More than a Sip or Two Drinking at least Once a Month Source: Florida Youth Substance Abuse Surveys 2000-2010

Percent Reporting Use 80 70 60 50 40 30 20 10 0 BROWARD COUNTY STUDENT 25.3 10.2 ALCOHOL USE BY GRADE LEVEL - 2008 Past 30 days Lifetime 35.4 16.4 48.9 23.5 58.1 30.8 62 34.8 66.8 40 71.9 6th 7th 8th 9th 10th 11th 12th 45.7 Source: Florida Youth Substance Abuse Survey 2008 Broward County

PERCEIVED ATTITUDES ABOUT ALCOHOL AMONG BROWARD COUNTY MIDDLE AND HIGH SCHOOL STUDENTS 2000-2010 % Reporting Current Use 100 90 80 70 60 50 40 30 20 10 0 Wrong to Drink Regularly Daily Use Harmful Seen as Cool to Drink 67.8 66.8 66.7 66 69.6 63.9 41.6 42.1 44.5 45.6 46.3 39.1 8.1 9 8.2 10.5 12.1 8 2000 2002 2004 2006 2008 2010 Source: Florida Youth Substance Abuse Surveys 2000-2010

USUAL SOURCE OF ALCOHOL IN PAST 30 DAYS AMONG BROWARD COUNTY AND STATE OF FLORIDA HIGH SCHOOL STUDENTS WHO DRINK: 2010 % of high school drinkers reporting 50 45 40 35 30 25 20 15 10 5 0 11.3 Bought in store 9.2 Broward Florida 4.8 2.4 Bought in restaurant, bar, club 0 0.4 Bought at public event 11.3 19.3 Someone bought it for me Source: Florida Youth Substance Abuse Surveys 2010 47 41.5 Someone gave it to me 1.8 4.3 0.6 7.5 Took it from a Took it from a store family member 19.6 19.1 Some other way

USUAL DRINKING LOCATION IN PAST 30 DAYS AMONG BROWARD COUNTY AND STATE OF FLORIDA HIGH SCHOOL STUDENTS WHO DRINK: 2010 % of high school drinkers reporting 60 50 40 30 20 10 0 22.8 24.6 My home 44.9 48.9 Another person's home 9 4.9 2.6 1.9 4 5.1 Car or Vechile Restaurant, bar, or club Public Place Broward Florida 1.9 1.2 1.1 1.1 Public event School property 12.813.2 Some other place Source: Florida Youth Substance Abuse Surveys 2010

Economic Costs of Underage Drinking in Broward County $ 258,700,000* *2007 Dollars Violent Crime 49% Motor Vechicle Crashes 17% Drownings 4% Burns.02% Fetal Al Synd 3% Risky Sex Behav 11% Poisoning 3% Suicide Property 1% Crime 11% Source: Popovici,I et al. University of Miami Study for Florida s State Epidemiology Work Group, June 2009

Number of Cocaine Reports Detected Among Decedents in South Florida: Jan. 2000 - June 2010 300 250 281 NUMBER of COCAINE OCCURRENCES Including Present & Cause of Death 200 150 100 50 144 80 149 151 94 121 189 138 182 160 162 157 150 136 120 Miami-Dade 201 146 155 135 82 138 0 Broward 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2X 1h'10 SOURCE: Florida Medical Examiners Commission Interim Report 2010

Number of Cocaine Reports Detected Among Decedents in Florida: Jan. 2000 - June 2010 2,500 2,000 1,500 1,000 500 NUMBER of 0 COCAINE OCCURRENCES Including 300 Present & 250 Cause of 200 Death 150 100 50 0 1,3071,614 1,034 1,105 1,702 1,943 2,052 2,179 1,791 1,462 All Florida 1,206 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2X 1h'10 144 149 151 80 94 121 189 138 160 162 120 136 182 150 157 Miami-Dade Broward 2000 2001 2002 2003 2004 2005 2006 2007 2008 20092X 1h'10 SOURCE: Florida Medical Examiners Commission Interim Report 2010 281 201 146 155 135 138 82

Number of Cocaine Reports Among Deceased Persons by Polysubstance Use Status in Florida: 2001-2010 # of Cocaine Detections Among Decedents 2000 1500 1000 500 0 Cocaine Plus Cocaine Only 2001 2002 2003 2004 2005 2006 2007 2008 2009 2X 1h '10 Cocaine Plus 801 942 1142 1269 1443 1520 1639 1,367 1,159 980 CocaineOnly 304 365 472 433 500 532 540 424 303 226 SOURCE: Florida Dept. of Law Enforcement, Florida Medical Examiners Commission Reports 2001-2010

Rates per 100,000 of Cocaine Emergency Dept. Reports Broward (2008), Miami-Dade, and USA: 2004-2009 600 541.1 Rates per 100,000 500 400 300 200 100 397.7 Miami-Dade 162.2 163.6 407.7 400.5 183.7 183.5 USA 302.5 Broward 183.9 158.4 258.3 147 137.7 0 2004 2005 2006 2007 2008 2009 SOURCE: US Dept HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates.

Number of South Florida* Crime Lab Reports for Cocaine and All Other Drugs: 2007-Jun 10 *Miami-Dade, Broward, & Palm Beach Counties Combined Legend Cocaine All Other Drugs 2007 2008 2009 2X1h '10 2007 Cocaine 67% 20,913 10,449 2008 Cocaine 65% 19,156 10,083 2009 Cocaine 62% 15,309 9,403 2010 Cocaine 57% 13,196 10,312 0 10,000 20,000 30,000 40,000 Number of Crime Lab Samples Source: US DEA National Forensic Laboratory Information System

PRICE AND PURITY OF ALL USA LAW ENFORCEMENT COCAINE PURCHASES JANUARY 2006 - JUNE 2009 Price/Pure Gram $200 $180 $160 $140 $120 $100 $80 $60 $40 68.65 $94.05 61.33 $158.01 51.6 $116.36 Price/Pure Gram Purity $174.38 48.6 80 70 60 50 40 30 20 Percent Pure $20 10 $0 2006 2007 2008 1H 2009 0 Source: Based on unpublished US DEA System to Retrieve Information from Drug Evidence (STRIDE) Data

NUMBER OF OPIATE-RELATED DEATHS BY HEROIN OR RX OPIOID IN FLORIDA: 2000-20102010 # of Opiates Detected Among Decedents 4500 4000 3500 3000 2500 2000 1500 1000 500 0 869 276 Heroin 3 Rx Opioids 3 Rx Opioids Heroin 3,986 The 3 Rx Opioids are Methadone, Hydrocodone, and Oxycodone 60 SOURCE: Florida Medical Examiners Commission Reports 2000-2010

Prescription Opioid Nonmedical Use and Heroin Rx Opioid frequently misused by heroin users Not a significant number of Rx Opioid misusers also using heroin Increasing Injecting Drug Use among Rx Opioid nonmedical users in their 20s. Born 1981 to 1990; Entered Adolescence 1994 2003 After major interventions for HIV Injecting Drug Users Priority Public Health Issue: Infected Syringes - Young Adults

Number of Oxycodone Reports Detected Among Decedents in Florida: Jan. 2007 - June 2010 NUMBER of Oxycodone OCCURRENCES Including Present & Cause of Death 1200 1000 800 600 400 200 0 568 685 705 869 Florida 941 1,007 1,117 1H '07 2H '07 1H '08 2H '08 1H '09 2H '09 1H '10 SOURCE: Florida Medical Examiners Commission Interim Report 2010

Number of Oxycodone Reports Detected Among Decedents in Florida: Jan. 2007 - June 2010 NUMBER of Oxycodone OCCURRENCES Including Present & Cause of Death 1200 1000 800 600 400 200 0 160 140 120 100 80 60 40 20 0 1,007 1,117 869 941 568 685 705 Florida 1H '07 2H '07 1H '08 2H '08 1H '09 2H '09 1H '10 60 49 9 Palm Beach Broward Miami-Dade 84 136 124 88 77 96 89 103 91 88 70 47 36 30 30 36 33 16 1H '07 2H '07 1H '08 2H '08 1H '09 2H '09 1H '10 SOURCE: Florida Medical Examiners Commission Interim Report 2010

PERCENT OF OTHER DRUGS DETECTED IN THE 1,185 LETHAL OXYCODONE DEATHS IN FLORIDA: 2009 80% 70% 60% 50% 40% 30% 20% 10% 0% 72% 42% 12% 9% 7% Source: Analysis of 2009 Florida Medical Examiner Commission Complete Electronic Database by Nova Southeastern University Center for Study & Prevention of Substance Abuse

Drug Overdose Death Risk Profile* Demographic Indicators: White Male Approximately 39 years old High School Diploma or GED Employed Static Indicators: History of substance abuse History of drug related arrests History of addiction treatment History of mental health treatment History of non fatal drug overdose Circumstantial Indicators: Died at home Discovered by family member Last act = sleeping Found unconscious Others present at death scene Others aware of fatal drug use Others recognized distress Died from accidental multiple drug toxicity Most likely combinations = (alprazolam, oxycodone, cocaine, methadone) Under a physician s care * The above profile is derived from variables present in at least one third (33.3%) of the 207 closed, overdose death cases in Palm Beach County. SOURCE: Palm Beach County Sheriff s Office and Lynn University 2008

Percent of Primary Treatment Admissions by Substance for the State of Florida: 1999 (n= 84,524) Compared to 2009 (n= 77,604) 5% 0.50% 1% 3% 1999 6.50% 28% Alcohol Only Alcohol w/drug Crack Cocaine Other Cocaine Marijuana 2% 1% 5% 16% 2009 18% 20% 5% 18% 13% Heroin Opioids Amphetamines Tranquilizers Other/Unknown 31% 11% 10% SOURCE: US Dept. HHS-SAMHSA, CBHSQ: Treatment Episodes Data Set (TEDS) as reported by the Florida Department of Children and Families 09/30/2010 2% 4%

Percent of Primary Addiction Treatment Admissions for Rx Opioids among all substances (including alcohol) in Florida: 1998 to 2010 20% 18% 16% 14% 12% 10% 8% 6% 4% 2% 0% 19.1% 15.8% 10.7% 7.3% 8.3% 4.8%4.8% 5.4%5.4% 4.2% 2.1% 2.6%3.4% Source: SAMHSA - Treatment Episode Data Sets Submitted by the Florida Dept. of Children and Families as of January 6, 2011

Number of Primary Addiction Treatment Admissions Number of Primary Addiction Treatment Admissions for Prescription Opioids for Prescription Opioids in Florida by Age: 1999 vs. 2009 3500 3000 1999 n= 2,165 2500 2009 n= 12,103 2000 1500 1000 500 0 1217 yrs 1820 yrs 2125 yrs 2630 yrs 3135 yrs 3640 yrs 4145 yrs 4650 yrs 5155 yrs 5660 yrs 6166 & 65 over yrs 1999 n= 2,165 19 2009 n= 12,103 424 54 160 255 385 437 478 227 93 22 9 6 944 3243 3038 1670 1017 678 569 351 133 24 12 SOURCE: US Dept. HHS-SAMHSA, CBHSQ: Treatment Episodes Data Set (TEDS) as reported by the Florida Department of Children and Families 09/30/2010

Percent of Primary Rx Opioid Addiction Treatment Admissions By Age Groups in Florida: 1998 TO 2010 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010* Unknown Age 66 and older 61 to 65 yrs 56 to 60 yrs 51 to 55 yrs 46 to 50 yrs 41 to 45 yrs 36 to 40 yrs 31 to 35 yrs 26 to 30 yrs 21 to 25 yrs 18 to 20 yrs 12 to 17 yrs Source: SAMHSA - Treatment Episode Data Sets Submitted by the Florida Dept of Children and Families as of January 6, 2011

Sources of Oxycodone Dose Units Dispensed Annually in Florida 83,000,000 Pills 440,000,000 Pills Dispensed by Practitioner Dispensed by Pharmacist or Hospital Source: Analysis of US Department of Justice 2009 and 2010 data by NSU Center for Study And Prevention of Substance Abuse

Oxycodone Dispensed in Florida In 2009, Florida with 5.9 percent of the nation s population dispensed 12.2 percent of all the Oxycodone dose units (or pills) in the nation and 16.9 percent of the total grams of Oxycodone dispensed nationwide. The average dose unit dispensed in Florida was 18 mg as compared to 13 mg nationally. Florida dispensed more pills and total grams of Oxycodone that any other state or territory.

Rates per 100,000 of Nonmedical Use Oxycodone Emergency Dept. Reports Miami-Dade, Broward, and USA: 2004-2009 Rates per 100,000 60 50 40 30 20 10 0 14.2 5.3 17.9 8.2 21.7 25.4 8 8.7 37.8 10.2 34.5 52.8 2004 2005 2006 2007 2008 2009 48.4 SOURCE: US Dept HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates.. Broward USA Miami-Dade 14

Rates per 100,000 of Oxycodone Nonmedical Use Emergency Department Reports by Age Groups DAWN Ft. Lauderdale Division vs. USA: 2009 Rate per 100,000 180 160 140 120 100 80 60 40 20 0 153 158.1 106 117.3 88.6 73.5 USA Broward & Palm Beach 92.6 80.2 67.9 69.1 62.9 61.1 47.1 43 18-20 yrs.21-24 yrs.25-29 yrs.30-34 yrs.35-44 yrs.45-54 yrs.55-64 yrs. SOURCE: US Dept HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates.

Number of Oxycodone Reports Detected Among Decedents by Age Groups in Florida: Jan-Jun 2010 700 # of Oxycodone Reports 600 500 400 300 200 State of Florida 1,117 423 320 238 131 100 1 5 0 <18 yrs. 18-25 yrs. 26-34 yrs. 35-50 yrs. >50 yrs. Source: FDLE Florida Medical Examiners Commission Interim Report 2010

Percent of Persons Aged 12 and Above Reporting Nonmedical Use of Rx Pain Relievers in the Past Year: 2002-2008 6 Percent Reporting Past Year Use 5 4 3 2 1 0 5.01 4.82 4.59 4.53 4.46 4.35 3.82 4.05 3.59 3.43 3.49 3.23 Florida Palm Beach Broward Miam i-dade 2002-04 2004-06 2006-08 SOURCE: SAMHSA (2010): Substate Estimates from the 2002-2008 National Surveys on Drug Use and Health (Office of Applied Studies).

Number of Alprazolam Reports Detected Among Decedents in Florida: Jan. 2007 - June 2010 NUMBER of Alprazolam OCCURRENCES Including Present & Cause of Death 1200 1000 800 600 400 200 0 160 140 120 100 80 60 40 20 0 1,035 942 1,021 796 838 986 652 Florida 1H '07 2H '07 1H '08 2H '08 1H '09 2H '09 1H '10 Palm Beach 151 139 62 44 22 Broward Miami-Dade 107 106 80 77 69 79 81 71 52 63 44 53 38 1H '07 2H '07 1H '08 2H '08 1H '09 2H '09 1H '10 100 55 36 SOURCE: Florida Medical Examiners Commission Interim Report 2010

Percent of High School Students Reporting Any Past 30-Day Marijuana Use Broward County, FL: 1991-2009 Percent Reporting Current Use 25 20 15 10 5 13.5 17.9 19.1 19 20.9 Broward 21.8 17.9 17.3 17 23.7 0 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 Source: Centers for Disease Control and Prevention: Youth Risk Behavior Surveillance

PERCEIVED ATTITUDES ABOUT MARIJUANA AMONG BROWARD COUNTY MIDDLE AND HIGH SCHOOL STUDENTS 2000-2010 % Reporting Current Use 100 90 80 70 60 50 40 30 20 10 0 Wrong to Smoke Marijuana Regular Use Harmful Seen as Cool to Use Trying Marijuana Harmful 80.5 81 81.3 84.5 80.9 80.3 58 58.2 29.9 29.4 61.4 65.1 33.3 36.1 58.9 10.5 12.4 10.9 9.8 11.3 Source: Florida Youth Substance Abuse Surveys 2000-2010 54.8 31.4 30.6 2000 2002 2004 2006 2008 2010 14.9

Percent of Broward Middle School Students Reporting Delinquent Behaviors by 60% 50% 40% 30% 20% 10% 0% 28% 19% 2% 2% 3% Carried Handgun Not Current Marijuana Users Past Month Marijuana Users Attempted Steal Vehicle 28% Be en Arrested 1% 7% Handgun to School 13% 48% Bee n Suspended 11% 40% Attacked to Hurt 3% Drunk or High at School 57% 1% 35% Sold Illegal Drugs Source: FL DCF 2008 Florida Youth Substance Abuse Survey Broward County % Reporting Delinquent Behavior in Past Year Current (past 30-day) & Non-Current Marijuana Use

Percent of Broward High School Students Reporting Delinquent Behaviors by 60% 50% 40% 30% 20% 10% 0% 3% 10% Carried Handgun Not Current Marijuana Users Past Month Marijuana Users 6% 1% Attempted Steal Vehicle 3% 17% Be en Arrested 3% 1% Handgun to School 22% 9% 8% Bee n Suspended 27% Attacked to Hurt 5% Drunk or High at School 51% 2% 30% Sold Illegal Drugs Source: FL DCF 2008 Florida Youth Substance Abuse Survey Broward County Sample= 4,993 Broward High School Students % Reporting Delinquent Behavior in Past Year Current (past 30-day) & Non-Current Marijuana Use

5% 20% Percent of Primary Treatment Admissions by Substance for the State of Florida: 1999 (n= 84,524) Compared to 2009 (n= 77,604) 0.50% 1999 1% 6.50% 3% 5% 18% 28% 13% Alcohol Only Alcohol w/drug Crack Cocaine Other Cocaine Marijuana Heroin Opioids Amphetamines Tranquilizers Other/Unknown 18% 11% 10% SOURCE: US Dept. HHS-SAMHSA, CBHSQ: Treatment Episodes Data Set (TEDS) as reported by the Florida Department of Children and Families 09/30/2010 2% 16% 31% 2% 1% 5% 2009 4%

Widely Available Synthetic Cannabinoids Need for Laboratory Standards - Crime Labs - Urine Drug Tests

WHOLE NEW PHARMACOPOEIA? Synthetic Stimulants, Hallucinogens, and Marijuana Substitutes Not New Science 40 years of Pharmaceutical Research Rejected for Medical/Human Use Not profitable for drug traffickers

21 ST CENTURY: THE PERFECT STORM Cheap to make in China and elsewhere Easy to Market Worldwide via Internet Particularly to Drug Users Subculture International Delivery Services Legal Retailers Not for Humans The Mimic Drugs Fake Pot, Ecstasy Beat the Drug Test Highly Profitable Incense. Bath Salts Role of Organized Crime or Terrorism? Global Phenomena

65 PERCENT OF BROWARD CRIME LAB ALLEGED ECSTASY IS BZP IN 2010 BZP TFMPP?

Be On ALERT MEPHEDRONE Meow Meow MDPV I-10 from New Orleans 2C-E Europa Chlorophenylpiperazine - mcpp

MDPV (3,4-Methylenedioxypyrovalerone)

ON THE RADAR Return of GHB Drug-Facilitated Rape New Sources of Methamphetamine

The Broward Report April 2011 James N. Hall South Florida Drug Observatory Nova Southeastern University Phone: (786) 242-8222 E-Mail: upfrontin@aol.com