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
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 24-211 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 28-21 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
Rate per 1, NUMBER of COCAINE OCCURRENCES Including Present & Cause of Death Number of Cocaine Reports Detected Among Decedents in Florida: 2-212 2,5 2, 1,5 1, 5 3 25 2 15 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 1,336 21 22 23 24 25 26 27 28 29 21 211 2X 1h 212 149 151 94 121 189 138 281 182 16 162 12 21 155 198 184 186 136 15 157 146 135 127 Broward 115 116 21 22 23 24 25 26 27 28 29 21 211 2X 1h 212 Rate of Cocaine Emergency Department Reports Per 1,, Broward & Palm Beach Counties, and USA: 24-211 6 5 4 3 2 1 41.5 547.4 = Significant Difference with 211 413.3 46.8 37.8 262.1 227.8 311.4 184.2 147.3 Broward & Palm Beach USA 199.4 157.8 162.4 163.7 183.9 183.8 158.6 162.1 137.9 132.7 24 25 26 27 28 29 21 211 SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates 24-211 Jim Hall upfrontin@aol.com 3
# 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 11,411 48.2% Down 16 % Marijuana/Cannabis 5,388 22.8% Up 8 % Rx Opioids 975 4.1% Down 31 % Rx Benzodiazepines 882 3.7% Down 16 % Heroin 696 2.9% Up 21 % Hallucinogen 524 2.2% Up 16 % Methylone (N-Methyl-3,4- Methylenedioxycathinone) 388 1.6% Up 15 % Phenylimidothiazole Iso Undeterm 246 1.% Down 9 % Caffeine 237 1.% Down 17 % Methamphetamine 17.7% Up 17 % All Other Analyzed Drugs 2,754 11.6% 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 212 4 328 35 326 3 276 261 25 Florida Broward 2 18 15 122 11 132 111 96 1 61 58 53 5 49 35 22 2 26 38 5 3 26 39 46 32 17 18 4 17 13 4 17 8 5 2 1 7 2 4 SOURCE: Florida Medical Examiners Commission Reports 2-212 Jim Hall upfrontin@aol.com 4
# of primary Treatment Admissions Number of Primary Heroin Treatment Admissions and Broward Counties, FL: 29-212 35 3 25 2 15 1 5 Broward 292 227 15 183 161 156 169 15 29 1 21 2 211 3 212 4 29 5 621 7211 212 8 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
# Cause of Death Occurrences Number of Selected Lethal Rx Opioid Occurrences Among Deceased Persons in Florida Jan 28 to Jun 212 9 8 7 6 5 4 3 2 1 476 465 337 336 533 38 652 34 715 336 358 81 67 64 341 35 1H8 2H8 1H9 2H9 1H1 2H1 1H11 2H11 1H12 392 274 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: 27-212 NUMBER of Oxycodone OCCURRENCES Including Present & Cause of Death 6 5 4 3 2 1 Palm Beach Broward All 3 Counties 513 475 382 38 225 236 171 144 165 184 177 1 119 66 45 46 489 24 276 174 12 88 75 68 27 28 29 21 211 2x1H12 SOURCE: Florida Medical Examiners Commission Interim Report 212 Jim Hall upfrontin@aol.com 6
Rate per 1, Rate per 1, Rate of NMU Rx Opioid Emergency Department Reports Per 1,, Broward & Palm Beach Counties, and USA: 24-211 2 15 1 5 Broward & Palm Beach USA = Significant Difference with 211 156.6 153.3 135 12.6 118.7 95.8 17.3 95.1 77.9 73.6 83 42.4 59 19.7 3.7 27.2 3.7 29.2 33.4 33.4 24 25 26 27 28 29 21 211 SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates 24-211 E 2 18 16 14 12 1 8 6 4 2 Rates per 1, of Oxycodone Nonmedical Use Emergency Department Reports by Age Groups DAWN Ft. Lauderdale Division vs. USA: 211 65.2 18-2 yrs. 186.9 184.3 1.4 91.9 88.7 21-24 yrs. 25-29 yrs. USA 3-34 yrs. 157.5 Broward & Palm Beach 78.3 66.8 57.4 35-44 yrs. 45-54 yrs. 14.8 5.9 5.7 55-64 yrs. SOURCE: US Dept HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates. Jim Hall upfrontin@aol.com 7
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 11,411 48.2% Down 16 % Marijuana/Cannabis 5,388 22.8% Up 8 % Rx Opioids 975 4.1% Down 31 % Rx Benzodiazepines 882 3.7% Down 16 % Heroin 696 2.9% Up 21 % Hallucinogen 524 2.2% Up 16 % Methylone (N-Methyl-3,4- Methylenedioxycathinone) 388 1.6% Up 15 % Phenylimidothiazole Iso Undeterm 246 1.% Down 9 % Caffeine 237 1.% Down 17 % Methamphetamine 17.7% Up 17 % All Other Analyzed Drugs 2,754 11.6% 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 211 212 OXYCODONE 1,22 679 HYDROCODONE 115 122 METHADONE 66 33 BUPRENORPHINE 47 28 MORPHINE 3 51 CODEINE 25 31 HYDROMORPHONE 24 151 TRAMADOL 7 11 OXYMORPHONE 3 1 PROPOXYPHENE 3 FENTANYL 1 BENZYLMORPHINE 1 DIHYDROCODEINE 1 DIHYDRONORMORPHINONE 1 TOTAL OPIOIDS 1,525 975 Jim Hall upfrontin@aol.com 8
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
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: 22-21 6 5 4 3 2 1 4.82 5.1 4.76 4.89 4.46 USA 3.82 Florida Broward 4.35 5.3 4.87 3.43 4.22 2.96 22-4 24-6 26-8 28-1 SOURCE: SAMHSA-CBHSQ(212): Substate Estimates from the 22-21 National Surveys on Drug Use and Health Jim Hall upfrontin@aol.com 1
# Cause of Death Occurrences Number of Alprazolam and Diazepam Occurrences Among Deceased Persons in Florida Jan 28 to Jun 212 6 5 4 3 2 1 354 351 15 1 378 444 439 542 Alprazolam Diazepam 127 121 136 141 126 461 486 18 323 11 1H8 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 211 212 ALPRAZOLAM 981 729 CLONAZEPAM 72 74 DIAZEPAM 42 46 LORAZEPAM 22 14 TEMAZEPAM 4 17 TRIAZOLAM 2 BROMAZEPAM 1 FLURAZEPAM 1 TOTAL 1,123 882 Jim Hall upfrontin@aol.com 11
Rate per 1, Rate of Marijuana Emergency Department Reports Per 1,, Broward & Palm Beach Counties, and USA: 24-211 3 25 2 15 1 5 159.2 = Significant Difference with 211 217.6 18.1 148 138.6 137 96.2 94.6 97.4 12.4 123.1 122.7 97 94.4 Broward & Palm Beach USA 187.8 149 146.2 126 128.6 15.7 24 25 26 27 28 29 21 211 SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates 24-211 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 139 58 93 161 292 122 55 67 1,26 1,69 1,36 941 1,576 1,748 5 1 15 2 Number of Primary Admissions Broward Source: Florida Department of Children and Families Jim Hall upfrontin@aol.com 12
The pen is mightier than the pipe? Jim Hall upfrontin@aol.com 13
Cannabinmimetics Poison Exposure Calls Number of Cannabinmimetics Poison Control Exposure Calls 211 212 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 517 537* 78 Broward County 38 37 2 County 36 45 6 Palm Beach County 29 24 1 * The total of 537 includes 271 in Jan-Apr 212 Source: Florida Poison Information Center Miami 1-8-222-1222 Number of Cannabinmimetic Poison Control Exposure Calls Jan-Apr 213 Source: Florida Poison Information Center Miami 1-8-222-1222 Jim Hall upfrontin@aol.com 14
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 211 212 AM-221 114 JWH-18 19 27 XLR-11 25 JWH-81 6 UR-144 5 JWH-122 4 JWH-25 4 JWH-73 2 RCS-8 2 JWH-23 1 TOTAL 19 19 Rate of MDMA Emergency Department Reports Per 1,, Broward & Palm Beach Counties, and USA: 24-211 25 2 15 1 5 Broward & Palm Beach USA 8.8 8.7 3.5 3.8 6 5.6 8 4.2 12.1 7.3 5.9 = Significant Difference with 211 8.3 7.8 15.6 1.4 13.1 7.4 7.1 7.2 24 25 26 27 28 29 21 211 SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates 24-211 Jim Hall upfrontin@aol.com 15
Number of South Florida Synthetic Cathinones Crime Lab Reports 211 vs. 212 46-% 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 211 212 Methylone 27 388 4-MEC 3 36 3,4-METHYLENEDIOXY- DIMETHYLCATHINONE 2 Mephedrone 12 2 TOTAL 42 428 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 1-8-222-1222 Jim Hall upfrontin@aol.com 16
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 211 212 BZP 13 113 5-MEO-DIPT 133 89 TFMPP 83 86 MDPV 32 58 DMT 6 4 2C-B 2 2 4- METHOXYMETHAMPHETAMINE 5-MEO-MIPT 2 ALPHA-PVP 2 MMDA 1 ALPHA-METHYLTRYPTAMINE 1 TRYPTAMINE 1 TOTAL 386 361 2 Rate of Illicit Stimulant Emergency Department Reports Per 1,, Broward & Palm Beach Counties, and USA: 24-211 8 7 6 5 4 3 2 1 55.5 7.1 46.6 1.9 36.1 Broward & Palm Beach USA 28.2 3.2 3.5 6.7 6.4 5.9 6.3 5.2 6.2 44.8 7.1 5.6 51.3 1.6 8 24 25 26 27 28 29 21 211 SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates 24-211 Jim Hall upfrontin@aol.com 17
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
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
Surveillance Support Committee Jim Hall upfrontin@aol.com 2