National Drug Early Warning System (NDEWS) Sentinel Community Site (SCS) Drug Use Patterns and Trends: SCS Data Tables

National Drug Early Warning System (NDEWS) Sentinel Community Site (SCS) Drug Use Patterns and Trends: SCS Data Tables The SCS Data Tables are prepared by NDEWS Coordinating Center staff and include information on demographic and socioeconomic characteristics of the population, drug use, substance use disorders and treatment, drug poisoning deaths, and drug seizures for the Sentinel Community Site. The SCS Data Tables attempt to harmonize data available for each of the 12 sites by presenting standardized information from local treatment admissions and five national data sources: American Community Survey; National Survey on Drug Use and Health; Youth Risk Behavior Survey; SCE-provided local treatment admissions data; National Vital Statistics System mortality data queried from CDC WONDER; and National Forensic Laboratory Information System. The SCS Data Tables for each of the 12 Sentinel Community Sites and detailed information about NDEWS can be found on the NDEWS website at www.ndews.org. NDEWS Atlanta Metro SCS Drug Use Patterns and Trends, 2017 20

Table 1: Demographic and Socioeconomic Characteristics Atlanta Metropolitan Statistical Area (MSA)^, Georgia 2011 2015 ACS 5-Year Estimates Estimate Margin of Error Total Population 5,535,837 ** Age 18 years and over (%) 74.4% +/-0.1 21 years and over (%) 70.3% +/-0.1 65 years and over (%) 10.3% +/-0.1 Median Age (years) 35.7 +/-0.1 Race (%) White, Not Hisp. 49.4% +/-0.1 Black/African American, Not Hisp. 32.5% +/-0.1 Hispanic/Latino (of any race) 10.5% ** American Indian/Alaska Native, Not Hisp. 0.2% +/-0.1 Asian, Not Hisp. 5.3% +/-0.1 Native Hawaiian/Pacific Islander, Not Hisp. 0.0% +/-0.1 Some Other Race 0.3% +/-0.1 Two or More Races 1.9% +/-0.1 Sex (%) Male 48.5% +/-0.1 Female 51.5% +/-0.1 Educational Attainment (Among Population Aged 25+ Years ) (%) High School Graduate or Higher 88.2% +/-0.1 Bachelor's Degree or Higher 35.8% +/-0.2 Unemployment (Among Civilian Labor Force Population Aged 16+ Years ) (%) Unemployment 9.5% +/-0.2 Income ($) Median Household Income (in 2015 inflation-adjusted dollars) $57,000 +/-272 Health Insurance Coverage (Among Civilian Noninstitutionalized Population) (%) No Health Insurance Coverage 16.8% +/-0.2 Poverty (%) All People Whose Income in Past 12 Months Is Below Poverty Level 15.6% +/-0.2 Margin of Error: Can be interpreted roughly as providing a 90% probability that the interval defined by the estimate minus the margin of error and the estimate plus the margin of error (the lower and upper confidence bounds) contains the true value. ^Atlanta MSA: In 2013, the U.S. Office of Management and Budget (OMB) revised MSA delineations across the country; the new Atlanta-Sandy Springs-Roswell, Georgia MSA comprises 29 counties (previously, 28 counties). The 29 counties are Barrow, Bartow, Butts, Carroll, Cherokee, Clayton, Cobb, Coweta, Dawson, DeKalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Haralson, Heard, Henry, Jasper, Lamar, Meriwether, Morgan, Newton, Paulding, Pickens, Pike, Rockdale, Spalding, and Walton. The principal cities of the Atanta MSA include Atlanta, Sandy Springs, Roswell, Alpharetta, and Marietta. **The estimate is controlled; a statistical test for sampling variability is not appropriate. SOURCE: Adapted by the NDEWS Coordinating Center from data provided by the U.S. Census Bureau, 2011 2015 American Community Survey (ACS) 5-Year Estimates. NDEWS Atlanta Metro SCS Drug Use Patterns and Trends, 2017 21

Table 2a: Self-Reported Substance Use Behaviors Among Persons 12+ Years in Atlanta Region^, 2012 2014 Estimated Percent, 95% Confidence Interval, and Estimated * Annual Averages Based on Combined 2012 to 2014 NSDUH Data Substate Region: Atlanta^ Substance Use Behaviors Used in Past Month Estimated % (95% CI)* Estimated #* Alcohol 49.91 (45.72 54.10) 1,213,751 Binge Alcohol** 19.50 (16.89 22.40) 474,135 Marijuana 7.95 (6.34 9.93) 193,391 Use of Illicit Drug Other Than Marijuana 3.87 (2.88 5.20) 94,212 Used in Past Year Cocaine 2.15 (1.36 3.37) 52,302 Nonmedical Use of Pain Relievers 4.18 (3.25 5.37) 101,747 Substance Use Disorders in Past Year*** Illicit Drugs or Alcohol 7.99 (6.64 9.60) 194,422 Alcohol 6.47 (5.19 8.04) 157,410 Illicit Drugs 3.06 (2.34 4.00) 74,476 ^Atlanta Region: NSDUH Substate Region 3, which comprises Clayton, DeKalb, Fulton, Gwinnett, Newton, and Rockdale counties. *Estimated %: Substate estimates are based on a small area estimation methodology in which 2012 2014 substate level NSDUH data are combined with county and census block group/tract-level data from the state; 95% Confidence Interval (CI): Provides a measure of the accuracy of the estimate. It defines the range within which the true value can be expected to fall 95 percent of the time; Estimated #: The estimated number of persons aged 12 or older who used the specified drug or are dependent/abuse a substance was calculated by multiplying the prevalence rate and the population estimate of persons 12+ years (2,431,810) from Table C1 of the NSDUH report. The population estimate is the simple average of the 2012, 2013, and 2014 population counts for persons aged 12 or older. **Binge Alcohol: Defined as drinking 5 or more drinks on the same occasion on at least 1 day in the past 30 days. ***Substance Use Disorders in Past Year: Persons are classified as having a substance use disorder in the past 12 months based on reponses to questions that meet the criteria specified in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). SOURCE: Adapted by the NDEWS Coordinating Center from data provided by the Substance Abuse and Mental Health Services Administration (SAMHSA), Substate Estimates of Substance Use and Mental Illness from the 2012 2014 National Surveys on Drug Use and Health. Available at: http://www.samhsa.gov/data/population-data-nsduh/reports?tab=38 NDEWS Atlanta Metro SCS Drug Use Patterns and Trends, 2017 22

Table 2b: Self-Reported Substance Use Behaviors Among Persons in Atlanta Region^, by Age Group, 2012 2014 Estimated Percent and 95% Confidence Interval (CI)*, Annual Averages Based on Combined 2012 to 2014 NSDUH Data Substate Region: Atlanta^ Substance Use Behaviors Used in Past Month 12 17 18 25 Estimated Percent (95% CI)* Estimated Percent (95% CI)* 26+ Estimated Percent (95% CI)* Binge Alcohol** 4.90 (3.65 6.57) 28.47 (24.13 33.25) 19.88 (16.74 23.45) Marijuana 6.78 (5.09 8.97) 19.82 (16.09 24.17) 6.07 (4.37 8.36) Use of Illicit Drug Other Than Marijuana 4.44 (3.11 6.30) 6.04 (4.29 8.43) 3.43 (2.33 5.02) Used in Past Year Cocaine 0.49 (0.25 0.96) 3.67 (2.30 5.81) 2.11 (1.22 3.61) Nonmedical Use of Pain Relievers 5.14 (3.70 7.11) 7.72 (5.92 10.02) 3.45 (2.44 4.86) Substance Use Disorder in Past Year*** Illicit Drugs or Alcohol 5.03 (3.67 6.85) 15.88 (12.74 19.61) 7.03 (5.54 8.89) Alcohol 2.02 (1.38 2.93) 11.55 (8.99 14.74) 6.19 (4.74 8.04) Illicit Drugs 3.96 (2.80 5.57) 7.63 (5.64 10.24) 2.16 (1.45 3.21) ^Atlanta Region: NSDUH Substate Region 3, which comprises Clayton, DeKalb, Fulton, Gwinnett, Newton, and Rockdale counties. *Estimated %: Substate estimates are based on a small area estimation methodology in which 2012 2014 substate level NSDUH data are combined with county and census block group/tract-level data from the state; 95% Confidence Interval (CI): Provides a measure of the accuracy of the estimate. It defines the range within which the true value can be expected to fall 95 percent of the time. **Binge Alcohol: Defined as drinking 5 or more drinks on the same occasion on at least 1 day in the past 30 days. ***Substance Use Disorders in Past Year: Persons are classified as having a substance use disorder in the past 12 months based on responses to questions that meet the criteria specified in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). SOURCE: Adapted by the NDEWS Coordinating Center from data provided by the Substance Abuse and Mental Health Services Administration (SAMHSA), Substate Estimates of Substance Use and Mental Illness from the 2012 2014 National Surveys on Drug Use and Health. Available at: http://www.samhsa.gov/data/population-data-nsduh/reports?tab=38 NDEWS Atlanta Metro SCS Drug Use Patterns and Trends, 2017 23

Table 3: Self-Reported Substance Use Behaviors Among Georgia ^ Public High School Students, 2013 1 Estimated Percent and 95% Confidence Interval (CI) 2011 and 2013 YRBS* 2013 vs 2011 2013 by Sex 2013 by Race 2013 2011 Male Female White Black Hispanic Substance Use Behaviors Percent Estimate (95% CI) Estimate (95% CI) p- value Percent Estimate (95% CI) Estimate (95% CI) p- value Estimate (95% CI) Percent Estimate (95% CI) Estimate (95% CI) Used in Past Month Alcohol 27.9 (23.8-32.3) 34.6 (30.7-38.7) 0.02 25.0 (20.1-30.7) 30.3 (25.7-35.4) 0.06 31.9 (25.4-39.2) 22.6 (18.3-27.5) 30.8 (23.4-39.5) Binge Alcohol** 13.3 (11.1-15.8) 17.5 (14.4-21.0) 0.04 13.8 (10.5-17.9) 12.7 (10.4-15.4) 0.58 17.4 (13.5-22.1) 7.9 (6.1-10.1) 15.8 (10.8-22.6) Marijuana 20.3 (17.0-23.9) 21.2 (18.8-23.9) 0.64 21.3 (17.5-25.7) 19.1 (15.8-22.9) 0.20 16.9 (13.0-21.8) 23.1 (18.4-28.6) 23.9 (18.5-30.3) Ever Used in Lifetime Alcohol 59.2 (55.1-63.2) 66.1 (62.2-69.8) 0.01 55.5 (50.5-60.3) 62.8 (57.8-67.5) 0.01 61.2 (55.1-66.9) 55.2 (51.3-59.1) 65.4 (57.2-72.7) Marijuana 35.9 (31.7-40.2) 37.9 (34.4-41.6) 0.44 38.0 (32.6-43.7) 33.7 (29.8-37.7) 0.06 31.3 (25.3-38.0) 41.2 (35.6-47.0) 40.0 (30.6-50.2) Cocaine 7.0 (5.4-9.1) 6.7 (5.3-8.5) 0.80 8.0 (5.8-10.9) 5.6 (4.2-7.6) 0.07 5.3 (3.6-7.6) 6.5 (4.0-10.4) 11.0 (7.8-15.4) Hallucinogenic Drugs ~ ~ Inhalants 9.9 (8.2-12.0) 13.2 (11.8-14.8) 0.01 11.2 (8.6-14.5) 8.2 (6.7-9.9) 0.06 8.1 (5.7-11.4) 9.1 (6.7-12.1) 15.0 (10.5-21.0) Ecstasy also called "MDMA" 7.1 (5.6-8.8) 8.5 (6.8-10.6) 0.24 8.7 (6.6-11.4) 5.0 (3.8-6.7) 0.00 5.6 (3.8-8.2) 6.2 (3.7-10.3) 11.2 (7.7-15.9) Heroin 4.7 (3.4-6.3) ~ ~ Methamphetamine 6.0 (4.8-7.6) ~ ~ Rx Drugs without a Doctors Prescription 17.7 (16.1-19.5) ~ 19.5 (16.7-22.6) 15.7 (13.4-18.4) 0.08 18.5 (14.8-22.9) 14.9 (11.7-18.9) 18.7 (13.3-25.6) Injected Any Illegal Drug 2.9 (2.2-3.9) ~ ~ 1 2013: 2015 YRBS data not available for Atlanta or Georgia so 2013 Georgia data is presented. ' ' = Data not available; ~ = P-value not available; N/A = < 100 respondents for the subgroup. ^Georgia: data not available for Atlanta so data for State of Georgia provided; weighted data were available for Georgia in 2011 and 2013; weighted results mean that the overall response rate was at least 60%. The overall response rate is calculated by multiplying the school response rate times the student response rate. Weighted results are representative of all students in grades 9 12 attending public schools in each jurisdiction. *Sample Frame for the 2011 and 2013 YRBS: sampling frame consisted of public schools with students in at least one of grades 9-12. The sample size for 2011 was 1,969 with an overall response rate of 72%; the 2013 sample size was 1,992 with a 61% overall response rate. **Binge Alcohol: defined as had five or more drinks of alcohol in a row within a couple of hours on at least 1 day during the 30 days before the survey. Source: Adapted by the NDEWS Coordinating Center from data provided by the Centers for Disease Control and Prevention (CDC), 1991-2013 High School Youth Risk Behavior Survey Data. Available at http://nccd.cdc.gov/youthonline/. Accessed on [3/12/2015]. NDEWS Atlanta Metro SCS Drug Use Patterns and Trends, 2017 24

Table 4a: Trends in Admissions* to Programs Treating Substance Use Disorders, Atlanta MSA^, 2012-2016 of Admissions and Percenage of Admissions with Selected Substances Cited as Primary Substance of Abuse at Admission, by Year and Substance (%) (%) (%) (%) (%) Total Admissions 9,000 100% 8,911 100% 8,384 100% unavail unavail unavail unavail Primary Substance of Abuse (%) Calendar Year 2012 2013 2014 2015 2016 Alcohol 4,470 49.7% 4,205 47.2% 3,856 46.0% unavail unavail unavail unavail Cocaine/Crack 928 10.3% 862 9.7% 845 10.1% unavail unavail unavail unavail Heroin 377 4.2% 548 6.1% 631 7.5% unavail unavail unavail unavail Prescription Opioids 629 7.0% 619 6.9% 366 4.4% unavail unavail unavail unavail Methamphetamine 567 6.3% 667 7.5% 736 8.8% unavail unavail unavail unavail Marijuana** 1,435 15.9% 1,423 16.0% 1,342 16.0% unavail unavail unavail unavail Benzodiazepines 185 2.1% 192 2.2% 140 1.7% unavail unavail unavail unavail MDMA 6 <1% 6 <1% 3 <1% unavail unavail unavail unavail Synthetic Stimulants 69 0.8% 118 1.3% 119 1.4% unavail unavail unavail unavail Synthetic Cannabinoids** unavail unavail unavail unavail unavail unavail unavail unavail unavail unavail Other Drugs/Unknown 334 3.7% 271 3.0% 346 4.1% unavail unavail unavail unavail *Admissions: Includes admissions to publicly funded programs. Each admission does not necessarily represent a unique individual because some individuals are admitted to treatment more than once in a given period. ^Atlanta MSA: Includes the following 29 counties Barrow, Bartow, Butts, Carroll, Cherokee, Clayton, Cobb, Coweta, Dawson, DeKalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Haralson, Heard, Henry, Jasper, Lamar, Meriwether, Morgan, Newton, Paulding, Pickents, Pike, Rockdale, Spalding, and Walton. **Marijuana/Synthetic Cannabinoids: The data do not differentiate between marijuana and synthetic cannabinoids. unavail: Data not available. NOTE: Data for Calendar Years 2015 and 2016 are not available for the Atlanta Metro SCS at this time. SOURCE: Data provided to the Atlanta Metro NDEWS SCE by the Georgia Department of Human Resources. NDEWS Atlanta Metro SCS Drug Use Patterns and Trends, 2017 25

Table 4b: Demographic and Drug Use Characteristics of Primary Treament Admissions* for Select Substances of Abuse, Atlanta MSA^, 2014** of Admissions, by Primary Substance of Abuse and Percentage of Admissions with Selected Demographic and Drug Use Characteristics # % # % # % # % # % # % # % of Admissions 3,856 100% 845 100% 631 100% 467 100% 736 100% 1,342 100% 140 100% Sex (%) Male 2,622 68.0% 495 58.6% 359 56.9% 200 42.8% 307 41.7% 875 65.2% 82 58.6% Female 1,234 32.0% 350 41.4% 272 43.1% 267 57.2% 429 58.3% 467 34.8% 58 41.4% Race/Ethnicity (%) White, Non-Hisp. 1,819 47.2% 148 17.5% 485 76.9% 396 84.8% 686 93.2% 421 31.4% 120 85.7% African-Am/Black, Non-Hisp 1,859 48.2% 663 78.5% 118 18.7% 56 12.0% 26 3.5% 803 59.8% 15 10.7% Hispanic/Latino 97 2.5% 21 2.5% 13 2.1% 3 0.6% 8 1.1% 69 5.1% 5 3.6% Asian/Pacific Islander 11 0.3% 0 0.0% 9 1.4% 4 0.9% 5 0.7% 6 0.4% 0 0.0% Other 70 1.8% 13 1.5% 6 1.0% 8 1.7% 11 1.5% 43 3.2% 0 0.0% Age Group (%) Under 18 9 0.2% 1 0.1% 4 0.6% 4 0.9% 5 0.7% 178 13.3% 2 1.4% 18-25 307 8.0% 55 6.5% 160 25.4% 88 18.8% 133 18.1% 453 33.8% 30 21.4% 26-44 1,816 47.1% 379 44.9% 352 55.8% 307 65.7% 510 69.3% 592 44.1% 82 58.6% 45+ 1,724 44.7% 410 48.5% 115 18.2% 68 14.6% 88 12.0% 119 8.9% 26 18.6% Route of Administration (%) Smoked 0 0.0% 612 72.4% 7 1.1% 12 2.6% 349 47.4% 1,282 95.5% 2 1.4% Inhaled 0 0.0% 188 22.2% 80 12.7% 34 7.3% 112 15.2% 5 0.4% 0 0.0% Injected 0 0.0% 15 1.8% 523 82.9% 48 10.3% 215 29.2% 0 0.0% 2 1.4% Oral/Other/Unknown 3,856 100.0% 30 3.6% 21 3.3% 373 79.9% 60 8.2% 55 4.1% 136 97.1% Secondary Substance (%) None 1,477 38.3% 239 28.3% 143 22.7% 130 27.8% 218 29.6% 581 43.3% 23 16.4% Alcohol 0 0.0% 341 40.4% 71 11.3% 46 9.9% 115 15.6% 447 33.3% 12 8.6% Benzodiazepines unavail unavail unavail unavail unavail unavail unavail unavail unavail unavail unavail unavail 0 0.0% Cocaine/Crack 1,050 27.2% 12 1.4% 99 15.7% 12 2.6% 38 5.2% 103 7.7% 8 5.7% Heroin 84 2.2% 19 2.2% 0 0.0% 20 4.3% 36 4.9% 8 0.6% 15 10.7% Prescription Opioids 84 2.2% 6 0.7% 79 12.5% 0 0.0% 65 8.8% 23 1.7% 34 24.3% Methamphetamine 131 3.4% 12 1.4% 72 11.4% 5 1.1% 0 0.0% 118 8.8% 19 13.6% Marijuana** 837 21.7% 196 23.2% 78 12.4% 9 1.9% 212 28.8% 0 0.0% 14 10.0% *Admissions: Includes admissions to publicly funded programs. Each admission does not necessarily represent a unique individual because some individuals are admitted to treatment more than once in a given period. ^Atlanta MSA: Includes the following 29 counties Barrow, Bartow, Butts, Carroll, Cherokee, Clayton, Cobb, Coweta, Dawson, DeKalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Haralson, Heard, Henry, Jasper, Lamar, Meriwether, Morgan, Newton, Paulding, Pickents, Pike, Rockdale, Spalding, and Walton. **2014: Data for Calendar Years 2015 and 2016 are not available at this time; therefore, CY 2014 data, the most current data available, are presented. ***Marijuana/Synthetic Cannabinoids: The data do not differentiate between marijuana and synthetic cannabinoids. unavail: Data not available. SOURCE: Data provided to the Atlanta Metro NDEWS SCE by the Georgia Department of Human Resources. Primary Substance of Abuse Alcohol Cocaine/Crack Heroin Prescription Opioids Methamphetamine Marijuana*** Benzodiazepines NDEWS Atlanta Metro SCS Drug Use Patterns and Trends, 2017 26

Table 5: Drug Poisoning Deaths*, by Drug** and Year, Atlanta MSA ^, 2011 2015, Crude, and Age-Adjusted *** (per 100,000 population) 2011 2012 2013 2014 2015 Crude Age- Adjusted Crude Age- Adjusted Crude Age- Adjusted Crude Age- Adjusted Crude Age- Adjusted Drug Poisoning Deaths 556 10.3 10.0 555 10.2 9.9 576 10.4 10.1 716 12.8 12.5 796 13.9 13.6 Opioids ± 286 5.3 5.1 295 5.4 5.2 286 5.2 5.1 431 7.7 7.5 561 9.8 9.6 Heroin 25 0.5 0.4 34 0.6 0.6 53 1.0 0.9 131 2.3 2.3 195 3.4 3.4 Natural Opioid Analgesics 183 3.4 3.3 158 2.9 2.8 154 2.8 2.7 218 3.9 3.8 256 4.5 4.3 Methadone 65 1.2 1.2 79 1.4 1.4 41 0.7 0.7 50 0.9 0.9 63 1.1 1.1 Synthetic Opioid Analgesics 34 0.6 0.6 21 0.4 0.4 36 0.7 0.6 114 2.0 2.0 204 3.6 3.5 Benzodiazepines 116 2.2 2.1 96 1.8 1.7 97 1.8 1.7 104 1.9 1.8 163 2.9 2.8 Benzodiazepines AND Any Opioids 95 1.8 1.7 81 1.5 1.4 86 1.6 1.5 89 1.6 1.6 144 2.5 2.5 Benzodiazepines AND Heroin SUP SUP SUP SUP SUP SUP SUP SUP SUP 14 UNR UNR 24 0.4 0.4 Psychostimulants Cocaine 54 1.0 0.9 64 1.2 1.1 80 1.4 1.4 98 1.7 1.7 119 2.1 2.0 Psychostimulants with Abuse Potential 34 0.6 0.6 37 0.7 0.7 63 1.1 1.1 82 1.5 1.5 133 2.3 2.3 Cannabis (derivatives) SUP SUP SUP SUP SUP SUP SUP SUP SUP SUP SUP SUP SUP SUP SUP Percent with Drugs Specified 73.6% 76.6% 76.4% 83.0% 94.5% *Drug Poisoning Deaths: Drug poisoning deaths are defined as deaths with underlying cause-of-death codes from the World Health Organization's (WHO's) International Classification of Diseases, Tenth Revision (ICD-10) of X40-X44, X60-X64, X85, and Y10-Y14. See Overview & Limitations section for additional information on mortality data and definitions of the specific ICD-10 codes listed. **Drug Poisoning Deaths, by Drug: Among the deaths with drug poisoning identified as the underlying cause, the specific drugs are identified by ICD-10 multiple cause-of-death (MCOD) T-codes (see below). Each death certificate may contain up to 20 causes of death indicated in the MCOD field. Thus, the total count across drugs may exceed the actual number of dead persons in the selected population. Some deaths involve more than one drug; these deaths are included in the rates for each drug category. ^Atlanta MSA: Comprised of Barrow, Bartow, Butts, Carroll, Cherokee, Clayton, Cobb, Coweta, Dawson, DeKalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Haralson, Heard, Henry, Jasper, Lamar, Meriwether, Morgan, Newton, Paulding, Pickens, Pike, Rockdale, Spalding, and Walton Counties. ***Age-Adjusted : Age-adjusted rates are weighted averages of the age-specific death rates, where the weights represent a fixed population by age (2000 U.S. Population). Age adjustment is a technique for removing the effects of age from crude rates, so as to allow meaningful comparisons across populations with different underlying age structures. Age-adjusted rates should be viewed as relative indexes rather than as direct or actual measures of mortality risk. See http://wonder.cdc.gov/wonder/help/mcd.html for more information. ± Opioids: Includes any of these MCOD codes T40.0-T40.4, or T40.6 Heroin (T40.1); Natural Opioid Analgesics (T40.2) - Including morphine and codeine, and semi-synthetic opioid analgesics, including drugs such as oxycodone, hydrocodone, hydromorphone, and oxymorphone; Methadone (T40.3); Synthetic Opioid Analgesics (T40.4) - Other than methadone, including drugs such as tramadol and fentanyl; Other and Unspecified Narcotics (T40.6) Benzodiazepines: (T42.4) Benzodiazepines AND Any Opioids (T42.4 AND T40.0-T40.4, or T40.6) Benzodiazepines AND Heroin (T42.4 AND T40.1) Psychostimulants: Cocaine (T40.5); Psychostimulants with Abuse Potential [excludes cocaine] (T43.6) Cannabis (derivatives): (T40.7) Drug Poisoning Deaths with Drug(s) Specified: Among drug poisoning deaths, deaths that mention the type of drug(s) involved are defined as those including at least one ICD-10 MCOD in the range T36-T50.8. See Overview & Limitations section for more information about this statistic. SUP=Suppressed: Counts and s are suppressed for subnational data representing 0 9 deaths. UNR=Unreliable: s are Unreliable when the death count <20. SOURCE: Adapted by the NDEWS Coordinating Center from data taken from the Centers for Disease Control and Prevention, National Center for Health Statistics, Multiple cause of death 1999-2015, available on the CDC WONDER Online Database, released December 2016. Data compiled in the Multiple cause of death 1999-2015 were provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Retrieved between February 2017 - June 2017, from http://wonder.cdc.gov/mcd-icd10.html NDEWS Atlanta Metro SCS Drug Use Patterns and Trends, 2017 27

Table 6a: Drug Reports* for Items Seized by Law Enforcement in Atlanta MSA^ in 2016 Drug Identified DEA National Forensic Laboratory Information System (NFLIS) of Drug-Specific Reports and Total Analyzed Drug Reports Total Drug Reports* Total Drug Reports 14,961 100.0% METHAMPHETAMINE 4,680 31.3% COCAINE 2,900 19.4% UNSPECIFIED PHARMACUETICAL PREPARATION 1,540 10.3% ALPRAZOLAM 1,345 9.0% HEROIN 892 6.0% OXYCODONE 664 4.4% HYDROCODONE 424 2.8% CANNABIS 327 2.2% AMPHETAMINE 168 1.1% TETRAHYDROCANNABINOLIC ACID 143 1.0% CLONAZEPAM 141 0.9% TRAMADOL 115 0.8% N-ETHYLPENTYLONE 85 0.6% METHADONE 83 0.6% DIBUTYLONE (BETA-KETO-N,N-DIMETHYL-1,3-BENZODIOXOLYLBUTANAMINE; BK- DMBDB) 72 0.5% CODEINE 66 0.4% MORPHINE 66 0.4% 3,4-METHYLENEDIOXYMETHAMPHETAMINE (MDMA) 59 0.4% 3,4-METHYLENEDIOXYETHYLCATHINONE (ETHYLONE) 58 0.4% DIAZEPAM 55 0.4% BUPRENORPHINE 47 0.3% FENTANYL 47 0.3% PENTYLONE (ß-KETO-METHYLBENZODIOXOLYLPENTANAMINE) 45 0.3% PROMETHAZINE 44 0.3% PSILOCIN 42 0.3% METHYLPHENIDATE 40 0.3% LISDEXAMFETAMINE 36 0.2% LORAZEPAM 36 0.2% CARISOPRODOL 34 0.2% 1-(3-TRIFLUOROMETHYL)PHENYL-PIPERAZINE (TFMPP) 33 0.2% LYSERGIC ACID DIETHYLAMIDE (LYSERGIDE) 31 0.2% PHENYLIMIDOTHIAZOLE ISOMER UNDETERMINED 31 0.2% ETIZOLAM 27 0.2% ZOLPIDEM 26 0.2% NO CONTROLLED DRUG IDENTIFIED 25 0.2% CAFFEINE 20 0.1% DIPHENHYDRAMINE 20 0.1% TESTOSTERONE 19 0.1% XLR-11 (1-(5-FLUOROPENTYL-1H-3-YL)(2,2,3,3- TETRAMETHYLCYCLOPROPYL)METHANONE) 19 0.1% 1,4-BUTANEDIOL 17 0.1% KETAMINE 16 0.1% LIDOCAINE 16 0.1% HYDROMORPHONE 14 < 0.1% QUETIAPINE 14 < 0.1% U-47700 14 < 0.1% 3,4-METHYLENEDIOXYAMPHETAMINE (MDA) 13 < 0.1% FUB-AMB 13 < 0.1% PIPERAZINE 13 < 0.1% 2-(4-IODO-2,5-DIMETHOXYPHENYL)-N-(2-METHOXYBENZYL)ETHANAMINE (25-I- NBOME) 12 < 0.1% AB-CHMINACA (N-[(1S)-1-(AMINOCARBONYL)-2-METHYLPROPYL]-1- (CYCLOHEXYLMETHYL)-1H-INDAZOLE-3-CARBOXAMIDE) 12 < 0.1% DIMETHYLSULFONE 12 < 0.1% AB-FUBINACA 11 < 0.1% PHENTERMINE 10 < 0.1% ALPHA-PYRROLIDINOPENTIOPHENONE (ALPHA-PVP) 9 < 0.1% BENZOCAINE 9 < 0.1% NICOTINAMIDE 9 < 0.1% NDEWS Atlanta Metro SCS Drug Use Patterns and Trends, 2017 28

Table 6a (cont'd): Drug Reports* for Items Seized by Law Enforcement in Atlanta MSA^ in 2016 DEA National Forensic Laboratory Information System (NFLIS) Total Drug Drug Identified Reports* 4-CHLOROMETHCATHINONE (4-CMC; CLEPHEDRONE) 8 < 0.1% ACETAMINOPHEN 8 < 0.1% N-BENZYLPIPERAZINE (BZP) 8 < 0.1% 4-CHLORO-ALPHA-PYRROLIDINOVALEROPHENONE (4-CHLORO-ALPHA-PVP) 7 < 0.1% BENOCYCLIDINE (1-[1-(1-BENZOTHIOPHEN-2-YL)CYCLOHEXYL]PIPERIDINE) 7 < 0.1% GUAIFENESIN 7 < 0.1% TRAZODONE 7 < 0.1% 5-FLUORO-ADB 6 < 0.1% BUTALBITAL 6 < 0.1% DIMETHYLTRYPTAMINE (DMT) 6 < 0.1% NORDIAZEPAM 6 < 0.1% ADB-FUBINACA (N-(1-AMINO-3,3-DIMETHYL-1-OXOBUTAN-2-YL)-1-(4- FLUOROBENZYL)-1H-INDAZOLE-3-CARBOXAMIDE) 5 < 0.1% DOXYLAMINE 5 < 0.1% IBUPROFEN 5 < 0.1% N-METHYL-3,4-METHYLENEDIOXYCATHINONE (METHYLONE) 5 < 0.1% OXYMORPHONE 5 < 0.1% TRENBOLONE 5 < 0.1% BUPROPION 4 < 0.1% CANNABIDIOL 4 < 0.1% SILDENAFIL CITRATE (VIAGRA) 4 < 0.1% TEMAZEPAM 4 < 0.1% 2-(4-BROMO-2,5-DIMETHOXYPHENYL)-N-(2-METHOXYBENZYL)ETHANAMINE (25-B- NBOMe) 3 < 0.1% 2-(4-CHLORO-2,5-DIMETHOXYPHENYL)-N-(2-METHOXYBENZYL)ETHANAMINE (25- C-NBOME) 3 < 0.1% 4-CHLORO-N-ETHYLCATHINONE 3 < 0.1% BUSPIRONE 3 < 0.1% CANNABINOL 3 < 0.1% FURANYL FENTANYL 3 < 0.1% GABAPENTIN 3 < 0.1% INOSITOL 3 < 0.1% LACTOSE 3 < 0.1% METHORPHAN 3 < 0.1% PROPOXYPHENE 3 < 0.1% PSEUDOEPHEDRINE 3 < 0.1% 1-(2-FLUOROPHENYL)PIPERAZINE 2 < 0.1% 3-METHYLFENTANYL 2 < 0.1% 5-FLUORO AMB 2 < 0.1% AMOXICILLIN 2 < 0.1% ANASTROZOLE 2 < 0.1% BUTYRYL FENTANYL 2 < 0.1% CATHINONE 2 < 0.1% CHLORDIAZEPOXIDE 2 < 0.1% CLONAZOLAM 2 < 0.1% CYCLOBENZAPRINE 2 < 0.1% ISONICOTINAMIDE 2 < 0.1% MAB-CHMINACA (ADB-CHMINACA) 2 < 0.1% META-CHLORPHENYLPIPERAZINE (MCPP) 2 < 0.1% METHANDROSTENOLONE (METHANDIENONE) 2 < 0.1% MITRAGYNINE 2 < 0.1% MMB2201 2 < 0.1% PHENAZEPAM 2 < 0.1% PREGABALIN 2 < 0.1% PROCAINE 2 < 0.1% QUININE 2 < 0.1% STANOZOLOL 2 < 0.1% SUCROSE 2 < 0.1% 4-BROMO-2,5-DIMETHOXYPHENETHYLAMINE (2C-B) 1 < 0.1% 4-CHLORO-ALPHA-PYRROLIDINOPROPIOPHENONE (4-CHLORO-ALPHA-PPP) 1 < 0.1% NDEWS Atlanta Metro SCS Drug Use Patterns and Trends, 2017 29

Table 6a (cont'd): Drug Reports* for Items Seized by Law Enforcement in Atlanta MSA^ in 2016 DEA National Forensic Laboratory Information System (NFLIS) Total Drug Drug Identified Reports* 5-FLUORO-ADBICA 1 < 0.1% 5-METHOXY-N,N-DIMETHYLTRYPTAMINE (5-MEO-DMT) 1 < 0.1% 5-METHOXY-N-METHYL-N-ISOPROPYLTRYPTAMINE (5-MEO-MIPT) 1 < 0.1% ALPHA-PYRROLIDINOHEPTAPHENONE (PV8) 1 < 0.1% BARBITAL 1 < 0.1% BARBITURIC ACID 1 < 0.1% BOLDENONE 1 < 0.1% BROMAZEPAM 1 < 0.1% BUTABARBITAL 1 < 0.1% BUTYLONE (ß-KETO-N-METHYLBENZO-DIOXYLPROPYLAMINE) 1 < 0.1% CARFENTANIL 1 < 0.1% CATHINE 1 < 0.1% CHLORPHENIRAMINE 1 < 0.1% CLONIDINE 1 < 0.1% DIPYRONE 1 < 0.1% DRONABINOL 1 < 0.1% ESTAZOLAM 1 < 0.1% FLUOXETINE 1 < 0.1% MANNITOL 1 < 0.1% MEPERIDINE 1 < 0.1% METHOCARBAMOL 1 < 0.1% METOCLOPRAMIDE 1 < 0.1% METOPROLOL 1 < 0.1% METRONIDAZOLE 1 < 0.1% NALTREXONE 1 < 0.1% NANDROLONE 1 < 0.1% NAPROXEN 1 < 0.1% NIACINAMIDE 1 < 0.1% NICOTINE 1 < 0.1% NICOTINIC ACID 1 < 0.1% PAPAVERINE 1 < 0.1% PHENDIMETRAZINE 1 < 0.1% PHENOBARBITAL 1 < 0.1% PROPRANOLOL 1 < 0.1% TADALAFIL 1 < 0.1% TAMOXIFEN 1 < 0.1% TAPENTADOL 1 < 0.1% TIZANIDINE 1 < 0.1% ^Atlanta MSA: The Atlanta-Sandy Springs-Roswell, Georgia MSA includes the following 29 counties: Barrow, Bartow, Butts, Carroll, Cherokee, Clayton, Cobb, Coweta, Dawson, DeKalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Haralson, Heard, Henry, Jasper, Lamar, Meriwether, Morgan, Newton, Paulding, Pickens, Pike, Rockdale, Spalding, and Walton. The principal cities of the Atanta MSA include: Atlanta, Sandy Springs, Roswell, Alpharetta, and Marietta. *Drug Report: Drug that is identified in law enforcement items, submitted to and analyzed by federal, state, or local forensic labs, and included in the NFLIS database. The time frame is January - December 2016. The NFLIS database allows for the reporting of up to three drugs per item submitted for analysis. The data presented are a total count of first, second, and third listed reports for each selected drug item seized and analyzed. Source: Adapted by the NDEWS Coordinating Center from data provided by the U.S. Drug Enforcement Administration (DEA), Diversion Control Division, Drug and Chemical Evaluation Section, Data Analysis Unit. Data were retrieved from the NFLIS Data Query System (DQS) on May 28, 2017. NDEWS Atlanta Metro SCS Drug Use Patterns and Trends, 2017 30

Table 6b: Drug Reports* for Items Seized by Law Enforcement in Atlanta MSA^ in 2016 DEA National Forensic Laboratory Information System (NFLIS) Drug Reports* by Selected Drug Categories** of Interest, of Drug-Specific Reports, Analyzed Drug Category Reports, & Total Analyzed Drug Reports Drug Identified, by Selected Drug Category** Drug Category (%) Total Reports (%) Total Drug Reports* 14,961 100.0% 100.0% Opioids Category 2,456 100.0% 16.4% Heroin 892 36.3% 6.0% Narcotic Analgesics 1,558 63.4% 10.4% OXYCODONE 664 27.0% 4.4% HYDROCODONE 424 17.3% 2.8% TRAMADOL 115 4.7% 0.8% METHADONE 83 3.4% 0.6% CODEINE 66 2.7% 0.4% MORPHINE 66 2.7% 0.4% BUPRENORPHINE 47 1.9% 0.3% FENTANYL 47 1.9% 0.3% HYDROMORPHONE 14 0.6% < 0.1% U-47700 14 0.6% < 0.1% OXYMORPHONE 5 0.2% < 0.1% FURANYL FENTANYL 3 0.1% < 0.1% PROPOXYPHENE 3 0.1% < 0.1% 3-METHYLFENTANYL 2 < 0.1% < 0.1% BUTYRYL FENTANYL 2 < 0.1% < 0.1% MITRAGYNINE 2 < 0.1% < 0.1% MEPERIDINE 1 < 0.1% < 0.1% Narcotics 6 0.2% < 0.1% METHORPHAN 3 0.1% < 0.1% CARFENTANIL 1 < 0.1% < 0.1% NALTREXONE 1 < 0.1% < 0.1% PAPAVERINE 1 < 0.1% < 0.1% Synthetic Cathinones Category 295 100.0% 2.0% Synthetic Cathinones 290 98.3% 1.9% N-ETHYLPENTYLONE 85 28.8% 0.6% DIBUTYLONE (BETA-KETO-N,N-DIMETHYL-1,3- BENZODIOXOLYLBUTANAMINE; BK-DMBDB) 72 24.4% 0.5% 3,4-METHYLENEDIOXYETHYLCATHINONE (ETHYLONE) 58 19.7% 0.4% PENTYLONE (ß-KETO-METHYLBENZODIOXOLYLPENTANAMINE) 45 15.3% 0.3% ALPHA-PYRROLIDINOPENTIOPHENONE (ALPHA-PVP) 9 3.1% < 0.1% 4-CHLOROMETHCATHINONE (4-CMC; CLEPHEDRONE) 8 2.7% < 0.1% 4-CHLORO-ALPHA-PYRROLIDINOVALEROPHENONE (4-CHLORO-ALPHA-PVP) 7 2.4% < 0.1% 4-CHLORO-N-ETHYLCATHINONE 3 1.0% < 0.1% 4-CHLORO-ALPHA-PYRROLIDINOPROPIOPHENONE (4-CHLORO-ALPHA-PPP) 1 0.3% < 0.1% ALPHA-PYRROLIDINOHEPTAPHENONE (PV8) 1 0.3% < 0.1% BUTYLONE (ß-KETO-N-METHYLBENZO-DIOXYLPROPYLAMINE) 1 0.3% < 0.1% Synthetic Cathinones (Hallucinogen) 5 1.7% < 0.1% N-METHYL-3,4-METHYLENEDIOXYCATHINONE (METHYLONE) 5 1.7% < 0.1% Synthetic Cannabinoids Category 73 100.0% 0.5% XLR-11 (1-(5-FLUOROPENTYL-1H-3-YL)(2,2,3,3- TETRAMETHYLCYCLOPROPYL)METHANONE) 19 26.0% 0.1% FUB-AMB 13 17.8% < 0.1% AB-CHMINACA (N-[(1S)-1-(AMINOCARBONYL)-2-METHYLPROPYL]-1- (CYCLOHEXYLMETHYL)-1H-INDAZOLE-3-CARBOXAMIDE) 12 16.4% < 0.1% AB-FUBINACA 11 15.1% < 0.1% 5-FLUORO-ADB 6 8.2% < 0.1% ADB-FUBINACA (N-(1-AMINO-3,3-DIMETHYL-1-OXOBUTAN-2-YL)-1-(4- FLUOROBENZYL)-1H-INDAZOLE-3-CARBOXAMIDE) 5 6.8% < 0.1% 5-FLUORO AMB 2 2.7% < 0.1% MAB-CHMINACA (ADB-CHMINACA) 2 2.7% < 0.1% MMB2201 2 2.7% < 0.1% 5-FLUORO-ADBICA 1 1.4% < 0.1% Piperazines Category 58 100.0% 0.4% Piperazines (Hallucinogen) 50 86.2% 0.3% 1-(3-TRIFLUOROMETHYL)PHENYL-PIPERAZINE (TFMPP) 33 56.9% 0.2% PIPERAZINE 13 22.4% < 0.1% NDEWS Atlanta Metro SCS Drug Use Patterns and Trends, 2017 31

Table 6b (cont'd): Drug Reports* for Items Seized by Law Enforcement in Atlanta MSA^ in 2016 DEA National Forensic Laboratory Information System (NFLIS) Drug Category (%) Total Reports (%) Drug Identified, by Selected Drug Category** 1-(2-FLUOROPHENYL)PIPERAZINE 2 3.4% < 0.1% META-CHLORPHENYLPIPERAZINE (MCPP) 2 3.4% < 0.1% Piperazines (Stimulant) 8 13.8% < 0.1% N-BENZYLPIPERAZINE (BZP) 8 13.8% < 0.1% Phenethylamines (2C Series) (H) Category 19 100.0% 0.1% 2-(4-IODO-2,5-DIMETHOXYPHENYL)-N-(2-METHOXYBENZYL)ETHANAMINE (25-I-NBOME) 12 63.2% < 0.1% 2-(4-BROMO-2,5-DIMETHOXYPHENYL)-N-(2- METHOXYBENZYL)ETHANAMINE (25-B-NBOMe) 3 15.8% < 0.1% 2-(4-CHLORO-2,5-DIMETHOXYPHENYL)-N-(2- METHOXYBENZYL)ETHANAMINE (25-C-NBOME) 3 15.8% < 0.1% 4-BROMO-2,5-DIMETHOXYPHENETHYLAMINE (2C-B) 1 5.3% < 0.1% Tryptamines Category 8 100.0% < 0.1% DIMETHYLTRYPTAMINE (DMT) 6 75.0% < 0.1% 5-METHOXY-N,N-DIMETHYLTRYPTAMINE (5-MEO-DMT) 1 12.5% < 0.1% 5-METHOXY-N-METHYL-N-ISOPROPYLTRYPTAMINE (5-MEO-MIPT) 1 12.5% < 0.1% ^Atlanta MSA: The Atlanta-Sandy Springs-Roswell, Georgia MSA includes the following 29 counties: Barrow, Bartow, Butts, Carroll, Cherokee, Clayton, Cobb, Coweta, Dawson, DeKalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Haralson, Heard, Henry, Jasper, Lamar, Meriwether, Morgan, Newton, Paulding, Pickens, Pike, Rockdale, Spalding, and Walton. The principal cities of the Atanta MSA include: Atlanta, Sandy Springs, Roswell, Alpharetta, and Marietta. *Drug Report: Drug that is identified in law enforcement items, submitted to and analyzed by federal, state, or local forensic labs, and included in the NFLIS database. The time frame is January - December 2016. **Selected Drug Categories: Opioids, Synthetic Cannabinoids, Synthetic Cathinones, 2C Phenethylamines, Piperazines, and Tryptamines are drug categories of current interest to the NDEWS Project because of the recent increase in their numbers, types, and availability. The NFLIS database allows for the reporting of up to three drugs per item submitted for analysis. The data presented are a total count of first, second, and third listed reports for each selected drug item seized and analyzed. Source: Adapted by the NDEWS Coordinating Center from data provided by the U.S. Drug Enforcement Administration (DEA), Diversion Control Division, Drug and Chemical Evaluation Section, Data Analysis Unit. Data were retrieved from the NFLIS Data Query System (DQS) on May 28, 2017. NDEWS Atlanta Metro SCS Drug Use Patterns and Trends, 2017 32