Transcript Broward County Issues and Trends - Jim Hall

Broward County
Report
Substance Abuse Issues and
Trends – Winter 2013
James N. Hall
Welcome Dr. Michael Wolwa
Broward County Trends
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Decline of Cocaine Consequences
Rx Non-Medical Misuse Stable at Epidemic Levels
Heroin Rising
Underage Drinking Age 12-18
Marijuana
Fake Drugs: Real Poisons
– Synthetic Cannabinmimectics
– Synthetic Stimulants
Number of Cocaine Reports Detected
Among Decedents in Florida: 2000 - 2011
2,500
2,000
1,500
1,000
500
NUMBER of
0
COCAINE
OCCURRENCES
Including
300
“Present” &
250
“Cause of
Death”
200
150
1,105
State of Florida
1,034
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
281
Miami-Dade
189
144 149 151
100
50
2,179
1,943 2,052
1,791
1,614 1,702
1,462
1,307
1,402 1,444
80
94
121
138
160 162
182
201
155
198 184
157 146
136 150
135 127
120
115
Broward
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
SOURCE: Florida Medical Examiners Commission Report 2011
# of ED Report Estimates
Number of Cocaine Emergency Departments Reports
in Broward & Palm Beach Counties, FL: 2008,,2009 & 2010
6,000
5,560
5,000
4,479
4,081
4,000
3,000
2,000
1,000
0
2008
2009
2010
Note: Cocaine visits had a statistically significant decrease from 2008 to 2009.
SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates 2008-2009.
Percent of All Admissions
Percent of Primary Addiction Treatment
Admissions by Substance 2007-2011: State of Florida
35
30
25
20
15
10
5
0
Cocaine
22.3
Cocaine
18.4
14.5
11.2
8.5
2007
2008
2009
2010
2011
Source: Substance Abuse and Mental Health Services Administration’s Center for
Behavioral Health Statistics and Quality: Treatment Episode Data Set as
provided by the Florida Department of Children and Families as of July 9, 2012.
# of primary Treatment Admissions
Number of Primary Cocaine Treatment Admissions
Broward County, FL: 2009-2012*
900
800
769
700
159
600
481
500
57
400
300
Powder Cocaine
Crack Cocaine
Total Cocaine in Red
555
524
123
122
610
200
424
432
402
2010
2011
2012*
100
0
2009
* 2012 Admissions based on 2 x‘s 1st Half 2012
SOURCE: Florida Department of Children and Families
Jackson
lum
bia
Hamilton
Union
Duval
S t.
Clay Johns
Bra
ye
tte
Dixie
Baker
rd
Madison
Suwannee
Taylor Lafa
d fo
ffer
so
Je
Leon
Liberty Wakulla
Gulf Franklin
Nas sau
n
Gadsden
Calhoun
Bay
Co
hin
gto
W
as
n
alto
W
Holmes
Okaloosa
n
Santa
Rosa
Escambia
Numbers of Substances Identified among
Decedents in Florida: Jan.-Dec. 2011
Gilchrist Alachua
Putnam
Flagler
Levy
Marion
Volusia
Citrus
Sumter
Hernando
Lake
Seminole
Orange
va rd
Osceola
Bre
Pasco
Hillsborough
Polk
Indian River
Pinellas
O ke
Hardee
e
Lee
St. Lucie
be
Charlotte
Highlands
ho
Sarasota De Soto
ec
Manatee
Martin
Glades
Hendry
Palm Beach
Broward
Collier
6,000
5,000
Dade
Monroe
5,949
6,333
All Rx
= 13,045
Alcohol +
Illicit Drugs = 5,758
4,252
4,000
3,000
2,000
1,444
1,000
62
285
0
Source: Florida Department of Law Enforcement:
Florida Medical Examiners Commission Report 2011
478
Prescription Drug-Related Deaths
in Florida: 2011
5,489 individuals died with one
or more prescription drugs in their
system. The drugs were at both
lethal and non-lethal levels.
Source: Florida Department of Law Enforcement:
Florida Medical Examiners Commission Report 2011
Number of Oxycodone Reports Detected
among Decedents in Florida: 2011
3,000
2,384
2,500
NUMBER of
Oxycodone
OCCURRENCES
Including
“Present” &
“Cause of Death”
1,948
2,000
1,500
2,128
1,574
1,253
1,000
500
0
2007
2008
2009
2010
2011
Source: FDLE – Drugs Identified In Deceased Persons by Florida Medical Examiners
2007 - 2010 Reports and 2011 Report
Number of Oxycodone Reports Detected
among Decedents in South Florida: 2007-2011
300
Palm Beach
250
NUMBER of
Oxycodone
OCCURRENCES
Including
“Present” &
“Cause of Death”
200
150
100
Broward
Miami-Dade
144
171
165
225
236
240
184
177
174
100
119
75
66
50
45
46
0
2007
2008
2009
2010
2011
SOURCE: Florida Medical Examiners Commission Report 2011
# of ED Report Estimates
Number of Emergency Departments Reports
by Drug in Broward & Palm Beach Counties, FL:
2008,,2009 and 2010
6,000
5,500
5,560
5,000
4,500
4,000
Cocaine
4,479
4,081
3,500
2,913
3,000
2,500
2,351
3,299
NMU Rx Opioids
2,000
2008
2009
2010
Note:
Cocaine visits had statistically significant decreases from 2008 to 2009.
Prescription Opioid nonmedical use visits had statistically significant increases from
2008 to 2010. No statistically significant changes were noted for 2008 or 2009 compared
with 2010 for Benzodiazepines.
SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates 2008-2009.
Rates per 100,000 of Oxycodone Nonmedical Use
Emergency Department Reports by Age Groups
DAWN Ft. Lauderdale Division vs. USA: 2010
E
Rate per 100,000
300
241.6
250
215.7
Broward & Palm Beach
200
150
142
102.6
USA
100
50
85.3
64.6
83.6
67.9
71.3
71.1
79.2
72.9
47.1
39.8
0
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.
Percent of Primary Rx Opioid Addiction Treatment
Admissions By Age Groups in Florida: 1998 to 2011
100
90
80
70
60
50
40
30
20
10
0
Aged 12 to 30 Years
62%
26 to 30 yrs
22%
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 July 9, 2012
Percent of All Admissions
Percent of Primary Addiction Treatment
Admissions by Substance 2007-2011:
State of Florida
35
30
25
20
15
10
5
0
27.5
22.3
18.4
23.9
Cocaine
16.1
11.2
10.8
Rx Opioids
14.5
8.3
2.7
2.5
2007
2008
Heroin
2.2
2009
2.2
2010
8.4
2.2
Heroin
2011
Source: Substance Abuse and Mental Health Services Administration’s Center for
Behavioral Health Statistics and Quality: Treatment Episode Data Set as
provided by the Florida Department of Children and Families as of July 9, 2012.
# of primary Treatment Admissions
Number of Primary Rx Opioid Treatment Admissions
Broward County, FL: 2009-2012*
1600
Rx Opioids
1400
1,459
1,242
1,118
1200
1000
800
600
400
336
200
0
2009
2010
2011
2012*
* 2012 Admissions based on 2 x‘s 1st Half 2012
SOURCE: Florida Department of Children and Families
Source: 2011
National Survey on
Drug Use and
Health
Percent of Persons Aged 12 and Above Reporting
Nonmedical Use of Rx Pain Relievers in the Past Year:
2002-2008
6
5
4
Percent
Reporting
3
Past Year Use
4.82
5.01
4.35
4.22
4.46
3.82
3.43
Florida
2.96
2
Broward
1
0
2002-04
2004-06
2006-08
2008-10
SOURCE: SAMHSA-CBHSQ(2012): Substate Estimates from the 2002-2010
National Surveys on Drug Use and Health
Diversion Sources: Primary Opioid
70%
66.6%
60%
54.6%
50%
40%
30%
20%
13.8%
12.5%
10%
11.1%
0%
Dealer
Sharing/Trading
Legitimate
Illegitimate
Medical PracticeMedical Practice
Theft
Source: Kurtz, S & Surratt, H: ARSH Nova Southeastern University June 2012
Number of Alprazolam Reports Detected
among Decedents in Florida: 2007 – 2011
Alprazolam
2,500
2,000
NUMBER of
Alprazolam
OCCURRENCES
Including
“Present” &
“Cause of Death”
1,500
1,873
1,963
2008
2009
2,193
1,879
1,348
1,000
500
0
2007
2010
2011
Source: FDLE – Drugs Identified In Deceased Persons by Florida Medical Examiners
2007 - 2010 Reports and 2011 Report
Number of Alprazolam Reports Detected
among Decedents in South Florida: 2007- 2011
300
Palm Beach
250
NUMBER of
Alprazolam
OCCURRENCES
Including
“Present” &
“Cause of Death”
200
150
100
Broward
245
235
216
203
Miami-Dade
133
199
176
158
124
124
124
101
101
98
2007
2008
2009
114
50
0
2010
2011
SOURCE: Florida Medical Examiners Commission Report 2011
# of ED Report Estimates
Number of Emergency Departments Reports
by Drug in Broward & Palm Beach Counties, FL:
2008,,2009 and 2010
6,000
5,500
5,560
Cocaine
5,000
4,479
4,500
4,081
4,000
3,500
3,000
2,500
2,000
2,351
2,274
2008
2,913
2,900
3,299
3,110
NMU Benzodiazepines
2009
2010
Note:
Cocaine visits had statistically significant decreases from 2008 to 2009.
Prescription Opioid nonmedical use visits had statistically significant increases from
2008 to 2010. No statistically significant changes were noted for 2008 or 2009 compared
with 2010 for Benzodiazepines.
SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates 2008-2009.
# Lethal Heroin Deaths
NUMBER OF HEROIN-RELATED DEATHS
IN FLORIDA: 2000 –2011
400
350
300
250
200
150
100
50
0
Florida
Miami-Dade
Broward
62
15
3
SOURCE: Florida Medical Examiners Commission Reports 2000-2011
# of primary Treatment Admissions
Number of Primary Heroin Treatment Admissions
Miami-Dade and Broward Counties, FL: 2009-2012
350
300
Miami-Dade
150
100
Broward
316
227
250
200
308
183
156 169
150
105
50
0
2009
2010
2011
2012*
2009
2010
2011
2012*
1
2
3
4
5
6
7
8
* 2012 Admissions based on 2 x‘s 1st Half 2012
SOURCE: Florida Department of Children and Families
# of ED Report Estimates
Number of Emergency Departments Reports
by Drug in Broward & Palm Beach Counties, FL:
2008,,2009 and 2010
6,000
5,500
5,560
Cocaine
5,000
4,479
4,500
4,081
4,000
3,500
3,000
2,500
2,928
2,913
2,351
2,870
2008
2009
3,299
3,249
Marijuana
2,000
2010
Note:
Cocaine visits had statistically significant decreases from 2008 to 2009.
Prescription Opioid nonmedical use visits had statistically significant increases from
2008 to 2010. No statistically significant changes were noted for 2008 or 2009 compared
with 2010 for Marijuana.
SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates 2008-2009.
Current (past 30-day) Alcohol Use Among
% Reporting Current Use
Broward County Middle and High School Students
2000-2012
50
45 44
40
35
30
25
19.8
20
15
10
5
0
2000
39.9
20.1
36
34.1
34.1
31.3
24
18.7
High School
2002
37.3
2004
16.8
14.8
Middle School
2006
2008
2010
11.2
2012
Source: Florida Youth Substance Abuse Surveys 2000-2012
Current (past 30-day) Binge Drinking Among
Broward County Middle & High School Students
2000-20012
% Reporting Current Use
25
22.8
20
20.3
17.2
17
15
10
18.8
16.8
16.8
High School
8.9
6.9
Middle School
8.8
5.6
5
5
4.4
4.4
0
2000
2002
2004
2006
2008
2010
2012
Source: Florida Youth Substance Abuse Surveys 2000-2012
Current (past 30-day) Marijuana Use Among
% Reporting Current Use
Broward County Middle and High School Students
2000-2012
20
18 17.2
16
14
12
10
8
4.5
6
4
2
0
2000
19
13.9
14.5
14
15.3
11.4
High School
5.2
Middle School
5
2.5
2002
2004
2006
3.5
4.3
3.7
2008
2010
2012
Source: Florida Youth Substance Abuse Surveys 2000-2012
Perceived Attitudes about Marijuana Among
Broward County Middle and High School
% Reporting Current Use
Students 2000-2012
100
90
80
70
60
50
40
30
20
10
0
Wrong to Smoke Marijuana
Seen as Cool to Use
80.5
58
29.9
81
81.3
58.2
61.4
29.4
10.5
12.4
2000
2002
33.3
10.9
2004
Regular Use Harmful
Trying Marijuana Harmful
84.5
80.9
80.3
74.4
65.1
58.9
36.1
54.8
48
31.4
9.8
11.3
2006
2008
30.6
25.7
15.7
14.9
2010
2012
Source: Florida Youth Substance Abuse Surveys 2000-2012
Source: 2011
National Survey on
Drug Use and
Health
# of ED Report Estimates
Number of Emergency Departments Reports
by Drug in Broward & Palm Beach Counties, FL:
2008,,2009 and 2010
6,000
5,500
5,560
Cocaine
5,000
4,479
4,500
4,081
4,000
3,500
3,000
2,500
2,928
2,913
2,351
2,870
2008
2009
3,299
3,249
Marijuana
2,000
2010
Note:
Cocaine visits had statistically significant decreases from 2008 to 2009.
Prescription Opioid nonmedical use visits had statistically significant increases from
2008 to 2010. No statistically significant changes were noted for 2008 or 2009 compared
with 2010 for Marijuana.
SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates 2008-2009.
Number of Primary Treatment Admissions for
Juveniles and Adults by Drug in Broward and
Miami-Dade Counties: Jan - Dec 2011
Miami-Dade
Marijuana
Rx Opioids
Alcohol
Cocaine/Crack
Rx Benzo's
Heroin
Other/Unknown
-300
Broward
2,008
1,949
302
1,459
1,406
1,302
555
1,052
79
140
227
169
321
397
200
700
1200
1700
2200
Number of Primary Admissions
Source: Florida Department of Children and Families
The Synthetic Drugs
Percent of Florida 9th-12th Graders Reporting
Having Used Synthetic Marijuana
in their Lifetime
20%
18%
16%
14%
12%
10%
8%
6%
4%
2%
0%
16.7%
14.8 %
9.7 %
11.8 %
9th Graders 10th Graders 11th Graders 12th Graders
Source: Florida Youth Substance Abuse Survey 2012
Percent of High School Males Reporting
Having Used Synthetic Marijuana Florida and
Broward County - 2012
20%
18%
16%
14%
12%
10%
8%
6%
4%
2%
0%
15.1 %
12.4 %
5.3 %
Florida
Lifetime
Broward
Lifetime
3.9%
Florida Past Broward Past
30 Days
30 Days
Source: Florida Youth Substance Abuse Survey 2012
Percent of High School Females Reporting
Having Used Synthetic Marijuana Florida and
Broward County - 2012
20%
18%
16%
14%
12%
10%
8%
6%
4%
2%
0%
10.9 %
6.0 %
2.2 %
Florida
Lifetime
Broward
Lifetime
3.3%
Florida Past Broward Past
30 Days
30 Days
Source: Florida Youth Substance Abuse Survey 2012
Number of Cannabinmimetics
Poison Control Exposure Calls
Jan-Dec 2011 and Jan-June 2012
Cannabinmimetics
Poison Exposure Calls
State of Florida
Broward County
Miami-Dade County
Palm Beach County
# of Poison
Exposure Calls
Jan-Dec 2011
517
38
36
29
# of Poison
Exposure Calls
Jan-June 2012
377
25
36
20
Source: Florida Poison Information Center – Miami
1-800-222-1222
11 Different Cannabinmimetics
Jan. – July 2012
Florida Crime Lab Reports n= 403
111244 8
16
AM2233
JWH-073
JWH-203
32
RCS-4
UR-144
58
JWH-250
JWH-081
n=276
68 %
JWH-018
JWH-122
JWH-210
AM2201
Source: US DEA: National Forensic Lab Information System (NFLIS) 08/24/2012
Bath salts Stimulants often have trendy names
and slick packaging
White lightening
Zoom
Cloud 9
Cloud 10
Red Dove
Blue silk
Moon dust
NRG (4-MEC)
Head trip
Radiance
Ivory Wave
Power surge
Sextasy
Vanilla Sky
Number of Emerging Psychoactive
Substance Drug Poison Control Exposure Calls
in Florida: Jan-Dec 2011 and Jan-April 2012
# of Poison
# of Poison
Synthetic Drug
Exposure Calls
Exposure Calls
Category
Jan-Dec 2011
Jan-April 2012
Synthetic Cannabinoids
Hallucinogenic
Amphetamines
MDPV & Mephedrone
(Bath Salts)
Other Hallucinogens
DMT and 5-MeO-DIPT
517
184
269
64
152
28
6
2
Source:
Florida Poison Information Center – Miami 1-800-222-1222
Molly’s
Methylone
3,4 methylenedioxy-methcathinone
96 Crime Lab Cases since March 2012
in Broward County
8 Different Cathinmimetics
Jan. – July 2012
Florida Crime Lab Reports n= 76
1 13
Fluoromethcathinone
3
Alpha-PBP
4
4-MEC
3,4-DMMC
9
Pentylone
Ethylone
33
Pentedrone
A-PVP
22
A-PVP
4-MEC
Source: US DEA: National Forensic Lab Information System (NFLIS) 08/24/2012
Born 1952-1956
20%
45%
Broward County
Report
Substance Abuse Issues and
Trends – Winter 2013