Transcript Document

The South Florida
Report
January 2013
National Institute on Drug Abuse
Community Epidemiology
Work Group
James N. Hall Report # 56
Center for Applied Research on Substance Use
and Health Disparities
Nova Southeastern University
Jacks on
Dixie
Duval
Baker
Union
fo
rd
La Suwannee
fay
ett
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Co
Taylor
Hamilton
Clay
Br
ad
Je
Franklin
Madis on
lu
mb
ia
so
Leon
Liberty Wakulla
Gulf
Nas sau
n
Gadsden
Calhoun
Bay
ffe
r
n
W
as
hin
gt
o
Holmes
n
Okaloosa
o
alt
W
Santa
Rosa
Escambia
Gilchrist Alachua
S t.
Johns
Putnam
Flagler
Levy
Marion
Volusia
Pasco
Hillsborough
Seminole
Orange
Osceola
va
Bre
rd
Polk
Indian River
Pinellas
Hardee
Charlotte
Lee
e
be
Sarasota De Soto
Highlands
o
ch
Manatee
ee
Ok
19
Million
Citrus
Lake
Sumter
Hernando
St. Lucie
1.3 Million
Martin
Glades
Hendry
Palm Beach
Broward
Collier
Dade
Monroe
1.8 Million
2.6 Million
US
Census
Bureau
US
Census
Bureau
2011
Population
Estimates
2008
Population
Estimates
Data Sources January 2013
• Florida Medical Examiners Commission 2011 Report on Drugs
Identified In Deceased Persons by Florida Medical Examiners from
Florida Department of Law Enforcement
• Emergency department data 2005-2010 from DAWN (SAMHSA)
• Florida Department of Children and Families treatment data from
all publicly-funded adult and youth treatment programs for MiamiDade and Broward Counties primary admissions for all treatment
modalities January - June 2012.
• National Forensic Laboratory Information System (NFLIS), Drug
Enforcement Administration (DEA), for January – June 2012
• Florida Poison Information Center – Miami Poison Exposure Calls for
Emerging Synthetic Drugs
• 2012 Florida Youth Substance Abuse Survey for Miami-Dade and
Broward Counties, Florida Dept. of Children and Families
• National Survey on Drug Use & Health Sub State Data (SAMHSA)
South Florida Most Recent Changes
•
•
•
•
•
•
•
•
•
Cocaine: Decline continues but slows
Heroin: Increases related to crackdown on Rx Opioids
Rx Opioids: Modest Declines
Benzodiazepine: Modest Declines
Methamphetamine: Low and Limited to Gay Males
Marijuana: High and Increasing
Cannabinmimetics: Increasing Use, Types & Problems
Ecstasy: Mostly “Mollys” tests as bk-Methylone
GHB: Low; but back on radar. Is it Diverted “Xyrem”?
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
Rate of Cocaine Emergency Department.
Reports Per 100,000 All Age Groups
600.0
543.1
500.0
409.6
398.8
402.7
400.0
USA
304.4
260.3
300.0
200.0
162.4
163.7
183.9
183.7
184.9
158.5
100.0
228.0
148.0
157.8
137.9
134.0
Miami-Dade
Broward &
Palm Beach
0.0
Rates
2004
Rates
2005
Rates
2006
Rates
2007
Rates
2008
Rates
2009
Rates
2010
SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates 2004-2010
# of primary Treatment Admissions
Number of Primary Cocaine Treatment Admissions
Miami-Dade and Broward Counties, FL: 2009-2012
1800
1600
1,557
1400
1200
690
918
1000
800
369
600
400
Miami-Dade
1,052
437
776
328
Powder Cocaine
Crack Cocaine
Total Cocaine in Red
769
159
867
200
549
615
Dade
2010
Dade
2011
448
610
Broward
481
555
57
123
424
432
524
122
402
0
Dade
2009
Dade Broward Broward Broward Broward
2x1h2012 2009
2010
2011 2x1h2012
* 2012 Admissions based on 2 x‘s 1st Half 2012
SOURCE: Florida Department of Children and Families
# of primary Treatment Admissions
Number of Primary Heroin Treatment Admissions
Miami-Dade and Broward Counties, FL: 2009-2012
350
300
Miami-Dade
150
100
316
227
250
200
Broward
308
183
156 169
150
105
50
0
12009 22010 32011 2012*
4
52009 62010 7 2011 82012*
* 2012 Admissions based on 2 x‘s 1st Half 2012
SOURCE: Florida Department of Children and Families
Number of Deaths with One or More
Prescription Medications Detected
2010 vs. 2011
2010
2011
% Changed
Broward County
470
431
Down
Miami-Dade County
359
312
Down 13 %
Palm Beach County
365
626
Up 71 %
5,647
5,489
State of Florida
8%
Down 3 %
Source: FDLE – Drugs Identified In Deceased Persons by Florida
Medical Examiners - 2011 Report
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.
# of primary Treatment Admissions
Number of Primary Rx Opioid Treatment Admissions
Miami-Dade and Broward Counties, FL: 2010-2012
1600
1500
1400
1300
1200
1100
1000
900
800
700
600
500
400
300
200
100
0
Miami-Dade
Broward
1,459
1,118
246
302
1,242
230
2010
2011
2012*
2010
2011
2012*
1
2
3
4
5
6
* 2012 Admissions based on 2 x‘s 1st Half 2012
SOURCE: Florida Department of Children and Families
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
Number of Primary Treatment Admissions for
Juveniles and Adults by Drug in Broward and
Miami-Dade Counties: January - June 2012
Miami-Dade
Marijuana
Rx Opioids
Alcohol
Cocaine/Crack
Rx Benzo's
Heroin
Other/Unknown
Broward
829
867
115
621
669
694
262
388
43
34
154
158
163
0
284
100 200 300 400 500 600 700 800 900 1000
Number of Primary Admissions
Source: Florida Department of Children and Families
Current (past 30-day) Marijuana Use Among
Miami-Dade and Broward Counties
% Reporting Current Use
High School Students 2000-2012
20
18 17.2
16
14 12.4
12
10
8
6
4
2
0
2000
19
13.9
14.5
12.6
13.5
11.4
14
15.3
17.8
13.6
13
9.1
Broward
2002
2004
Miami-Dade
2006
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
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 in Florida,
Broward, and Miami-Dade Counties - 2012
20%
18%
16%
14%
12%
10%
8%
6%
4%
2%
0%
15.1 %
12.4 %
9.8 %
5.3 %
3.9% 3.4%
Florida Broward Dade
Florida Broward Dade
Lifetime Lifetime Lifetime Past 30 Past 30 Past 30
Days
Days
days
Source: Florida Youth Substance Abuse Survey 2012
Number of Cannabinmimetics
Poison Control Exposure Calls
2011 and 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-Dec 2012
537
37
45
24
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
Molly’s
Not Pure MDMA but….
methylone
bk- 3,4 methylenedioxy-methcathinone
96 Crime Lab Cases since March 2012
in Broward County
276 Crime Lab Cases in Miami-Dade County
during 2012
Top 10 Most Frequently Identified Drugs of Total
Analyzed Drug Reports, South Florida
January - June 2012
Drug
Cocaine
Marijuana/Cannabis
Oxycodone
Alprazolam
Heroin
Hallucinogen
N-Methyl-3,4-Methylenedioxycathinone
(Methylone)
Caffeine
Phenylimidothiazole Isomer Undetermined
AM-2201 (1-(5-Fluoropentyl)-3-(1Naphthoyl)Indole)
Other
Total
1 Data
Number
6,153
2,864
389
368
343
262
Percent
48.9%
22.7%
3.1%
2.9%
2.7%
2.1%
154
119
111
1.2%
0.9%
0.9%
86
1,741
12,590
0.7%
13.8%
100.0%
are for January–June 2012 and include primary, secondary, and tertiary reports.