Transcript South Florida Epidemiology

Community
Epidemiology Report
Fall 2014
South Florida
Drug Abuse Trends Update
James N. Hall, Epidemiologist
Center for Applied Research on
Substance Use and Health Disparities
Nova Southeastern University
n
Gulf
Franklin
Taylor
La Suwannee
fay
ett
e
lu
m
bia
Hamilton
Dixie
Duval
Baker
Union
fo
rd
Madis on
Co
Wakulla
Clay
Br
ad
Leon
Je
Liberty
Nas sau
so
W
as
Gadsden
Calhoun
Bay
ffe
r
n
gt
o
Jacks on
hin
Holmes
n
Okaloosa
o
alt
W
Santa
Rosa
Escambia
Gilchrist Alachua
S t.
Johns
Putnam
Flagler
Levy
Marion
Volusia
Pasco
Hillsborough
Seminole
Orange
va
Bre
Osceola
rd
Polk
Indian River
Pinellas
Hardee
Charlotte
Lee
ee
ob
Sarasota De Soto
Highlands
ch
Manatee
ee
Ok
19.5
Million
Citrus
Lake
Sumter
Hernando
St. Lucie
1.4 Million
Martin
Glades
Hendry
Palm Beach
Broward
Collier
Dade
Monroe
1.8 Million
2.6 Million
US Census Bureau
2013 Population Estimates
Lower Moderate
HIGH
South Florida Most Recent Indicator Changes
•
•
•
•
•
Fall 2014
Marijuana: Down
– Grow House “Wax”
Cocaine: Stable, Mostly Modest Declines
Rx Opioids: Deaths Declining
Hydromorphone
Benzodiazepines: Deaths Declining
Methylone as Mollys: Escalating
• Other Emerging Synthetic Drugs
• Heroin: Increases related to Rx Opioids crackdown
• Methamphetamine: Increasing among MSM et al
• MDMA: Disappearing
• Muscle Relaxants: Declining
Levels of Indicator Intensity: HIGH
Moderate
Lower
South Florida Key Findings 2014
Fall 2014
• # 1 Key Change: There has been significant progress
in reducing RX drug diversion along with moderate
declines in consequences related to the nonmedical
use of pharmaceuticals in most of Florida. However
the availability of Hydromorphone (e.g. Dilaudid®)
and deaths related to its misuse are rapidly rising.
• # 2 Key Change: Methylone along with other
hallucinogens are the fastest rising drugs analyzed by
South Florida crime labs. There were 1,194 methylone
crime lab items, mostly sold as “Mollys,” compared to
only 54 MDMA reports in 2013.
Percent of All Admissions
Percent of Primary Addiction Treatment
Admissions by Substance 2007-2012:
State of Florida
35
30
25
20
15
10
5
0
28,8
28,4
22,3
30,6
8,3
2,7
10,8
24,1
23,9
Alcohol
27,5
25,1
25,1
23
16,1
14,5
8,9 All Other 7,7
2,5
31,6
29,9
27,8
28,8 Alcohol 28,2
18,4
9,5
31,3
2,2
11,2
8,9
8,7
8,5
Heroin
2,2
2,2
Cocaine
Marijuana
Rx Opioids
8,9
8,2
3,2
Heroin
All Other
2007 2008 2009 2010 2011 2012
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 May 8, 2014.
Exhibit 4 Top 10 Most Frequently Identified Drugs of Total
Reports from South Florida Crime Labs Reports CY 20131
Drug
2013
% Δ vs. 2012
Cocaine
10,147
Down 11 %
Marijuana/Cannabis/THC
5,276
Down 2 %
Methylone (N-Methyl-3,4Methylenedioxycathinone) 1,194
Up 208 %
Hallucinogen
984
Up 88 %
Rx Opioids
933
Down 4 %
Heroin
925
Up 33 %
Rx Benzodiazepines
849
Down 4 %
Methamphetamine
211
Up 24 %
Phenylimidothiazole Isomer
154
Down 37 %
Caffeine
131
Down 45 %
All Other Analyzed Drugs
2,272
Down 18 %
Total
23,069
Down 3 %
1Data
are for January–December 2013 and include primary, secondary, and tertiary reports.
SOURCE: NFLIS, DEA, data retrieved May 9, 2014
Miami MSA includes
Palm Beach, Broward,
and Miami-Dade Counties
Number of Cocaine Reports Detected
Among Decedents in Florida: 2000 - 2013
2 500
2 000
1 500
1 000
500
0
NUMBER of
COCAINE
OCCURRENCES
Including 300
“Present” & 250
“Cause of
Death” 200
150
100
50
0
1 307
1 105
1 943 2 052 2 179 1 791
1 614 1 702
1 462
State of Florida
1 444
1 402
1 336
1 318
Palm Beach
197 191
182
168
147 151
146 135 127
129
125 121
100
157
150
143 126
138
106 115
120 136 Broward
113
87
94
82
SOURCE: Florida Medical Examiners Commission Interim Report Jan-June 2013
Number of Cocaine Reports Detected
Among Decedents in Florida: 2000 - 2013
300
250
NUMBER of 200
COCAINE
OCCURRENCES150
Including
“Present” &
“Cause of 100
Death”
50
281
Palm Beach
Miami-Dade
Broward
189
160
149 151 147
238
201
197 191
198
184
198
168
155
182
146
135 127
129
157
125 121
151
150
143
136
100
138
126
120
115
113
106
94
87
82
162 182
0
SOURCE: Florida Medical Examiners Commission Interim Report Jan-June 2013
Cocaine Trends
Related Deaths
2012
2 X 1h2013
Δ 2012 vs. x1h2013
State of Florida
1,318
1,336
Up
1%
Palm Beach County
87
100
Up
15 %
Broward County
129
82
Down 36 %
Primary Treatment
2011
2012
State of Florida
8.5 %
8.2 %
Down 4 %
So FL Crime Labs
2012
2013
Δ 2012 vs. 2013
3 SE FL Counties
11,411
10,147
Down 11 %
Δ 2011 vs. 2012
Responding to
an Epidemic
Rx Nonmedical Use in Florida
2000 -2013
Florida’s Response
• July 2010 – Senate Bill 2272 Legal authority to
close “Pill Mills” and limited practitioner
dispensing of CS Schedule II to 3-day supply
• August 2010 – Tamper-resistant OxyContin®.
• March 2011 – Law Enforcement Strike Force
• July 2011 - House Bill 7095 Comprehensive
law bans practitioner dispensing of CS II and
new regulations. Permits PDMP to operate.
Number of Selected Lethal Rx Opioid Occurrences Among
Deceased Persons in Florida Jan 2008 to Jun 2013
CS-II Dispensing Limits & OxyContin Tamper Resistant
# “Cause of Death” Occurrences
900
801
800
715
652
700
600
500
Strike Force
476 465
533
380
640
House Bill 7095
Takes effect
607
392
350
274
341
300
201 176
200 153 147 160 142 139 176 144
152 136 171
100 141 129 136 129
118
110
0
400
337 336
340 336 358
Oxycodone
343
Methadone
279
239
268 Morphine
238 221
126 158
Hydrocodone
Source: FDLE – Drugs Identified In Deceased Persons by Florida Medical Examiners
Jan 2008 - Jun 2013 Reports
# of Drugs Detected Among Decedents
Exhibit 6
Number of Nonmedical Rx Opioids and
Benzodiazepine Reports Detected among Decedents
in Florida 2005 – 2x1h2013
7 000
6 000
5 000
4 000
3 000
2 000
1 000
Opioids
6 608 6,333
6 006
Benzodiazepines
5 454
5 489
6 188
5 059
5 947
5 290
4 416
4 035
5 184
4 574
4 340
Strike
4 167
Force
2 973 3 339
2 608
House Bill 7095
CS-II Dispensing Limits and
OxyContin Tamper Resistant
Takes effect
0
Source: FDLE – Drugs Identified In Deceased Persons by Florida Medical Examiners
Jan 2005 - Jun 2013 Reports
Number of Unique Patients Identified By Threshold Levels
Number of Prescribers and Number of Pharmacies
by Quarter 2012-2013
3,000
2,864
5 Prescribers &
5 Pharmacies
51-%
Decrease
Level 5
1,097
500
514
Level 7
1,415
Level 6
427
Level 8
Source: 2012-2013 Annual Report
Florida’s Prescription Drug
Monitoring Program (PDMP)
Levels 9,
10
15
178
Grams of Oxycodone Sales in Florida
Per 100,000 Population
Grams of Oxycodone Sold per 100,000
Grams Sold Per 100,000 Population
70 000
63 325
60 000
National Rank Among
States and Territories
#1
50 000
40 000
28 808
30 000
# 19
21 614
20 000
# 22
10 000
0
2009
2010
2011
2012
2013
Source: US Drug Enforcement Administration – ARCOS
Automation of Reports and Consolidated Orders System
Hydromorphone (eg., Dilaudid®)
2013 ARCOS Grams Sold
Per 100/Population
1 FLORIDA
2 DELAWARE
3 VERMONT
GRAMS/
100K POP
270,718.70 1,439.89
500
10,501.64 1,169.53
6,099.61
974.78
4 CONNECTICUT
34,362.81
961.44
5 VIRGINIA
67,026.15
837.72
253
300
200
440
414
400
# of Deaths
STATE
TOTAL
GRAMS
Hydromorphone
Related-Deaths in
Florida
199
212 213
6 MONTANA
NEW
7 HAMPSHIRE
8,049.45
813.56
10,389.74
789.21
8 MARYLAND
43,353.71
750.9
9 WASHINGTON
48,346.19
718.95
2008 2009 2010 2011 2012 2013
10 OREGON
27,172.92
709.28
Source: Florida Medical
Examiners Commission
Source: US DEA ARCOS 3 Report 4 March 5, 2014
100
0
2 X1H
Exhibit 4 Top 10 Most Frequently Identified Drugs of Total
Reports from South Florida Crime Labs Reports CY 20131
Drug
2013
% Δ vs. 2012
Cocaine
10,147
Down 11 %
Marijuana/Cannabis/THC
5,276
Down 2 %
Methylone (N-Methyl-3,4Methylenedioxycathinone) 1,194
Up 208 %
Hallucinogen
984
Up 88 %
Rx Opioids
933
Down 4 %
Heroin
925
Up 33 %
Rx Benzodiazepines
849
Down 4 %
Methamphetamine
211
Up 24 %
Phenylimidothiazole Isomer
154
Down 37 %
Caffeine
131
Down 45 %
All Other Analyzed Drugs
2,272
Down 18 %
Total
23,069
Down 3 %
1Data
are for January–December 2013 and include primary, secondary, and tertiary reports.
SOURCE: NFLIS, DEA, data retrieved May 9, 2014
Number of Heroin Deaths in Florida: 2000 – 2x1h2013
350
328 326
Florida
Palm Beach
Broward
Miami-Dade
300
# Heroin Deaths
250
261
276
200
180
150
122 110
96
100
61
50
0
140
132
58 62
57
46
15 39
36
32
26
27
18
22
17
20
8
26
10
117
111
38
6
30
6
26
4
33
15
6
36
20
12
SOURCE: Florida Medical Examiners Commission Reports 2000-2013
Number of Heroin Deaths in Florida: 2000 – 2x1h2013
70
61
Palm Beach
57
60
50
# Heroin Deaths
50
Broward
49
53 46
40
Miami-Dade
39
36
26
27
10
17
15
33
18
26
22
20
17
13
17
26
17
10
8
0
36
30
32
30
20
38
35
4
8
6
20
15
6
5
4
9
12
3
4
6
SOURCE: Florida Medical Examiners Commission Reports 2000-2013
Heroin Trends
Related Deaths
2012
2 x 1H 2013
Δ 2012 vs. 2X1h 2013
State of Florida
117
140
Up
Palm Beach County
6
20
Up 233 %
Broward County
9
4
Down 56 %
Primary Treatment
2011
2012
State of Florida
2.2 %
3.2 %
Up 45 %
So FL Crime Labs
2012
2013
Δ 2012 vs. 2013
3 SE FL Counties
696
925
Up 33 %
20 %
Δ 2011 vs. 2012
Top 10 Most Frequently Identified Drugs of Total Reports
from South Florida Crime Labs Reports CY 20131
Drug
2013
% Δ vs. 2012
Cocaine
10,147
Down 11 %
Marijuana/Cannabis/THC
5,276
Down 2 %
Methylone (N-Methyl-3,4Methylenedioxycathinone) 1,194
Up 208 %
Hallucinogen
984
Up 88 %
Rx Opioids
933
Down 4 %
Heroin
925
Up 33 %
Rx Benzodiazepines
849
Down 4 %
Methamphetamine
211
Up 24 %
Phenylimidothiazole Isomer
154
Down 37 %
Caffeine
131
Down 45 %
All Other Analyzed Drugs
2,272
Down 18 %
Total
23,069
Down 3 %
Source: US DEA – National Forensic Laboratory Information System as of May 9, 2014
Molly
Methylone is
beta-ketone MDMA
“Ecstasy” and “Mollys” Items Identified in DEA’s
NFLIS Toxicology Labs: 2004- 2013
Number of Items
25000
23114
MDMA
24330
23332
22720
21790
20000
Methylone
*
15000
14134
10749
10337
10000
9495
4411
5000
9985
5147
5367
10
24
11
1
15
28
3752
0
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Source: US Drug Enforcement Administration –
National Forensic Laboratories Information System (NFLIS)
*The synthetic cathinones mephedrone and methylone act on the brain like MDMA
1400
1242
1200
Synthetic
Cannabinoids
Synthetic
Cathinones
Other Emerging
Synthetics
1000
800
600
400
200
0
386
43
19
2011
428
361
145
144
190
2012
2013
15
Emerging Psychoactive
10
Substances
2011–2013
5
0
South
Florida
Crime Labs
Reports
12
10
6
3
1
13
11
10
4
Number of Different Drugs
2011
2012
Synthetic
Cannabinoids
Synthetic
Cathinones
Other Emerging
Synthetics
2013
SOURCE: US DEA: National Forensic Laboratory Information System DQS on May 9, 2014
Current (past 30-day) Marijuana Use Among Broward
% Reporting Current Use
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
4,3
3,5
3,7
2008
2010
Source: Florida Youth Substance Abuse Surveys 2000-2012
2012
Percent of Broward County High School Students
Reporting Marijuana Use by Age 13 or Younger
2000-2012
% Reporting Use by Age 13
18
16.7%
16
14
11% 10.5%
9.4%
12
10
9.7%
8.1% 8%
8
6
4
2
0
2000
2002
2004
2006
2008
2010
2012
Source: Florida Youth Substance Abuse Surveys 2000-2012
Current (past 30-day) Marijuana Use Among
Palm Beach County Middle and High School Students
2000-2012
% Reporting Current Use
25
22,7
22,7
20,7
20
17,8
17,3 17,4
20,6
15
High School
10
6
5,5
5
3,3
Middle School
5,2
6
3,8
2,7
0
2000
2002
2004
2006
2008
2010
Source: Florida Youth Substance Abuse Surveys 2000-2012
2012
Percent of Palm Beach County High School
Students Reporting Marijuana Use by Age 13 or
Younger
2000-2012
% Reporting Use by Age 13
14
12
13.6% 13.2%
12.1%
11%
12.4%
11%
8.9%
10
8
6
4
2
0
2000
2002
2004
2006
2008
2010
2012
Source: Florida Youth Substance Abuse Surveys 2000-2012
Addiction is a Developmental Disease:
It Starts Early
57%
100
36%
Percent of
First Time
Marijuana
Users
By Age
5.5%
10
1.5%
1
Child
Teen
<12
12-17
Young Adult
18-25
Adult
>25
Source: US Dept HHS: SAMHSA National Survey on Drug Use & Health 2011
A major concern about marijuana use among youth is the
link between its early first use and life-long drug
dependency and addiction problems. Nearly 13 percent
of adults who met the criteria for drug abuse or
dependency in the past year first used marijuana by age
14 or younger as compared to 2 percent of those who did
not use marijuana for the first time until age 18 or older.
(Source: US Department of HHS: SAMHSA 2011 National Survey on
Drug Use and Health, Released August 2012.)
% Past Year Depdence/Abuse
Percent of Past Year Drug Dependence or Abuse
Among Adults Aged 18 or Older
By Age of First Marijuana Use: 2011
14%
12.7%
12%
14 Years or
Younger
10%
8%
18 or Older
6%
4%
2.2%
2%
0%
14 yrs. Or Younger
18 or Older
Age of First Marijuana Use
Source: SAMHSA-National Surveys on Drug Use and Health 2011
Percent of Past Year Serious Mental Illness
Among Lifetime Marijuana Users Aged 18 or Older
By Age of First Marijuana Use: 2002 and 2003
Before 12 Yrs
25%
% Past Year SMI
21.0%
20%
12-14 Yrs
15-17 Yrs
17.4%
18 or Older
15%
12.2%
10.5%
10%
5%
0%
< 12 yrs.
12-14 yrs.
15-17 yrs. 18 or Older
Age of First Marijuana Use
Source: SAMHSA-National Surveys on Drug Use and Health 2002-2003
Percent of high school students having ridden
or driven in the past 30 days with or as driver
having used marijuana or alcohol
RODE with Driver who had used
marijuana or alcohol
% Reporting
25
Marijuana
25,7
25,4
21,4
20
Alcohol
27,0
Alcohol
25
20,6
18,4
15
10
20
15
10
5
5
0
0
Florida
Marijuana
30
% Reporting
30
DROVE after using marijuana or
drinking alcohol
Plam Beach
Broward
12,3
11,2
8,1
Florida
10
10,9
7
Palm Beach Broward
Source: FL-DCF - 2012 Florida Youth Substance Abuse Survey
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 Males Reporting
Having Used Synthetic Marijuana Florida and
Palm Beach County - 2012
20%
18%
16%
14%
12%
10%
8%
6%
4%
2%
0%
15.1 %
14.6 %
5.3 %
Florida
Lifetime
Palm Beach
Lifetime
Florida Past
30 Days
4.7%
Palm Beach
Past 30 Days
Source: Florida Youth Substance Abuse Survey 2012
Number of Synthetic Cannabinoids
Poison Control Exposure Calls
2012
2013
Jan-Apr 2014
# of Poison
Exposure
Calls
Jan-Dec 2012
# of Poison
Exposure
Calls
Jan-Dec 2013
# of Poison
Exposure
Calls
Jan-Apr 2014
State of Florida
537*
194**
34
Broward County
37
7
0
Miami-Dade County
45
9
3
Palm Beach County
24
6
0
Synthetic
Cannabinoids
Poison Exposure Calls
* The total of 537 includes 271 calls in January-April 2012
** The total of 194 includes 78 calls in January-April 2013
Source: Florida Poison Information Center – Miami 1-800-222-1222
29.2
Marijuana Trends
Detected in ME
Decedents
2012
2 x 1H 2013
Δ 2012 vs. 2X1h 2013
767
802
Up 5 %
2011
2012
25.1 %
23 %
Down 8 %
So FL Crime Labs
2012
2013
Δ 2012 vs. 2013
3 SE FL Counties
5,388
5,276
Down 2 %
State of Florida
Primary Treatment
State of Florida
Δ 2011 vs. 2012
“Budder” Beware:
Dangers of Marijuana Wax
•
•
•
•
Marijuana Wax
“Budder,” or
Butane hash oil, or even
“ear wax hash”
Produced by soaking
marijuana plant material in
a solvent such as butane
which extracts various
cannabinoids of the plant.
• Thirty-four percent or 1/3 of High School Seniors who say
that they have used marijuana in the past year who
live in the states that have passed medical marijuana
laws report that one of their sources of marijuana is
another person's medical marijuana prescription. And
6 percent say they get it from their own prescription.
• It thus appears that state medical marijuana laws
provide an additional avenue of accessibility to the
drug for teens.
(Source: US Department of HHS: NIH-NIDA 2013
Monitoring the Future Survey Released December 2013)
The Question for Doctors……..
How a Bill becomes Law
How a Pill becomes Medicine
US Food and Drug Administration
• Clinical Trials
• FDA Medical Review
• FDA Medical Panel Approval
Marijuana Use in the Past Month Age 12 and Above: Comparison of 2004-06,
2006-08, 2008-10 & 2010-12 NSDUH: Metro Denver vs. Colorado vs. USA
16
13,45
14
12,2
12
P
e
r
c
e
n
t
10
8
11,66
11,18
2004-06
9,62
7,88
2006-08
8,56
7,29
6
2008-10
7,01
6,58
6,05 6,01
2010-12
Source:
National
Survey on Drug
Use and Health
4
2
0
Denver Area
Colorado
USA
Perception of Great Risk of Smoking Marijuana Once a Month:
Comparison of 2004-2006, 2006-2008, 2008-2010, & 2010-2012
NSDUH: Denver Metro vs. Colorado vs. USA
45
39,15
38,18
40
35
P
e
r
c
e
n
t
32,03
30,61
30
25
20
34,7
31,82
28,84
2004-06
26,82
21,99
19,63
2006-08
24,2
22,1
2008-10
2010-12
15
Source: National
10
Survey on Drug
Use and Health
Substate Data
5
0
Denver Area
Colorado
USA
Do you know anyone with a Medical Marijuana
License/Card?
Denver Public Schools 2011-12 school year
No Marijuana Use in Past
30 Days
Yes,
36%
No,
64%
Used Marijuana in Past 30
Days
No,
20%
Yes,
80%
The range of all students answered yes, rose from
19% among 6th graders to 51% among 12th graders.
Current (past 30-day) Alcohol Use Among
Palm Beach County Middle and High School Students
2000-2012
% Reporting Current Use
60
48,3
50
46,3
42,2
41,8
38,8
40 40
38
30
25,6
21,8
20
10
18,4
19,8
High School
19,1
16,5
Middle School
11,9
0
2000
2002
2004
2006
2008
2010
2012
Source: Florida Youth Substance Abuse Surveys 2000-2012
Current (past 30-day) Binge Drinking Among
Palm Beach County Middle & High School Students
2000-20012
% Reporting Current Use
30
25,1
25
22,1
22,3
22,3
21,8
21
20
18,1
High School
15
10
10,5
Middle School
9,4
9,2
7,2
5,9
6,6
4,2
5
0
2000
2002
2004
2006
2008
2010
2012
Source: Florida Youth Substance Abuse Surveys 2000-2012
Current Alcohol Use Among Palm Beach
High County School Students by Gender 2006-2012
% Reporting Use Past 30 Days
38
Male
36
Female
36,8
34
32
30
32,7
33,8
32,4
31,2
33,1
31,6
29,9
28
26
27,8
26,8
24
22
Note: Rates by Gender not available for 2002 to 2004
20
2000
2006
2008
2010
Source: Florida Dept. of Children & Families
Florida Youth Substance Abuse Surveys 2006-2012
2012
Percent of Palm Beach County High School
Students Reporting Alcohol Use by
Age 13 or Younger
2000-2012
% Reporting Use by Age 13
45
41,8
40
43,3
38,4
36,3
More than a
Sip or Two
33,2
35
27,3
30
25,4
25
20
15
11,9
10
7,2
6
5
4,3
5,2
5,9
5,4
Drinking at
least Once a
Month
0
2000
2002
2004
2006
2008
2010
2012
Source: Florida Youth Substance Abuse Surveys 2000-2012
Age of Alcohol Onset and
Any Lifetime Alcohol Dependency
% Alcohol Dependent
among Adults Aged 18 and Older
50%
47% 45%
38%
40%
32%
30%
28%
20%
15%
17%
10%
11% 9%
0%
13
14
15
16
17
18
19
20
21
Age Began Drinking
Source: National Epidemiologic Survey on
Alcohol and Related Conditions Sample = 43,093
Methamphetamine Arrests
Broward County, FL: Jan 2010–July 2014
Percent By Year
40%
20%
n=168
38%
10%
17% 17%
18%
Percent By
Race/Gender
0%
2010 2011 2012 2013 1st H
20114
1%
64%
Percent By Age
28%
35%
40%
26% 27%
30%
20%
10%
7%
9%
2%
1%
0%
< 20 20's 30's 40's 50's 60's
Black Female
White Female
Black Male
White Male
Methamphetamine Trends
Related Deaths
2012
2 x 1H 2013
Δ 2012 vs. 2X1h 2013
State of Florida
146
162
Up 11 %
Primary Treatment
2011
2012
State of Florida
1.6 %
2%
Up 25 %
So FL Crime Labs
2012
2013
Δ 2012 vs. 2013
3 SE FL Counties
170
211
Up 24 %
Δ 2011 vs. 2012
Percent of Addiction Treatment Clients Reporting
Injecting Drug Use by Primary Drug at Admission:
State of Florida 2012
Treatment
Primary Drug
Heroin
Prescription Opioid
Methamphetamine
Cocaine
State of
Florida
%
82 %
36 %
27 %
5%
Sources: US SAMHSA Treatment Episode Data Sets (TEDS)
for Statewide 2012
SBIRT
• Screening
• Brief Intervention
• Referral to Treatment
What is SBIRT?
SBIRT is a comprehensive, integrated, public
health approach to the delivery of early
intervention and treatment services
• For persons with substance use disorders and
• Those who are at risk of developing these
disorders
Primary care centers, trauma centers, and
other community settings provide
opportunities for early intervention with atrisk substance users.
SBIRT: Review of Key Terms
Screening: Very brief set of questions that
identifies risk of substance use related problems.
Brief Intervention: Brief counseling that raises
awareness of risks and motivates client toward
acknowledgement of problem.
Referral: Procedures to help patients access
specialized care.
SBIRT Goals
Increase access to care for persons with
substance use disorders and those at
risk of substance use disorders.
Foster a continuum of care by integrating
prevention, intervention, and
treatment services.
Improve linkages between health care
services and alcohol/drug treatment
services.