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Dru
ug Abusse Trennds in M
Jun
Miami-D
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Dade C
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County Florida
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The Miami Coalition 1 Annual Drug Trends Report May 2015
TABLE OF CONTENTS
SECTION I. INTRODUCTION ........................................................................................... 2
SECTION I A. REPORT HIGHLIGHTS ........................................................................................... 2
SECTION I B. AREA DESCRIPTION ............................................................................................. 3
SECTION I C. DATA SOURCES ................................................................................................ 3
SECTION II. EMERGING DRUGS and PATTERS of DRUG USE .......................................... 4
NEW ISSUES and SUBSTANCES with SIGNIFICANT INCREASES in INDICATORS of ABUSE
HEROIN and NONMEDICAL USE of PRESCRIPTION OPIOIDS .......................................................... 4
SYNTHETIC CATHINONES (“FLAKKA” and “MOLLY”) ................................................................... 9
SYNTHETIC CANNABINOIDS (“FAKE MARIJUANA”) ........................................................................ 13
METHAMPHETAMINE/AMPHETAMINES ...................................................................................... 14
VAPING ................................................................................................................................ 15
SECTION III. UPDATE on CONTINUING DRUG USE PROBLEMS .................................... 15
MAJOR SUBSTANCES WITH ONGOING but STABLE INDICATORS OF ABUSE
COCAINE/CRACK ................................................................................................................ 15
MARIJUANA/CANNABIS ....................................................................................................... 17
NONMEDICAL USE OF PRESCRIPTION BENZODIAZEPINES ............................................................. 19
SECTION IV. APPENDIX with DATA TABLES ................................................................ 20
The Miami Coalition 2 Annual Drug Trends Report May 2015
Miami‐Dade County, Florida Drug Epidemiology Network Annual Report ‐ June 2015
James N. Hall, Epidemiologist The Miami‐Coalition for a Safe and Drug‐Free Community and The Center for Applied Research on Substance Use and Health Disparities Nova Southeastern University
Section IA. Highlights
o An Opiate epidemic involving heroin and the nonmedical misuse of pharmaceutical
opioids is increasing in Miami‐Dade County with rising numbers of deaths, primary
treatment admissions, and crime lab cases between 2013 and 2014.
o None‐the‐less the proportion of heroin consequences among all substances is lower in
Miami‐Dade County and the State of Florida than in most other areas of the nation.
o Synthetic cathinone (e.g., ethylone, alpha‐PVP, and methylone) crime lab cases in
Southeast Florida during 2014 totaled 1,811 representing a 46‐percent increase over the
previous year and accounting for 16 percent of such reports nationwide and 54 percent
of those in Florida.
o Alpha‐PVP is sold as “Flakka” in the region and is attributed to 18 deaths in neighboring
Broward County between September 2014 and May 22, 2015 and numerous incidents of
excited delirium medical emergencies and bizarre behavior in Southeastern Florida.
o Synthetic Cannabinoid crime lab cases totaled 228 during 2014 in the three Southeast
Florida counties representing a 57‐percent increase over the previous year but just 11
percent of the 2014 reports Statewide. There were 25 Poison Information Center
exposure calls for THC‐homologs during 2014 in Miami‐Dade County and 14 such
reports in the first four months of 2015.
o Cocaine remains a major drug problem locally with significant increases in treatment
admissions between 2013 and 2014. Cocaine‐related deaths remained stable in Miami‐
Dade between the same two years with an 8‐percent increased projected Statewide.
o While significantly below the rates and numbers reported in the US West and the
Atlanta, Georgia metro area in the East, methamphetamine deaths, treatment
admissions, and crime lab reports increased in Florida during 2014 continuing a trend in
rising consequences since 2011.
o More than half of marijuana primary treatment clients in Miami‐Dade are below the age
of 18 years.
o MDMA has dramatically decreased in recent years as the drug detected in “ecstasy” or
“Mollys.”
o Benzodiazepine‐related deaths have decreased a projected 37‐percent Statewide and
16‐perecent in Miami‐Dade County since 2010.
The Miami Coalition 3 Annual Drug Trends Report May 2015
o Injecting drug use (IDU) is the route of administration for 77 percent of the 2014
primary heroin treatment clients and 25 percent of primary prescription opioid
treatment clients in Miami‐Dade County.
o Increasingly e‐cigarette and other vaporizing devices are reported for use of marijuana,
methamphetamine, and new psychoactive synthetic drugs including alpha‐PVP
(“Flakka”).
Section IB. Area Description The total population of Miami‐Dade County is 2,549,075. Those age 21 years or older comprise 79 percent of the population and 64.9 percent are Hispanic or Latino. Black, Non‐Hispanics make up 17.1 percent of the County’s residents while 15.6 percent are White, Non‐Hispanic. Asians account for 1.5 percent and 0.9 percent are of other racial/ethnic groups. The median household income is $43,100.00 and 19.9 percent are people whose income in the past year was below the poverty level. The National Survey on Drug Use and Health estimates that there are 106,346 current (past 30‐days) users of marijuana in the County and 61,337 current users of an illicit drug other than marijuana. Section IC. Data Sources
Florida Department of Law enforcement: Florida Medical Examiners Commission Interim and
annual reports on Drugs Detected in Deceased Persons in Florida January 2010 ‐ June 2014
Florida Department of Children and Families: Primary Drug Treatment Admissions in Miami‐
Dade County 2010 – 2014 and Florida Youth Substance Abuse Surveys 2000 ‐ 2014
Florida Agency for Health Care Administration: Opioid Poisoning Hospitalization Cases 2007‐13
Florida Poison Information Center exposure calls for calendar year 2014 and January‐April 2015
US Drug Enforcement Administration: National Forensic Laboratory Information System
(NFLIS):Southeastern Florida crime lab cases 2014 data Queried: March 23, 2015
Center for Disease Control and Prevention: 2011 and 2013 Youth Risk Behavior Surveys
Florida Department of Health: Diagnosis of HIV and Hepatitis B and C for Miami‐Dade County
U.S. Census Bureau: 2009‐2013: Five‐Year American Community Survey Demographic and
Socio‐Economic Characteristics of the Southeastern Florida MSA
US Substance Abuse and Mental Health Administration: Substate Estimates from the 2010‐
2012 National Survey on Drug Use and Health (NSDUH)
The Miami Coalition for a Safe and Drug‐Free Community Drug Epidemiology Network (DEN)
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Drug Trends
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Drug Trends
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Drug Trends
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Drug Trends
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Drug Trends
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Drug Trends
retail sale there subject tare now aves. Also, theillegal by thre were 175synthetic canalls in 2011. ounty, and 3 exposure caonths of 201through Apriach County. nthetic cathississippi, and
f 2014 acros to 26 such death,
annabinoids
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hroughout 2to frequent dailable for te five synthhe 2011 Flo5 exposure cnnabinoids (eAmong the cwere from Palls for synth14 and 78 inil 2015, 14 wNationally thnones betwAlabama.
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The Miami Coalition 14 Annual Drug Trends Report May 2015
Jn Southeastern Florida there were 228 crime lab reports for synthetic cannabinoids in 2014, up from 145 in 2013, 190 in 2012, and 19 in 2011. Among the 14 different synthetic cannabinoids reported in 2014 were 88 items for XLR‐11, 55 for AB‐Fubinaca, 26 for PB‐22, 20 for Tetrahydrocannabinols, 17 for AB‐Pinaca, 5 for AB‐Chminaca, 5 for UR‐144, 3 for 5‐Fluoro AMB, 3 for THJ 2201, 2 for AM‐2201, as well as one each for 5F‐PB‐22, AKB48 N, JWH‐018, and JWH‐122.
Methamphetamine/Amphetamines
Indicators of methamphetamine abuse reflect continuing increases in the drug’s use in 2014 and 2015, yet remained at low levels relative to other substances and other areas of the nation. Methamphetamine was cited as the primary drug for addiction treatment by 27 clients in Miami‐Dade County during 2014. However private treatment counselors continued to report a resurgence in methamphetamine abuse among men who have sex with men beginning in 2012.
It is suspected that the methamphetamine being used locally is produced in Mexico. Domestic clandestine laboratory production in Florida mostly appears still to be in the north and central parts of the State using the 2‐liter soda bottle “shake and bake” method that yields a relatively small amount of methamphetamine for personal use by the “cook” and for sharing with those who may have helped supply the precursor, pseudoephedrine.
Methamphetamine was detected among 109 deceased persons during the first half of 2014 statewide in Florida, compared with 81 in the first half of 2013 and 169 for the full year of 2013. Methamphetamine was considered a cause of death in 40 (37 percent) of the cases during the first half of 2014. There were also 132 reports of amphetamine detected among decedents across Florida in the first 6 months of 2014, compared to 111 such occurrences in the first half of 2013. Amphetamine was considered the cause of death in 28 (or 21 percent) of the cases in the first half of 2014.
There were 27 primary treatment admissions for methamphetamine in Miami‐Dade County during 2014. Males accounted for 64 percent of the clients in 2014 and 67 percent were between 18 and 34 years of age. Injecting was the primary route of administration for 36 percent of the clients. There were also 16 primary treatment admissions for amphetamine during 2014. Males accounted for 50 percent of the amphetamine clients and 56 percent were between 18 and 34 years of age.
There were 387 methamphetamine crime laboratory reports, or 1.4 percent of the 26,992 total primary, secondary, and tertiary NFLIS reports for Miami‐Dade, Broward, and Palm Beach Counties combined in 2014. Methamphetamine ranked seventh among all substances analyzed in the three counties in 2014. The number of methamphetamine crime laboratory reports increased 83‐percent between 2013 and 2014. There were also 306 amphetamine crime laboratory reports, or 1.1 percent of the 2014 total ranking eighth among all substances and representing a 410‐percent increase from the 60 amphetamine crime lab reports in 2013.
The Miami Coalition 15 Annual Drug Trends Report May 2015
Vaping
The Oxford English Dictionary’s word of the year for 2014 was “vape” used to describe inhaling and exhaling vapors produced by an electronic cigarette or similar device. Usage of the word doubled last year. While most use of vaporizing devices are for liquid nicotine, illicit drug are increasing being vaped including marijuana, methamphetamine, alpha‐PVP (“Flakka”), crushed and liquefied pharmaceuticals. An even more advanced vaping deliver system for marijuana wax or “budder” is called dabbing and uses a special water pipe with metal that can withstand extreme temperatures from a butane torch.
Marijuana wax is produced by soaking left over marijuana leaves and stems of plants in a solvent such as butane which extracts various components of the plant including any number of cannabinoids which are the active drugs in the marijuana. The gooey residue is then allowed to dry‐out resulting in a sticky paste ranging in color from brown to dark green or yellow. The wax can be smeared onto a marijuana joint or tobacco cigarette, placed in a water pipe, or most often melted in a vaporizer or electronic cigarette devise. The inhaled wax vapors have a much higher dose level of not only THC but other cannabis ingredients. Products called marijuana wax could also be made from synthetic marijuana chemicals bought online from China.
Section III. Update on Continuing Drug Use Problems
This section of the report monitors the most current available data on issues related to major
substances with ongoing but generally stable indicators of abuse between the two most current
reporting periods 2013 vs. 2014.
Cocaine/Crack
The proportion of indicators for consequences of cocaine use in Miami‐Dade County as compared to other drugs continues to be among the highest rates in the Nation. The relatively steady decline in cocaine problems from 2007 to 2010 stabilized through 2013. However the numbers of deaths in which cocaine was detected increased in all of Florida in the first half of 2014 while remaining stable in Miami‐Dade County. The percent of deaths considered to be caused by cocaine among the total number of cases where the drug was detected also increased across the State and locally. Both the number and proportion of primary treatment admissions for cocaine among all substances increased between 2013 and 2014. The majority of cocaine‐related deaths and addiction treatment admissions were among those older than 35 years. Many of the indicators reflected cocaine use in combination with other drugs, including a significant majority of cocaine‐related deaths.
The Miam
mi Coalition 16 Annual Drug Trends Report May
2015
The Miami Coalition 17 Annual Drug Trends Report May 2015
There were 697 primary treatment admissions for cocaine smoking (crack) and an additional 443 for powder cocaine in Miami‐Dade County during 2014. These cases accounted for a total of 1,140 (or 18 percent) of the 6,306 primary treatment admissions in publicly‐funded programs (including 2,151 for alcohol) in Miami‐Dade County during 2014, as reported by the Florida Department of Children and Families. These totals represent a modest increase in the proportion of cocaine primary admissions from 2013 (n=683), when cocaine accounted for 16.3 percent of all admissions. Males accounted for 62 percent of the 2014 clients, and 59 percent (n=677) were age 35 or older; none were below the age of 18.
Cocaine continued to be the most commonly analyzed substance by local crime laboratories. It accounted for 8,942 NFLIS reports, or 33 percent of the 26,992 total primary, secondary, and tertiary crime laboratory reports for Miami‐Dade, Broward, and Palm Beach Counties combined in 2014. This represents a 12‐percent decline compared to the 10,147 cocaine crime laboratory reports in 2013. Projections from the National Survey on Drug Use and Health (NSDUH) Substate Data estimate that there were 34,419 users of cocaine in the past year aged 12 and above living in Miami‐Dade and Monroe (The Florida Keys) Counties. The estimate for Broward County was 24,271 and an additional 19,507 in Palm Beach County for a total of 78,197 for these four southeastern Florida counties or 27 percent of the estimated 283,287 past year cocaine users Statewide.
Marijuana/Cannabis
Marijuana remains the number two primary substance for addiction treatment after alcohol in Miami‐Dade County.The portion of primary marijuana clients among all treatment admissions declined 9‐percent between 2010 and 2014, a trend observed nationally. Yet the actual number of clients increased locally as it did for most all other substances. Consequences of marijuana use and addiction continued at high levels, particularly among adolescents and young adults.
Cannabinoids were detected in 492 deaths statewide in Florida during the first half of 2014, a 23‐percent increase from the 401 occurrences during the first six months of 2013. One of the occurrences was considered to be a cause of death.
There were 1,849 primary treatment admissions for marijuana in Miami‐Dade County during 2014. These cases accounted for 29.3 percent of the 4,061 primary treatment admissions. This total was second only to alcohol. The 2014 proportion of marijuana admissions was slightly below that from 2013 when the drug accounted for 33 percent of all admissions but significantly lower than 2012 at 39 percent. Among the 2014 marijuana clients, 71 percent were male; 50 percent were younger than 18; 21 percent were age 18–25; 17 percent were 26–34; and 12 percent were age 35 or older.
Cannabis/THC (tetrahydrocannabinol) accounted for 4,587 crime laboratory reports, or 17 percent of the 26,992 total primary, secondary, and tertiary NFLIS reports for Miami‐Dade, Broward, and Palm Beach Counties combined in 2014. This total decreased 13‐percent from the number of marijuana crime laboratory cases in 2013. As in previous years, marijuana ranked second among all substances analyzed in the three counties.
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ubstantial prion with otbenzodiazepng a 15‐percthe first hal
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