san francisco bay area drug trends and effective intervention strategies
DESCRIPTION
San Francisco Bay Area Drug Trends and Effective Intervention Strategies. Alice Gleghorn, Ph.D County Alcohol and Drug Program Administrator San Francisco Department Of Public Health. HEROIN PRICE* AND PURITY *Price unit = per milligram pure. $1.4010% - PowerPoint PPT PresentationTRANSCRIPT
San Francisco Bay Area Drug Trends and Effective
Intervention Strategies
Alice Gleghorn, Ph.D
County Alcohol and Drug Program Administrator
San Francisco Department Of Public Health
HEROIN PRICE* AND PURITY*Price unit = per milligram pure
2001 $1.40 10%
2002 $0.99 12%
2003 $0.98 11%
2004 $0.98 11%
2005 $0.89 12%
2006 $0.69 10%
2007 $1.28 8%
2008 $1.07 7.8%
2009 $2.09 5.8%
2010 $2.32 5.7%
2011 $1.40 3.9%
Source: DEA 2011 Heroin DMP, March 2011
Lab analysis of “Gunpowder” sample in 2012 found heroin, lidocaine, codeine, and morphine
San Francisco ED Reports 2004-2011 Source: DAWN 2011(weighted data)
Drugs 2004 2005 2006 2007 2008 2009 2010 2011
Heroin 2,424 3,138 1,994 1,993 1,616 1,224 1,242 731
Opiates/opioids 1,055 2,172 1,703 1,369 1,784 2,043 2,474 2,614
-Opiates,unspec 243 475 446 255 317 433 659 723
-NarcoticAnalges 839 1,804 1,332 1,152 1,504 1,649 1,863 1,953
---Buprenorphine/ * * * * * * * *
---Codeine/combo 69 * * * * * * *
---Fentanyl/combo * * * * * 124 * 171
---Hydrocodone/co 239 440 335 299 434 351 546 529
---Hydromorphone * * * * * 141 * 180
---Methadone 311 805 560 496 514 508 521 421
---Morphine/comb 107 180 131 121 155 188 270 283
---Oxycodone/co 104 251 246 217 315 449 504 543
San Francisco ED Reports 2004-2011, % changeSource: DAWN 2011
Percent Change (p < 0.05)
2004 2010 20112011 vs.
20042011 vs.
20092011 vs.
2010
Heroin 2,424 1,242 731 -70 -40 -41
Opiates 1,055 2,474 2,614 148
-Opiates, unspec 243 659 723 197
-Narcotic analges 839 1,863 1,953 133
--Fentanyl/comb * * 171
--Hydrocodone/co 239 546 529 122
--Hydromorphone/ * * 180
--Methadone 311 521 421 -17
--Morphine/comb 107 270 283 164 51
--Oxycodone/comb 104 504 543 424
Drug Abuse Warning Network, 2011: Selected Tables of National Estimates of Drug-Related Emergency Department Visits. Rockville, MD: Center for Behavioral Health Statistics and Quality, SAMHSA, 2013
0
200000
400000
600000
800000
1000000
1200000
1400000
1600000
1800000
Hydro
codone
Zolpid
em
Loraze
pam
Oxyco
done/al
l
Clonaz
epam
Alpra
zola
m
Diaze
pam
Codeine
Temaz
epam
Caris
oprodol
Met
hadone
Adderal
l
Hydro
morp
hone
Ritalin
5 Bay Area Counties: 2012 Prescription Quantities By Drug Name
5 Bay Area Counties: Prescription QuantitiesHydrocodone/APAP
1550000
1600000
1650000
1700000
1750000
1800000
1850000
Hydrocodone/APAP
2011
2012
CURES Data provided by Mike Small, CA DOJ
Primary Drug Treatment Problem: Percent of total admissions
5 Bay Area Counties; FY2012-13
0 10 20 30 40
Alcohol
Methamphet.
Heroin
Cocaine
Marijuana
Other Opiates
Oxycodone
Other
FY2012/13
Source: DHCS 12-19-13 CalOMS Data System, Craig Chaffee
San Francisco Treatment Service Episode by Primary Drug Problem : FY0607 through FY1112
(Source: CBHS BIS Admission Data)
0
50
100
150
200
250
FY0607 FY0708 FY0809 FY0910 FY1011 FY1112
Non-Prescription Methadone Other Opiates OxyCodone/OxyContin
SAN FRANCISCO COUNTY PRIMARY DRUG AT TREATMENT ADMISSION PERCENTAGE BY AGE, 2011-12[I]
[i] Source: CalOMS Tx Data, Department of Alcohol and Drug Programs
1997: Treatment On Demand• Treatment Expansion: Significant,
sustained local funding increase• Commitment to Harm Reduction
approach: Reaching people wherever they are to reduce death and drug-related harm
• “Heroin Issues” subcommittee: – 1. Hep C Prevention– 2. Alternative Treatment modalities– 3. Soft-Tissue Infection – 4. OVERDOSE DEATH PREVENTION
TOD Heroin Issues Committee Actions:
• 1) Train Community Outreach & Syringe Exchange on overdose prevention education
• 2) Conduct broad public education campaign to increase overdose awareness
• 3) Target overdose response training for people at-risk of heroin overdose in jails, probation, and drug treatment programs
• 4) Test the feasibility and effectiveness of training heroin users to administer naloxone as an overdose death prevention tool
Drug Overdose Prevention Education (DOPE) Focus• Overdose Risk Factors • Recognizing Overdose signs• Overdose response:
– Call 911, Rescue Breathing, Recovery Position,& Follow Up Medical care
• Naloxone Pilot Program– 2003- Naloxone distribution and refills
• 2010 – Intra-Nasal device• Target populations
– SROs, Jail, SEPs, – Residential and Opiate Treatment Programs– AB 109 (Prisoners released to communities)– Pharmacy/Primary Care, Pain medication
Deaths Involving Drug Abuse – DAWN SF Metropolitan Area -1994-2002
343
378 388
317 322
362
286274
212
21 23 29 216 15 26 19 24
255
291 297
228253
288
217 206
143
67 64 62 68 63 5943 49 45
050
100150200250300350400450
1994
1995
1996
1997
1998
1999
2000
2001
2002
TotalMetro
MarinCounty
SanFranciscoCounty
San MateoCounty
Source: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 2002 (092003 update)
Heroin deaths: 1997= 297; 2010= 8