substance abuse issues and trends – winter 2013

Broward County Report

Substance Abuse Issues and Trends – Winter 2013

James N. Hall

Welcome Dr. Michael Wolwa

http://www.state.fl.us/cf_web/

Broward County Trends

• 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

NUMBER of COCAINE

OCCURRENCESIncluding

“Present” &“Cause of

Death”

SOURCE: Florida Medical Examiners Commission Report 2011

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 20110

5001,0001,5002,0002,500

1,034

1,105 1,3071,614 1,702

1,943 2,052 2,1791,791

1,4621,402 1,444State of Florida

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 20110

50

100

150

200

250

300

144 149 151189

160 162182

281

201155

198 184

80 94121 138 120 136 150 157 146 135 127 115

Miami-Dade

Broward

Number of Cocaine Emergency Departments Reports in Broward & Palm Beach Counties, FL: 2008,,2009 & 2010

2008 2009 20100

1,000

2,000

3,000

4,000

5,000

6,000 5,560

4,4794,081

# o

f ED

Rep

ort

Esti

mat

es

SOURCE: US Dept. HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates 2008-2009.

Note: Cocaine visits had a statistically significant decrease from 2008 to 2009.

Percent of Primary Addiction Treatment Admissions by Substance 2007-2011: State of Florida

2007 2008 2009 2010 201105

101520253035

22.318.4

14.5 11.2

8.5

Series1CocaineSeries3Series4Series5Series6

Perc

ent o

f All

Adm

issio

ns

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.

Cocaine

Number of Primary Cocaine Treatment AdmissionsBroward County, FL: 2009-2012*

2009 2010 2011 2012*0

100200300400500600700800900

610424 432 402

159

57 123 122

Powder CocaineCrack Cocaine

# o

f pri

mar

y Tr

eatm

ent

Adm

issi

ons

SOURCE: Florida Department of Children and Families

769

481

Total Cocaine in Red555 524

* 2012 Admissions based on 2 x‘s 1st Half 2012

Numbers of Substances Identified among Decedents in Florida: Jan.-Dec. 2011

Alcoho

l

Cocain

e

Benzo

s

Rx Opio

id

Heroin

Zolpide

m

Muscle

Rela

xant

0

1,000

2,000

3,000

4,000

5,000

6,000

4,252

1,444

5,949 6,333

62 285 478

All Rx = 13,045Alcohol +Illicit Drugs = 5,758

Fla gler

HighlandsHardee

Polk

Martin

St. Lucie

Indian River

PutnamAlachua

Union

Gilchrist

Levy

Dixie

Suwa nnee

Hamilton

S t.JohnsClay

Duval

Nas sau

Baker

Pinellas

Pasco

Mana tee

Hillsborough Osceola

Orange

Se minole

Collie r

HendryLee

Glade s

De SotoSarasota

Palm Beach

LakeSumterHernando

Citrus

Marion

Taylor

Ma dis on

Wa kulla

Leon

Franklin

Liberty

Gadsden

Ja cks on

Ca lhoun

Gulf

Bay

EscambiaOkaloosa

Broward

Dade

Holmes

Monroe

Volusia

Charlotte

Source: Florida Department of Law Enforcement: Florida Medical Examiners Commission Report 2011

5,489 individuals died with one or more prescription drugs in their system. The drugs were at both lethal and non-lethal levels.

Prescription Drug-Related Deaths in Florida: 2011

Source: Florida Department of Law Enforcement: Florida Medical Examiners Commission Report 2011

Number of Oxycodone Reports Detected among Decedents in Florida: 2011

Source: FDLE – Drugs Identified In Deceased Persons by Florida Medical Examiners 2007 - 2010 Reports and 2011 Report

NUMBER of Oxycodone


“Present” &“Cause of Death”

2007 2008 2009 2010 20110

500

1,000

1,500

2,000

2,500

3,000

1,2531,574

1,948

2,3842,128

Number of Oxycodone Reports Detected among Decedents in South Florida: 2007-2011

NUMBER of Oxycodone




2007 2008 2009 2010 20110

50

100

150

200

250

300

144 165 184 177

240

119

171

225 236

174

45 4666

100

75

Palm BeachBrowardMiami-Dade

Number of Emergency Departments Reports by Drug in Broward & Palm Beach Counties, FL:

2008,,2009 and 2010

2008 2009 20102,0002,5003,0003,5004,0004,5005,0005,5006,000

5,560

4,4794,081

2,3512,913

3,299

# o

f ED

Rep

ort

Esti

mat

es

Cocaine


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.

NMU Rx Opioids

Rates per 100,000 of Oxycodone Nonmedical Use E Emergency Department Reports by Age Groups

DAWN Ft. Lauderdale Division vs. USA: 2010

102.6

215.7241.6

142

67.9 79.2

39.864.6

85.3 83.6 71.3 71.1 72.9 47.1

0

50

100

150

200

250

300

18-20 yrs.21-24 yrs.25-29 yrs.30-34 yrs.35-44 yrs.45-54 yrs.55-64 yrs.

Rat

e pe

r 100

,000

SOURCE: US Dept HHS-SAMHSA, CBHSQ: DAWN Emergency Dept. Estimates.

Broward & Palm Beach

USA

Percent of Primary Rx Opioid Addiction Treatment Admissions By Age Groups in Florida: 1998 to 2011

199819992000200120022003200420052006200720082009201020110

10

20

30

40

50

60

70

80

90

100

26 to 30 yrs

21 to 25 yrs

18 to 20 yrs

12 to 17 yrs

Aged 12 to 30 Years

Source: SAMHSA - Treatment Episode Data Sets Submitted by

the Florida Dept. of Children and Families as of July 9, 2012

22%

62%

Percent of Primary Addiction Treatment Admissions by Substance 2007-2011:

State of Florida

2007 2008 2009 2010 201105

101520253035

22.318.4

14.511.2

8.48.3

10.8

16.1

23.9

27.5

2.7 2.5 2.2 2.2 2.2

Series1CocaineSeries3Rx OpioidsHeroinSeries6

Perc

ent o

f All

Adm

issio

ns

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.

Cocaine

Rx Opioids

Heroin

Number of Primary Rx Opioid Treatment AdmissionsBroward County, FL: 2009-2012*

2009 2010 2011 2012*0

200

400

600

800

1000

1200

1400

1600

336

1,118

1,4591,242

Rx Opioids

# o

f pri

mar

y Tr

eatm

ent

Adm

issi

ons

SOURCE: Florida Department of Children and Families* 2012 Admissions based on 2 x‘s 1st Half 2012

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

4.82 5.014.35

4.224.463.82

3.43 2.96

0

1

2

3

4

5

6

2002-04 2004-06 2006-08 2008-10

Florida

Broward

SOURCE: SAMHSA-CBHSQ(2012): Substate Estimates from the 2002-2010National Surveys on Drug Use and Health

Percent Reporting

Past Year Use

Dealer

Sharin

g/Trading

Legitimate M

edical P

ractice

Illegiti

mate Medica

l Practi

ceTheft

0%

10%

20%

30%

40%

50%

60%

70% 66.6%54.6%

13.8% 12.5% 11.1%

Diversion Sources: Primary Opioid

Source: Kurtz, S & Surratt, H: ARSH Nova Southeastern University June 2012

Number of Alprazolam Reports Detected among Decedents in Florida: 2007 – 2011

Source: FDLE – Drugs Identified In Deceased Persons by Florida Medical Examiners 2007 - 2010 Reports and 2011 Report

NUMBER of Alprazolam



2007 2008 2009 2010 20110

500

1,000

1,500

2,000

2,500

1,348

1,873 1,9632,193

1,879

Alprazolam

Number of Alprazolam Reports Detected among Decedents in South Florida: 2007- 2011

NUMBER of Alprazolam




2007 2008 2009 2010 20110

50

100

150

200

250

300

124

176158 124

216

133

203

245 235

199

101 101 98124 114

Palm Beach

Broward

Miami-Dade


2008,,2009 and 2010

2008 2009 20102,0002,5003,0003,5004,0004,5005,0005,5006,000

5,560

4,4794,081

2,3512,913

3,299

2,274

2,900 3,110

# o

f ED

Rep

ort

Esti

mat

es


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.

Cocaine

NMU Benzodiazepines

NUMBER OF HEROIN-RELATED DEATHS IN FLORIDA: 2000 –2011

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

050

100150200250300350 Florida

Miami-DadeBroward

SOURCE: Florida Medical Examiners Commission Reports 2000-2011

62

# L

etha

l Her

oin

Dea

ths

153

2012 ??

Number of Primary Heroin Treatment AdmissionsMiami-Dade and Broward Counties, FL: 2009-2012

1 2 3 4 5 6 7 80

50

100

150

200

250

300

350

150183

227

308

105156 169

316

# of

prim

ary

Trea

tmen

t Adm

issio

ns

SOURCE: Florida Department of Children and Families

2009 2010 2011 2012* 2009 2010 2011 2012*

Miami-Dade Broward

* 2012 Admissions based on 2 x‘s 1st Half 2012


2008,,2009 and 2010

2008 2009 20102,0002,5003,0003,5004,0004,5005,0005,5006,000

5,560

4,4794,081

2,928

2,870

3,249

2,3512,913

3,299

# o

f ED

Rep

ort

Esti

mat

es


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.

Cocaine

Marijuana

Just Released January 4, 2013

http://www.state.fl.us/cf_web/

Current (past 30-day) Alcohol Use Among Broward County Middle and High School Students

2000-2012

Source: Florida Youth Substance Abuse Surveys 2000-2012

2000 2002 2004 2006 2008 2010 201205

101520253035404550

4439.9

36 34.1 37.334.1

31.319.8 20.1

2418.7 16.8 14.8

11.2High School Middle School

% R

epor

ting

Cur

rent

Use

Current (past 30-day) Binge Drinking Among Broward County Middle & High School Students

2000-20012


2000 2002 2004 2006 2008 2010 20120

5

10

15

20

25 22.8

20.3 17.2 1718.8

16.8 16.8

8.96.9

8.85.6 5 4.4 4.4

High SchoolMiddle School

% R

epor

ting

Cur

rent

Use

Current (past 30-day) Marijuana Use Among Broward County Middle and High School Students

2000-2012


2000 2002 2004 2006 2008 2010 201202468

101214161820

17.2

13.9 14.511.4

14 15.3

19

4.5 5.2 5

2.5 3.5 4.3

3.7

High School Middle School

% R

epor

ting

Cur

rent

Use

Perceived Attitudes about Marijuana Among

Broward County Middle and High School Students 2000-2012


2000 2002 2004 2006 2008 2010 20120

102030405060708090

100

80.5 81 81.3 84.5 80.9 80.374.4

58 58.2 61.4 65.158.9 54.8

48

10.5 12.4 10.9 9.8 11.3 14.9 15.7

29.9 29.4 33.3 36.1 31.4 30.625.7

Wrong to Smoke Marijuana Regular Use HarmfulSeen as Cool to Use Trying Marijuana Harmful

% R

epor

ting

Cur

rent

Use

Source: 2011 National Survey on Drug Use and Health


2008,,2009 and 2010

2008 2009 20102,0002,5003,0003,5004,0004,5005,0005,5006,000

5,560

4,4794,081

2,928

2,870

3,249

2,3512,913

3,299

# o

f ED

Rep

ort

Esti

mat

es


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.

Cocaine

Marijuana

Number of Primary Treatment Admissions for Juveniles and Adults by Drug in Broward and

Miami-Dade Counties: Jan - Dec 2011

Source: Florida Department of Children and Families

Other/UnknownHeroin

Rx Benzo'sCocaine/Crack

AlcoholRx OpioidsMarijuana

-300 200 700 1200 1700 2200397

169

140

555

1302

14591949

321227

791052

1406

302

2008

Miami-Dade Broward

Number of Primary Admissions

Fake Drugs; Real Poisons

The Synthetic Drugs

Percent of Florida 9th-12th Graders Reporting Having Used Synthetic Marijuana

in their Lifetime

9th Graders 10th Graders 11th Graders 12th Graders0%2%4%6%8%

10%12%14%16%18%20%

9.7 %11.8 %

14.8 %16.7%

Source: Florida Youth Substance Abuse Survey 2012

Percent of High School Males Reporting Having Used Synthetic Marijuana Florida and

Broward County - 2012

Florida Lifetime

Broward Lifetime

Florida Past 30 Days

Broward Past 30 Days

0%2%4%6%8%

10%12%14%16%18%20%

15.1 %12.4 %

5.3 % 3.9%


Percent of High School Females Reporting Having Used Synthetic Marijuana Florida and

Broward County - 2012

Florida Lifetime

Broward Lifetime

Florida Past 30 Days

Broward Past 30 Days

0%2%4%6%8%

10%12%14%16%18%20%

10.9 %

6.0 %

2.2 % 3.3%


Number of CannabinmimeticsPoison Control Exposure Calls Jan-Dec 2011 and Jan-June 2012

Source: Florida Poison Information Center – Miami1-800-222-1222

CannabinmimeticsPoison Exposure Calls

# of Poison Exposure Calls Jan-Dec 2011

# of Poison Exposure Calls Jan-June 2012

State of Florida 517 377Broward County 38 25Miami-Dade County 36 36Palm Beach County 29 20

11 Different Cannabinmimetics Jan. – July 2012Florida Crime Lab Reports n= 403

Source: US DEA: National Forensic Lab Information System (NFLIS) 08/24/2012

1 11 24 4816

32

58

AM2233JWH-073JWH-203RCS-4UR-144JWH-250JWH-081JWH-018JWH-122JWH-210AM2201

n=276

68 %

White lighteningZoomCloud 9Cloud 10Red DoveBlue silkMoon dustNRG (4-MEC)

Head tripRadianceIvory WavePower surgeSextasyVanilla Sky

Bath salts Stimulants often have trendy names and slick packaging

Number of Emerging Psychoactive Substance Drug Poison Control Exposure Calls

in Florida: Jan-Dec 2011 and Jan-April 2012

Source: Florida Poison Information Center – Miami 1-800-222-1222

Synthetic Drug Category

# of Poison Exposure Calls Jan-Dec 2011

# of Poison Exposure Calls Jan-April 2012

Synthetic Cannabinoids 517 269Hallucinogenic Amphetamines

184 64

MDPV & Mephedrone (Bath Salts)

152 28

Other Hallucinogens DMT and 5-MeO-DIPT

6 2

1,222 Exposure calls Jan 2011 to April 2012

Molly’s

Methylone

3,4 methylenedioxy-methcathinone

96 Crime Lab Cases since March 2012 in Broward County

8 Different Cathinmimetics Jan. – July 2012Florida Crime Lab Reports n= 76

Source: US DEA: National Forensic Lab Information System (NFLIS) 08/24/2012

1 133

4

9

22

33

Fluorometh-cathinone

Alpha-PBP

3,4-DMMC

Pentylone

Ethylone

Pentedrone

A-PVP

4-MECA-PVP

4-MEC

Born 1952-1956

45%

20%

Broward County Report

Substance Abuse Issues and Trends – Winter 2013

substance abuse issues and trends – winter 2013

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