Powder Cocaine⁺

Two sources in Denver (law enforcement and epidemiologic) and one in Boston (law enforcement) are the only ones who name powder cocaine as the drug with the most serious consequences, whether medically, legally, societally, or otherwise. Two additional sources (in El Paso and Seattle) mention cocaine without distinguishing between crack and powder. No single source names powder cocaine as the most widely abused drug.

Compared with the last Pulse Check, the Boston law enforcement source perceives that powder cocaine has replaced crack as the drug with the most serious consequences but that marijuana has replaced powder cocaine as the most widely abused drug.

How available is powder cocaine across the country?
(Exhibits 1 and 2) The majority of the Pulse Check law enforcement sources (14 of 19) and nearly half of the epidemiologic/ ethnographic sources (9 of 20) consider powder cocaine widely available in their communities. The remaining sources describe it as "somewhat available," with four exceptions: sources in Chicago, Los Angeles, and St. Louis describe it as "not very available"; and one source in Honolulu believes powder cocaine is not available at all. The Washington, DC, epidemiologic source elaborates that the drug is somewhat available in clubs but not very available on the street.

How available is powder cocaine across the 20 Pulse Check cities (fall 2001)?

*The law enforcement source in Baltimore did not respond.

Exhibit 2 How has powder cocaine availability changed (spring 2001 vs fall 2001)?*

*The Baltimore law enforcement source did not respond.

According to the majority of law enforcement and epidemiologic/ethnographic sources, powder cocaine availability remained stable between spring and fall 2001, with increases perceived in only three cities (Columbia [SC], El Paso, and Portland [ME]) and declines in two (Honolulu and Washington, DC).

What are powder cocaine prices and purity levels across the country?
(Exhibit 3) Although prices range widely across the country, the most common gram price, as reported in the last Pulse Check, is still approximately $100. Only one price change is reported since the last issue: a slight decline in Memphis, which has the lowest gram price of all the sites.

Gram purity levels have increased in Portland (ME) and declined in Denver. "Eightball" (1/8 ounce) purity levels have increased in Washington, DC, and declined in Seattle.

How much do grams and "eightballs" of powder cocaine cost in 15 Pulse Check cities?*

GRAMS				"EIGHTBALLS" (1/8 OUNCE)
	City	Price/Change**	Purity/Change**	Purity/Change	Purity/Change
	Boston, MAL	$60/	60%/NR	$200–$250/	60%/
	Boston, MAE	$40/	NR/NR	$180/	NR/NR
	New York, NYL	$28–$30/	75%/
	Philadelphia, PAL	$100–$125/	60–80%/	$120/NR	60–80%/
	Portland, MEL	$80–$100/NR	40–60%/
	Memphis, TNL	$20/	NR/NR
	Memphis, TNE	$45–$100/	NR/NR
	Miami, FLE	$20/	NR/NR
	Washington, DCL	$100/	30–60%/
	Washington, DCE	$50–$100/NR	NR/NR	$150–$335/	NR/NR
	Chicago, ILL	$125/	NR/NR
	Chicago, ILE	NR/NR	50–140%/
	Detroit, MIL	$75–$100/	NR/
	Detroit, MIE	$75–$125/NR	NR/
	St. Louis, MOL	$100/	NR/NR
	Sioux Falls, SDL	$100/	/NR	$275/	NR/NR
	Billings, MTL	$100/	50–70%/
	Denver, COL	$100/	20–40%/
	Denver, COE	$80–$100/	50–90%/
	Honolulu, HIL	100–$120/	NR/NR
	Honolulu, HIE			$250–$350/NR	NR/NR
	Los Angeles, CAL	$80–$85/	80%/
	Seattle, WAL	$80–$100/NR	57–58%/
	Seattle, WAE	$30/	NR/	$80–$100/	NR/

Sources: Law enforcement (L) and epidemiologic/ethnographic (E) respondents
*Respondents in Baltimore, Billings, El Paso, and New Orleans did not provide this information.
**Arrows indicate up, down, or stable between spring and fall 2001.
NR= not reported

Ounce-level purity in Miami has declined due to increasing use of adulterants, such as caffeine (new this reporting period) and "any white powder." "Any powder" is also reported in Chicago, and a wide range of other adulterants are reported elsewhere: inositol (a crystalline stereoisomeric cyclic alcohol) in El Paso and St. Louis; manitol (similar to inositol) in El Paso and Memphis; baby laxatives in Baltimore and Memphis; chalk, laundry detergent, procaine (an herbal supplement ingredient), and rat poison in Memphis; meat tenderizer (which leads to severe skin abscesses) in Boston; corn starch and crushed vitamin C in El Paso; and talcum or baby powder in Billings, El Paso, and Washington, DC.

How is powder cocaine referred to and packaged across the country?
(Exhibit 4) "Yao," reported by the methadone treatment source in Seattle, is one of the few new slang names mentioned since the last Pulse Check. As in the past, and as in the case of crack, slang names seem to proliferate among users in the South more than in the other regions.

Various types of plastic bags are still the most common packaging, and no packaging changes are reported since the last Pulse Check. Other commonly reported forms include tinfoil, vials, capsules, and balloons. Some more unusual forms are reported: bricks (wax paper bound with brown sticky wrapping tape), perfume containers, and motor oil jugs in Billings; vacuum-sealed plastic in Denver; "pony packs" (folded pieces of paper) and cigarette packs in Memphis; and dollar bills in New York (if a $20 bag is packaged in a dollar bill, the price goes up to $21). Fewer labels or logos are reported during this period than in the past: in Denver, plastic wrapping sometimes has scorpions or stars; in Memphis, labels are used only on large (kilogram) amounts; and in Miami, some logos appear on bags sold in head shops.

How is powder cocaine referred to across different regions of the country?

Sources: Law enforcement, treatment, and epidemiologic/ethnographic respondents

POWDER COCAINE: THE SELLERS

Who sells powder cocaine?
Young adults (18–30 years), either exclusively or with another age group, are named as powder cocaine sellers by all law enforcement and epidemiologic/ethnographic sources except for one: the El Paso epidemiologic source names adults older than 30 as the predominant sellers. Older adults (along with younger adults) also sell the drug in Boston, Chicago, and Portland (ME), while adolescents sell it in Baltimore, Chicago, and Los Angeles.

As noted in the last Pulse Check, law enforcement sources tend to report that powder cocaine sellers operate independently, while epidemiologic/ethnographic sources tend to report both independent and organized sales structures. Only one change is reported: the Memphis epidemiologic source notes that independent sellers have increased, while sales groups appear less organized.

Law enforcement sources generally believe that powder cocaine dealers are either very likely or somewhat likely to use their own drug. Only in two cities do they believe that dealers are not very likely to do so: in Denver and Miami. Four epidemiologic/ethnographic sources believe that dealers are not very likely to use their drug: in Baltimore, Boston, Denver, and New Orleans. Only one change is reported since the last Pulse Check: the Memphis epidemiologic source reports that dealers are less likely to use their drug than before.

What type of crimes are related to the powder cocaine scene?
Powder cocaine dealers are less likely to be involved in violent crime than crack dealers, according to law enforcement sources (8 versus 12) and epidemiologic/ethnographic sources (6 versus 10). Similarly, gang-related activity and prostitution are less frequently associated with powder cocaine than with crack. Domestic violence, however, is named more frequently in relation to powder cocaine than to crack: in nine cities (Boston, Detroit, El Paso, Honolulu, Memphis, New York, Portland [ME], St. Louis, and Sioux Falls) versus six. In discussing powder cocaine, sources tend to name nonviolent crime slightly more often than violent crime. Some specify the crimes: shoplifting in Boston; burglary or theft in Billings, El Paso, and Memphis; auto thefts, break-ins, and larcenies in Columbia, SC; residing as or transporting illegal aliens in El Paso; money laundering in Miami; and domestic disputes in Sioux Falls.

A fine distinction... New York still has the widest range of drugs obtainable at single locations—heroin, crack, powder cocaine, marijuana, and ecstasy—but the ethnographic source notes a fine distinction: it is heroin sellers who sell all five drugs. Dealers who specialize in any of the other drugs don't necessarily sell anything but that drug.

What other drugs do powder cocaine dealers sell?
Powder cocaine dealers also sell marijuana in 15 of the 20 Pulse Check cities (the 5 exceptions are Baltimore, Chicago, New Orleans, Philadelphia, and Washington, DC), according to law enforcement and epidemiologic/ethnographic sources. They sell crack in nine cities (including five in the South), heroin in seven (including three in the West), ecstasy or other club drugs in another seven (five of which are in the South), and methamphetamine in four (three of which are in the West).

Compared with the last Pulse Check, marijuana sales by powder cocaine dealers are newly reported in Boston, El Paso, Los Angeles, Memphis, and Portland (ME). Ecstasy or other club drugs are newly reported in Columbia (SC), El Paso, and Washington, DC. Sometimes the drug sold is driven by the sales setting: in Columbia, for example, ecstasy and powder cocaine are only likely to be sold together in nightclubs, while marijuana is more likely to be sold with powder cocaine on the street. Similarly, in New Orleans, powder cocaine sellers also sell heroin in central city areas, but in the suburbs they sell only powder cocaine.

Where is powder cocaine sold?
Powder cocaine is sold primarily in central city locations in the majority of Pulse Check cities, as reported in past issues. Other types of locations, however, are more frequently reported for powder cocaine sales than for crack sales. Suburban areas (or both central city and suburban areas) are mentioned in Boston, Los Angeles, New Orleans, and Seattle, while all three types of areas—central city, suburban, and rural—are named in Chicago, Denver, Detroit, El Paso, Miami, New York, and Portland (ME). The only change mentioned since the last Pulse Check is in Memphis, where the epidemiologic source notes that powder cocaine sales are moving out of the city and into the suburbs and rural areas.

Powder cocaine is equally likely to be sold either indoors or outdoors, according to about half of the law enforcement (9 of 19) and epidemiologic/ethnographic (7 of 13) sources who provided this information. In the remaining cities, indoor sales are reported more often than outdoor sales. Outdoor sales, however, still predominate in Miami, New Orleans, Philadelphia, and Sioux Falls. The specific settings for powder cocaine sales are as varied as those for heroin and crack, with no changes reported since the last Pulse Check. In Memphis, however, while the types of selling locations have not changed, powder cocaine is sold in more places overall.

POWDER COCAINE: THE USERS

Who uses powder cocaine?
(Exhibit 5) Like heroin users, powder cocaine users tend to be White males, older than 30, who live in central city areas—particularly as reported by epidemiologic/ethnographic sources. More variations are reported by treatment sources. For example, nonmethadone treatment sources seem to report younger users: adolescents are the predominant powder cocaine users among clients in the Columbia (SC), Los Angeles, and Sioux Falls non-methadone programs, and young adults (18–30 years) are the predominant users in another six programs. Methadone treatment sources are more likely than other sources to mention female users of powder cocaine: 7 out of 12 responding methadone treatment sources report that males and females are equally likely to use the drug. Racial/ethnic distributions among powder cocaine users, as the table shows and as reported in past Pulse Checks, are more similar to those of heroin users than to those of crack users.

What racial/ethnic group is most likely to use specific drugs?*

	City	Heroin		Crack		Powder Cocaine
		E	N	E	N	E	N
	Boston, MA	Whites	Whites	Blacks	Whites	Whites	Whites
	New York, NY	Hispanics	Blacks; Hispanics	Blacks	Blacks	Blacks	Blacks; Hispanics
	Philadelphia, PA	Whites	Whites; Blacks	Blacks	Whites; Blacks; Hispanics	NR	NR
	Portland, ME	Whites	Whites	Whites	Hispanics	Whites	Whites
	Baltimore, MD	Whites	NR	Blacks	NR	Blacks; Hispanics	NR
	Columbia, SC	Whites; Blacks	Numbers Low	Blacks	Numbers Low	Whites; Blacks	Whites
	El Paso, TX	Hispanics	Hispanics	Blacks	Blacks; Hispanics	Whites; Hispanics	Hispanics
	Memphis, TN	Whites	NR	Blacks	NR	Whites; Blacks	NR
	Miami, FL	Whites	Hispanics	Blacks	Blacks	Whites	Hispanics
	New Orleans, LA	Blacks	Blacks	Blacks	Blacks	Whites	NR
	Washington, DC	Blacks	Blacks	Blacks	Blacks	Blacks	Blacks
	Chicago, IL	Blacks	Blacks	Blacks	Blacks	Blacks	Blacks; Hispanics
	Detroit, MI	Whites	Blacks	Whites	Blacks	Whites	Blacks
	St. Louis, MO	Whites; Blacks	Blacks; Hispanics	Blacks	Blacks	Whites	Whites
	Sioux Falls, SD**	Whites	Whites	Whites	Whites	Whites	Whites; American Indians
			Numbers Low		Numbers Low
	Billings, MT**	Whites	Whites; American Indians	Whites	Whites; American Indians	Whites	Whites
			Whites		Whites
	Denver, CO	Whites	Whites	Whites	Blacks	Whites	Blacks
	Honolulu, HI	Whites	NR	Whites; Asians	NR	NR	NR
	Los Angeles, CA	Whites; Hispanics	Numbers Low	Blacks	Hispanics	Whites	Hispanics
	Seattle, WA	Whites	Whites	Blacks	Whites	Whites	Whites

Sources: Epidemiologic/ethnographic (E) and non-methadone treatment (N) respondents
*Shaded boxes indicate that a given drug-using population is overrepresented relative to that city's general population. Not all sources, however, had this information available.
**Billings and Sioux Falls have no methadone treatment programs, so two non-methadone sources reported from each.

Since the last Pulse Check reporting period, only a few changes are reported in the age, gender, race/ethnicity, and residence area of users:
Age:	Boston, MAN: Young adults and older adults are equally likely to use powder cocaine—during the last Pulse Check reporting period, only young adults were named as the predominant group. This change, however, might simply be a case of the older clients increasingly admitting to powder cocaine use. Columbia, SCE: Young adults and older adults are equally likely to use powder cocaine—again, a change from the last Pulse Check, when only young adults were named as the predominant group. But this change could be just a random fluctuation because the numbers are small, since most cocaine use involves crack rather than powder. Washington, DCE: While the predominant users are Black adult (>30 years) male injectors, an emerging group is reported: young adult (18–30 years) White male snorters.
Race/Ethnicity:	Columbia, SCE: Whites and Blacks are equally likely to use powder cocaine. During the last Pulse Check reporting period, only Blacks were named as the predominant group. Again, the numbers are small, so this change could be just a random fluctuation. Denver, COE: Hispanic users of powder cocaine are overrepresented relative to the general population, and their representation in treatment has increased slightly since the last Pulse Check. Whites, however, are still the predominant users. Philadelphia, PAE: Hispanic representation has increased. However, Whites are still the predominant powder cocaine users.
Gender:	Columbia, SCN: While users are predominantly adolescent males, the number of female novice users has been increasing. It is possible that they are not using more, but rather they are admitting to use because, as the Pulse Check source states, "the perceived risk of cocaine is dropping among the clients."
Residence:	Denver, COE: Although powder cocaine users reside primarily in central city areas, some users reside in the suburbs, and increases are reported in rural areas since the last Pulse Check. Memphis, TNE: With the increasing use of powder cocaine in suburban areas, the suburbs have now overtaken central city areas (as reported in the last Pulse Check) as the predominant place of residence. New Orleans, LAE: In addition to central city areas, much powder cocaine use also takes place in the suburbs. Treatment figures show particular increases in East Baton Rouge.

How do powder cocaine users take their drug?
Snorting remains the primary route of administration for cocaine powder according to all but four sources: injecting is named as the predominant route by the Washington, DC, epidemiologic source, the El Paso non-methadone treatment source, and the methadone treatment sources in Baltimore and El Paso. Injecting or smoking are also occasionally mentioned elsewhere as a minority choice. The Boston ethnographic source names two other unusual, but not new, routes of administration and rituals: local affluent college students sometimes slit vitamin E capsules, pack them densely with powder cocaine, and use them as suppositories; and both males and females sometimes rub powder cocaine into the genitalia, claiming that the anesthetic effects on the mucous membranes alters the sexual experience.

Only a few changes in route of administration are reported since the last Pulse Check:

• Denver, CO^E: A resurgence in snorting powder cocaine as opposed to crack smoking is reported.
  
  
• El Paso, TX^E: While snorting predominates, users often progress from snorting to smoking to injecting.
  
  
• New Orleans, LA^E: While the predominant users are Whites who snort the drug, some Blacks report smoking the drug, suggesting they might be turning it into crack.
  
  
• St. Louis, MO^E: A slight (2 percent) recent increase in smoking among patients admitted for cocaine (unspecified) use might indicate an increase in use of powder cocaine. However, crack continues to account for at least 90 percent of cocaine use.

Non-methadone vs methadone clients: How often do they use powder cocaine? Clients in non-methadone treatment programs are more likely to use powder cocaine on a daily basis than those in methadone treatment programs. Those in methadone programs are more likely to binge intermittently.

What other drugs do powder cocaine users take?
(Exhibit 6) Heroin combined with powder cocaine is often referred to as a "speedball." In El Paso, it is also known as a "belushi." In addition to the epidemiologic/ethnographic and non-methadone treatment sources listed in the table, this combination is also reported, not surprisingly, by the majority of methadone treatment sources. Interestingly, however, none of the methadone treatment sources report the combination of marijuana and powder cocaine. That combination, sometimes referred to as a "primo," is also known as a "p-dog" in Los Angeles and as a "coolie" in New York. The Boston ethnographic source notes that, since the last Pulse Check, "oolies" (joints laced with crack or powder cocaine) are gone, and instead, marijuana and cocaine (either form) are used sequentially.

Oral opioids (including diverted OxyContin® and Percocet®) are mentioned only by the Boston ethnographic source. The other drugs listed —benzodiazepines, methamphetamine, and ecstasy—are more likely to be taken sequentially, as a substitute, or as a secondary drug, rather than in combination with powder cocaine. For example, in Billings, powder cocaine is incidental to methamphetamine use. In St. Louis, powder cocaine users are increasingly substituting methamphetamine because it has become more available. In Miami, ecstasy users often begin their evening with a line of cocaine.

Where and with whom is powder cocaine used?
As reported previously, powder cocaine still tends to be used indoors, in private, and in small groups among friends, although methadone treatment sources report more solitary use than do other sources. Private residences remain the most commonly reported specific use settings, followed, in descending order, by parties, cars, nightclubs or bars, and public housing developments.

Compared with the last Pulse Check reporting period, only two changes in specific use settings are reported. The Memphis epidemiologic source reports that powder cocaine use has increased on college campuses, and it is sold in more places in general. In Sioux Falls, the epidemiologic source believes that use in hotel/motel settings may be increasing: during several recent methamphetamine lab busts in such venues, users were also found to be in possession of powder cocaine.

What other drugs do powder cocaine users take?

Powder Cocaine+ Marijuana	Powder Cocaine+ Heroin	Powder Cocaine+Ben- zodiazepines	Powder Cocaine+Meth- amphetamine	Powder Cocaine+ Ecstasy
Baltimore, MDE	Baltimore, MDE	Boston, MAE,N	Billings, MTE	Miami, FLE
Billings, MTN	Billings, MTE	Memphis, TNE	St. Louis, MON	Portland, MEN
Boston, MAE	Boston, MAE	Portland, MEE
Chicago, ILE	Chicago, ILE,N
Denver, COE	Denver, COE
Detroit, MIE	El Paso, TXE,N
El Paso, TXE,N	Miami, FLE
Los Angeles,CAE,N	New York, NYE
Memphis, TNE	Philadelphia, PAE
Miami, FLE	Seattle, WAE
New York, NYE	Washington, DCE
Philadelphia, PAE
Portland, MEE
St. Louis, MOE,N
Sioux Falls, SDN
Washington,DCE,N

Sources: Epidemiologic/ethnographic (E) and non-methadone treatment (N) respondents

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+The following symbols appear throughout this chapter to indicate type of respondent: ^LLaw enforcement respondent, ^EEpidemiologic/ethnographic respondent, ^NNon-methadone treatment respondent, and ^MMethadone treatment respondent.