How were the sites selected?
(See map in the Introduction) A total
of 21 sites were studied for this issue
of Pulse Check, including a new site
not studied in the last (Mid-Year 2000)
issue: Baltimore, MD. Baltimore was
included at the request of the Office
of National Drug Control Policy
(ONDCP) because of concerns about
its unique problems involving heroin
and cocaine. We selected the other 20
sites using Census Bureau regions and
divisions with a goal of achieving
geographic and demographic diversity.
In addition, we made an effort to
select sites in areas with special drug
abuse problems of national concern.
More specifically, we applied the following
methodology in selecting sites.
We purposely selected the most
populous States in the four census
regions: New York in Region I
(Northeast Region); Texas in Region
II (South Region); Illinois in Region
III (Midwest Region); and California
in Region IV (West Region). In three
of these States, we selected the most
populous metropolitan areas: New
York City, Chicago, and Los Angeles.
In Texas, however, we selected El
Paso—a known high trafficking area
with particularly high levels of unemployment,
population growth, and
poverty—because of its proximity to
the United States border with Mexico.
We included four rural States, one per
census region. (Rural States are
defined by the Census Bureau as
those in which 50 percent or more of
the State's population reside in census-designated rural areas.) The four
rural sites selected are as follows:
- Region I (Northeast): Portland,
ME—Of the three rural States in
the Northeast Region (including
New Hampshire and Vermont),
Maine has the only Atlantic coastline
and shares the longest border
with Canada. It also includes an
ONDCP-designated High Intensity
Drug Trafficking Area (HIDTA).
Portland is Maine's most populous
metropolitan area.
- Region II (South): Columbia, SC—The three other rural States in the
South census region are Kentucky,
Mississippi, and West Virginia.
However, South Carolina's location
along a major drug trafficking corridor
makes that State a strategic
choice. Recent cocaine seizures in
Columbia further highlight its
strategic importance.
- Region III (Midwest): Sioux Falls,
SD—Sioux Falls is the most populous
metropolitan area within the
Midwest Region's two rural States
(North Dakota and South Dakota).
- Region IV (West): Billings, MT—Montana is the only census-designated
rural State in the West
Region, and Billings is its most
populous metropolitan area.
The remaining 12 sites were selected to ensure that the entire list included
at least 2 sites from each of the 9
Census Bureau divisions (East North
Central, Mountain, Middle Atlantic,
New England, Pacific, South Atlantic,
South East Central, South West
Central, and West North Central).
Additional selection criteria included
population density, representation of
racial/ethnic minorities, and emphasis
on high drug trafficking areas.
Applying these criteria resulted in the
final selection of the following 21
Pulse Check sites:
Baltimore, MD
Billings, MT
Birmingham, AL
Boston, MA
Chicago, IL
Columbia, SC
Denver, CO
Detroit, MI
El Paso, TX
Honolulu, HI
Los Angeles, CA
Miami, FL
Memphis, TN
New Orleans, LA
New York City, NY
Philadelphia, PA
Portland, ME
St. Louis, MO
Seattle, WA
Sioux Falls, SD
Washington, DC
How do the 21 sites vary
demographically? Appendix 2
highlights the demographic diversity
of these 21 sites. For example, their
population density per square kilometer
ranges from a sparse 18.6 in
Billings, MT, to a crowded 2,931.6 in
New York City. Their unemployment
rates range from a 1.7 low in Sioux
Falls, SD, to a 9.4 high in El Paso,
TX. The racial/ethnic breakdowns in
the 21 sites further exemplify their
diversity: White representation ranges
from 30.9 percent in Honolulu, HI,
to 97.8 percent in Portland, ME;
Black representation ranges from 0.5
percent in Billings, MT, to 42.4 percent
in Memphis, TN; and Hispanic
representation ranges from less than 1
percent in Birmingham, AL, and
Portland, ME, to 75.4 percent in El
Paso, TX.
What other data are available at
the 21 selected sites? Information
from other national-level data sources
will be useful for framing, comparing,
corroborating, enhancing, or explaining
the information obtained for Pulse
Check. The following data sources,
listed in Appendix 3, are available in
nearly every site: ONDCP's past Pulse
Check reports; the National Institute
on Drug Abuse (NIDA) Community
Epidemiology Work Group (CEWG);
the Substance Abuse and Mental
Health Services Administration
(SAMHSA) Drug Abuse Warning
Network (DAWN); and the National
Institute of Justice (NIJ) Arrestee Drug
Abuse Monitoring (ADAM) program.
Who are the Pulse Check
sources, and how were they
selected? Consistent with previous
issues, the information sources for
Pulse Check were telephone
discussions with 4 knowledgeable
individuals in each of the 21 sites: 1
ethnographer or epidemiologist, 1
law enforcement official, and 2 treatment
providers. Excluding the new
Baltimore recruits, the vast majority
of the 42 epidemiologists, ethnographers,
and law enforcement sources
who reported for this issue of Pulse
Check were the same, or associated
with the same agencies, as those who
reported for the previous issue.
Ethnographers and epidemiologists
were recruited based on several possible
criteria: past participation in the
Pulse Check program; membership in
NIDA's CEWG; research activities in
local universities; or service in local
community programs. We recruited
law enforcement officials by contacting
local police department narcotic
units, Drug Enforcement Administration
(DEA) local offices, and HIDTA
directors.
To identify treatment sources for the
previous (Mid-Year 2000) issue of
Pulse Check, we randomly selected
providers from the 1998 Uniform
Facility Data Set (UFDS), a listing
of Federal, State, local, and private
facilities that offer drug abuse and
alcoholism treatment services. For
this purpose, we excluded facilities
that reported more than 50 percent
of their clientele as having a primary
alcohol abuse problem, served a
caseload of fewer than 100 clients, or
provided only prevention or detox
services. We then divided the remaining
facilities into two groups—methadone and non-methadone
treatment facilities—in order to
capture two client populations whose
demographic characteristics and use
patterns often differ widely. We
selected one from each of these two
categories of programs for each of the
20 selected sites. Because Billings,
MT, and Sioux Falls, SD, have no
UFDS-listed methadone treatment
facilities, we selected two nonmethadone
facilities in those sites.
For this issue of Pulse Check, in order
to preserve continuity, we retained all
available treatment sources who
reported for the last issue. Additionally,
to ensure regular reporting for
the future, any treatment provider
who was unavailable to participate
was replaced via purposeful, rather
than random, selection based on consultation
with experts in the field.
Altogether, we recruited 43 treatment
sources: 20 methadone providers (2
from Boston, and 1 from each of the
other Pulse Check sites except for
Billings and Sioux Falls), and 23 nonmethadone
providers (1 from each
Pulse Check site plus extra sources
from Billings and Sioux Falls to compensate
for their lack of methadone
representation).
Thus, a total of 85 sources were
identified and recruited, and we
successfully obtained information for
this Pulse Check issue from 83 of
them: a response rate of 98 percent.
The nonresponding participants were
the methadone treatment providers
from Baltimore and Memphis. A full
list of responding sources appears in
Appendix 4.
What kind of data were collected,
and how? For each of the 83
responding sources, we conducted a
single telephone discussion lasting
about 1 hour. We asked sources to
explore with us their perceptions of
the change in the drug abuse situation
between spring 2000 and fall 2001.
We discussed a broad range topic
areas with these individuals, as
delineated in Appendix 5. Not
surprisingly, ethnographic and
epidemiologic sources seemed to be
very knowledgeable about users and
patterns of use; they were somewhat
knowledgeable about drug availability;
and they were less informed about
sellers, distribution, and trafficking
patterns. Treatment providers had a
similar range of knowledge, but they
generally focused on the specific populations
targeted by their programs.
Some providers, however, were able
to provide a broader perspective
about the communities extending
beyond their individual programs.
Among the three Pulse Check source
types, law enforcement officials
appeared to be most knowledgeable
about drug availability, trafficking
patterns, seller characteristics, sales
practices, and other associated
activities; they were, understandably,
less knowledgeable about user groups
and characteristics.
