Pulse Check:
Trends in Drug Abuse
November 2001
Crack: The Perception
How do Pulse Check sources
perceive the crack cocaine
problem in their communities? Crack is considered the most
commonly used drug in Pulse Check
communities by 20 law enforcement,
epidemiologic, ethnographic, and
non-methadone treatment sources in
14 cities. As reported in the last Pulse
Check issue, more than half of those
cities are in the South (all eight Pulse
Check sites in that region). The rest
span the remaining regions: the
Northeast (New York and Portland,
ME); the Midwest (Chicago and
Detroit); and the West (Los Angeles,
and Seattle). Additionally, the Denver
non-methadone treatment source
considers both crack and powder
cocaine as the most commonly used
drugs. Further, crack is considered
the second most commonly used drug
by sources in Boston, Philadelphia,
and St. Louis.
Crack is also named as the drug with
the most serious consequences in
Pulse Check communities by 29 of the
82 sources who provided this infor-mation.
These sources span 14 cities,
and again, more than half are in the
South (all 8 Pulse Check sites). The
rest span the remaining three regions:
the Northeast (Boston and New
York); the Midwest (Chicago, Detroit,
and St. Louis); and the West (Los
Angeles). Another two sources (in
Baltimore and Philadelphia) name
both crack and heroin as the most
serious drug problem, while two
name cocaine without differentiating
between the two types. Crack is
named as the drug with the second
most serious consequences by 22
additional sources in 16 cities, and it
is considered equal to other drugs
(in causing the second most serious
consequences) in another 5 cities: powder cocaine in Denver and Seattle;
heroin in Baltimore and Los Angeles;
and benzodiazepines in Philadelphia.
Has the perception of the crack
problem changed between fall
2000 and spring 2001? One
source in Memphis believes that crack
has overtaken powder cocaine as the
most commonly abused drug among
hardcore users in the community.
However, all other sources who list
crack as the most commonly abused
drug during the current period report a stable trend since the
previous period. Similarly, all but two
sources report a stable trend in crack
as the drug with the most serious
consequences in their communities.
El Paso is one exception: that city's
epidemiologic source believes that
crack has been making inroads and is
replacing heroin in terms of serious
consequences. Memphis is the other
exception, but in reverse: the non-methadone
treatment source believes
that powder cocaine has overtaken
crack in this area.
CRACK: THE DRUG
How available is crack cocaine
across the country? (Exhibit 1)
More than three-quarters (32 of 42)
of law enforcement, epidemiologic,
and ethnographic Pulse Check sources
who discussed this question consider
crack to be widely available in their
community. Only six sources give
a"somewhat available"
response: three in the West
(Denver, Los Angeles, and
Seattle); the two sources in
Portland, ME; and one
source in Chicago. And
only three sources, in three
different regions, consider it
not very available: in Billings,
El Paso, and Sioux Falls.
According to law enforcement sources (N=21)...
According to epidemiologists and ethnographers (N=20)...*
Has crack availability changed?
(Exhibit 2) Crack availability
remained stable between fall 2000
and spring 2001, according to the
majority of Pulse Check sources who
discussed this question (17 of 20 law
enforcement sources and 14 of 19
epidemiologic and ethnographic
sources). Increased availability of
crack is reported by only one law
enforcement source (in Sioux Falls)
and one epidemiologic source (in
Seattle). Two law enforcement
sources perceive a decline in crack
availability (in Chicago and in
Portland, ME), as do four epidemio-logic
and ethnographic sources: two
in the West (Denver and Los
Angeles), one in the South (El Paso),
and one in the Northeast (Portland).
L Law enforcement respondents
E Epidemiologic/ethnographic respondents
*The Columbia (SC) epidemiologic and the
Memphis law enforcement sources did not
provide this information.
What are crack cocaine prices
across the country? (Exhibit 3)
Crack tends to be sold in 0.1 and 0.2
gram rocks, which generally cost
approximately $10 and $20, respec-tively,
according to law enforcement,
epidemiologic, and ethnographic
sources. Gram prices tend to be approximately $100, but prices are as
low as $24 in New York and as high
as $250 in Honolulu. Purity levels are
usually not reported. Nearly all prices
are stable in comparison to the last
Pulse Check reporting period. Two
minor changes are reported: the Los
Angeles law enforcement source
reports some market fluctuation,
resulting in a slight increase in the
price of some rocks (0.2 gram); and
the Seattle epidemiologic source
reports a price decline for "kibbles
and bits," a unit smaller than the
standard rock size (not included in
the chart), to $5.
| MOST COMMON STREET UNIT |
1 GRAM |
|---|
| City |
Unit | Size |
Price |
Purity |
Price |
Purity |
|---|
 |
Boston, MA |
"jum" (small rock) | 0.1 gm | $10 | NR | NR | NR |
|---|
| New York, NY |
bag | NR | $3–$10 | NR | $24–$30 | 58% |
|---|
| "eightball" | 1/8 oz | $20 | 58% | NR | NR |
| rock | NR | $7–10 | 58% | | |
| Philadelphia, PA |
rock | 0.05–0.1 gm | $5–$10 | 80% | NR | NR |
|---|
| Portland, ME |
rock | NR | $80 | 75% | NR | NR |
|---|
| "100-rock" | 0.5 gm | $100 | 80% | | |
 |
Baltimore, MD |
vial | NR | $5–$10 | NR | NR | NR |
|---|
| Birmingham, AL | rock | 0.2–0.5 gm | $10–$20 | NR | $100 | NR |
|---|
| Columbia, SC | rock | 0.2 gm | $20 | NR | $100 | NR |
|---|
| "slab" | 0.5 gm | $100 | NR | | |
| El Paso, TX |
rock | 0.25 gm | $20 | NR | NR | NR |
|---|
| Memphis, TN |
rock | 0.2 gm | $20 | 40–50% | $100 | 40–50% |
|---|
| Miami, FL |
rock | 0.1 gm | $5–$20 | 80% | NR | 80–90% |
|---|
| New Orleans, LA | rock
| 0.25 gm | $10 | NR | $40–$50 | NR |
|---|
| Washington, DC |
"dimebag" | 75 mg | $10 | 30–60% | $80–$100 | NR |
|---|
 |
Chicago, IL |
rock | 0.2 gm | $5–$20 | NR | $123 | NR |
|---|
| Detroit, MI |
rock | 0.1 gm | $10 | 90% | $70–$125 | 90% |
|---|
| Sioux Falls, SD | rock | 0.3–0.5 gm | $50 | NR | NR | NR |
|---|
 |
Denver, CO | rock | 0.1–0.2 gm | $20 | 70% |
$100–$125 |
NR |
|---|
| Honolulu, HI |
rock | 0.25 gm | $25–$35 | 70% | $100–$250 | NR |
|---|
| Los Angeles, CA | rock | 0.2 gm |
$20 |
NR |
$80 | NR |
|---|
| Seattle, WA |
"20 rock" | 0.1–0.125 gm | $20 | NR | $100 | 40–85% |
|---|
| "40 rock" | 0.2–0.25 gm | $40 | NR | | |
|
Sources: Law enforcement, epidemiologic, and ethnographic respondents
*Respondents in Billings and St. Louis did not provide this information.
How and where is crack cocaine
made? Crack continues to be
processed locally in most Pulse Check
communities, as noted in the last
issue. In Denver and Portland (ME),
however, sources note that it is
processed prior to arriving in the
community, while in Washington,
DC, crack may be processed
locally or in New York. Baking
soda continues to be the
standard ingredient added
to powder cocaine to
convert it into crack. A
few sources, however,
mention the use of other
adulterants. In New York,
for example, the ethnographic
source reports vitamin B12 and
lidocaine. Vitamin B12 is also
mentioned by the epidemiologic
source in Memphis. The Baltimore
ethnographic source notes different
types of cooking solutions and ammonia
as crack cocaine adulterants.
| Do-it-yourself "chemistry"...
The New York ethnographic source
notes that "One crack user told a
researcher that while a lot of crack is
available it is better to buy your own
powder cocaine and cook it yourself "
(rather than buy ready-made crack)" if
you want to get your money's worth.
These people refer to themselves as
'chemists.'"
Crack by bus...
According to the El Paso epidemiologic
source, street outreach workers report
that some individuals regularly travel
by bus between Los Angeles and El
Paso for personal reasons and, in the
process, also transport crack. Thus, not
all of El Paso's crack comes from
across the border: some of the supply
comes from California. |
How is crack referred to across
the country? (Exhibit 4) Slang
names for crack seem particularly
common in the South, with numerous
names listed by law enforcement, epidemiologic,
and ethnographic sources
in all eight Pulse Check sites. The
majority of the names listed for the
Northeast come from Philadelphia.
Few slang names are reported by
sources in the Midwest and the West.
Sources: Law enforcement, epidemiologic, and ethnographic respondents
How is crack packaged and
marketed? The New York ethnosgraphic
source reports that small
glassine bags and light plastic wrap knotted at both ends are replacing
plastic colored vials as the preferred
method of packaging crack cocaine.
The Portland, ME, law enforcement
source mentions a similar packaging:
a plastic bag whose corner is knotted
in "Dominican ties." Elsewhere, packaging
remains relatively unchanged
since the last Pulse Check reporting
period. The most commonly reported
packaging, as in the case of heroin,
remains small plastic, cellophane,
glassine, or coin bags, often the
"zipper" type, particularly throughout
the Northeast, the South, and the
Midwest. In the West, however, that
packaging is reported only in
Honolulu. Other types of packaging
are more common in that region:
plastic or glass vials (as reported in
Denver, Los Angeles, and Seattle);
foldover bindles of plastic, paper, or
magazine pages (as reported in
Billings, Denver, Honolulu, Los
Angeles, and Seattle); plastic wrap or
cellophane (in Denver, Honolulu, and
Los Angeles); foil (in Los Angeles and
Seattle); plastic balloons (in Los
Angeles); and just loose rocks (in
Seattle). Loose rocks are mentioned
most frequently in the South
(Birmingham, Columbia, Memphis,
Miami, New Orleans, and Washington,
DC), but are also found in the
Northeast (in Boston and New York)
and the Midwest (Detroit and St.
Louis). Baltimore is the only Pulse
Check city outside of the West where
sources report crack sold in vials.
According to that city's ethnographic
source, different neighborhoods use
different colors on the crack vial tops
for identification: "The vial tops are
red on Monroe Street, but blue on
East Baltimore...." Elsewhere in the
South, the El Paso law enforcement
source reports balloon packaging and
paper diamond folds—similar to
packaging found nearby in the West.
CRACK: THE SELLERS
How are crack cocaine sellers
organized? According to law
enforcement sources, crack sellers in
all four Pulse Check cities in the
Northeast operate independently.
Recently, however, gangs have started
taking over sales in New York. In the
South, by contrast, sales structures
vary: independent operations are
reported in Baltimore, El Paso,
Miami, and Washington, DC; both
types of sales structures—independent
and organized—are reported in
Birmingham and New Orleans; and
loosely organized structures or small
networks are reported in Columbia
(SC) and Memphis. Sales structures
also vary in the Midwest: operations
are organized in Chicago and (loosely)
in Sioux Falls, while both independent
and organized structures are reported
in Detroit and St. Louis. Similarly, in
the West, sales structures vary, from
organized in Billings, Denver, and
Seattle to independently run operations
in Honolulu, to a mix of structures
in Los Angeles.
By contrast, nearly all epidemiologic
and ethnographic sources who provide
this information report that crack sellers
are affiliated with organized sales
structures, such as gangs. As is the case
with heroin, this seeming discrepancy
might be explained by differing
definitions of what constitutes an
organized group.
| Then and Now:
How have crack sellers and sales changed across the country (fall 2000
vs spring 2001)?
The crack sales scene has remained relatively stable since the last Pulse Check report.
Only a handful of changes are reported, with no discernible regional trends: |
| Baltimore, MD; Birmingham, AL;
Columbia, SC; and Memphis, TN: | Law enforcement sources note a tendency
toward younger crack sellers. |
| Boston, MA: |
Continuing a trend noted in the last issue
of Pulse Check, crack sales are increasingly
moving indoors, with more deliveries made via
beeper orders. The Boston ethnographic source
attributes this phenomenon to increased law
enforcement efforts and to urban renewal. |
| Denver, CO: |
Sales are starting to take place in the suburbs,
according to the law enforcement source. |
| Los Angeles, CA: | The law enforcement source notes that electronic
equipment, such as cell phones, continues
to be increasingly involved in crack sales. |
| New York, NY: | The law enforcement source reports that gangs
have recently started taking over sales. |
| St. Louis, MO: | According to the epidemiologic source, crack
used to come into the area from Colombia
through Mexico, but now more seems to be
coming directly from Mexico. |
How is street-level crack sold? Hand-to-hand crack sales are reported
by law enforcement sources in
every Pulse Check city, as noted in the
last Pulse Check, and similar to the
most common method for selling
heroin. Sales involving beepers or cell
phones are also quite common—reported by law enforcement sources
in 16 cities: all four Pulse Check sites
in the Midwest, all but one (Washington,
DC) of the sites in the South, all
but one (Seattle) in the West, and New
York in the Northeast. Acquaintance
networks are mentioned in 13 cities,
and home delivery (which often also
involves beeper or cell phone use) is
mentioned in 11. Internet sales are
reported in New York.
Epidemiologic and ethnographic
sources, similarly, report that hand-to-
hand sales are the most common
(in 14 cities), followed by beeper/cell
phone sales (in 10 cities), then by
home delivery and acquaintance networks
(in 7 cities each). In El Paso,
crack is also reportedly sold over
the Internet.
How old are street-level crack
sellers? As reported in the last Pulse
Check issue, young adults (18–30
years) continue to be the predominant
crack sellers at the street level,
according to law enforcement sources
in nearly every city. Several exceptions,
however, are noteworthy. In
the Northeast, for example, older
adults are more likely to sell crack in
Philadelphia. In the South, adolescents
are the primary sellers in
Baltimore, while all three age groups
(adolescents, young adults, and older
adults) are equally likely to sell crack
in Memphis. In the Midwest, both
young and older adults are named as
the primary crack sellers in Sioux
Falls and St. Louis. And in the West, all three age groups are listed for
Denver, while adolescents reportedly
predominate in Seattle crack sales. In
comparing the fall 2000 and spring
20001 reporting periods, four law
enforcement sources—all in the
South—note a tendency toward
younger crack sellers: in Baltimore,
Birmingham, Columbia (SC), and
Memphis.
Epidemiologic and ethnographic
sources concur that young adults are
the most likely to sell crack, as reported
in nearly every city where this
information was provided. Five exceptions,
however, are noted in the South
and the Midwest: young adults and
adolescents are equally likely to be the
primary crack sellers in Birmingham
and Detroit; young adults and older
adults are equally likely in Memphis;
and adolescents are considered the
predominant seller group in Baltimore
and Chicago. Adolescents are also
noted, to a lesser extent, as sellers in
other cities. In New York, for example,
the ethnographic source reports
that "some dealers in Manhattan are
as young as 13."
What other drugs do crack dealers
sell? (Exhibit 5) As reported in
previous issues of Pulse Check, crack
dealers are often polydrug sellers. In
New York, law enforcement, epidemiologic,
and ethnographic sources
report that some dealers sell as many as four drugs in addition to crack.
Other "one-stop shops," where dealers
sell two or three drugs in addition
to crack, are particularly common in
the South (Birmingham, Columbia,
and New Orleans) and the Midwest
(Chicago, Detroit, and St. Louis);
they are less commonly reported in
the Northeast (Portland, ME) and the
West (Billings and Seattle). Overall,
marijuana is reported in 11 cities,
followed by heroin (in 8 cities) and
powder cocaine (in 7 cities). Methamphetamine
is mentioned in only two
western sites, and ecstasy is named
only in New York. Eight law enforcement
sources and three epidemiologic
and ethnographic sources, however,
report that crack sellers in their
communities sell no other drugs.
Exhibit 5.
What other drugs do crack dealers sell?*
| City |
Marijuana |
Powder
Cocaine |
Heroin |
Methamphetamine |
Ecstasy |
No
Other Drugs Sold |
| |
|
LE |
E |
LE |
E |
LE |
E |
LE |
E |
LE |
E |
LE |
E |
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Boston, MA |
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| New York,
NY |
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PA |
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| Portland,
ME |
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Baltimore,
MD |
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AL |
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SC |
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| El Paso,
TX |
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TN |
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LA |
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DC |
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IL |
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MI |
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| St. Louis, MO |
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| Sioux Falls, SD |
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| Billings,
MT |
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| Denver, CO |
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| Honolulu,
HI |
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| Los Angeles,
CA |
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WA |
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Sources: Law enforcement (LE), epidemiologic, and
ethnographic (E) respondents
*Epidemiologic sources in Billings,
Columbia, El Paso, Denver, Honolulu, Los Angeles, Philadelphia, Portland,
Seattle, Sioux Falls, and Washington, DC, did not provide this information
| One-stop shopping...
In some cities, such as St. Louis—as
noted by that city's epidemiologic
source—crack dealers affiliated with
gangs are the ones most likely to run a
"one-stop shop," selling multiple drugs. |
Do crack sellers use their own
drug? (Exhibit 6) In Miami, St.
Louis, and Seattle, crack sellers usually
do not use the product they sell,
according to law enforcement
sources. In all other Pulse Check sites,
sellers are somewhat or very likely to
use their own drug.
Epidemiologic
and ethnographic sources, however,
generally consider crack sellers as less
likely to use their own drug. Only in
Boston, El Paso, Memphis, New
Orleans, and St. Louis do these
sources describe crack dealers as
very or somewhat likely to use crack
themselves. The Boston ethnographic
source adds that "nearly all users eventually sell" and that "older sellers
are selling to make enough to 'hustle'
their own crack," but that "a few of
the dealers are younger, in gangs, and
less likely to use." Nearly all the
remaining epidemiologic and ethnographic
sources who addressed this
issue believe that crack sellers are not
very likely to use crack. Furthermore,
in Baltimore, the ethnographic source
reports that sellers, who are predominantly
adolescents, do not use crack.
What type of crimes are crack
sellers involved in? All law
enforcement sources consider crack
sellers as somewhat or very likely to
be involved in other criminal activity.
The majority name both violent and
nonviolent crimes (15 and 16 sources,
respectively, out of 21). The most
commonly mentioned crime is gang-related
activity, as noted by 13 sources,
heavily concentrated in the South (in
Baltimore, Birmingham, Columbia,
Memphis, New Orleans, and
Washington, DC) and the West (in
Denver, Honolulu, Los Angeles, and
Seattle), and to a lesser extent in the
Northeast (in Boston) and the
Midwest (in Chicago and St. Louis).
Prostitution is also mentioned frequently,
again particularly in the South
(Birmingham, Columbia, El Paso, New
Orleans, and Washington, DC), and to
a lesser extent elsewhere (Boston and
Philadelphia in the Northeast; St. Louis
in the Midwest; and Denver and
Honolulu in the West). Domestic
violence is noted in six cities (Baltimore,
Birmingham, Boston, Denver,
Memphis, and St. Louis). Other crimes
specified include theft and burglary (in
Billings and Chicago), robberies and
shootings involving other dealers (in
Columbia, SC), and money laundering
(in Detroit).
Exhibit 6. How likely are crack sellers to
use their own drug?*
Sources: Law enforcement, epidemiologic,
and ethnographic respondents
*Law enforcement, epidemiologic, and
ethnographic respondents in Baltimore,
Billings, El Paso, and St. Louis did not
provide this information.
Where is crack cocaine sold? (Exhibit 7) All but 6 of the 21 law
enforcement sources agree that crack
sales generally take place in central
city areas. Five of those six exceptions
are in the South. In Miami and
New Orleans, crack is equally likely
to be sold in central city and suburban
areas. In El Paso, crack sales are
more likely to occur in the suburbs.
In Birmingham, Memphis, and—outside of the South—New York,
crack is sold in a wide range of areas,
including central city, suburban, and
rural areas. The locations for crack
sales remain the same since the last
Pulse Check reporting period, except
for Denver, where crack sales have
expanded to suburban areas, according
to the law enforcement source.
Similarly, nearly every epidemiologic
and ethnographic source who provided
this information indicates that
crack is sold primarily in central city
areas. In Birmingham and El Paso,
however, it is sold both in central city
and rural areas. And in Detroit, crack
is sold in central city, rural, and suburban
areas.
Both outdoor and indoor sales occur
across sites, with a few exceptions.
According to law enforcement
sources, outdoor sales are more common
in Chicago and Philadelphia
while indoor sales predominate in
Baltimore. According to epidemiologic
and ethnographic sources, indoor
sources are more common in Detroit
while outdoor sales predominate in
Washington, DC.
The specific settings for crack sales,
like for heroin sales, are varied.
Public housing developments, cars,
and crack houses are mentioned by
law enforcement, epidemiologic, or
ethnographic sources in nearly every
city. Parties and schools are the next
most common settings, followed by
parks, private housing, and clubs.
College campuses and raves are also
mentioned in at least half the sites,
while sales in shopping malls, outside
supermarkets, and over the Internet
are mentioned in some cities. Overall,
several cities have a particularly wide
range of crack sales settings.
Sources: Law enforcement, epidemiologic, and ethnographic respondents for seller settings
Epidemiologic and ethnographic respondents for user settings
*The law enforcement sources in Sioux Falls, and the epidemiologic/ethnographic sources in Billings, Columbia, Los Angeles, and Seattle, did not provide
seller setting information. The epidemiologic source in Columbia did not provide user setting information.
CRACK: THE USERS
How old are crack cocaine
users? (Exhibit 8) Epidemiologic
and ethnographic sources vary in
their views of which age groups are
most likely to use crack. Three (in
Boston, Birmingham, and Detroit)
consider both young adults (18—30
years) and older adults (older than
30 years) equally likely to use the
drug, although in Birmingham, crack
use among young adults has declined.
Young adults are considered the primary
user group in nine Pulse Check
cities: Philadelphia in the Northeast;
Baltimore, El Paso, and New Orleans
in the South; St. Louis and Sioux
Falls in the Midwest; and Billings,
Honolulu, and Seattle in the West.
Older adults are named in eight
cities: Portland, ME, in the
Northeast; Columbia, Memphis,
Miami, and Washington, DC, in the
South; Chicago in the Midwest; and
Denver and Los Angeles in the West.
In Washington, DC, however, while
older adults remain the primary user
group, use among younger adults is
increasing. These findings differ from
those in the last Pulse Check issue,
when epidemiologic and ethnographic
sources named older adults as the
group likeliest to use crack in all but
four cities (Birmingham, Honolulu,
Los Angeles, and Sioux Falls).
All reporting Pulse Check treatment
sources note that the age of crack
users in treatment has remained stable.
The non-methadone treatment
providers are more likely to report
younger adults (18—30 years) than
older adults (>30 years) as the
predominant crack users. Both age
groups are considered equally likely
to use crack in three cities: Birmingham,
Memphis, and Philadelphia.
The younger adult group is named in 11 cities: Boston and Portland in the
Northeast; El Paso, Miami, New
Orleans, and Washington, DC, in the
South; Chicago and Detroit in the
Midwest; and Honolulu, Los Angeles,
and Seattle in the West. Older adults,
exclusively, are named in only two
cities: Baltimore and Denver. Most
disturbingly, adolescents (younger
than 18) are the largest crack-using
group in the Columbia, SC, non-methadone
program, and they share
the dubious number-one spot with
young adults in Los Angeles, and with
older adults in Sioux Falls.
By contrast, crack-using clients in the
methadone programs appear older
than those in the non-methadone
programs: nearly all responding Pulse
Check sources in this category report
that any clients who use crack tend to be in the older adult (>30 years)
category. This finding, similar to findings
about heroin-using clients, is not
surprising because methadone maintenance
tends to involve people who
have been treated over a long period
of time. The only exceptions are in
Boston, Philadelphia, Columbia (SC),
and New Orleans programs, where
the younger adults outnumber the
older adults among crack users in
methadone maintenance.
Exhibit 8.
What age group is most likely to use crack?
| |
Adolescents
(<18) |
Young Adults
(18–30) |
Adults (<30) |
|
|
Boston, MAE,N,M
| Boston, MAE,M |
| | Philadelphia, PAE,N,M | Philadelphia, PAN |
| |
Portland, MEN |
Portland, MEE |
|
Columbia,
SCN |
Baltimore,
MDE |
Baltimore,
MDN |
| | Birmingham, ALE,N |
Birmingham, ALE,N,M |
| | Columbia, SCM | Columbia, SCE |
| | El Paso, TXE,N | Memphis, TNE,N |
| | Memphis, TNN | Miami, FLE |
| | Miami, FLN | Washington, DCE,M |
| | New Orleans, LAE,N,M | |
| | Washington, DCN | |
|
Sioux Falls,
SDN |
Chicago,
ILN |
Chicago,
ILE,M |
| | Detroit, MIE,N | Detroit, MIE,M |
| | St. Louis, MOE | St. Louis, MON |
| | Sioux Falls, SDE |
Sioux Falls, SDN |
|
Los Angeles,
CAN |
Billings,
MTE | Denver, COE,N |
| | Honolulu, HIE,N | Honolulu, HIM |
| | Los Angeles, CAN | Los Angeles, CAE,M |
| | Seattle, WAE,N | Seattle, WAME |
E Epidemiologic/ethnographic respondents N Non-methadone treatment respondents
M Methadone treatment respondents
| Then and Now:
How have crack cocaine users changed across the country (fall 2000 vs
spring 2001)?
According to epidemiologic and ethnographic sources...
Crack use has remained relatively stable since the last Pulse Check reporting period. Only
a few changes are reported among young adults, among Hispanics, among women, and in
where crack users reside:
| Among young adults: | - Birmingham, AL: Crack use has declined among young
adults (18–30 years), who are now as likely to use the
drug as older adults (>30 years).
- Washington, DC: Crack use has increased among
younger adults, but older adults remain most likely to
use the drug.
|
| Among Hispanics: | - Columbia, SC: A small increase in the number of
Hispanics using crack reflects a similar increase in the
overall population. The numbers, however, remain small.
- Philadelphia, PA: Hispanics, who are overrepresented
among crack users, have increased in proportion since
the last Pulse Check report.
|
| Among women: | -
Columbia, SC: The percentage of females among crack
users has been fluctuating during the past 12 months
(between 38 and 56 percent), with no particular pattern.
- St. Louis, MO: While crack users are still predominantly
males (approximately 60 percent), the number of female
users has been increasing over the past 5 or 6 years.
|
| Where crack users reside: | - St. Louis, MO: With the mass exodus from the city into
the surrounding counties over the past few years, the
crack problem is becoming more concentrated among
people of lower SES, who remain in the city.
- Washington, DC: Crack users continue to reside
primarily in the central city, but increases are noted
among suburban dwellers.
|
| According to treatment sources... |
| Crack user demographic
characteristics and use
patterns have remained
stable since the last Pulse
Check reporting period,
with only a few
exceptions: |
- Novice use: Recent initiation of crack use by any
drug treatment client has increased in only four non-methadone
programs (in Billings, Memphis, Portland,
and Sioux Falls) and one methadone program (in
Columbia, SC).
- Female use: The Washington, DC, non-methadone
provider notes an increase in females smoking crack.
| |
Are there any gender differences
in who uses crack? (Exhibit 9)
According to the New York ethnographic
source, females are the pre-dominant
crack users in that city.
Moreover, females and males are
evenly split among crack users
according to epidemiologic and
ethnographic sources in nine Pulse Check cities: Chicago and Sioux Falls
in the Midwest; Boston and
Philadelphia in the Northeast;
Baltimore, Columbia, Miami, and
Washington, DC, in the South; and
Seattle in the West. The remaining 11
epidemiologic and ethnographic
sources report males as the predominant
crack users in their respective
cities. In St. Louis, while crack users
are still predominantly males
(approximately 60 percent), the number
of female users has been increasing
over the past 5 or 6 years.
| What drugs do female users tend
to take?
The Boston ethnographic source comments
that "females are more likely to
use crack than IV drugs such as heroin
and powder cocaine." Indeed, as
Exhibit 9 shows, epidemiologic and
ethnographic sources tend to consider
females as equally or more likely than
males to use crack, more so than any
other illicit drug except ecstasy. |
Non-methadone treatment sources,
like epidemiologic and ethnographic
sources, report an even gender split
among crack-using clients in several
Pulse Check cities: Philadelphia in the
Northeast; Washington, DC, in the
South; Sioux Falls and St. Louis in
the Midwest; and Billings, Honolulu,
Los Angeles, and Seattle in the West.
Males are the predominant crack
users among clients in the remaining
non-methadone treatment programs.
The only reported change is in
Washington, DC, where more females
are smoking crack than ever before.
Only four methadone treatment
providers report males as predominant
among crack users in their
programs: in Birmingham, Boston, New Orleans, and Seattle. Both males
and females are equally likely to use
crack in another five methadone programs
(in Boston, Columbia, Detroit,
Los Angeles, and Washington, DC).
Females comprise the majority of
crack-using clients in the Chicago and
Honolulu methadone programs. Eight
methadone sources, however, did not
supply breakdowns of their client
population by gender.
Exhibit 9. Which genders are the predominant users of specific drugs
in the 21 Pulse Check cities?
Source: Epidemiologic and ethnographic respondents
Is any racial/ethnic group more
likely to use crack? (Exhibit 10)
According to epidemiologic and
ethnographic sources, Blacks account
for the largest proportion of crack
users in 11 of the 21 Pulse Check
cities, where they are overrepresented
relative to the general population. In
Birmingham, Blacks and Whites are
equally likely to use crack, reflecting
their distributions in the general population.
El Paso has two distinct
racial/ethnic groups of crack users:
Blacks are the predominant sole crack
users; but Hispanics are the most
likely to use both crack and heroin.
Whites are more likely than other
racial/ethnic groups to use crack in
seven cities and are overrepresented
relative to the general population in three of those cities. Only two
race/ethnicity changes are reported:
in Philadelphia, Hispanics, who are
overrepresented among crack users,
have increased in proportion since
the last report; and in Columbia, SC,
a small increase in the number of
Hispanics using crack (which remains
small) reflects a similar increase in the
overall population.
| White crack users in Boston?
"The majority of crack users are
Black," states Boston's ethnographic
source. "White crack users tend to be
heroin addicts who are losing injectable
surface veins." |
According to Pulse Check treatment
sources, Blacks are the predominant
crack users among clients in 11 non-methadone
programs but only 5
methadone programs. Whites account
for the largest proportions of crack
users at four non-methadone programs
and six methadone programs.
Blacks and Whites are split approximately
evenly as the foremost crack
users in the Columbia, SC,
methadone program, while Blacks, Whites, and Hispanics are about
equally represented at three non-methadone
programs: in El Paso, Los
Angeles, and Philadelphia. No
racial/ethnic shifts are reported by
any treatment sources since the last
Pulse Check reporting period.
What is the most common
socioeconomic background of
crack users? Crack-using populations
are predominantly in lower SES
categories in all but 4 of the 21 cities,
according to epidemiologic and ethnographic sources. In Honolulu
and Sioux Falls, crack users are primarily
middle SES; in Birmingham,
they are both lower and middle SES;
and in Detroit, users cross all SES
categories. Treatment sources concur
that crack users are generally found
in the lower SES groups. The only
exceptions are in Boston, Columbia
(SC), Honolulu, Los Angeles, New
Orleans, and Sioux Falls, where either
the middle SES or both lower and
middle SES groups are cited by treatment
providers.
Exhibit 10.
What racial/ethnic group is most
likely to use crack?
| | City | Crack |
|---|
| E | N | M |
|---|
|
Boston, MA |
Black | White | White |
|---|
| New York, NY |
NR | NR | NR |
|---|
| Philadelphia, PA | Black | All | Black |
|---|
| Portland, ME |
White | White | NR |
|---|
|
Baltimore, MD | Black | Black | Black |
|---|
| Birmingham, AL |
Black/
White | Black | Black |
|---|
| Columbia, SC | Black | White | Black/
White |
|---|
| El Paso, TX |
Black | All | NR |
|---|
| Memphis, TN |
White | Black | NR |
|---|
| Miami, FL |
Black | Black | NR |
|---|
| New Orleans, LA |
Black | Black | White |
|---|
| Washington, DC |
Black | Black | Black |
|---|
|
Chicago, IL |
Black | Black | Black |
|---|
| Detroit, MI |
White | Black | Black |
|---|
| St. Louis, MO |
Black | Black | NR |
|---|
| Sioux Falls, SD | White | Black | N/A |
|---|
| Billings, MT |
White | White/
American
Indian | N/A |
|---|
| Denver, CO |
White | Black | Black |
|---|
| Honolulu, HI | White | NR | White |
|---|
| Los Angeles, CA | Black | All | White |
|---|
| Seattle, WA | Black | White | White |
|---|
Sources: Epidemiologic/ethnographic (E),
non-methadone treatment (N), and
methadone treatment (M) respondents
Note: Shaded boxes indicate that a given drugusing
population is overrepresented relative to
that city’s general population. Not all sources,
however, had this information available.
| Crack in St. Louis: Increasingly a
lower SES problem...
As the St. Louis epidemiologic source
notes, "With the mass exodus from the
city into the surrounding counties over
the past few years, St. Louis' crack
problem is becoming more concentrated
among people of lower SES, who
remain in the city." |
Where do crack users tend to
reside? Crack users reside primarily
in central city areas, as reported by
nearly all (18 of the 21) epidemiologic
and ethnographic sources. In El Paso
and Sioux Falls, however, crack users
are more likely to reside in the suburbs,
while in Detroit users reside
throughout the area. While Birmingham's
crack users reside primarily in
the central city, the epidemiologic
source notes that many users reside
throughout small rural towns all
over Alabama.
Similarly, all but three treatment
sources report that the majority of
crack users reside in central city
areas. Two exceptions are in Sioux
Falls, where crack users in the two
non-methadone Pulse Check sites are
more likely to live in rural areas. Seattle is the third exception, with
crack users equally likely to reside in
both central city and suburban locations.
Additionally, smaller populations
of crack users reside in the suburban
and rural areas surrounding
Honolulu and St. Louis, as reported
by those cities' methadone and
non-methadone treatment sources,
respectively.
| How do crack cocaine users wind
up in treatment?
As reported in the last Pulse Check issue,
courts and the criminal justice system
remain the most common referral
sources for clients entering treatment for
crack addiction, according to the
responding treatment sources. Individual
referrals, again, follow closely as the
second most common referral source. |
| Then and Now:
How have crack cocaine use patterns changed across the country
(fall 2000 vs spring 2001)?
According to epidemiologic and ethnographic sources...
|
| Increased crack injection: | - Baltimore, MD: Solid crack is sometimes cooked and
injected, according to recent reports.
- Washington, DC: Crack is being injected with heroin
and marijuana.
|
| More drugs: | - Philadelphia, PA: Crack users are taking a wider range
of other drugs than before, including heroin, marijuana,
ecstasy, and diverted prescription drugs such as alprazolam
(Xanax ® ), diazepam, amitriptyline (Elavil ® ), and,
most recently, oxycodone (OxyContin ® ).
|
| Decline in crack houses: | - Denver, CO: Crack houses have become less prominent,
but this change is long term, rather than recent.
- St. Louis, MO: Crack houses have become less prominent,
possibly because cell phones and beepers are
increasingly used and because users know which blocks
to drive down in order to make their "connections."
|
| Increased public use: | -
Seattle, WA: Public smoking of crack has increased since
the last report. Users are now equally likely to smoke
the drug either in public or in private.
|
How do users take crack? Smoking, by far, remains the predominant
route of crack administration in
every Pulse Check city, according to
all epidemiologic and ethnographic
sources and nearly all treatment
sources. The only exceptions are in
three non-methadone treatment
programs: in Boston, injecting equals
smoking; in Memphis, snorting predominates;
and in Sioux Falls, both
snorting and smoking are common.
Occasional crack injection is also
mentioned by epidemiologic and
ethnographic sources in Baltimore
(where solid crack is sometimes
cooked and injected), New Orleans
(where crack is injected with heroin
in speedballs), and Washington, DC
(where it is injected with heroin and
marijuana).
How frequently do users take
crack? The majority of non-methadone
treatment sources (15 of
21) report that crack users in their
program tend to take the drug daily.
Less frequent usage is reported in six
programs, three of which are in midwestern
Pulse Check cities: Chicago
(four to seven times a week),
Columbia (SC) (once to twice a
month), Los Angeles (twice a month),
Portland (ME) (three to four times a
week), St. Louis (three to four times a
week), and Sioux Falls (once to twice
a month). In methadone programs, by
comparison, usage frequency appears
lower: only seven Pulse Check sources
report daily crack usage by clients in
their programs, while another seven
report less than daily use. In Philadelphia,
for example, some clients use
crack daily, but binge use is more
typical.
What other drugs do crack users
take? Aside from alcohol, the substances
most commonly consumed
with crack—either sequentially or in
combination—are marijuana and
heroin. Marijuana is mentioned by
epidemiologic, ethnographic, and
treatment sources across the country:
Philadelphia in the Northeast;
Baltimore, Birmingham, Columbia,
Miami, New Orleans, and
Washington, DC, in the South;
Detroit and St. Louis in the Midwest;
and Denver, Honolulu, and Seattle in
the West. Heroin is also mentioned
by the same source categories in all
four regions: Boston, New York,
Philadelphia, and Portland in the
Northeast; El Paso, Memphis, New
Orleans, and Washington, DC, in the
South; only Chicago in the Midwest;
and Denver, Honolulu, and Los
Angeles in the West.
The marijuana-crack combination
(in a blunt) in Philadelphia is known
as a "diablito" or a "turbo." That
city's epidemiologic source also lists
a variety of diverted prescription
drugs abused by crack users,
including alprazolam and diazepam
(benzodiazepines); amitriptyline (an
antidepressant); and oxycodone (the
opiate in Percodan ® , Percocet ® , and
OxyContin ® ). The New York ethnographic
source similarly mentions the
crack-diazepam combination, stating
that "A woman in the Bronx told a
researcher that when she cooked up
her crack she would put 'a valium'
in it. She said when she smoked this
crack combination it felt like she was
using heroin." New York users also
combine crack with PCP, a practice
known as cspace basing." Further
south, alprazolam and diazepam are
also commonly taken by crack users
in Memphis, according to the epidemiologic
source. In the West, three
treatment sources—in Billings,
Honolulu, and Los Angeles—report
that crack users in their programs
also abuse diverted benzodiazepines,
such as diazepam and clonazepam.
The Los Angeles methadone
treatment source adds that some
crack-using clients also abuse the
diverted prescription muscle
relaxant carisoprodol (Soma ® ).
Where and with whom is crack
used? (Exhibit 7) Unlike crack sales,
which occur both indoors and out-doors,
crack use is more likely to take
place indoors than outdoors (according
to 12 out of 20 responding epidemiologic
and ethnographic
sources). Users also prefer to smoke
crack in private, rather than public
(13 out of 20 sources) and in small
groups or among friends, rather than
while alone (11 out of 20 sources).
Nearly all the remaining epidemiologic
and ethnographic sources report that
sales and use occur both indoors and
outdoors and in both private and
public locations. But sources in six
cities (Baltimore, Los Angeles,
Memphis, Miami, New York, and
Portland) report that crack users tend
to use their drug while alone, rather
than in a group. The Baltimore
ethnographic source explains that
"crack users tend to smoke their drug
alone, not in groups, because of the
short duration of the high." Baltimore
is also the only city where outdoor
use is slightly more common than
indoor use, but the ethnographic
source notes a particularly wide range
of use settings, including "abandominiums"
(abandoned row houses)
and fast-food restaurant bathrooms.
Similarly, the El Paso epidemiologic
source lists a particularly wide range
of use settings. El Paso is also the
only city where use in public places is
more common than use in private
locations.
Overall, a wide variety of specific
settings are reported, with private residences
most commonly mentioned,
followed by crack houses and public
housing developments. Crack houses,
however, are becoming less prominent
in some areas, such as Denver and St.
Louis. Other venues mentioned, in
descending order of frequency,
include parties, cars, nightclubs,
schools, and college campuses. The
Honolulu epidemiologic source adds
two other unusual crack use settings:
adult video galleries, and hotel rooms.
Treatment sources concur that crack
is usually used indoors, in private,
and in small groups or among friends.
Outdoor use is more common than
indoor use in only two programs
(the Boston and Columbia [SC] non-methadone programs), public
use is more common than private use
in only one (the Columbia non-methadone
program), and solo use is
more common than social use in only
six programs (at the methadone
programs Chicago, Detroit, New
Orleans, and Washington, DC, and at
the non-methadone programs in the
Miami and Washington, DC). A treatment source in Honolulu points out
that people tend to use crack in small
groups and among friends in order to
share costs and, when availability is
low, to share the drug.
| Indoor versus outdoor crack use in
Boston...
Outdoor use in Boston, while slightly less
common than indoor use, is still wide-spread.
As that city's ethnographic source
points out, "crack is used outdoors more
than other drugs because it's easier to
'do' without being seen." By contrast, a
Boston treatment source states that "crack
can't be used in public because of its dis-tinct
odor."
Crack houses on the decline...
The St. Louis epidemiologic source notes
a decline in crack houses, possibly
because cell phones and beepers are
increasingly used and because users know
which blocks to drive down in order to
make their "connections. The Denver
epidemiologic source also reports a long-term
decline in crack houses.
Small-group versus private use...
The Baltimore ethnographic source
explains that ccrack users tend to smoke
their drug alone, not in groups, because
of the short duration of the high." A
Honolulu treatment source points out,
however, that group use is more economical:
friends can share costs and, when
availability is low, they can share the drug. |
