ONDCP Seal
 Skip NavigationPublicationsONDCP Mast
Search Contact Podcast Mobile Web Blog ONDCP Mast Skip Navigation
ONDCP Web Site About ONDCP News and Public Affairs Policy Drug Facts Publications Related Links
Prevention Treatment Science and Technology Enforcement State and Local International Funding
Pulse Check: Trends in Drug Abuse, November 2001

Highlights

This report is based on discussions with 83 epidemiologists, ethnographers, law enforcement officials, and methadone and non-methadone treatment providers from 21 Pulse Check sites. Telephone discussions with these individuals, conducted between May and July 2001, reveal that overall, when comparing spring 2001 with fall 2000, the majority of Pulse Check sources consider the drug problem to be very serious but stable. (Exhibits 1 and 2)

Exhibit 1. Bar graph showing how serious the perceived drug problem in the 21 Pulse Check communities. A Majority of the 83 Pulse Check sources say the drug problem in their communities is Very Serious, followed by Somewhat Serious, and Not Very Serious.

Sources: Epidemiologic, ethnographic, treatment, and law enforcement respondents

The situation is characterized by several key features:
  • Diversion and abuse of OxyContin®, a high-dose formulation of the pharmaceutical opiate oxycodone, is the latest and most rapidly emerging problem. (Exhibits 3 and 4)
  • Heroin and crack are both equally associated with more serious consequences than any other illicit drugs, as reported in 14 Pulse Check sites each. (Exhibits 5 and 6)
  • Marijuana remains the most widely abused illicit drug, as reported in 19 sites. (Exhibits 5 and 6)
  • The emerging problem of "ecstasy" (methylenedioxymethamphetamine, or MDMA) and, to a lesser extent, other club drug use continues to intensify. (Exhibit 4)
  • Methamphetamine continues to be reported as an emerging problem in some areas. (Exhibit 4)

Exhibit 2. Bar graph showing how has the perceived drug problem changed (fall 2000 vs spring 2001). A Majority of the 83 Pulse Check sources say the drug problem in their communities has stayed the same, followed by some-what worse, much worse, and less serious.

Sources: Epidemiologic, ethnographic, treatment, and law enforcement respondents

HIGHLIGHTS FROM THE SPECIAL SECTION TOPIC: Synthetic Opiates

Pulse Check sources asked about synthetic opiates reported the diversion and abuse of the prescription pain reliever OxyContin® as the emerging drug problem in their sites:

  • Nearly all law enforcement sources report increased availability of diverted OxyContin®, with sources in the Northeast generally reporting higher availability than elsewhere.

  • Although in most cities OxyContin® abusers are predominantly young adults (18–30 years) or adults (older than 30), adolescent (13–17 years) users are emerging in a few cities, such as Portland (ME) and Miami. Similarly, sources in six cities (in Billings, Boston, Detroit, Miami, Portland, and St. Louis) report OxyContin® abuse specifically among adolescents who have not used opiates previously.

  • OxyContin® abuse and diverted sales are emerging in the rave and nightclub scene in Billings, Boston, Miami, New Orleans, Philadelphia, and St. Louis.

  • While the media often refer to diverted OxyContin® as "hillbilly heroin," its use is not isolated to rural areas. For example, in Baltimore, Philadelphia, and Washington, DC, abusers reside primarily in central city areas; in Birmingham, Detroit, and Memphis, they reside in rural areas and the suburbs; and in Columbia (SC) and Miami, they reside predominantly in the suburbs.

  • Since the last reporting period, OxyContin® diversion has intensified. For example, in Portland (ME), armed robberies of pharmacies for OxyContin® and home invasions of clients who have legitimately filled prescriptions have increased. In Miami, dealers recruit patients from substance abuse treatment facilities, drive them to doctors who prescribe the drug, have the prescriptions filled, then sell the pills illegally.

OxyContin®Ecstasy/Club DrugsMethamphetamine
Baltimore, MDE,NBaltimore, MDLColumbia, SCL
Billings, MTL,NBoston, MAL,NDetroit, MIE
Birmingham, ALL,N,MColumbia, SCN,MEl Paso, TXN
Boston, MAL,E,MDenver, COL,E,NMemphis, TNL
Columbia, SCEDetroit, MILSt. Louis, MOE
Denver, COMEl Paso, TXESioux Falls, SDN
Detroit, MIEHonolulu, HIL,E,NSeattle, WAL
Miami, FLL,E,NLos Angeles, CAL,EWashington, DCL
Honolulu, HIMMemphis, TNE,N 
Philadelphia, PAL,E,N,MNew York, NYE 
Portland, MEL,E,NPhiladelphia, PAN,E 
New Orleans, LAL,N,MPortland, MEL 
St. Louis, MOE,MSeattle, WAN 
Washington, DCE,MSt. Louis, MOE 
 Sioux Falls, SDL,E 
Other Emerging Drug Problems
Clonidine (Catapres®): Chicago, ILM
"Devil's trumpet" herbal: Honolulu, HIE
Dextromethorphan (DXM): Washington, DCE
Diphenhydramine (Benadryl®): Portland, MEM
Hydromorphone (Dilaudid®): Memphis, TNE
Marigolds, Khat: Boston, MAL
Marijuana + Methamphetamine: Sioux Falls, SDN
Marijuana + Cocaine or Heroin: El Paso, TXM
PCP: New York, NYN
"Red ferrari" (designer amphetamine): Los Angeles, CAN
White heroin: Honolulu, HIE
LLaw enforcement respondents EEpidemiologic/ethnographic respondents
NNon-methadone treatment respondents MMethadone treatment respondents

HIGHLIGHTS BY SPECIFIC ILLICIT DRUG

The 83 discussions also yielded key findings about heroin, crack cocaine, powder cocaine, marijuana, methamphetamine, and club drugs:

HEROIN

  • Heroin availability remains generally stable at high levels, with only a few increases and no declines reported. High-purity, snortable South American (Colombian) white heroin is the most commonly cited type, followed by lower purity, injectable Mexican black tar, which predominates in the West and in some parts of the South.

  • Street-level prices and purity are generally stable—at low and high levels, respectively—with a few exceptions, such as a price drop in El Paso and an increase in Baltimore.

  • Young adults (18–30 years) are increasingly using heroin in the majority of Pulse Check sites, according to epidemiologic and ethnographic sources. The number of novice heroin users (any drug treatment client who has recently begun using heroin) has increased in programs across nine Pulse Check sites.

  • Heroin use is spreading to suburban areas surrounding five Pulse Check sites: Baltimore, Memphis, Miami, and Washington, DC, in the South; and Seattle in the West. Use is also spreading to the rural areas surrounding Portland (ME) and El Paso.

  • Injecting remains the most common route of heroin administration. Snorting, however, either equals or surpasses injecting in nine Pulse Check sites, and it has increased in six sites: Columbia (SC), Denver, El Paso, Miami, New Orleans, Philadelphia, and Washington, DC. New and younger users tend to snort rather than inject.

  • "Speedballs" containing heroin plus crack (as opposed to powder cocaine) have increased in El Paso and Los Angeles. Reports of heroin combined with ecstasy have increased in three southern Pulse Check sites: Birmingham, Memphis, and Miami.

CRACK COCAINE

  • Crack remains widely available in the majority of Pulse Check sites, with few changes in availability or price. The crack sales scene has remained relatively stable, with only a few isolated changes, including the following:

    • Younger crack sellers are increasingly reported in the South.
    • Electronic equipment, such as cell phones and beepers, continue to be increasingly involved in sales. As a result, sales are moving indoors in some cities, and crack houses are becoming less prominent in others.
    • Gangs have recently started taking over sales in New York.
    • Sales in the Denver area are starting to take place in the suburbs.


  • Females are equally or more likely than males to use crack in many cities, more so than any other illicit drug except ecstasy, according to epidemiologic and ethnographic sources.

  • While crack is nearly always smoked, increased crack injection is reported in Baltimore and Washington, DC.

POWDER COCAINE

  • Powder cocaine remains widely available, with few changes in price or purity. El Paso, however, is one exception: powder cocaine and heroin are now cheaper and more abundant on the American side of the border than on the Mexican side.

  • Availability and purity levels are particularly high in New York.

  • Powder cocaine users often resemble heroin users, rather than crack users. For example, they are more likely to be male, rather than female, and White, rather than Black.

  • Young adults and, in some cases, adolescents are increasingly using powder cocaine in five sites: Birmingham, Detroit, Los Angeles, Sioux Falls, and Washington, DC.

  • In some sites, such as Washington, DC, powder cocaine use is increasing among White middle socioeconomic suburbanites—sometimes in nightclubs, bars, and private parties.

  • Powder cocaine sellers in New York have recently added ecstasy to the many other drugs they sell. In Los Angeles, powder cocaine plus ecstasy is a recent combination.

MARIJUANA

  • Marijuana availability continues to be wide and stable in nearly every Pulse Check site. However, hydroponically grown marijuana availability is increasing in several cities, including Chicago, Miami, St. Louis, and Washington, DC.

  • Young adult (18–30 years) user groups are increasing in several cities: Detroit, Los Angeles, and Memphis.

  • Compared with heroin, crack, and powder cocaine users, who tend to reside predominantly in central city areas, marijuana users reside in all areas (central, suburban, and rural), reflecting the pervasiveness of marijuana use.

  • More than 80 percent of nonmethadone treatment sources report that marijuana users are referred to treatment by the criminal justice system, an increase from the last reporting period. Criminal justice referrals involving heroin and crack have also increased dramatically. The next Pulse Check will continue to monitor this trend.

METHAMPHETAMINE

  • Methamphetamine continues to be more widely available in the West than in other U.S. regions. Moreover, half of western sources report increasing availability.

  • Methamphetamine is considered the most widely used drug in two western Pulse Check cities: Billings and Honolulu. It is reported as the drug contributing to the most serious consequences by 13 sources in 4 cities: Billings, Denver, Honolulu, and Sioux Falls.

  • Most sources link methamphetamine sellers to domestic violence, much more so than any other illicit drug sellers.

CLUB DRUGS

  • Ecstasy continues to be the most available club drug (more than 90 percent of law enforcement, epidemiologic, and ethnographic sources report it as widely or somewhat available), followed by gamma hydroxybutyrate (GHB), ketamine, and flunitrazepam (Rohypnol). Ecstasy availability continues to increase in most sites, while GHB, ketamine, and Rohypnol availability is stable.

  • Ecstasy is reported as an emerging drug of abuse in 15 sites.

  • Ecstasy seller and user populations continue to expand to include various ethnic sellers in the Northeast, Black sellers in the South, adolescent users across the country, and non-White and Hispanic users in some southern and western cities. Ecstasy sale and use settings also continue to expand from raves, concerts, nightclubs, and bars to streets, private residences, and private parties.

  • Drugs sold and used with ecstasy are expanding from marijuana and other club drugs to heroin and powder and crack cocaine.

Where has the drug with "the most serious consequences" changed?
Site/Source Fall 2000 Spring 2001
El PasoE Heroin Crack
MiamiE Heroin OxyContin®
New OrleansM Heroin OxyContin®
MemphisN Crack Powder cocaine
PortlandL Powder cocaine Pharmaceutical opiates


Where has "the most commonly abused drug" changed?
Site/Source Fall 2000 Spring 2001
New YorkM Crack Heroin
PortlandL Powder cocaine Heroin and pharmaceutical opiates
MemphisN Powder cocaine Crack

LLaw enforcement respondents EEpidemiologic/ethnographic respondents
NNon-methadone treatment respondents MMethadone treatment respondents

Exhibit 5. What are the most serious drug problems in the 21 Pulse Check sites, by type of source?*

City Most commonly abused?* Most serious consequences?
L E N L E N M
Northeast Boston, MA HCl MJ H Crack Crack H Cocaine+ Alcohol
New York, NY MJ MJ Crack H Crack Crack Crack
Philadelphia, PA MJ MJ H H H H+Crack H
Portland, ME H/Pharm. Opiates MJ Crack Pharm. opiates H H Benzos
South Baltimore, MD H H Crack H H Crack+H NR
Birmingham, AL Crack MJ Crack Crack Crack Crack Any IV drugs
Columbia, SC MJ Crack MJ Crack Crack Alcohol H
El Paso, TX MJ MJ Crack NR Crack H H
Memphis, TN Crack MJ MJ Crack Crack HCl NR
Miami, FL Crack MJ Crack Crack Oxy Crack NR
New Orleans, LA MJ Crack Crack Crack Crack Crack Oxy
Washington, DC Crack Cocaine Crack MJ H Crack H
Midwest Chicago, IL Crack MJ Crack Crack Crack Crack H
Detroit, MI MJ MJ Crack Crack H Crack H
St. Louis, MO MJ MJ NR Crack Crack Crack H
Sioux Falls, SD MJ MJ MJ Meth Meth Meth Meth
West Billings, MT Meth MJ Alcohol Meth Meth Meth NR
Denver, CO MJ MJ Crack +HCl HCl HCl Meth MJ
Honolulu, HI MJ Meth MJ Meth Meth Meth Benzos + Meth
Los Angeles, CA Crack MJ MJ Crack H Meth H
Seattle, WA MJ H MJ H H Cocaine Benzos

*Heroin is almost always, by definition, the most commonly used drug in methadone programs, so methadone treatment sources are excluded from this question.
Note: HCl = Powder cocaine; MJ = Marijuana; H = Heroin; Meth = Methamphetamine; Benzos = Benzodiazepines; Oxy = OxyContin®
LLaw enforcement respondents EEpidemiologic/ethnographic respondents NNon-methadone treatment respondents MMethadone treatment respondents

Drug Most commonly abused?* Most serious consequences?
  No. of sources No. of sites No. of sources No. of sites
Heroin 6 5 24 14
Crack 20 14 29 14
Powder cocaine 1 1 2 1
Marijuana 30 19 1 1
Methamphetamine 3 2 13 4
Pharmaceutical opiates 1 1 3 3
Benzodiazepines 1 1 3 3
Alcohol 2 2 2 2

*Methadone treatment sources are excluded from this count.
Sources: Law enforcement, epidemiologic/ethnographic, non-methadone treatment, and methadone treatment respondents







PRIVACY POLICY | SITE MAP | DISCLAIMER | ACCESSIBILITY




Last Updated: March 4, 2002