Since 1992, the Office of National
Drug Control Policy (ONDCP) has
published the Pulse Check, a source
for timely information on drug abuse
and drug markets. The report aims to
describe hardcore drug-abusing populations,
emerging drugs, new routes
of administration, varying use patterns,
changing demand for treatment,
drug-related criminal activity,
and shifts in supply and distribution
patterns. Pulse
Check regularly
addresses five drugs
of serious concern:
cocaine, marijuana,
heroin, methamphetamine,
and—as of the last issue—"ecstasy" (methylenedioxymethamphetamine,
or MDMA) and other club drugs. Additionally, the
current issue provides
information
on an emerging
problem: diversion
and abuse of OxyContin®, a high-dose formulation of
the pharmaceutical opiate oxycodone.
The Pulse Check is not designed to be
used as a law enforcement tool but
rather to be a research report presenting
findings on drug use patterns and
drug markets as reported by ethnographers,
epidemiologists, treatment
providers, and law enforcement officials.
With regards to race and ethnicity,
just as the National Household
Survey on Drug Abuse and other
national data sources report findings
by race and ethnicity, sources contributing
to the Pulse Check are asked to describe the age, ethnicity, and
gender of illegal drug users and those
who sell drugs and any changes in
these characteristics. The information
provided to Pulse Check reflects the
observations of the sources, and their
descriptions are purely for determining
the size, scope, and diversity of
the drug problem. The intent of the
Pulse Check has been and continues
to be merely to describe patterns in
illicit drug use and illicit drug markets
that are emerging in local communities.
Enhancements to Pulse Check
The current Pulse Check issue
includes two changes over the previous
issue, reflecting ONDCP's ongoing
effort to enhance the project and
keep up with the changing nature of
the Nation's drug abuse situation.
First, due to particular concerns
about the drug abuse situation in
Baltimore, MD, that city was added
to the list of Pulse Check sites, bringing
the total to 21 geographically
diverse cities—highlighted on the
map above—spread across the four
Census regions and representing both rural and urban areas. Second, to
ensure regular reporting, any treatment
provider who was unavailable
to participate was replaced via
purposeful selection, in consultation
with experts in the field, rather than
the random selection that was used in
the past.
Use and Interpretation of Pulse
Check Information
By contacting professionals from
three different disciplines—ethnography/
epidemiology,
law enforcement,
and treatment—a
rich picture of the
changing drug abuse
situation emerges.
Though this
approach offers substantial
strengths in
timeliness and depth,
Pulse Check is not a
measure of the
prevalence of drug
abuse or its consequences.
As an anecdotal
source of information,
any interpretation
or conclusion
drawn from Pulse
Check must be viewed carefully and
in conjunction with other more quantifiable
direct and indirect measures
of the drug abuse problem.
More specifically, several of the
limitations of Pulse Check are briefly
discussed below.
- Pulse Check is limited to a report
on the drug abuse situation in 21
specific sites throughout the
Nation. Though considerable
effort was made to select sites
across a broad range of geographic
areas, including Census regions and divisions, urban and rural
States, racial/ethnic coverage, and
high intensity drug trafficking
areas, Pulse Check cannot be
viewed as a national study, and
information cannot be reasonably
aggregated up to a national level.
- Of the 85 sources identified and
recruited across the three disciplines,
83 provided information
for this Pulse Check issue. The
information presented in this
report is based solely on the observations
and perceptions of those
83 individuals. These individuals
may not be knowledgeable about
every aspect of the drug abuse
situation in their sites, and they
may have biases based on their
experiences and exposures.
-
Due to the comprehensive nature
of the telephone discussions,
sources were asked to discuss only
areas in which they were thoroughly
knowledgeable. Thus, the
total number (N) of respondents to
any one question might be less
than 83.
Any contradictory reports within an
individual site are not necessarily a
Pulse Check limitation. Just as the site
sampling methodology was designed
to reflect the country's geographic
and population diversity, recruiting
four sources per site was incorporated
into the design to reflect diversity
within each of the 21 sites. For example,
a law enforcement source in one
site might perceive cocaine to be the
community's most serious problem,
while an ethnographic source at that
same site might consider the most
serious problem to be heroin. And
they would both be right—because each might come in contact with
different populations or each might
deal with a specific geographic
neighborhood.
Information from treatment sources is
particularly susceptible to variance
because some facilities target specific
populations. Furthermore, treatment
providers from methadone and nonmethadone
programs are likely to
have very different perspectives on
their communities' drug problems
because their respective clientele
differ in the nature of their drug
problems and in their demographic
characteristics. It is for this reason
that two treatment sources were
selected from each of the 21 sites—
one from a methadone program, and
one from a non-methadone program.
Taken together, all four sources at
each site provide a richer picture of
the drug problem's nature.
Current Sources and Reporting
Periods
The current report includes information
gathered during May through
July 2001 from telephone conversations
with 83 sources, representing 21
sites across the various regions of the
country. These individuals discussed
their perceptions of the drug abuse
situation as it was during the spring
months of 2001 and in comparison
to a period 6 months earlier, during
fall 2000.
The law enforcement sources who
provided information include 21
narcotics officers from local police
departments, field office agents of the
Drug Enforcement Administration
(DEA), and representatives of High
Intensity Drug Trafficking Areas (HIDTAs). The epidemiologists and
ethnographers are 21 researchers
associated either with local health
departments, university-based
research groups, or other community
health organizations. Some of those
21 individuals are qualitative
researchers who employ ethnographic
techniques to obtain observational
data directly from the drug user's
world; others are epidemiologists
who access both qualitative and
quantitative data. The treatment
sources are 41 providers from 23
non-methadone programs and 18
methadone programs across the 21
sites. Those providers include two
non-methadone sources each from
Billings and Sioux Falls because those
cities do not have methadone programs.
They also include two methadone
sources from Boston, both of
whom were available to contribute
information. They do not include two
methadone sources from Baltimore
and Memphis, who were unable to
participate in this round of discussions.
These sources offer a wealth of
information that, when taken together,
provides a comprehensive snapshot of
drug abuse patterns in communities
across the country. Further, these
individuals provide expertise that can
alert policy makers to any short-term
changes or newly emerging problems
concerning specific drugs, drug users,
and drug sellers.
The appendices at the end of this
report provide a list of these sources,
describe the methodology used to
select them, and discuss the content
of the approximately 1-hour
conversations held with them.
