Highlights
Mid-Year 2000 Pulse Check Highlights
Unlike previous issues of Pulse Check, this issue reports on changes between 1999 and 2000. Future Pulse Checks will be issued by the Office of National Drug Control Policy (ONDCP) twice annually. The current report is based on discussions with epidemiologists, ethnographers, law enforcement officials, and methadone and non-methadone treatment providers. More specifically, 74 telephone discussions were conducted between September and October 2000. Based on these conversations, two key features characterize an otherwise stable illicit drug problem in comparing 1999 and 2000.
- An emerging club drug scene continues to grow across the Nation.
- In some cities, heroin has increased in supply, in purity levels, and in the number of users.
Heroin:
- In several areas, sources note increases in supply, purity, aggressive marketing strategies, and indoor selling.
- Several increases are noted in the numbers of younger people, often suburbanites, starting to use the drug, usually via snorting.
- In New York and Portland (Maine), some adolescents are reportedly shifting from snorting to injecting as the primary route of administration.
- Availability is stable in the majority of sites.
- Only a few isolated changes are reported in user groups. Some young people are increasingly abusing powder cocaine, sometimes as a club drug, as noted by sources in Boston, Columbia (South Carolina), Denver, Los Angeles, Memphis, Miami, and New Orleans.
- While epidemiologic and ethnographic sources report few signs of crack initiation, treatment sources in 10 cities, spanning all regions of the country, report increases in novice use of crack.
- Street-level crack and powder cocaine sellers usually use their own drug and are often involved in violence, according to law enforcement sources in nearly every site.
- " According to law enforcement, epidemiologic, and ethnographic sources, availability is stable in the majority of sites; however, potency has increased in at least seven cities, mostly due to improved cultivation techniques, such as hydroponic growing of marijuana.
- "Users span a wide range of age, racial/ethnic, gender, socioeconomic, and residence groups, with adolescent users often outnumbering young adult users.
- Law enforcement sources indicate that sellers span a wide age range but are predominantly adolescents and young adults.
- Sellers are usually users, as reported by law enforcement sources in nearly every site, but are seldom involved in violence.
- Availability has increased in numerous sites, particularly in the West, but findings are mixed elsewhere.
- Lab seizures have increased, often due to increased targeted law enforcement efforts.
- While the methamphetamine scene is generally a rural phenomenon, it has started spreading to some suburban and inner–city areas, as in Seattle.
- Demographic shifts are noted, such as an increase in methamphetamine use among women in Denver and Honolulu, increased adolescent use in Los Angeles, and the initiation of use in New York's gay community.
- Route of administration varies widely across sites, and some shifts are noted.
- Availability of club drugs has increased dramatically across the Nation, especially for ecstasy, which has increased in nearly every city.
- Ketamine availability is increasing in most cities, whereas gamma hydroxybutyrate (GHB) and flunitrazepam (Rohypnol) is concentrated in the South and West, where availability trends are mixed.
- " Club drug users and sellers tend to be young, white, middle-class males and females who use or sell the drugs in combination with other drugs, such as hallucinogens, cocaine, heroin, marijuana, methamphetamine, and prescription drugs.
- "Club drug activity generally occurs in suburban areas, although ecstasy activity is moving to urban areas as well.
- "Ecstasy user and seller groups are also expanding to include more blacks and Hispanics, and use and sales settings continue to expand from exclusively night-clubs and raves to high schools, streets, and open venues.
- "As the ecstasy supply increases, the use of ecstasy adulterants, especially other stimulants, is also increasing.
- OxyContin ®: This long acting form of the opiate oxycodone, prescribed for severe pain, is abused in some areas, such as Portland, Maine. Recently, it has been involved in numerous over-doses and prescription altering schemes in Portland, especially in rural areas.
- Viagra ® (sildenafil citrate): Use of this drug with methamphetamine has resulted in medical consequences in the Los Angeles gay community. It is also used with club drugs in that city to gain a "better bump."
How has the perceived drug problem changed between 1999 and 2000? (Exhibit 2) In comparing the two reporting periods, nearly half (45 percent) of the 73 responding sources describe their community's drug problem as "unchanged." About one-third (36 percent) consider the situation to have worsened somewhat, and 16 percent feel the problem has gotten much worse. Only two sources (in Memphis and New York) perceive that their community's drug problem has become less serious.
What are the most serious drug problems in the 20 Pulse Check communities? (Exhibits 3 and 4) Cocaine is most commonly described as the most serious drug problem, especially in terms of adverse consequences. Sources, however, tend to combine both crack and powder cocaine into one category. If those two cocaine forms could be separated, it is possible that heroin would equal or even surpass crack as the most serious drug problem.
Marijuana is perceived as the most serious drug problem by seven sources in six cities (Billings, Boston, Columbia, Denver, Los Angeles, and Sioux Falls), and methamphetamine is considered the most serious drug problem by another seven sources in three cities (Billings, Honolulu, and Sioux Falls).
In only five Pulse Check sites do any sources perceive a change between 1999 and 2000 in the drug that presents the most serious problem: heroin replaced cocaine as the most serious drug problem according to sources in three cities (Detroit, New Orleans, and Portland); and, conversely, cocaine replaced heroin as the most serious drug problem according to sources in Birmingham and El Paso.
What new problems have emerged or intensified during 2000? (Exhibit 5) Club drugs, particularly "ecstasy" (methylene-dioxymethamphetamine, or MDMA), are named as the largest emerging illicit drug problem in all but two sites: Billings and Birmingham.
Methamphetamine is a distant second, with sources in five sites, spanning all census regions, naming it as an emerging problem.
Marijuana is named in two sites (more as an intensifying, rather than an emerging, problem): Honolulu and Washington, DC.
Crack is described as an emerging problem by only one source, in Billings.
Abuse of prescription drugs is named as the most serious emerging problem in three sites: Billings, (particularly sedatives); Birmingham, and Portland, (OxyContin).
How available are the major illegal drug groups in Pulse Check communities? (Exhibit 6) Marijuana, by far, is the most widely available illicit drug, according to law enforcement, epidemiologic, and ethnographic sources. It is followed by cocaine, then heroin. As reported in previous Pulse Checks, methamphetamine continues to be the least widely available of the four major illegal drug groups, with supply remaining concentrated heavily in the western Pulse Check sites (Billings, Denver, Honolulu, Los Angeles, and Seattle).
