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Substance Abuse Trends

in Texas:
June 2003

“Unifying research, education and practice to transform lives.”

The Gulf Coast Addiction Technology Transfer Center


The Center for Social Work Research, School of Social Work
The University of Texas at Austin
1717 West 6th Street, Suite 335
Austin, Texas 78703
Table of Contents

Overview ...........................................................................................................................................................1
Area Description................................................................................................................................................2
Data Sources and Time Periods.........................................................................................................................2
Drug Abuse Trends ...........................................................................................................................................3
Cocaine and Crack.............................................................................................................................................3
Alcohol ..............................................................................................................................................................7
Heroin ...............................................................................................................................................................9
Other Opiates.....................................................................................................................................................14
Marijuana ..........................................................................................................................................................16
Stimulants..........................................................................................................................................................19
Depressants........................................................................................................................................................23
Club Drugs and Hallucinogens..........................................................................................................................24
Ecstasy...............................................................................................................................................................24
Gamma Hydroxybutrate ....................................................................................................................................27
Ketamine ...........................................................................................................................................................28
LSD ...................................................................................................................................................................28
PCP....................................................................................................................................................................29
Rohypnol ...........................................................................................................................................................30
Dextromethorphan.............................................................................................................................................31
Inhalants ............................................................................................................................................................32
AIDS and Drug Use...........................................................................................................................................33

©June 2003. The Gulf Coast Addiction Technology Transfer Center (GCATTC) grants full permission to
reproduce and distribute any part of this document for non-commercial use. Appropriate credits
appreciated. The GCATTC is located in the Center for Social Work Research at The University of Texas at
Austin and serves Texas, Louisiana, and Mississippi. The purpose of the center is to work through multiple
collaborative networks to bridge research and practice. It also includes theNational Center of Excellence in
Drug Epidemiology. Published in cooperation with the Texas Commission on Alcohol and Drug Abuse
(TCADA).

The Gulf Coast Addiction Technology Transfer Center (GCATTC)


The Center for Social Work Research, School of Social Work
The University of Texas at Austin
1717 West 6th Street, Suite 335
Austin, Texas 78703

Web site: http://www.utattc.net


Substance AbuseTrends in Texas: June 2003

Substance Abuse Trends in Texas


June 2003
Jane Carlisle Maxwell, Ph.D.
Research Scientist
The Center for Social Work Research
The University of Texas at Austin
Austin, Texas

Overview Hydrocodone is a much larger continue to rise and the 2002


problem in Texas than is Texas secondary school survey
Twenty-nine percent of TCADA oxycodone or methadone. showed lifetime use rose from
treatment clients report a primary Codeine cough syrup continues 4.5 percent in 2000 to 8.6
problem with cocaine. Cocaine to be abused and its use is percent in 2002. GHB, GBL,
remains a problem on the border, spreading. and similar precursor drugs
as documented in the school remain a problem, particularly in
survey and ADAM data. Poison Seventy-eight percent of youths the DFW Metroplex area, with a
control center calls and overdose entering treatment report high rate of emergency
deaths due to cocaine are marijuana as their primary department mentions and forensic
increasing and use of crack problem drug. Dallas emergency laboratory identifications.
cocaine, which is at an endemic department mentions of Although indicators are down,
level, continues to move beyond marijuana have declined. The Rohypnol remains a problem
African American users to Anglo 2002 school survey found use by along the border. Ketamine
and Hispanic users. seventh and eighth graders continues as a problem, although
continues to decline, but use the number of cases reported is
Alcohol is the primary drug of among older grades has lower than for other club drugs.
abuse in Texas in terms of increased since 2000. Use of marijuana joints dipped in
dependence, deaths, treatment embalming fluid that can contain
admissions, and arrests. Use Methamphetamine and PCP (“Fry”) continues, with
among Texas secondary school amphetamine are widely available cases seen in the poison control
students between 2000 and 2002 and are problems, particularly in centers, emergency departments,
was stable. the northern part of the state. and treatment. DXM continues to
be a problem with adolescents.
Heroin addicts entering treatment Alprazolam (Xanax) remains
are primarily injectors, and they popular with heroin addicts, but The proportions of AIDS cases
are most likely to be Hispanic or indicators are mixed. of females and persons of color
Anglo males. Statewide poison are increasing and in the first
control center calls about heroin Club drug users differ in their quarter of 2003, the proportion
and emergency department socio-demographic of cases due to the heterosexual
mentions of heroin in Dallas have characteristics just as the mode of transmission exceeded
declined. Heroin from Mexico is properties of these drugs differ. the proportion of cases involving
available and cheap. Ecstasy treatment admissions injecting drug use. Paralleling this

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Substance Abuse Trends in Texas: June 2003

trend, the proportion of needle is published every six months as a characteristics of clients entering
users entering treatment continues report to the Community with a primary problem with the
to decrease. Epidemiology Work Group drug are discussed, but in the
meetings sponsored by the case of emerging club drugs,
Area Description National Institute on Drug Abuse. information is provided on any
To compare June 2003 data with client with a primary, secondary,
The population of Texas in 2003 earlier periods, please refer to or tertiary problem with that drug.
is 21,828,569, with 51 percent previous editions that are
Anglo, 12 percent African available in hard copy from the • Overdose death data—
American, 34 percent Hispanic, Texas Commission on Alcohol Statewide data on drug overdose
and 3 percent “Other.” Illicit and Drug Abuse (TCADA) or on deaths through 2001 came from
drugs continue to enter from the TCADA web page at death certificates from the Bureau
Mexico through cities such as El http://www.tcada.state.tx.us/ of Vital Statistics of the Texas
Paso, Laredo, McAllen, and research/subabusetrends.html Department of Health. Data on
Brownsville, as well as smaller and at the web page of the Gulf the Dallas and San Antonio
towns along the border. They Coast Addiction Technology metropolitan areas came from
then move northward for Transfer Center at http:// medical examiner data collected
distribution through Dallas/Fort www.utattc.net. by the Drug Abuse Warning
Worth and Houston. In addition, Network (DAWN), 2001, of the
drugs move eastward from San Data were obtained from the Substance Abuse and Mental
Diego through Lubbock and from following sources: Health Services Administration.
El Paso to Amarillo and Dallas/
Fort Worth. A major problem is • Price, purity, trafficking, • Emergency department
that Mexican pharmacies sell distribution, and supply—This mentions—Mentions of drugs in
many controlled substances to information was provided by first the Dallas area emergency
US citizens who can legally bring quarter 2003 reports on trends in departments (ED) through the first
up to 50 dosage units into the trafficking from the Dallas, El half of 2002 came from the Drug
U.S. Private and express mail Paso, and Houston Field Abuse Warning Network
companies are used to traffic Divisions of the Drug (DAWN) of the Substance Abuse
narcotics and smuggle money. Enforcement Administration and Mental Health Services
Seaports are used to import (DEA). Administration. The 2002 data
heroin and cocaine via are provisional.
commercial cargo vessels and the • Treatment data—
international airports in Houston TCADA’s Client Oriented Data • Drug use by arrestees—
and Dallas/Fort Worth are major Acquisition Process (CODAP) The Arrestee Drug Abuse
ports for the distribution of drugs provided data on clients at Monitoring Program (ADAM) of
in and out of the state. admission to treatment in the National Institute of Justice
TCADA-funded facilities from provided data through 2002 for
Data Sources and first quarter 1983 through Dallas, Laredo and San Antonio.
Time Periods December 31, 2002; however, The 2002 data are provisional.
only partial data have been
Substance Abuse Trends in available for Dallas County since • Student substance use—
Texas is an on-going series which July, 1999. For most drugs, the Data came from TCADA’s Texas

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Substance AbuseTrends in Texas: June 2003

School Survey of Substance • Acquired Immuno- border counties had ever used
Abuse: Grades 7-12 2002 and deficiency Syndrome (AIDS) powder cocaine and 2.5 had
Texas School Survey of data—The Texas Department of used cocaine in the past month.
Substance Abuse: Grades 4-6 Health provided annual and year- In comparison, students in
2002. to-date AIDS data for the period schools on the Texas border
ending March 31, 2003. reported higher levels of powder
• Adult substance use— cocaine use: 13.3 percent lifetime
Data came from TCADA’s 2000 • Reports by users—Drug and 6.0 percent past month use.
Texas Survey of Substance Use trends for January-March 2003 Use of crack was lower, with
Among Adults. were reported to TCADA by non-border students reporting
HIV street outreach workers and 2.7 percent lifetime and 0.6
• Poison Control Center to the author as part of a study percent past month use; border
data—The Texas Department of funded by NIDA grant R21 students reported 4.0 percent
Health provided data from the DA014744. lifetime and 1.5 percent past
Texas Poison Control Centers for month use (Exhibit 1).
1998, 1999, 2000, 2001, and
2002. Drug Abuse TCADA’s 2000 Texas Survey
Trends of Substance Use Among
• Drugs identified by Adults reported 12 percent of
laboratory tests—The National Cocaine and Crack Texas adults had ever used
Forensic Laboratory Information powder cocaine and 1 percent
System reported data collected The TCADA Texas School had used it in the past month, up
by all of the Texas Department of Survey of Substance Abuse: from 10 percent lifetime and 0.4
Public Safety (DPS) laboratories Grades 7-12 2002 found that percent past month use in 1996.
for 1998 through 2002. 7.2 percent of students in non- The increase in past-year use
Exhibit 1. Percentage of Border and Non-Border Secondary
Students Who Had Ever Used Powder Cocaine and Crack, by
Grade: 2002
25.0%
20.5%
20.0% 18.5%
17.3%

15.0% 13.8%

11% 11%
10.0% 8.5%
8% 9%

5.1%
5.0% 4%
3%

0.0%
Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12

Cocaine-Border Cocaine-Non-Border
Crack-Border Crack-Non-Border

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Substance Abuse Trends in Texas: June 2003

Exhibit 2. Dallas DAWN Emergency Department Mentions of Cocaine Per 100,000 Population:
2nd Half 1996-1st Half 2002
Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul-Dec Jan - Jun Jul-Dec Jan - Jun
1996 1997 1997 1998 1998 1999 1999 2000 2000 2001 2001 2002
Cocaine 29.3 34.0 39.6 51.9 54.1 41.2 44.4 44.6 42.7 31.3 25.7 23.0

(1.4 percent to 1.9 percent) was


statistically significant. The levels
Exhibit 3. Characteristics of Adult Clients Admitted to of crack cocaine use did not
TCADA-Funded Treatment with a Primary Problem
with Cocaine by Route of Administration: 2002
change between 1996 and 2000
(2 percent lifetime and 0.1
percent past month).
Crack Powder Powder
Cocaine Cocaine Cocaine Cocaine
Smoke Inject Inhale All* Texas Poison Control Centers
reported 497 cases of misuse or
# Admissions 8,604 1,066 2,076 12,264
abuse of cocaine in 1998, 498 in
% of Cocaine Admits 70% 8% 16% 100%
Lag-1st Use to Tmt-Yrs. 11 13 9 11
1999, 874 in 2000, 1,024 in
Average Age 37 34 31 35 1002, and 1,195 in 2002.
% Male 57% 66% 62% 58%
% African American 52% 5% 11% 39% Exhibit 2 shows that the rate of
% Anglo 33% 68% 32% 36% cocaine emergency department
% Hispanic 13% 25% 55% 24% mentions per 100,000 population
% CJ Involved 34% 40% 51% 39% in the Dallas ED data is
% Employed 13% 16% 29% 18% continuing to decrease from the
% Homeless 19% 15% 6% 16%
peak period in 1998. The
*Total includes clients with "other" routes of administration
decreases in rates between first
half of 2001 and first half of 2002
were statistically significant.

Cocaine (crack and powder)


Exhibit 4. Routes of Administration of Cocaine by comprised 28.8 percent of all
Race/Ethnicity of Treatment Admissions: 1993-
adult admissions to TCADA-
2002
funded treatment programs in
100%
2002. Crack cocaine is the
90% primary illicit drug abused by
80% clients admitted to publicly-
70%
60% Hispanic
funded treatment programs in
50% Anglo Texas, at 21.1 percent of all
40% African American admissions.
30%
20%
10% Abusers of powder cocaine
0% comprise 7.7 percent of all adult
Crack- Crack- IDU-93 IDU-02 Inhale- Inhale- admissions to treatment. Cocaine
93 02 93 02
inhalers are the youngest and

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Substance AbuseTrends in Texas: June 2003

Exhibit 5: Age & Race/Ethnicity of Persons Dying with a


Mention of Cocaine: 1992-2001

600 40
500 39
Number of Deaths

38

Age (Years)
400 37
African American
Hispanic
300 36
Anglo
200 35
Age
34
100 33
0 32
19 2
19 3
19 4
19 5
19 6
19 7
19 8
20 9
20 0
01
9
9
9
9
9
9
9
9
0
19

most likely to be Hispanic and Americans, from 28 percent to while of the crack users, 33
involved in the criminal justice or 10 percent. Exhibit 4 not only percent were Hispanic, 52
legal system. Cocaine injectors shows this increase by Anglos percent were Anglo, and 13
are older than inhalers but and Hispanics in the use of percent were African American.
younger than crack smokers and powder cocaine by route of Average age of both groups was
are more likely to be Anglo administration, but it also shows 15.8 years. Eighty percent of the
(Exhibit 3). the proportion of crack cocaine powder users and 74 percent of
admissions who are African the crack users were involved in
The term “lag” refers to the American dropped from 75 the juvenile justice system.
period from first consistent or percent in 1993 to 52 percent in
regular use of a drug to date of 2002, while the proportion of The number of deaths in which
admission to treatment. Powder Anglos increased from 20 cocaine was mentioned increased
cocaine inhalers average 9 years percent in 1993 to 33 percent in to a high of 491 in 2001 (Exhibit
between first regular use and 2002, and the percentage of 5). The average age of the
entrance to treatment, while Hispanic admissions has gone decedents increased to 38.7
injectors average 13 years of use from 5 percent to 13 percent in years in 2001. Of the 2001
before they enter treatment. the same time period. decedents, 42 percent were
Anglo, 28 percent were
Between 1987 and 2002, the Some 4.7 percent of all Hispanic, and 28 percent were
percentage of treatment adolescent treatment admissions African American. Seventy-six
admissions using powder cocaine in 2002 were for powder cocaine percent were male.
who are Hispanic has increased and 1.1 percent were for crack
from 23 percent to 45 percent, cocaine. Of the powder cocaine The DAWN medical examiner
while for Anglos, the percent has users, 60 percent were Hispanic, system reported that the number
dropped from 48 percent to 44 33 percent were Anglo, and 4 of deaths in the Dallas
percent, and for African percent were African American, metropolitan area involving a

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Substance Abuse Trends in Texas: June 2003

Exhibit 6. Arrestees Testing Positive for Cocaine: 1991-2002

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

Dallas Males 43% 41% 45% 35% 31% 32% 32% 29% 34% 28% 30% 31%
Houston Males 56% 41% 41% 28% 40% 39% 39% 36% 36% 32% NR NR
Laredo Males NR NR NR NR NR NR NR 37% 42% 45% 35% 36%
San Antonio Males 29% 31% 31% 31% 24% 28% 26% 27% 23% 20% 30% 33%
Dallas Females 46% 48% 43% 46% 44% 36% 34% 30% 40% 24% NR NR
Houston Females 51% 44% 43% 36% 32% 34% 29% 37% 23% 32% NR NR
Laredo Females NR NR NR NR NR NR NR 33% 21% 22% 27% NR
San Antonio Females 24% 25% 24% 23% 23% 23% 18% 20% 19% NR NR NR

mention of cocaine increased Dallas, “one and one” packages for crack are more severe,
from 134 in 1996 to 185 in of heroin and cocaine have powder cocaine is usually
2001, while in San Antonio, the returned. They were commonly transported to the area of the sale
number of deaths with a mention sold on the streets through the and then converted to crack. In
of cocaine increased from 63 in mid-1990s, then were rarely seen Midland, crack is not only
1996 to 130 in 2001. until recently. “One and one” prevalent in the lower-income
packages encourage the use of African American communities,
The proportion of arrestees speedballs. but it is also seen in lower
testing positive for cocaine has economic Anglo areas. In the
decreased from the peak periods DEA reports crack cocaine is Dallas area, it is popular in
in the early 1990s. The high readily available except in predominately African American
percentage of male and female Laredo, where availability and and Hispanic neighborhoods in
arrestees in Laredo testing use is minimal. Since the penalties South Dallas and Oak Cliff, and
positive for cocaine shows the
extent of the cocaine problem on
the border (Exhibit 6). Exhibit 7. Substances Identified by DPS Labs: 1998- 2002

Exhibit 7 shows the proportion of


45%
substances identified by the DPS
labs which were cocaine. In 40%
2002, cocaine comprised 34 35%
percent of all items examined by 30% Cocaine
the labs. 25% Marijuana
Methamphet & Amphet
20%
In the first half of 2003, powder Heroin
cocaine was reported by DEA as 15%
readily available, except in 10%
Laredo and Eagle Pass, where 5%
availability has decreased. 0%
Cocaine is also available in rural 1998 1999 2000 2001 2002
areas and in small towns. In

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Substance AbuseTrends in Texas: June 2003

it is the most visible drug seen in People are reported to be Alcohol


the Tyler area. breaking out on their faces and
arms after smoking crack, but the Alcohol is the primary drug of
A rock of crack costs between reason is unknown. A dark abuse in Texas. The 1998 sec-
$10-$100, with $10-$20 being brown crack is also being seen ondary school survey found that
the most common price. An but no information is available as 72 percent had ever drunk alco-
ounce of crack cocaine costs to what it is cut with, and many hol and 38 percent had drunk in
$325-$600 in Houston, $750- injecting crack users are unaware the last month; in 2002, 71 per-
$1,100 in Dallas, $550-$750 in that acidic acid is milder on the cent had ever used alcohol and
Tyler, $500-$800 in Beaumont, veins than using lemon juice or 35 percent in the last month.
$650-$850 in Amarillo and vinegar when preparing crack for
Lubbock, $400-$650 in San injecting. There is an increase in Heavy consumption of alcohol or
Antonio, $830 in El Paso, $600- injection of crack and most binge drinking, which is defined as
$850 in McAllen, $700-$750 in overdoses in Austin this spring drinking five or more drinks at
Fort Worth, and $550 in East are from injecting crack. Some one time, is of concern, especially
Austin. addicts are lacing marijuana with when done by young people.
crack and rolling it up and About 17 percent of all second-
A gram of powder cocaine in smoking it, while others are ary students said that when they
Dallas costs $50-$80, $50-$60 smoking crack in cigarettes rather drank, they usually drank five or
in El Paso, $70-$90 in Midland, than using crack pipes. There is a more beers at one time, and 14
$60-$100 in Houston, and $100 reported increase in crack use by percent reported binge drinking of
in Alpine, Amarillo, and people in the 14-25 age group, wine coolers and liquor. Second-
Lubbock. An ounce ranges including Hispanics. ary students less frequently binged
between $400 and $1,200. An
ounce in Laredo costs $400-
$500; in Houston, $450-$800;
$650-$1,000 in Dallas; $600 in Exhibit 8. Price of a Kilogram of Cocaine in
Alpine; $500-$550 in McAllen; Texas as Reported by DEA:
$400-$600 in San Antonio; 1987-2003
$650-$850 in Amarillo and
$50,000
Lubbock; $700-$1,000 in Tyler; $45,000
and $750 in Fort Worth. The $40,000
price for a kilogram ranges $35,000
between $11,000-$23,000, and $30,000
$25,000
is cheaper at the border (Exhibit
$20,000
8). $15,000
$10,000
In Austin, street outreach $5,000
workers report that new dealers $-
1987
1989
1991
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003

are surfacing, there is a surge of


younger sex industry workers
trading sex for crack cocaine,
and oral sex is sold for $5.

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Substance Abuse Trends in Texas: June 2003

problems with alcohol use in the


Exhibit 9. Percentage of Texas Secondary Students Who Reported past year in 2000; 16.8 percent
They Normally Consumed Five or More Drinks at One Time, by reported past-year problems in
Specific Alcoholic Beverage: 1988-2002
1996. In comparison, 5.2
25% percent of adults in 2000 and 4.1
percent of adults in 1996
20%
Beer reported past-year problems with
15%
Wine Coolers
the use of drugs.
Liquor
10%
Wine
The number of mentions per
5% 100,000 population of alcohol-
in-combination with other drugs
0% in Dallas emergency departments
1988 1990 1992 1994 1996 1998 2000 2002
peaked in 1998 (Exhibit 10).

In 2002, 35 percent of adult


on wine, with only 6 percent of Among students in grades 4-6 in clients admitted to publicly-
them doing so. Binge drinking in- 2002, 25 percent had ever drunk funded programs had a primary
creased with grade level. Among alcohol and 16 percent had problem with alcohol. They were
seniors, 29 percent binged on drunk in the past school year. the oldest of the clients (average
beer and 19 percent on liquor. age of 38); 57 percent were
The percentage of students who The 2000 Texas adult survey Anglo, 23 percent were
normally drank five or more beers found that 66 percent of Texas Hispanic, and 18 percent were
has decreased since 1988, while adults reported having drunk African American; 71 percent
the percentage of binge drinking alcohol in the past year. In 1996, were male.
of wine or wine coolers has fallen 65 percent reported past-year
from its peak in 1994, but is still drinking. In 2000, 17 percent Among adolescents, alcohol
higher than in 1988 (Exhibit 9). reported binge drinking and 6 comprised 8 percent of all
The percentage of binge drinking percent reported heavy drinking treatment admissions. Some 66
of hard liquor has remained rela- in the past month. Some 15.7 percent were male; 47 percent
tively stable since 1994. percent of all adults reported were Hispanic, 42 percent were

Exhibit 10. Dallas DAWN Emergency Department Mentions of Alcohol-in-Combination


with Other Drugs Per 100,000 Population: 2nd Half 1996-1st Half 2002

Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun
1996 1997 1997 1998 1998 1999 1999 2000 2000 2001 2001 2002
Total 26.2 31.0 34.7 40.2 42.8 35.9 32.0 37.0 37.8 30.4 27.2 22.9

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Substance AbuseTrends in Texas: June 2003

Exhibit 11. Direct and Indirect Alcohol and Drug Deaths Per
100,000 Population: 1994-2001

50.0
45.0
40.0
35.0 Direct Alcohol
30.0 Indirect Alcohol
25.0 Direct Drug
20.0
Indirect Drug
15.0
10.0
5.0
0.0
1994 1995 1996 1997 1998 1999 2000 2001

Anglo, and 9 percent were crime, but alcohol or drugs were offense, although the arrest rate
African American. Eighty-eight involved. for PI per 100,000 is decreasing;
percent were involved with the the rates for the other substance
juvenile justice or legal systems. The DAWN medical examiner abuse offenses are fairly level
system reported that 38 percent (Exhibit 12).
Far more persons die as an of the drug-involved deaths in the
indirect result of alcohol, as Dallas metro area and 44 percent
Exhibit 11 shows. Direct deaths of the deaths in the San Antonio Heroin
are those where the substance, metro area in 2001 also involved
alcohol or drugs, caused the alcohol. The proportion of Texas
death, while indirect deaths are secondary students reporting
those where the actual cause of More Texans are arrested for lifetime use of heroin dropped
death was due to another reason, public intoxication (PI) than for from 2.4 percent in 1998 to 1.6
such as a car wreck or a violent any other substance abuse percent in 2000 to 1.7 percent in

Exhibit 12. Substance Abuse Arrests Per 100,000 Population:


1994-2002

1200

1000
DWI
800
LLV
600 PI
Drug Traffic
400
Drug Possess
200

0
1994 1995 1996 1997 1998 1999 2000 2001 2002

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Substance Abuse Trends in Texas: June 2003

Exhibit 13. Dallas DAWN Emergency Department Mentions of Heroin Per 100,000 Population:
2nd Half 1996-1st Half 2002
Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun
1996 1997 1997 1998 1998 1999 1999 2000 2000 2001 2001 2002

Heroin 7.3 10.4 10.6 10.7 9.8 8.2 9.2 10.6 8.5 8.2 6.1 5.2

2002, and past month use


dropped from 0.7 percent in
Exhibit 14. Characteristics of Adult Clients Admitted to 1998 to 0.5 percent in 2000 and
TCADA-Funded Treatment with a Primary Problem 2002.
with Heroin by Route of Administration: 2002

The 2000 Texas adult survey


Inject Inhale All*
found that 1.2 percent of adults
# Admissions 4,626 313 5,127
% of Heroin Admits 90% 6% 100%
reported lifetime use of heroin
Lag-1st Use to Tmt-Yrs. 15 10 15
and 0.1 percent reported past-
Average Age 37 32 36 month use.
% Male 71% 67% 70%
% African American 6% 47% 9% Calls to Texas Poison Control
% Anglo 36% 20% 36% Centers involving confirmed
% Hispanic 56% 31% 54% exposures to heroin have gone
% CJ Involved 33% 36% 33% from 181 in 1998 to 218 in 1999
% Employed 12% 17% 13%
to 295 in 2000 to 241 in 2001 to
% Homeless 14% 11% 14%
221 in 2002.
*Total includes clients with other routes of administration

The rate of emergency


department mentions of heroin
per 100,000 population has
Exhibit 15. Heroin Admissions to Treatment by
dropped since the peaks in 1997
Race/Ethnicity: 1986-2002 and 1998 (Exhibit 13). The
decrease between first half of
100% 2001 and first half of 2002 was
90% statistically significant.
80%
70%
60%
Heroin ranks third after alcohol
50% and cocaine as the primary drug
40% for which adult clients are
30% admitted to treatment. It
20%
10%
comprised 12 percent of
0% admissions in 2002 as compared
86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 to 9 percent in 1993. The
characteristics of these addicts
African American Anglo Hispanic
vary depending on the route of
administration, as Exhibit 14
shows.

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Substance AbuseTrends in Texas: June 2003

Exhibit 16: Age & Race/Ethnicity of Persons Dying with a


Mention of Heroin: 1992-2001

400 40 The number of deaths with a


350 39.5 mention of heroin or narcotics
Number of Deaths

300 39 statewide decreased from a high

Age (Years)
250 38.5 African American of 374 in 1998 to 339 in 2001
200
38 Hispanic (Exhibit 16). Of the 2001
37.5 Anglo decedents, 54 percent were
150 37 Age Anglo, 36 percent were
100 36.5 Hispanic, and 8 percent were
50 36
African American; 81 percent
0 35.5
were male and average age was
19 2
19 3
19 4
19 5
19 6
19 7
19 8
20 9
20 0
01
39.1 years.
9
9
9
9
9
9
9
9
0
19

The DAWN ME reporting


Most heroin addicts entering and HIV infection, become more system, which collects more
treatment inject heroin. While the impaired, and enter treatment detailed reports from medical
number of individuals who inhale later. examiners in the Dallas and San
heroin is small, it is significant to Antonio areas, reported that the
note that the lag period from first Exhibit 15 shows that the number of deaths involving a
use and seeking treatment is 10 proportion of clients who are mention of heroin or morphine in
rather than 15 years for injectors. Hispanic is increasing. the Dallas area increased from 66
This shorter lag period means in 1996 to 76 in 2001, while in
that contrary to street rumors that Only 0.6 percent (28 youths) of the San Antonio area, the number
“sniffing or inhaling is not all adolescents admitted to of deaths mentioning heroin/
addictive,” inhalers can become TCADA-funded treatment morphine increased from 51 in
addicted and will either enter programs reported a primary 1996 to 88 in 2001.
treatment sooner while still problem of heroin. Of these
inhaling, or else shift to injecting, youths, 79 percent were The results for arrestees testing
increase their risk of hepatitis C Hispanic. positive for opiates between

Exhibit 17. Arrestees Testing Positive for Opiates: 1991-2002

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
Dallas Males 4% 4% 5% 3% 5% 5% 4% 2% 5% 3% 5% 6%
Houston Males 3% 3% 2% 3% 5% 8% 10% 8% 6% 7% NR NR
Laredo Males NR NR NR NR NR NR NR 11% 11% 10% 11% 7%
San Antonio Males 15% 14% 14% 13% 10% 10% 10% 10% 10% 10% 9% 11%
Dallas Females 9% 9% 11% 8% 5% 10% 4% 5% 7% 5% NR NR
Houston Females 4% 4% 5% 6% 3% 4% 5% 7% 7% 3% NR NR
Laredo Females NR NR NR NR NR NR NR 0% 2% 7% 10% NR
San Antonio Females 20% 13% 15% 14% 13% 13% 9% 9% 10% NR NR NR

The Gulf Coast Addiction Technology Transfer Center 11


Substance Abuse Trends in Texas: June 2003

gram, $1,000-$1,500 per ounce.


Exhibit 18: Price of an Ounce of Mexican In Alpine, heroin costs $125 per
Black Tar Heroin in Texas as Reported by gram, and $2,100-$2,200 per
the DEA: 1987-2003
ounce; in Midland an ounce costs
$9,000 between $2,300-$4,800; and in
$8,000 Lubbock it costs $250 per gram
$7,000
$6,000
and $3,500-$4,500 per ounce.
$5,000 In Houston, an ounce costs
$4,000 $1,000-$2,500; in Laredo an
$3,000
$2,000 ounce costs $1,200-$1,400; in
$1,000 McAllen an ounce costs $1,200-
$-
$1,500; in San Antonio, an ounce
87
89
91
93
94
95
96
97
98
99
00
01
02
03
costs $1,800-$3,100; and in
19
19
19
19
19
19
19
19
19
19
20
20
20
20
Austin an ounce costs $2,200-
1991 and 2001 have remained an increase in the availability and $2,500.
mixed (Exhibit 17). use of white heroin; most of the
addicts who had ever used white Mexican brown heroin, which is
Exhibit 7 shows theproportion of heroin reported using it when black tar that has been cut with
items identified as heroin by DPS traveling on the east or west lactose or another substance and
labs has remained consistent at 1 coast. However, addicts did then turned into a powder to
to 2 percent over the years. report that white heroin was inject or snort, costs $10 per
available around the University cap, $110-$300 per gram, and
According to DEA, heroin from area in Austin. $800-$3,000 per ounce. In Fort
Mexico remains available. The Worth, it is packaged in a gel
Mexican states of Guerrero, The predominant form of heroin capsule and referred to as “a
Oaxaca, and Michoacan are the in Texas is black tar, which has a pill,” with 10-15 pills in a gram.
primary sources. White South dark gummy, oily texture that can In Houston, it costs $1,000-
American heroin is seen in beheated with water and $1,200 per ounce, in San
McAllen, but is passing through injected. The cost of an ounce of Antonio it costs $700-$900 per
for the East Coast and is not black tar heroin is up slightly ounce, and in Austin it costs
being used in McAllen. DEA (Exhibit 18). Depending on the $1,300-$1,500 per ounce.
intelligence has indicated that this location, black tar heroin sells on
white heroin is coming into Dallas the street for $10-$20 a capsule, Colombian heroin sells for
not only for transshipment but $100-$250 per gram, $800- $2,000 per ounce and $60,000-
also for consumption among local $4,800 per ounce, and $35,000- $70,000 per kilogram in Dallas
users and Colombian heroin $50,000 per kilogram. In the and $62,000 in Houston.
traffickers are reported interested Dallas area, heroin costs $10- Southwest Asian heroin costs
in expanding their operations in $20 per cap, $800-$2,000 per $70,000 per kilogram in Dallas.
the Dallas area. Interviews with ounce, and $35,000-$50,000
addicts in treatment in Dallas, per kilogram. In Fort Worth, an The Domestic Monitor Program
Fort Worth, Austin, San Antonio, ounce costs $1,200-$1,900, and of the DEA is a heroin purchase
and Houston by this CEWG a kilogram sells for $50,000. In program that provides data on
correspondent could not confirm El Paso, heroin costs $100 per the purity, price, and origin of

12 The Gulf Coast Addiction Technology Transfer Center


Substance AbuseTrends in Texas: June 2003

Exhibit 19. Price and Purity of Heroin Purchased in Dallas, El Paso, and Houston
by DEA: 1995-2001

1995 1996 1997 1998 1999 2000 2001

Dallas Purity 6.8% 3.5% 7.0% 11.8% 14.0% 16.0% 13.4%


Price/Milligram Pure $2.34 $6.66 $4.16 $1.06 $1.01 $0.69 $1.36
Houston Purity 16.0% 26.1% 16.3% 34.8% 17.4% 18.2% 11.3%
Price/Milligram Pure $1.36 $2.15 $2.20 $2.43 $1.24 $1.14 $1.51
El Paso Purity* 56.7% 50.8% 41.8%
Price/Milligram Pure $0.49 $0.34 $0.44

*El Paso began reporting in mid-1999

retail-level heroin available in the afraid of needles or of parole officers or to their


major metropolitan areas of the overdosing, having seen the spouses. In addition, there were
nation. As Exhibit 19 shows, over effects of injecting (“they lose older addicts who had started as
time, the purity and price varies, everything”), knowing the inhalers, shifted to injecting, then
although it is purer and cheaper in reputation of injectors as went through treatment and had
El Paso as compared to farther “junkies” and their low social ceased heroin use. However,
from the border. The DMP also status, or the fact their habits they had relapsed and were
shows that heroin from sources have not grown to the point they snorting heroin but were worried
other than Mexico was reported need to inject. about the possibility of shifting to
in 2001. Of the street “buys” in needles and came into treatment
Dallas, 32 were Mexican, five Some injectors never heard or this time as snorters.
were Southeast Asian, and one thought about snorting heroin;
was unknown. In El Paso, 15 they were only exposed to Because of the oily, gummy
were Mexican and one was people who injected. Others consistency of black tar heroin,
unknown. In Houston, 38 were reported that injecting is a “much special steps must be taken to
Mexican, one was South better high,” or that injecting was convert the heroin into brown
American, and one was “more economical.” Others powder so that it can be snorted.
unknown. reported that they injected In addition, since brown powder
because black tar, which is not has be “cut,” novice users and
This correspondent has been inhalable, was the only type of users who want to maintain
involved in interviewing heroin heroin available, while others smaller habits prefer brown
addicts in treatment in methadone injected because snorting hurt heroin. Cuts which can be used
programs in Austin, Dallas, Fort their noses and sinuses. include dormin, mannite, lactose,
Worth, Houston and San benadryl, Nytol, baby laxative,
Antonio. This study of the Some addicts started as snorters vitamin B, and coffee creamer.
differences in heroin inhalers and and then shifted to injecting, while The tar heroin can be frozen, the
injectors is funded by NIDA others continued to use both “cut” added, and then pulverized
grant DA014744. As noted in routes of administration in a coffee grinder or with mortar
Exhibit 14, heroin addicts who depending on whether or not and pestle. It can also be dried
are inhaling or snorting heroin needles were available, their out on a plate over the stove, on
enter treatment earlier. friends were snorting or injecting, a dollar bill over a lighter, or
Preliminary field notes indicate they had lost their veins, or they under a heat lamp and then
that reasons addicts give for had to prove they had no needle pulverized.
snorting heroin include being tracks to their probation or

The Gulf Coast Addiction Technology Transfer Center 13


Substance Abuse Trends in Texas: June 2003

Addicts who do not have the AIDS outreach workers in Austin Inhaling or snorting heroin is not
time or equipment to turn tar into report that in the first quarter of as common in Houston.
powder or do not have a sharp 2003, reports on the quality of
needle can mix the tar with water heroin ranged from very good In San Antonio, heroin is sold as
and squirt it into their nose with a (60 percent pure) to low quality “dimes,” “balloons,” “spoons,”
syringe barrel (with or without the and that many of their clients are or in grams, and it is usually cut
needle) or Visine bottle or pour it reluctant to believe that there was with lactose. In San Antonio,
into their nose with a teaspoon or a high risk of transmission of users reported a number of
medicine dropper or inhale the hepatitis C from sharing water different ways to turn black tar
liquid with a straw. This is know when injecting others. In the into brown powder heroin.
variously as “shebang,” second quarter of 2003, some AIDS outreach workers report
“waterloo,” “agua de chango,” or heroin was reported being cut users continue to speed-ball,
“monkey water.” Injectors also with vitamin C or ascorbic acid. which is injecting cocaine and
report preparing heroin this way Some addicts believed that if one heroin together
and then using this method when does cocaine and heroin
they are in situations where they combined for several weeks, In the Lower Rio Grande Valley,
cannot inject. there is less withdrawal from outreach workers reported
heroin. The type and quality of seeing an increase of young
In Austin, heroin is sold in grams heroin varies around town, with persons ages 16 - 21 injecting
and balloons, and black tar some neighborhoods having tar heroin. For several years there
heroin is usually cut with lactose and others having brown powder. has been an increase in cocaine
to produce brown heroin. A gram Six balloons of powder sell for use among young persons in this
quantity of black tar heroin, $60, while seven balloons of the area. However, now outreach
which would be about the size of stronger tar can sell for $100. workers are reporting increases
a marble, is packaged in black in heroin injection. This trend is
plastic or in a finger cot. A gram In Dallas, heroin is sold as grams, happening in the smaller Valley
of tar costs $250 and would in pills, or in “papers,” which are communities such as Donna,
average 12-16 shots. Small pieces of tin foil. It is usually cut Weslaco, and Mercedes, as
colored water balloons are used with dormin and sold as a cap. opposed to the larger Valley
to package a single dose or shot. cities such as McAllen and
While an ounce of tar would be In Fort Worth, heroin is sold as Brownsville.
about three-fourths the size of a grams, “pills,” and “turds”. It is
golf ball, an ounce of brown cut with mannite and the AIDS
heroin would be a little bigger outreach workers report that Other Opiates
than a golf ball since it has been injecting heroin is occurring
cut and powdered. There would among younger adults, who are This group excludes heroin but
be about 1.5 times as many shots prone to multiple occurrences of includes opiates such as
from a gram of brown heroin. relapse. methadone, codeine,
Ounces of heroin are packaged hydrocodone (Vicodin,
as balloons or in small zip lock In Houston, heroin is sold in Tussionex), oxycodone
bags in Austin. grams and is cut with lactose. (OxyContin, Percodan,

14 The Gulf Coast Addiction Technology Transfer Center


Substance AbuseTrends in Texas: June 2003

Exhibit 20. Dallas DAWN Emergency Department Mentions of Other Opiates: 2nd Half 1997-1st Half 2002

Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul-Dec Jan - Jun Jul-Dec Jan - Jun
1997 1998 1998 1999 1999 2000 2000 2001 2001 2002
Codeine/Combinations 33 41 28 27 32 16 28 17 10 18
Hydrocodone/Combinations 160 130 146 125 120 146 158 186 189 151
Methadone … 19 20 14 7 … 13 30 37 17
Oxycodone/Combinations … 5 8 … 1 23 … 8 34 17

Percocet-5, Tylox), d- oxycodone reported in 1998, 26 combinations was 4.3 per


propoxyphene (Darvon), in 1999, 22 in 2000, 56 in 2001, 100,000 nationally and 0.5 in
hydromorphone (Dilaudid), and 68 in 2002. There were also Dallas. The rate for methadone
morphine, meperidine (Demerol), 16 cases involving misuse or mentions was 2.2 per 100,000
and opium. abuse of methadone in 1998, 19 nationally and 0.5 in Dallas.
in 1999, 32 cases in 2000, 28 in
The 2000 Texas adult survey 2001, and 54 in 2002. Some 4.2 percent of all adults
found that in 2000, lifetime use of who entered treatment during
other opiates was 4.4 percent Dallas area emergency 2002 used opiates other than
and past-month use was 0.5 department mentions of drugs heroin. Of these, 61 used illegal
percent; in comparison, in 1996, containing methadone, codeine, methadone and 1,762 used other
lifetime use was 3 percent and hydrocodone, and oxycodone opiates. Those who reported a
past-month use was 0.2 percent. either alone or in combination primary problem with illicit
Some 2.3 percent of Texas with other substance have varied methadone were equally likely to
adults in 2000 reported ever over the years. None of the be male or female (50 percent
having used codeine and 0.7 changes between first half of each), 36 years old, Anglo (80
percent used in the past year; 2001 and first half of 2002 were percent) or Hispanic (18
lifetime use of hydrocodone was statistically significant (Exhibit percent). Twelve percent were
0.7 percent and past-year use 20). Compared to the national homeless, 13 percent were
was 0.4 percent. rates, the rates for Dallas are employed, 41 percent were
lower, except for hydrocodone. referred by the criminal justice
Hydrocodone is a larger problem The rate of mentions of codeine system, and 41 percent had
in Texas than is oxycodone. The and codeine combinations was never been in treatment before.
poison control centers reported 1.0 per 100,000 nationally and Of those with problems with
there were 192 cases of abuse or 0.6 per 100,000 in Dallas. The other opiates, 57 percent were
misuse of hydrocodone in 1998, rate for hydrocodone and female, average age was 36, 83
264 in 1999, 286 in 2000, 339 hydrocodone combinations was percent were Anglo, 32 percent
in 2001, and 429 in 2002. In 4.7 per 100,000 nationally and had never been in treatment, 9
comparison, there were 12 calls 4.8 in Dallas. The rate for percent were homeless, 14
about misuse or abuse of oxycodone and oxycodone percent were employed, and 29

The Gulf Coast Addiction Technology Transfer Center 15


Substance Abuse Trends in Texas: June 2003

percent were referred by the sells for $1-$5. OxyContin costs younger adults (16-25 year olds)
criminal justice system. $3 for 5 mg and $5 for 20 mg. are using it. One pint costs $200-
$250, but it can sometimes cost
There were eight deaths with a A “cold shake” is when a tablet as much as $350. People
mention of oxycodone in 1999; of dilaudid is turned to powder sometimes mix about six to eight
20 in 2000, and 40 in 2001. and put in a syringe with cold ounces in a three liter bottle of
There were 25 deaths involving water and then shaken to soft drink. A very small bottle of
hydrocodone in 1999; 52 in dissolve the particles prior to Robitussin or “Lean” is sold on
2000, and 107 in 2001. There injecting it. the street for $20-$60. It is
were also 36 deaths involving usually cut or mixed with Karo
methadone in 1999; 62 in 2000, DPS labs reported examining syrup and put in soda water to
and 93 in 2001. There were nine 479 hydrocodone exhibits in drink. T-shirts that advertise
deaths in 2001 involving fentanyl. 1999, 629 in 2000, 771 in 2001, “Lean” are sold in Austin, and
and 747 in 2002. In comparison, drinking Lean has spread from
The DAWN medical examiner the number of exhibits involving the African American community
system reported that there were oxycodone was 36 in 1999, 72 to Hispanics and Anglos.
36 deaths in the Dallas area with in 2000, 115 in 2001, and 106 in
a mention of hydrocodone and 2002. The number of exhibits
21 in the San Antonio area in involving methadone increased Marijuana
2001. There were also 35 deaths from one in 1998, 19 in 1999, 22
in San Antonio with a mention of in 2000, to 49 in 2002. The number of students in grades
methadone in 2001. 4-6 who had ever used marijuana
“Lean” (codeine cough syrup) is dropped from 2.8 percent in
In the Dallas-Fort Worth DEA reported as becoming more 2000 to 2.6 percent in 2002 and
Field Division, Dilaudid sells for popular among youth and young use in the school year dropped
$20-$80 per tablet, Soma sells adults in the suburban areas of from 2.1 percent to 1.7 percent.
for $4 per tablet, and Fort Worth. In Austin, “Lean” or Among secondary students, 32
hydrocodone sells for $4-$10 per “Drank” is called a “nighttime percent of Texas secondary
tablet. OxyContin sells for $15- drug” by some younger adults. students had ever tried marijuana
$30 per tablet. Methadone sells They like to use it at night and 14 percent had used in the
for $10 per 10 mg. tablet and because they can use it for past month, levels identical to
promethazine with codeine sells nodding or going into what they 2000. While use by students in
for $200-$300 per pint in Dallas call “slightly sleep.” They cut the seventh and eighth grades
and $40 for a 2 ounce bottle in syrup as mild or strong as desired continued to drop, use by
Tyler. In Houston, promethazine with orange or strawberry soda students in grades nine and 10
or phenergan with codeine sells water. There are also some increased from 2000; use by
for $100 - $125 for eight ounces, reports of older adults now using students in grades 11 and 12
and hydrocodone sells for $3-$5 “Lean”. It is usually sold in baby remained stable (Exhibit 21).
per pill. In San Antonio, bottles and measured out in
hydrocodone sells for $3 per pill. ounces and is readily available. In comparison, 37 percent of
In Austin, Vicodin sells for $2-$3 Texas rappers are singing about it adults reported lifetime and 4
a pill and 10mg. methadone pill and older adolescents and percent past-month marijuana

16 The Gulf Coast Addiction Technology Transfer Center


Substance AbuseTrends in Texas: June 2003

admissions to treatment programs


in 2002. Average age of adult
Exhibit 21. Percentage of Texas Secondary Students Who Had Used
Marijuana in the Past Month, by Grade: 1988-2002 marijuana clients continues to
increase: in 1985, the average
20%
Grade 7 age was 24; in 2002, it was 27.
Grade 8
15%
Seventy-eight percent of all
Grade 9
adolescent admissions in 2002
Grade 10 had a primary problem with
10% Grade 11
marijuana, as compared to 35
percent in 1987. In 2002, 47
Grade 12
percent of these adolescents
5% were Hispanic, 30 percent were
Anglo, and 21 percent were
African American (in 1987, 7
0%
percent were African American).
1988 1990 1992 1994 1996 1998 2000 2002
Eighty-three percent had legal
problems or had been referred
use in 2000, as compared to 34 cases involving misuse or abuse from the juvenile justice system,
percent lifetime and 3 percent of marijuana in 1998, 172 in and these clients did not appear
past month in 1996. Prevalence 1999, 360 in 2000, 358 in 2001, to be as impaired as those who
was much higher among younger and 412 in 2002. did not have legal problems. The
adults. Thirteen percent of those juvenile justice clients reported
aged 18-24 in 2000 reported Mentions of marijuana per using marijuana on 8.1 days in
past-month use, as compared to 100,000 in emergency the month prior to admission, as
6 percent of those aged 25-34 departments in Dallas have compared to 14.5 days for the
and 2 percent of those aged 35 declined since the peak levels in non-justice referrals. The same
and over. The increase in past- 1998 (Exhibit 22). The rate in differences were reported for
year use between 1996 and Dallas, 13.4 per 100,000, is number of days in the past month
2000 (6 percent to 7 percent) lower than the national rate of that the second problem drug
was statistically significant. 21.8 per 100,000. was used (3.8 days v. 6.0 days)
and number of days a third
The Texas Poison Control Marijuana was the primary problem drug was used (2.7 days
Centers reported there were 130 problem for 10 percent of adult v. 4.2). The Addiction Severity

Exhibit 22. Dallas DAWN Emergency Department Mentions of Marijuana Per 100,000 Population:
2nd Half 1996-1st Half 2002
Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun
1996 1997 1997 1998 1998 1999 1999 2000 2000 2001 2001 2002

Marijuana 10.8 18.1 19.9 31.2 30.7 25.0 22.6 27.1 22.0 18.5 15.3 13.4

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Substance Abuse Trends in Texas: June 2003

Exhibit 23. Arrestees Testing Positive for Marijuana: 1991-2002

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
Dallas Males 19% 28% 27% 33% 39% 43% 44% 43% 39% 36% 33% 35%
Houston Males 17% 24% 24% 23% 30% 28% 23% 36% 38% 36% NR NR
Laredo Males NR NR NR NR NR NR NR 39% 33% 29% 26% 28%
San Antonio Males 19% 28% 32% 30% 34% 38% 34% 41% 36% 41% 41% 42%
Dallas Females 11% 24% 20% 23% 23% 26% 27% 24% 27% 21% NR NR
Houston Females 8% 12% 15% 13% 20% 24% 17% 20% 23% 27% NR NR
Laredo Females NR NR NR NR NR NR NR 13% 9% 17% 14% NR
San Antonio Females 8% 16% 17% 15% 16% 18% 17% 18% 16% NR NR NR

Index scores were lower for Cannabis was identified in 35 to imported from Mexico. Mexican
justice referrals, as well. The 36 percent of all the exhibits Sinsemilla, which is usually in the
percent of justice clients reporting analyzed by DPS laboratories in pressed brick form, is the most
sickness or physical problems in 1999 and 2000, but dropped to common type seen. DEA’s
the month prior to admission was 31 percent in 2001 and 28 Potency Monitoring Project
13 percent v. 21 percent for non- percent in 2002 (Exhibit 7). Quarterly report for November
justice clients; for employment 9, 2002-February 8, 2003,
problems, 33 percent v. 48 The Houston Field Division found that the potency of
percent; for family problems 33 reports marijuana is routinely marijuana in the seven southern
percent v. 43 percent; for social moved in multi-thousand pound states (including Texas) had the
problems with peers, 26 percent quantities with an increase in the lowest THC level of 4.39
v. 28 percent; for emotional amount found in trailers or false percent, as compared to the
problems 19 percent v. 27 compartment at the border. highest level, 10.32 percent in the
percent, and for substance abuse Marijuana in the division is northeast region and 6.19
problems, 30 percent v. 34 reported readily available and the percent nationally.
percent. availability in McAllen has
increased greatly. The El Paso Sinsemilla sells for $750-$1,200
The DAWN medical examiner Field Division also reports a pound in the Dallas-Fort Worth
system reported there were 65 marijuana is readily available and area and $600 per pound in
deaths in the Dallas metro area in is packaged in kilogram Houston. The average price for a
2001 where marijuana was one increments, wrapped with pound of commercial grade
of the substances mentioned. In cellophane, and then sealed with marijuana is between $200-$250
comparison, there were six in the tan or brown tape. The Dallas in Laredo, $125-$250 in
San Antonio area. Field Division reports a McAllen, $400-$700 in San
noticeable increase in the Antonio, $300-$500 in Houston,
The percentage of arrestees availability of large amounts of $500 in El Paso, $500-$700 in
testing positive for marijuana marijuana. Significant amounts of the Alpine area, $500-$600 in
remains varied (Exhibit 23). It marijuana are grown in Midland, $400-$600 in the
has dropped from its peak levels Oklahoma and along the Texas- Dallas and Fort Worth areas,
in Dallas and Laredo, but remains Oklahoma border, but most of $500-$600 in Lubbock, and
high in San Antonio. the marijuana in Texas is $500-$650 in Tyler. Locally

18 The Gulf Coast Addiction Technology Transfer Center


Substance AbuseTrends in Texas: June 2003

emergency department mentions


Exhibit 24. Price of a Pound of Commercial Grade
in Dallas. As this exhibit shows,
Marijuana in Texas as Reported by DEA: 1992-
2003
all the indicators have risen since
$1,800
1992, although the number of
$1,600 emergency department mentions
$1,400 by adolescents in Dallas has
$1,200 declined since 2000.
$1,000
$800
Stimulants
$600
$400
Uppers include stimulants such as
$200 methamphetamines, “speed,”
$- “Ice,” amphetamines, “crank,”
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 “crystal,” over-the-counter
medicines containing ephedrine,
grown indoor marijuana sells for “have trouble keeping their eyes and prescription drugs such as
$6,000 per pound in Dallas and open” after smoking a dipped Ritalin or Adderall when taken
hydroponic marijuana grown in cigar. for non-medical reasons.
Matamoros sells for $120 for ¼
pound in McAllen. Exhibit 24 Exhibit 25 plots the trends in The 2002 secondary school
shows the range of prices across lifetime use of marijuana as survey reported the lifetime use
the state since 1992. reported in the secondary school of uppers was 8.1 percent in
surveys, adolescent admissions to 1998, 6.7 percent in 2000, and
In Austin, people are dipping treatment for a primary problem 7.3 percent in 2002. Past month
cigars in cognac brandy. The of marijuana, the proportion of use was 3.1 percent in 1998, 2.7
effect is reported like a adolescent drug arrests for percent in 2000, and 3.3 percent
“downward” high and people marijuana, and adolescent in 2002.

Exhibit 25. Adolescent Indicators of Marijuana Use: 1987-2002

90% 140
80% 120 Statewide Survey-% Ever Used
70% Marijuana
100
60% Statewide Drug Arrests-%
Per 100,000

80 Marijuana
50%
Statewide Tmt Admissions-%
40% 60 Marijuana
30% Dallas ER Marijuana Mentions-
40
20% Age 12-17
20
10%
0% 0
87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02

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Substance Abuse Trends in Texas: June 2003

Exhibit 26. Dallas DAWN Emergency Department Mentions of Stimulants: 2nd Half 1996-1st Half 2002

Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun
1996 1997 1997 1998 1998 1999 1999 2000 2000 2001 2001 2002

Amphetamines 57 81 182 163 173 138 169 185 166 187 191 164
Methamphetamines 62 77 82 118 67 58 42 75 60 56 55 54

Among Texas adults in 2000, 12 Exhibit 26 shows the number of percent in 2000. There were
percent reported lifetime use and mentions of methamphetamines 1,672 admissions in 1998 and
1 percent reported past month and amphetamines in Dallas 3,186 in 2002. The average
use of uppers in 2000. In emergency departments. The rate client admitted for a primary
comparison, in 1996, lifetime use of mentions for amphetamines in problem with stimulants is aging.
was 10 percent and past-month the Dallas emergency In 1985, average age was 26; in
use was 1 percent. The departments in the first half of 2002, it was 31. The proportion
difference in past year use from 2002 was higher than the national of Anglo clients has risen from 80
1996 to 2000 (1.1 percent to 1.9 rate (5.2 per 100,000 in Dallas v. percent in 1985 to 92 percent in
percent) was statistically 3.9 per 100,000 nationally), 2002, while the proportion of
significant. while the rate for Hispanics has dropped from 11
methamphetamines was lower, at percent to 6 percent and the
There were 220 calls to Texas 1.7 per 100,000 in Dallas and proportion of African Americans
Poison Control Centers involving 2.6 per 100,000 in the nation. has dropped from 9 percent to 1
abuse or misuse of amphetamines percent. Unlike the other drug
or methamphetamines in 1998, as Methamphetamines and categories, more than half of
compared to 282 in 1999, 393 in amphetamines comprised 8 these clients entering treatment
2000, 451 in 2001, and 392 in percent of adult admissions in are women (54 percent). Most
2002. 2002; this is an increase from 5 stimulant users are injectors, with
Exhibit 27. Characteristics of Adult Clients Admitted to TCADA-Funded
Treatment with a Primary Problem of Amphetamines or
Methamphetamines by Route of Administration: 2002

Smoke Inject Inhale Oral All


# Admissions 753 1,769 385 233 3,183
% of Stimulant Admits 24% 56% 12% 7% 100%
Lag-1st Use to Tmt-Yrs. 9 13 10 11 11
Average Age-Yrs. 29 31 30 32 31
% Male 47% 46% 53% 37% 46%
% African American 1% 1% 1% 3% 1%
% Anglo 90% 95% 87% 88% 92%
% Hispanic 7% 4% 9% 8% 6%
% CJ Involved 47% 49% 52% 43% 48%
% Employed 25% 15% 29% 20% 19%
% Homeless 7% 11% 6% 10% 9%

20 The Gulf Coast Addiction Technology Transfer Center


Substance AbuseTrends in Texas: June 2003

Exhibit 28. Arrestees Testing Positive for Amphetamines: 1991-2002

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
Dallas Males 1% 1% 4% 2% 2% 1% 4% 3% 3% 2% 2% 4%
Houston Males 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% NR NR
Laredo Males NR NR NR NR NR NR NR 0% 0% 0% 0% 0%
San Antonio Males 1% 0% 0% 0% 1% 1% 2% 0% 0% 0% 3% 2%
Dallas Females 3% 3% 6% 4% 4% 2% 4% 4% 4% 3% NR NR
Houston Females 0% 0% 1% 0% 1% 1% 2% 0% 0% 2% NR NR
Laredo Females NR NR NR NR NR NR NR 0% 0% 0% 0% 0%
San Antonio Females 2% 1% 2% 0% 3% 2% 4% 2% 2% NR NR NR

differences seen among the and 4 with a mention of commonly diverted chemicals are
clients based on route of amphetamines in the Dallas metro 60 mg. pseudoephedrine tablets
administration (Exhibit 27). Only area in 2001. In San Antonio, such as Xtreme Relief, Mini-
3 percent of adolescent there were 18 deaths with a Thins, Zolzina, Two-Way, and
admissions were for stimulants. mention of methamphetamines Ephedrine Release.
and 11 with a mention of
Methamphetamine and amphetamines. Methamphetamine and
amphetamine injectors are more amphetamine together comprised
likely to have been in treatment Given the high rate of seizures between 12 and 18 percent of all
before (54 percent readmissions) which proved to be items examined by DPS
than smokers (39 percent methamphetamines or laboratories between 1998 and
readmissions), oral users (50 amphetamines when tested by the 2002 (Exhibit 7), and the
percent readmissions), or inhalers DPS labs, the low percentage of numbers continue to increase. In
(45 percent readmissions). arrestees testing positive for 2002, 19.6 percent were
amphetamines in ADAM is methamphetamines and 0.61
There were 17 deaths where puzzling (Exhibit 28). percent were amphetamines.
amphetamines or
methamphetamines were Local labs are using the “Nazi Notice that while the Dallas ED
mentioned in 1997, 20 in 1998, method,” which includes mentions in Exhibit 26 are more
21 in 1999, 39 in 2000, and 51 ephedrine or pseudoephedrine, likely to be amphetamines, the
in 2001. Of the 2001 decedents, lithium, and anhydrous ammonia, DPS laboratory report for the
82 percent were male; average or the “cold method,” which uses Dallas area reported 33 percent
age was 36.2; and 76 percent ephedrine, red phosphorus, and of the exhibits were
were Anglo, 18 percent were iodine crystals. The “Nazi methamphetamines and 0.89
Hispanic, and 6 percent were method” is the most common percent were amphetamines.
African American. method used in North Texas. There is no explanation for these
Before these methods became differences.
The DAWN medical examiner common, most illicit labs used the
system reported 37 deaths with a “P2P method,” which is based on Stimulants are more of a problem
mention of methamphetamines 1-phenyl-2-propanone. The most in the northern half of the state, as

The Gulf Coast Addiction Technology Transfer Center 21


Substance Abuse Trends in Texas: June 2003

pseudoephedrine labs producing


Exhibit 29. Percent of Items Analyzed small amounts for local
by DPS Laboratories in 2002 That distribution. The Dallas Field
Were Methamphetamines or
Division also reports availability
Amphetamines
high, with multi-pound quantities
Hidalgo (McAllen) 0.42 of Mexican methamphetamine
Webb (Laredo) 0.83 and smaller amounts produced
El Paso (El Paso) 5.39
Nueces (Corpus Christi) 9.03
by local cooks. Availability is
Harris (Houston) 7.21 increasing in the Lubbock and
Travis (Austin) 19.06 Amarillo areas due to more clan
McLennan (Waco) 20.69 labs. Blister packs of cold tablets
Smith (Tyler) 23.62 are the predominant supply
Dallas (Dallas) 34.27
source for pseudoephedrine,
Midland (Odessa) 14.54
Taylor (Abilene) 46.3 although the 240 mg. tablets are
Lubbock (Lubbock) 25.00 also seen. Red phosphorus can
Potter (Amarillo) 46.66 be purchased at gun shows and
there are reports of increasing
Exhibit 29 shows. In Amarillo in the east and northeast sections of use of lithium metal/anhydrous
the Texas Panhandle, 47 percent El Paso. The Houston Field ammonia (“Nazi” method) in the
of all the drug items examined by Division reports that multi-pound manufacturing process. Precursor
the DPS laboratory were either quantities of Mexican chemicals are difficult to obtain in
methamphetamines or methamphetamine and smaller Texas and lab operators travel to
amphetamines, while in McAllen quantities of locally-produced Oklahoma or Louisiana to obtain
and Laredo, less than 1 percent versions are available and the needed supplies.
were these substances. Labs in drug is commonly encountered at
the northern part of the state are clubs and raves. Dealers are The price for a pound of
also more likely to report reported to be providing free methamphetamine is $10,600 in
analyzing substances that turned samples in efforts to build El Paso, $8,000-$10,000 in
out to be ammonia or consumer bases, and in the Midland, $6,000-$11,000 in the
pseudoephedrine, which are Austin and Houston areas, “Ice” Houston area, $4,500-$5,500 in
chemicals used in the is becoming more prevalent, with Laredo, $5,000-$8,000 in Fort
manufacture of an increase in trafficking of Ice by Worth, $6,000-$7,000 in Tyler,
methamphetamine. Mexican dealers. Most of the and $8,000-$9,000 in Lubbock.
methamphetamine encountered in In Dallas, a pound of domestic
According to DEA, the Houston Division is produced methamphetamine sells for
methamphetamine is readily in Mexico, although it is also $4,500-$10,000, an ounce sells
available in all areas of the El locally produced in small batches for $700-$1,100, and a gram
Paso Field Division except in by motorcycle gangs and costs $70-$100. A pound of
Alpine. Methamphetamine is independent cooks in home labs. Mexican methamphetamine sells
“cooked” in Midland, Odessa, Small labs have also been found for $5,800-$9,000 and an ounce
and Monahans, and mobile in East Texas, Corpus Christi, of this product sells for $400 in
laboratories are encountered in and Austin; most are small mobile Dallas. Ice sells for $19,000 per

22 The Gulf Coast Addiction Technology Transfer Center


Substance AbuseTrends in Texas: June 2003

Exhibit 30. Dallas DAWN ED Mentions of


Selected Benzodiazepines in the Dallas
Area: 2nd Half 1997-1st Half 2002
The number of mentions of
200
alprazolam (Xanax), diazepam
(Valium), and Klonopin
150 (clonazepam) in the Dallas
100 emergency departments is shown
in Exhibit 30. The decreases in
50
mentions for all three drugs
0 between first half of 2001 and
2H-- 1H-- 2H-- 1H-- 2H-- 1H-- 2H-- 1H-- 2H-- 1H-- first half of 2002 are statistically
97 98 98 99 99 00 00 01 01 02 significant. The rate of mentions
of alprazolam is higher nationally
Alprazolam Diazepam Clonazepam
than in Dallas (5.2 v 4.3 per
pound in Houston. In Austin, benzodiazepines, such as 100,000), as it is for clonazepam
“glass” methamphetamine is diazepam (Valium), alprazolam (3.1 v. 2.5 per 100,000) and
plentiful and very pure. A quarter (Xanax), flunitrazepam diazepam (2.1 v. 1.2 per
gram costs $20 and two ounces (Rohypnol), clonazepam 100,000).
cost $1,500. (Klonopin or Rivotril),
flurazepam (Dalmane), lorazepam About 1.2 percent of the adults
In Amarillo, street outreach (Ativan), and chlordiazepoxide entering treatment in 2002 (545
workers report that more African (Librium and Librax). Rohypnol clients) had a primary problem
Americans are beginning to inject is discussed separately in the with barbiturates, sedatives, or
methamphetamine, while in Club Drugs section of this report. tranquilizers. Only 37 percent
Tarrant County, particularly in the were male; 81 percent were
mid-cities area, there is an The 2002 secondary school Anglo, 8 percent were African
increase in Ice. Users are survey reported lifetime use of American and 9 percent were
requesting detoxification but there downers increased from 5.8 Hispanic. Forty-two percent
are no programs reported percent in 2000 to 7.1 percent in were involved in the criminal
available to provide this service. 2002. Past year use increased justice or legal systems and 20
from 2.6 percent in 2000 to 3.4 percent were employed.
percent in 2002.
Depressants There were 60 deaths in the
The 2000 adult survey reported Dallas area in 2001 that involved
This “downer” category includes lifetime use of downers at 6.9 benzodiazepines and 36 of these
three groups of drugs: percent and past-month use at mentioned diazepam, according
barbiturates, such as 0.6 percent; in 1996, lifetime use to the DAWN medical examined
phenobarbital and secobarbital was 6.2 percent and past-month reports. In the San Antonio area,
(Seconal); nonbarbiturate use was 0.3 percent. The there were 88 deaths mentioning
sedatives, such as methaqualone, difference in past year use benzodiazepine.
over-the-counter sleeping aids, between 1996 and 2000 (1
and chloral hydrate, and percent to 1.8 percent) was Alprazolam, clonazepam, and
tranquilizers and statistically significant. diazepam are among the 10 most

The Gulf Coast Addiction Technology Transfer Center 23


Substance Abuse Trends in Texas: June 2003

Exhibit 31. Benzodiazepines Identified by DPS Labs:


1998-2002

3.0%

2.5%

2.0%
Alprazolam
1.5% Diazepam
Clonazepam
1.0%

0.5%

0.0%
1998 1999 2000 2001 2002

commonly identified substances pills that are shaped like footballs the Dallas DAWN emergency
according to DPS lab reports, cost $2 a pill. The 2 mg “white departments. The changes in
although none of them comprise bar” or “handle bar” Xanax pills rates between the first half of
more than 2 percent of all items are scored and can be broken 2001 and 2002 were statistically
examined in a year. The into 4 small pieces. They sell for significant for ketamine, LSD,
proportion of alprazolam exhibits $4-$5 a pill and they are very and PCP.
is increasing (Exhibit 31). popular and readily available. In
Houston, there appears to be an Exhibit 33 shows the
Both Houston and Dallas DEA increase in the use of Xanax demographic characteristics of
report alprazolam (Xanax) to be (“Xandies”) on the streets, and in patients entering Dallas
one of the most commonly Dallas, Xanax and Soma are emergency departments in 2001.
abused diverted drugs. Xanax used to heighten and prolong the Because the numbers for some
sells for $3-$10 per tablet and effects of heroin. drugs were so low in the
diazepam (Valium) sells for $1- preliminary data for first half of
$10 a tablet. In Austin, street 2002, the full year 2001 numbers
outreach workers report a 2mg. Club Drugs and are shown. Based on this exhibit,
Klonopin costs $2-$3. Valium Hallucinogens users of ketamine and PCP were
tablets of the 10 mg or 20 mg the most likely to be male, users
strength can be purchased for Exhibit 32 shows the number of of PCP were most likely to be
$1-$2 and the blue 1 mg Xanax mentions of different club drugs in African American, users of LSD
Exhibit 32. Dallas DAWN Emergency Department Mentions of Club Drugs: 2nd Half 1994-1st Half 2002

Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun
1994 1995 1995 1996 1996 1997 1997 1998 1998 1999 1999 2000 2000 2001 2001 2002
GHB 3 8 28 38 22 21 51 75 86 61 95 81 87 75 53 57
LSD 65 72 60 57 27 62 15 40 53 57 48 42 23 38 5 4
Ecstasy 17 33 24 8 11 8 9 6 9 7 18 29 41 37 40 34
PCP 22 39 31 20 11 21 15 27 34 52 43 55 65 46 50 74
Ketamine 1 0 1 4 0 1 … 0 0 1 2 6 4 6 5 5
Rohypnol 1 4 10 7 … 11 2 7 0 2 3 2 2 … … …
*Dots (…) indicate that an estimate with a relative standard error greater than 50% has been suppressed.

24 The Gulf Coast Addiction Technology Transfer Center


Substance AbuseTrends in Texas: June 2003

Exhibit 33. Emergency Departments With Mentions of Club Drugs: 2001*

GHB LSD Ecstasy PCP Ketamine Rohypnol


n 128 43 77 96 11 8
% Male 66% 79% 62% 86% 91% 13%
% Anglo 77% 79% 60% 9% 64% 100%
% Hispanic 9% … 9% … 18% 0%
% African Amer 0% 0% 13% 80% 0% 0%
Age 12--17 2% 33% 25% 8% 27% 13%
Age 18-25 56% 63% 55% 57% 45% …
Age 26-34 35% 2% 14% 30% 18% …
Age 35+ 7% 2%. 6% 2% 9% …
*Dots (…) indicate that an estimate with a relative standard error greater than 50% has been suppressed.

Exhibit 34. Characteristics of Youths and Adults Entering TCADA Treatment


Programs with a Primary, Secondary, or Tertiary Problem with Club Drugs: 2002

GHB Hallucinogens Ecstasy PCP Ketamine Rohypnol


n 35 436 521 321 1 368
% Male 54% 73% 64% 72% 74%
% Anglo 91% 58% 61% 12% 2%
% Hispanic 9% 24% 23% 10% 94%
% African Amer 0% 16% 14% 78% 2%
Age 31.0 22.1 20.7 23.2 18.0
Criminal Justice Problem 60% 68% 57% 50% 69%
Employed 29% 20% 21% 16% 14%
History Needle Use 54% 27% 20% 6% 15%
Primary Drug=Club Drug 34% 20% 24% 45% 15%
Other Primary Drug
Marijuana 6% 41% 33% 29% 49%
Alcohol 0% 11% 10% 9% 7%
Methamphet/Amphetamines 20% 10% 11% 1% 3%
Powder Cocaine 6% 6% 11% 3% 13%
Crack Cocaine 17% 7% 5% 9% 6%
Heroin 9% 2% 1% 0% 8%

The Gulf Coast Addiction Technology Transfer Center 25


Substance Abuse Trends in Texas: June 2003

were the youngest, and users of have a primary problem with Texas poison control centers
GHB were the oldest. marijuana. reported 24 calls involving misuse
or abuse of ecstasy in 1998, 45
While Exhibit 33 shows Exhibit 35 shows the percent of in 1999, 116 in 2000, 155 in
characteristics of patients entering exhibits identified by DPS 2001, and 172 in 2002.
emergency departments in Dallas, laboratories that contained
Exhibit 34 shows the various club drugs. Notice the The rate of mentions of ecstasy
demographic characteristics of decrease in the percentage of per 100,000 in Dallas emergency
youths and adults entering cases involving LSD and the later departments in the first half of
TCADA treatment programs dominance of cases involving 2002 was 1.1; the national rate
statewide with a problem with a ecstasy (MDMA and MDA). was 0.9. Exhibit 32 shows the
club drug. The row “Primary number of mentions of ecstasy.
Drug” shows the percent of Notice that there was a larger
clients who cited a primary Ecstasy (MDMA) race/ethnicity diversity among
problem with the club drug shown ecstasy users than seen with
at the top of the column. The The 2002 secondary school other club drugs (Exhibit 33).
rows under the heading “Other survey reported that lifetime
Primary Drug” show the percent ecstasy use was 8.6 percent, up Adult and adolescent admissions
of clients who had a primary from 4.5 percent in 2000. Past for a primary, secondary, or
problem with another drug, such month use in 2002 was 3.1, as tertiary problem with ecstasy
as marijuana, but who had a compared to 1.9 percent in increased from 63 in 1998 to 114
secondary or tertiary problem 2000. in 1999 to 199 in 2000 to 349 in
with the club drug shown at the 2001 and 521 in 2002. Exhibit
top of the column. Note that the The 2000 adult survey reported 34 shows that in comparison to
treatment data uses a broader that 3.1 percent had ever used users of other club drugs, those
category, “Hallucinogens,” that ecstasy and 1.0 percent had used who used ecstasy were more
includes LSD, DMT, STP, in the past year. likely to be young, racially
mescaline, psilocybin, and peyote.

Based on Exhibit 34, Rohypnol, Exhibit 35. Club Drugs Identified by DPS Labs: 1998-2002
hallucinogen, and PCP clients are
the most likely to be male, GHB 1.8%
clients are the most likely to be 1.6%
Anglo, PCP clients are the most 1.4% LSD
likely to be African American, 1.2% Ecstasy
Rohypnol clients are the youngest, 1.0% PCP
and GHB clients are the oldest. 0.8% Ketamine
While users of GHB and PCP are 0.6% GHB, GBL, 1-4BD
the most likely to have primary 0.4% Rohypnol
problems with these specific club 0.2%
drugs, users of Rohypnol and 0.0%
hallucinogens are more likely to 1998 1999 2000 2001 2002

26 The Gulf Coast Addiction Technology Transfer Center


Substance AbuseTrends in Texas: June 2003

diverse, and to report marijuana Gamma Hydroxybutrate so-called “hard-core” drugs: 54


as their primary problem drug. (GHB), Gamma Butyrate percent had a history of injecting
Lactone (GBL), 1-4 Butanediol drug use, 20 percent had a
In 1999, there were two deaths (1,4 BD) problem with amphetamines or
which involved ecstasy in Texas. methamphetamines and 17
There was one death in 2000 and The 2000 Texas adult survey percent had a primary problem
five in 2001. Of those in 2001, reported that 0.4 percent had with crack cocaine, which are
average age was 24.6; 80 percent ever used GHB and 0.1 percent stimulant drugs. GHB may have
were Anglo; 60 percent were male. had used it in the past year. been used by these clients to
come down from stimulant
Exhibit 35 shows the increases in The number of cases of misuse or binges. It may also have been
substances identified by DPS labs. abuse of GHB reported to Texas used to potentiate the effects of
The labs identified MDMA as the poison control centers was 110 in heroin, since 9 percent had a
substance in 107 exhibits in 1999, 1998, 153 in 1999, 108 in 2000, primary problem with heroin.
387 in 2000, 814 in 2001, and 503 113 in 2001, and 100 in 2002.
in 2002. MDA was identified in 31 In 1999, there were three deaths
exhibits in 1999, 27 in 2000, 48 in Exhibit 32 shows that the which involved GHB, and in
2001, and 90 in 2002. mentions of GHB in the 2000 there were five deaths and
emergency departments in the three in 2001.
According to the Houston DEA Dallas area peaked in 1998-
Field Division, ecstasy coming 1999. In the first half of 2002, In 1998. there were 18 items
through Mexico is being sold in the the rate of mentions per 100,000 identified by DPS labs as being
McAllen District by brand names for GHB was 1.8, as compared GHB, in 1999 there were 112
such as Motorola (62 mg/dose), to the national average of 0.8 per GHB, four GBL, and four 1,4
Rolls Royce and White (87 mg/ 100,000. As shown in Exhibit 33, BD (Exhibit 35). In 2000, 45
dose), Mitsubishi (100 mg/dose), patients mentioning GHB were were GHB, seven were GBL,
Blue or Sky (110 mg/dose), and more likely to be Anglo and older and four were 1, 4 BD. In 2001,
Medusa (119 mg/dose). It is than patients mentioning other 34 were GHB, seven were GBL,
readily available in Juarez, across club drugs. and 19 were 1,4 BD. In 2002,
from El Paso, and the Dallas Field 81 were GHB, six were GBL,
Division reports increases in use by Adult and adolescent clients with and four were 1,4 BD (Exhibit
African American teenagers and a primary, secondary, or tertiary 35). In 2002, 95 percent of the
young adults. Single dosage units problem with GHB, GBL, or 1,4 GHB items were identified in the
of ecstasy sell for $7.50-$20 in butanediol are seen in treatment. DPS lab in the Dallas area, which
Dallas, $12-$23 in Tyler, $16-$20 In 1998, two were admitted, as shows use of GHB is centered in
in El Paso, $8-$30 in Houston, $7- compared to 17 in 1999, 12 in this area of the state.
$30 in McAllen, $8-$11 in Austin, 2000, 19 in 2001, and 35 in
$20 in Laredo, and $15-$25 in San 2002. Clients who used GHB In Dallas, GHB trafficking is
Antonio. Multi-thousand tablet tended to be the oldest of all the reported on the rise, and the
quantities are increasing in club drug users and the most price of a gallon of GHB has
availability, with a wholesale price likely to be Anglo. GHB users dropped. In the third quarter of
of $5-$6 per pill. were more likely to have used the 2002, a gallon sold for $1,600; it

The Gulf Coast Addiction Technology Transfer Center 27


Substance Abuse Trends in Texas: June 2003

now sells for $100-$200 per problem with ketamine. The had ever used LSD and 0.9
gallon. A dose of GHB costs $20 client was a 17 year old Anglo percent had used in the past year.
in Dallas, $5-$10 in Lubbock, female with a primary problem
and $5-$10 in Houston; a gallon with powder cocaine. Texas Poison Control Centers
costs $725-$1,000 in Houston. reported 64 mentions of abuse or
There were also two deaths in misuse of LSD in 1998, 101 in
Ketamine 1999 which involved use of 1999, 82 in 2000, 43 in 2001,
ketamine, none in 2000, and one and nine in 2002. There were
The 2000 adult survey reported in 2001. also 98 cases of intentional
that 0.3 percent had ever used misuse or abuse of hallucinogenic
ketamine and 0.1 percent had In 1999, 25 substances were mushrooms reported in 1998, 73
used it in the last year. identified as ketamine by DPS in 1999, 110 in 2000, 94 in
labs; in 2000, 29 were; in 2001, 2001, and 151 in 2002.
Eight cases of misuse or abuse of 119 were, and in 2002, 78 were
ketamine were reported to Texas (Exhibit 34). There were four mentions of
Poison Control Centers in 1998, LSD in the Dallas DAWN
seven in 1999, 15 were reported Ketamine is reported less emergency departments in the
in 2000, 14 in 2001, and 10 in available in the Houston area and first half of 2002 (Exhibit 32).
2002. it sells for $2,200-$2,500 per The rate of mentions per
liter in Fort Worth. 100,000 in Dallas in the first half
In the Dallas emergency of 2002 was 0.1, which was
departments in the first half of LSD below the national average of
2002, the rate of mentions of 0.2. The decline in the rate/
ketamine per 100,000 was 0.2, The secondary school survey 100,000 in Dallas between the
above the national average of shows that use of hallucinogens first half of 2001 and 2002 was
0.1. There were five mentions in (defined as LSD, PCP, etc.) is statistically significant. Exhibit 33
the first half of 2002 (Exhibit 32). continuing to decrease. Lifetime shows that in 2001, LSD patients
Exhibit 33 shows that in 2001, use peaked at 7.4 percent in were the youngest and the most
almost all the users were male 1996 and had dropped to 4.5 likely to be Anglo.
and they were among the percent by 2002. Past month use
youngest patients. dropped from 2.5 percent in In 2002, 436 adults and youths
1996 to 1.2 percent in 2002. with a primary, secondary, or
One client was admitted to tertiary problem with
TCADA treatment programs in The 2000 adult survey reported hallucinogens entered treatment,
2002 with a secondary or tertiary that 8.8 percent of Texas adults as compared to 486 in 2001 and

28 The Gulf Coast Addiction Technology Transfer Center


Substance AbuseTrends in Texas: June 2003

636 in 2000. Exhibit 34 shows Phencyclidine (PCP) between the first half of 2001 and
that these clients were racially the first half of 2002 was
diverse, likely to have criminal The 2000 Texas adult survey statistically significant, and as
justice problems, and users of reported that 0.9 percent of Exhibit 32 shows, the number of
marijuana in addition to adults had ever used PCP or mentions of PCP in Dallas is
hallucinogens. Angel Dust and 0.1 percent had increasing. Exhibit 33 shows
used in the past year. these emergency department
There were two deaths in 1999 patients were predominately
which involved LSD. There were Texas Poison Control Centers male, African American, and
no deaths with a mention of LSD cases where terms such as “fry,” older.
reported in 2000 or 2001. “amp,” or “PCP” were misused
or abused has increased from Adolescent and adult admissions
DPS labs identified 69 103 in 1998 to 169 in 1999 to to treatment with a primary,
substances as LSD in 1998, 406 175 in 2000 to 198 in 2001 to secondary, or tertiary problem
in 1999, 234 in 2000, 122 in 237 in 2002. There were 23 with PCP are increasing. In
2001 and 10 in 2002 (Exhibit cases involving misuse or abuse 1998, 164 were admitted, in
35). of formaldehyde or formalin in 1999, 243 were, in 2000, 250
1998, 20 in 1999, 26 in 2000, 11 were, in 2001, 245 were, and in
A dosage unit of LSD is selling in 2001, and 26 in 2002. 2002, 321 were. Of these clients
for $1-$10 in Dallas, $5-$10 in in 2002, 78 percent were African
Tyler, $6-$10 in Fort Worth, and The rate of mentions of PCP in American, 72 percent were male,
$7 in Lubbock. In McAllen it the Dallas emergency 50 percent were involved in the
sells for $8 a dose and an ounce departments was 2.4 per criminal justice system, 27
sells for $450. Its availability is 100,000 in the first half of 2002, percent were employed, and 21
reported stable in the Houston above the national rate of 1.3 per percent were homeless. While 45
area. 100,000. The 58 percent change percent reported a primary

Exhibit 36. Arrestees Testing Positive for PCP: 1991-2002

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2000 2001 2002
Dallas Males 0% 3% 3% 5% 8% 4% 3% 4% 5% 4% 2% 5% 5%
Houston Males 0% 0% 1% 3% 4% 3% 3% 6% 7% 5% NR NR NR
Laredo Males NR NR NR NR NR NR NR 0% 0% 0% 0% 0% 0%
San Antonio Males 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
Dallas Females 0% 0% 1% 2% 2% 1% 1% 0% 1% 2% NR NR NR
Houston Females 0% 0% 0% 1% 2% 1% 1% 2% 1% 2% NR NR NR
Laredo Females NR NR NR NR NR NR NR 0% 0% 0% 0% 0% NR
San Antonio Female 0% 0% 0% 0% 0% 0% 0% 0% 0% NR NR 0% 0%

The Gulf Coast Addiction Technology Transfer Center 29


Substance Abuse Trends in Texas: June 2003

problem with PCP, another 29 PCP use by teenagers in Fort The 2000 Texas adult survey
percent reported a primary Bend County has been reported. found that 0.8 percent reported
problem with marijuana, which lifetime use and 0.1 percent
demonstrates the link between Red Devil Dust is reported to be reported past-year use of
these two drugs and the use of a combination of PCP, opium, Rohypnol.
“Fry,” which is a marijuana joint and crystal methamphetamine.
or cigar dipped in embalming The number of confirmed
fluid that can contain PCP. Because of the tendency of some exposures to Rohypnol reported
users to strip off their clothes to the Texas Poison Control
There were three deaths in 1999, while under its influence, PCP has Centers peaked at 101 in 1998,
three in 2000, and five in 2001 in a nickname of “buck naked.” and dropped to 74 in 1999, 88 in
Texas which involved PCP. In 2000, 65 in 2001, and 73 in
2001, all were African American Rohypnol 2002.
males and average age was 23.6.
Rohypnol use in Texas first be- In the first half of 2002, the rate
PCP use in past years was most gan along the Texas-Mexico of mentions for Rohypnol in the
likely to be found among Dallas border and then spread north- Dallas emergency departments
and Houston male arrestees; ward. As shown in Exhibit 37, was 0.1 per 100,000, above the
however data for Houston is not the 2002 secondary school sur- national rate of 0.0. As Exhibit 39
currently being reported and vey found that students from the shows, the number of mentions of
Dallas began reporting again in border area were about three Rohypnol has decreased since
2002 (Exhibit 36). times more likely to report Ro- the peak in 1997. Not only is the
hypnol use than those living number of cases of Rohypnol
DPS labs identified 10 elsewhere in the state (10.9 per- shown in Exhibit 33 low, but the
substances as PCP in 1998, 84 in cent v. 3.8 percent lifetime, and fact that most Rohypnol use
1999, 104 in 2000, 163 in 2001, 4.4 percent v. 1.3 percent cur- occurs closer to the Mexican
and 95 in 2002 (Exhibit 35). rent). border would limit the

DEA reports that PCP sells for


$25 per cigarette and $10 per Exhibit 37. Percentage of Border and Non-Border
piece of “sherm stick” in Dallas. Secondary Students Who Had Ever Used Rohypnol, by
It costs $3,800 per pint bottle Grade: 2002
and $26,000-$28,000 per gallon
16%
in the Dallas-Fort Worth area. Its 14%
availability in the Houston area is 12%
10%
reported stable. Non-Border
8%
6% Border
According to the street outreach 4%
2%
workers in Houston, use of 0%
“Water,” which is a cigarette or Grade 7 Grade 8 Grade 9 Grade Grade Grade
marijuana joint dipped in 10 11 12

embalming fluid, is growing, and

30 The Gulf Coast Addiction Technology Transfer Center


Substance AbuseTrends in Texas: June 2003

generalizability of any conclusions proving effective: people intent on HBP pills are known as “Triple
that could be drawn from committing sexual assault are C’s” or “Skittles.”
DAWN about Rohypnol users now serving blue tropical drinks
statewide. and blue punches into which Poison control centers reported
Rohypnol can be slipped. the number of abuse and misuse
In 1998, 247 youths and adults cases involving
were admitted into treatment with Rohypnol is readily available in dextromethorphan increased
a primary, secondary or tertiary Juarez for $1-$2 per pill and it is from 93 in 1998 to 188 in 1999
problem with Rohypnol. In 1999, an increasing problem among to 263 in 2000 to 366 in 2001
364 were admitted, in 2000, 324 teenagers in El Paso, according and to 429 in 2002. The number
were, in 2001, 397 were, and in to DEA. Its availability is of cases involving abuse or
2002, 368 were. Clients abusing reported as stable in Houston. misuse of Coricidin HBP
Rohypnol were the youngest of increased from two in 1998 to
the club drug patients and they Dextromethorphan four in 1999 to 145 in 2000 to
were predominately Hispanic, 236 in 2001 to 266 in 2002.
which would reflect the use of School personnel in Texas have
this drug along the border been reporting problems with the DPS labs examined two
(Exhibit 34). Some 69 percent abuse of dextromethorphan substances in 1998 which were
were involved with the criminal (DXM), especially the use of dextromethorphan, 13 in 1999,
justice or legal system. While 15 Robitussin-DM, Tussin, and 36 in 2000, 17 in 2001, and 39
percent of these clients said that Coriciden Cough and Cold in 2002.
Rohypnol was their primary Tablets HBP. These substances
problem drug, 49 percent can be purchased over the Outreach workers in the Houston
reported a problem with counter and if taken in large area report an emerging trend in
marijuana. quantities, can product the use of Coricidin HBP Cough
hallucinogenic effects. Coriciden and Cold pills (“Triple Cs”) by
DPS lab exhibits for Rohypnol
numbered 43 in 1988, 56 in
1999, 32 in 2000, 35 in 2001, Exhibit 38. Percentage of Texas Secondary Students Who
and 22 in 2002. This decline in Had Used Inhalants Ever or in the Past Month, by Grade:
the percent of seizures, as shown 2002
in Exhibit 35, parallels the 25%
declines seen in other indicators. 19% 19%
20%
20%
16% 17%
15%
Although Roche is reported to no 15%
longer be making the 2 mg.
10%
Rohypnol tablet, which was a
favorite with abusers, generic 5%
versions are reported to still be
0%
produced, and the blue dye Grade Grade Grade Grade Grade Grade
added to the Rohypnol tablet is 7 8 9 10 11 12
not in the generic version.
Unfortunately, the dye is not Lifetime Use Past-Month Use

The Gulf Coast Addiction Technology Transfer Center 31


Substance Abuse Trends in Texas: June 2003

Exhibit 39. Dallas DAWN Emergency Department Mentions of Various Inhalants:


2nd Half 1997-1st Half 2002
Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun Jul-Dec Jan-Jun
1997 1998 1998 1999 1999 2000 2000 2001 2001 2002
Volatile Agents 23 19 12 19 19 19 8 18 … 2
Nitrite Inhalants 0 0 0 0 0 0 0 0 0 0
Chloro-fluoro-hydrocarbons 0 … 1 0 0 0 1 … 0 0
General Anesthetics 0 0 1 0 0 … 0 0 0 0

adolescents, with some recent percent of African-American refrigerant gases by inhaling in


admissions to treatment for abuse students had ever used inhalants. 2002; average age was 21.
of these pills. There were three cases of misuse
Inhalant use exhibits a peculiar of whiteout. Products used with
Inhalants age pattern not observed with automobiles are also misused,
any other substance. The with 17 cases of intentional
The 2002 elementary school prevalence of lifetime and past- inhaling of gasoline (average age
survey found that 9.3 percent of month inhalant use was higher in of 16) and 42 cases of intentional
students in grades four to six had the lower grades and lower in the inhaling of carburetor cleaner,
ever used inhalants, and 6.5 upper grades (Exhibit 38). This starter or transmission fluid, etc.
percent had used in the school decrease in inhalant use as (average age of 22). There were
year. The 2002 secondary school students age may be partially due 31 cases of intentional inhaling of
survey found that 18 percent had to the fact that inhalant users paint (average age 24), 21 cases
ever used inhalants and 6.8 drop out of school early and of intentional inhaling of aerosols
percent had used in the past hence are not in school in later such as compressed air or air
month. Some 18.5 percent of grades to respond to school- freshener (average age 15), and
secondary school males had ever based surveys. four cases of intentional abuse of
used inhalants, as compared to nitrous oxide (average age 31.3).
17.4 percent of females. Some Texas Poison Control Centers
20.7 percent of Hispanics, 17.9 reported 12 cases of misuse or Exhibit 39 shows the types of
percent of Anglos, and 11.8 abuse of Freon or other inhalants which are reported in

Exhibit 40. Texas Deaths With Mention of Inhalants: 1988-


2001

20 45
40
15 35
30
# Deaths

Av. Age

25
10
20
15
5 10
5
0 0
1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

32 The Gulf Coast Addiction Technology Transfer Center


Substance AbuseTrends in Texas: June 2003

Exhibit 41. AIDS Cases in Texas by Route of Transmission:


1987-1st Q 2003 (Cases with Risk Not Reported Excluded)
90%
80%
70%
60% MSM-BiSexual
MSM&IDU
50%
IDU
40%
Heterosexual
30%
20%
10%
0%
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
the Dallas emergency fact that TCADA has developed Freon and two involved nitrous
departments. The 2002 data are and funded programs which were oxide (Exhibit 40). Average age
preliminary and may change as targeted specifically to this group. was 38.4; 93 percent were male;
additional reports are received. Only 0.2 percent (64 clients) of 73 percent were Anglo and 13
adult admissions were for a percent were Hispanic or Black,
Inhalant abusers comprised 1.6 primary problem with inhalants. respectively.
percent of the admissions to Average age was 29, 64 percent
adolescent treatment programs in were male, and 70 percent were AIDS and Drug Use
2002. The youths entering Hispanic.
treatment tended to be male (80 The proportion of adult and
percent) and Hispanic (71 In 2000, there were 12 deaths adolescent AIDS cases related to
percent). The overrepresentation involving misuse of inhalants and injecting drug use has gone from
of Hispanic youths is due to the 15 in 2001. Six deaths involved 16 percent in 1987 to 27 percent

Exhibit 42. Male and Female AIDS Cases by Race/Ethnicity:


1987-1stQ 2003

100%
Hispanic Male
80% Af Amer Male
Anglo Male
60%
Hispanic Female
40% Af Amer Female
Anglo Female
20%

0%
87
88
89
90
91
92
93
94
95
96
97
98
99
00
01
02
03
19
19
19
19
19
19
19
19
19
19
19
19
19
20
20
20
20

The Gulf Coast Addiction Technology Transfer Center 33


Substance Abuse Trends in Texas: June 2003

in 2002. In 1987, 4 percent of in 2002, 21.5 percent were


the cases were injecting drug female. In 1987, 12 percent of
users (IDUs), and 12 percent the adult and adolescent cases
were exposed through male-to- were African American; in 2002,
male sex and IDUs. In 2002, of 40 percent were African
the cases where mode of American. As Exhibit 42 shows,
exposure is known, 20 percent of the proportion of Anglo males
the cases were IDUs, and 7 has dropped while the proportion
percent were male-to-male sex of African Americans and
and also IDUs (Exhibit 41). The Hispanics has increased.
proportion of cases resulting from -
heterosexual contact has risen The proportion of adult needle
from 1 percent in 1987 to 20 users entering TCADA-funded
percent in 2002. treatment programs has
decreased from 32 percent in
For first quarter 2003, the 1988 to 22 percent for 2002.
percent of cases involving Heroin injectors are most likely
heterosexual exposures was to be older, and nearly two-thirds
greater than the percent of cases are people of color, while
due to injecting drug use. injectors of stimulants and
cocaine are far more likely to be
In 1987, 3 percent of the AIDS Anglo (Exhibit 43).
cases were females over age 12;

Exhibit 43. Characteristics of Adult Needle Users


Admitted to TCADA-Funded Treatment: 2002

Heroin Cocaine Stimulants


# Admissions 4,645 1,062 1,771
% of All Needle Admits\ 59% 14% 23%
Lag-1st Use to Tmt-Yrs. 15 13 13
Average Age 37 34 31
% Male 71% 66% 46%
% African American 6% 5% 1%
% Anglo 36% 68% 95%
% Hispanic 56% 25% 4%
% CJ Involved 33% 40% 49%
% Employed 12% 16% 48%
% Homeless 14% 15% 11%

34 The Gulf Coast Addiction Technology Transfer Center