issues impacting broward youth september 2014 drug abuse patterns and trends update
TRANSCRIPT
Issues ImpactingBroward Youth
September 2014
Drug Abuse Patterns and Trends Update
James N. Hall, EpidemiologistCenter for Applied Research on Substance Use and Health DisparitiesNova Southeastern University
Alcohol Use in Past 30-Days
Source: CDC Youth Online High School YRBS Broward County, FL 1991-2013
1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013
4844
4044 44 44
4238
43 4137
30
22 2017
2320 21 20
1821 21
1814
% of high school students who had at least one drink of alcohol in past 30-days
% of high school students who had five or more drinks of alcohol in a row within a couple of hours in past 30-days
1 Drink
5+ Drinks
18%
8%
BrowardPrevention.org
Current (past 30-day) Alcohol Use Among Broward County Middle and High School Students
2000-2012
Source: Florida Youth Substance Abuse Surveys 2000-2012
2000 2002 2004 2006 2008 2010 201205
101520253035404550
4439.9
36 34.137.3
34.1
31.319.8 20.1
24
18.716.8
14.8
11.2High School Middle School
% R
ep
ort
ing
Cu
rre
nt
Us
e
Current (past 30-day) Binge Drinking Among Broward County Middle & High School Students
2000-20012
Source: Florida Youth Substance Abuse Surveys 2000-2012
2000 2002 2004 2006 2008 2010 20120
5
10
15
20
2522.8
20.3 17.2 1718.8
16.8 16.8
8.96.9
8.8
5.6 5 4.4 4.4
High School
Middle School
% R
ep
ort
ing
Cu
rre
nt
Us
e
Current Alcohol Use Among Broward Middle and High School Students
by Gender 2000-2012
2000 2002 2004 2006 2008 2010 201220
22
24
26
28
30
32
34
29.6
28.4
30.9
26
27.8
24.8
21.2
30.8
32.8
30.3 28.5 28.8
27
24.4
Male Female
% R
ep
ort
ing
Use P
ast
30
D
ays
Source: Florida Dept. of Children & Families Florida Youth Substance Abuse Surveys 2000-2012
Age of Alcohol Onset and Any L ifetime Alcohol Dependency
among Adults Aged 18 and Older
47% 45%
38%32%
28%
15% 17%11% 9%
0%
10%
20%
30%
40%
50%
13 14 15 16 17 18 19 20 21
Age Began Drinking
Source: National Epidemiologic Survey on Alcohol and Related Conditions Sample = 43,093
% A
lcoh
ol D
epen
den
t
Percent of Broward County High School Students Reporting Alcohol Use by Age 13 or Younger
2000-2012
2000 2002 2004 2006 2008 2010 20120
5
10
15
20
25
30
35
40
45 40.7 38.4 36.940.1
31.8
24 25.5
8.76.5 5.8 5.9 5.5 4.6 4.9
More than a Sip or Two
Drinking at least Once a Month
Source: Florida Youth Substance Abuse Surveys 2000-2012
% R
epo
rtin
g U
se
by
Ag
e 1
3
Marijuana Data Bank2014
• Consumption• Consequences • Contributing Factors• Colorado
Types of Drugs Used by Past Month Illicit Drug Users Aged 12 or Older: 2013
Marijuana and Some Other Drugn= 4,082,000
Marijuana Only
n= 15,728,000
Only Drug is Other Than Marijuanan= 4,763,000
24,573,000 Illicit Drug Users (9.4%)
16.6% 1
9.4%
64.0%
Source: 2013 National Survey on Drug Use and Health
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
Annual Numbers of New Users of Marijuana USA: 1966-2012
Thousands of New Users
All Ages
Sources: National Household Survey on Drug Use 1966-2001 and National Survey on Drug Use and Health 2002-2012
19731978
1990
2001
Under 18
57.3 % (1.4 million in 2012)
20122.4 million
1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 20130
5
10
15
20
25
30
13.5
17.9 19.11920.9
21.8
17.9 17.3 17
23.7
22.1 22.9
14.7
17.7
25.3 26.2 26.7
23.922.4
20.2 19.720.8
23.1 23.4
BrowardUSA
Percent of High School Students Reporting Any Past 30-Day Marijuana Use
USA & Broward County: 1991-2013
Source: Centers for Disease Control and Prevention: Youth Risk Behavior Surveillance
Pe
rce
nt
Re
po
rtin
g C
urr
en
t U
se
19992000
20012002
20032004
20052006
20072008
20092010
20112012
20130
5
10
15
20
25
17.2
13.9 14.5
11.4
1415.3
19
20.921.8
17.9 17.3 17
23.722.1 22.9
FYSAS
% o
f hig
h Sc
hool
Stu
dent
s re
porti
ng P
ast 3
0 D
ay U
se
Past 30 Day Use of Marijuana among Broward County high school StudentsFrom YRBS (Odd # Years) and FYSAS (even # Years) 1999-2013
Sources: Youth Risk Behavior Surveillance System (US CDC&P) and Florida Youth Substance Abuse Survey (FL-DCF)
2009 2011 201310
15
20
25
30
35
29.927.9
24.5
28.427.2 26.727.6
25.7
27
23.722.1
22.919.9
17.9 18.8
15.815.1
18.4
Hispanic
White Non-Hispanic
Male
All HS Students
Female
Black Non-Hispanic
Pe
rce
nt
Re
po
rtin
g C
urr
en
t U
se
Source: Centers for Disease Control and Prevention: Youth Risk Behavior Surveillance
Percent of Broward High School Students Reporting Any Past 30-Day Marijuana Use
By Demographic Groups: 2009-2013
Current (past 30-day) Marijuana Use Among Broward County Middle and High School Students
2000-2012
Source: Florida Youth Substance Abuse Surveys 2000-2012
2000 2002 2004 2006 2008 2010 201202468
101214161820
17.2
13.9 14.5
11.414 15.3
19
4.5 5.2 5
2.5 3.5 4.3
3.7
High School Middle School
% R
ep
ort
ing
Cu
rre
nt
Us
e
Percent of Broward County High School Students Reporting Marijuana Use by Age 13 or Younger
2000-2012
2000 2002 2004 2006 2008 2010 20120
2
4
6
8
10
12
14
16
18 16.7%
11% 10.5%9.4%
8.1% 8%9.7%
Source: Florida Youth Substance Abuse Surveys 2000-2012
% R
epo
rtin
g U
se
by
Ag
e 1
3
Addiction is a Developmental Disease: It Starts Early
1
10
100
Child Teen Young Adult Adult
57%
1.5%
5.5%
<12 12-17 18-25 >25
36%
Fi r
st M
ari j
uan
a U
se,
(Pe r
c en
t o
f I n
i tia
tes)
Source: US Dept HHS: SAMHSA National Survey on Drug Use & Health 2011
Percent of First TimeMarijuana UsersBy Age
A major concern about marijuana use among youth is the link between its early first use and life-long drug dependency and addiction problems. Nearly 13 percent of adults who met the criteria for drug abuse or dependency in the past year first used marijuana by age 14 or younger as compared to 2 percent of those who did not use marijuana for the first time until age 18 or older.
(Source: US Department of HHS: SAMHSA 2011 National Survey on Drug Use and Health, Released August 2012.)
Percent of Past Year Drug Dependence or Abuse Among Adults Aged 18 or Older
By Age of First Marijuana Use: 2011
12.7%
2.2%
0%
2%
4%
6%
8%
10%
12%
14%
Age of First Marijuana Use
% P
as
t Y
ea
r D
ep
de
nc
e/A
bu
se
14 Years orYounger
18 or Older
Source: SAMHSA-National Surveys on Drug Use and Health 2011
14 yrs. Or Younger 18 or Older
Percent of Past Year Serious Mental Illness Among Lifetime Marijuana Users Aged 18 or Older
By Age of First Marijuana Use: 2002 and 2003
21.0%
17.4%
12.2% 10.5%
0%
5%
10%
15%
20%
25%
Age of First Marijuana Use
% P
as
t Y
ea
r S
MI
Before 12 Yrs
12-14 Yrs
15-17 Yrs
18 or Older
Source: SAMHSA-National Surveys on Drug Use and Health 2002-2003
< 12 yrs. 12-14 yrs. 15-17 yrs. 18 or Older
Perceived Attitudes about Marijuana Among
Broward County Middle and High School Students 2000-2012
Source: Florida Youth Substance Abuse Surveys 2000-2012
2000 2002 2004 2006 2008 2010 20120
102030405060708090
100
80.5 81 81.3 84.5 80.9 80.374.4
58 58.2 61.4 65.158.9
54.8
48
10.5 12.4 10.9 9.8 11.314.9
15.7
29.9 29.433.3 36.1
31.4 30.625.7
Wrong to Smoke Marijuana Regular Use HarmfulSeen as Cool to Use Trying Marijuana Harmful
% R
ep
ort
ing
Cu
rre
nt
Us
e
Percent of high school students having ridden or driven in the past 30 days with or as driver
having used marijuana or alcoholRODE with Driver who had used
marijuana or alcohol
Florida Miami-Dade Broward0
5
10
15
20
25
30
25.4 24.527.0
21.4 20.518.4
Marijuana Alcohol
DROVE after using marijuana or drinking alcohol
Florida Miami-Dade Broward0
5
10
15
20
25
30
11.2 10.8 10.98.1 9
7% R
epor
ting
% R
epor
ting
Source: FL-DCF - 2012 Florida Youth Substance Abuse Survey
“Budder” Beware: Dangers of Marijuana Wax
• Marijuana Wax • “Budder,” or • Butane hash oil, or even • “ear wax hash”
Produced by soaking marijuana plant material in a solvent such as butane which extracts various cannabinoids of the plant.
Percent of High School Males Reporting Having Used Synthetic Marijuana Florida and
Broward County - 2012
Florid
a Life
time
Broward
Lifetime
Florid
a Pas
t 30 Day
s
Broward
Past 3
0 Days
0%
4%
8%
12%
16%
20%15.1 %
12.4 %
5.3 % 3.9%
Source: Florida Youth Substance Abuse Survey 2012
• Thirty-four percent or 1/3 of High School Seniors who say that they have used marijuana in the past year who live in the states that have passed medical marijuana laws report that one of their sources of marijuana is another person's medical marijuana prescription. And 6 percent say they get it from their own prescription.
• It thus appears that state medical marijuana laws provide an additional avenue of accessibility to the drug for teens.
(Source: US Department of HHS: NIH-NIDA 2013 Monitoring the Future Survey Released December 2013)
2006 to 2011
USA up 13 %
Colorado Up 44%
Ages 12-17 years 2006 -2011
Source: SAMHSA-National Survey on Drug Use and Health 2011
The Question for Doctors……..
How a Bill becomes Law
How a Pill becomes MedicineUS Food and Drug Administration• Clinical Trials• FDA Medical Review• FDA Medical Panel Approval
Kevin Sabet, Ph.D.
www.youtube.com/watch?v=VwqlNfXYcOY
Or Go To www.youtube.com andSearch “Commission on Substance Abuse”
Rx Nonmedical Use in Florida2000 -2013
Responding to an Epidemic
Florida’s Response• July 2010 – Senate Bill 2272 Legal authority to
close “Pill Mills” and limited practitioner dispensing of CS Schedule II to 3-day supply
• August 2010 – Tamper-resistant OxyContin®.• March 2011 – Law Enforcement Strike Force• July 2012 - House Bill 7095 Comprehensive
law bans practitioner dispensing of CS II and new regulations. Permits PDMP to operate.
Number of Selected Lethal Rx Opioid Occurrences Among Deceased Persons in Florida Jan 2008 to Jun 2013
Source: FDLE – Drugs Identified In Deceased Persons by Florida Medical Examiners Jan 2008 - Jun 2013 Reports
# “C
ause
of D
eath
” O
ccur
renc
es
1H'082H'08
1H'092H'09
1H'102H'10
1H'112H'11
1H'122H'12
2x1H'13
0
100
200
300
400
500
600
700
800
900
476 465533
652715
801
607640
392343
279337 336
380340 336
358
341
350274
238 221153 147 160 142
110152
144201 176
239 268
141 129 136 129
139176
136 171118 126 158
Oxycodone
Methadone
Morphine
Hydrocodone
House Bill 7095Takes effect
CS-II Dispensing Limits & OxyContin Tamper Resistant Strike Force
Number of Nonmedical Rx Opioids and Benzodiazepine Reports Detected among Decedents
in Florida 2005 – 2x1h2013
# of
Dru
gs D
etec
ted
Amon
g D
eced
ents
20052006
20072008
20092010
20112012
2X1h20130
1,000
2,000
3,000
4,000
5,000
6,000
7,000
4,0354,416
5,059 5,4546,006
6,608 6,333
5,4895,290
2,608 2,973 3,3394,167
4,340
6,188 5,947
5,184 4,574
OpioidsBenzodiazepines
House Bill 7095Takes effect CS-II Dispensing Limits and
OxyContin Tamper Resistant
Strike Force
Source: FDLE – Drugs Identified In Deceased Persons by Florida Medical Examiners Jan 2005 - Jun 2013 Reports
Number of Unique Patients Identified By Threshold Levels Number of Prescribers and Number of Pharmacies
by Quarter 2012-2013
Level 5
Level 6
Level 7
Level 8
Levels 9, 1015Source: 2012-2013 Annual Report
Florida’s Prescription Drug Monitoring Program (PDMP)
3,000
500
5 Prescribers &5 Pharmacies 2,864
1,4151,097
427
514
178
51-% Decrease
Hydromorphone (e.g., Dilaudid®)
STATETOTAL
GRAMSGRAMS/
100K POP
1 FLORIDA 270,718.70 1,439.892 DELAWARE 10,501.64 1,169.53
3 VERMONT 6,099.61 974.78
4 CONNECTICUT 34,362.81 961.44
5 VIRGINIA 67,026.15 837.72
6 MONTANA 8,049.45 813.56
7NEW HAMPSHIRE 10,389.74 789.21
8 MARYLAND 43,353.71 750.9
9 WASHINGTON 48,346.19 718.95
10 OREGON 27,172.92 709.282008 2009 2010 2011 2012
050
100150200250300350400450
199212 213
253
414
Hydromorphone Related-Deaths in Flor-
ida
# of
Dea
ths
2013 ARCOS Grams Sold Per 100/Population
Source: US DEA ARCOS 3 Report 4 March 5, 2014Source: Florida Medical Examiners Commission
South Florida
Crime Lab Cases
Up 950-%
2011-2013
Exhibit 5 Number of Heroin-related Deaths in Florida: 2000 – 2x1h2013
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2x1h
2013
0
50
100
150
200
250
300
350276
328 326
261
180
12296
110132
111
58 62
117140
61
39 46 3218
22 20 26 38 30 2615
33 36
17
53 50 49 35
17 13 4 17 8 5 3 9 4
Florida
Miami-Dade
Broward
SOURCE: Florida Medical Examiners Commission Reports 2000-2013
# H
eroi
n O
ccur
renc
es
Top 10 Most Frequently Identified Drugs of Total Reports from South Florida Crime Labs Reports CY 2013Drug 2013 % Δ vs. 2012Cocaine 10,147 Down 11 % Marijuana/Cannabis/THC 5,276 Down 2 %Methylone (N-Methyl-3,4-Methylenedioxycathinone) 1,194 Up 208 % Hallucinogen 984 Up 88 % Rx Opioids 933 Down 4 %Heroin 925 Up 33 %
Rx Benzodiazepines 849 Down 4 %Methamphetamine 211 Up 24 %Phenylimidothiazole Isomer 154 Down 37 %Caffeine 131 Down 45 %All Other Analyzed Drugs 2,272 Down 18 % Total 23,069 Down 3 %
SOURCE: US DEA: National Forensic Laboratory Information System DQS on May 9, 2014
South Florida
Crime Labs Reports
SOURCE: US DEA: National Forensic Laboratory Information System DQS on May 9, 2014
Emerging Psychoactive Substances 2011–2013
2011 2012 20130
200
400
600
800
1000
1200
1400
19 19014543
428
1242
386 361
144
Synthetic CannabinoidsSynthetic CathinonesOther Emerging Synthetics
2011 2012 201302468
101214
1
1011
3 4
106
12 13 Synthetic Cannabinoids
Synthetic Cathinones
Other Emerging Synthetics
Number of Different Drugs
2004 2005 2006 2007 2008 2009 2010 2011 2012 20130
5000
10000
15000
20000
25000
9495
14134
2179024330
22720 23332
23114
10337
53673752
10 24 11 1 15 28
4411 5147
107499985
“Ecstasy” and “Mollys” Items Identified in DEA’s NFLIS Toxicology Labs: 2004- 2013
MDMA
Methylone
Source: US Drug Enforcement Administration – National Forensic Laboratories Information System (NFLIS)
*The synthetic cathinones mephedrone and methylone act on the brain like MDMA
*
Nu
mb
er
of
Ite
ms
Dangerous, Imitation, Emerging Drugs
(DIED)Fake Drugs; Real Poisons
www.drugfreebroward.org Click On -Data Central
Presentations: October 2012
