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Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
Epidemiology of Drug Addiction
Jane C. Maxwell, Ph.D.Center for Excellence in Drug Epidemiology
Gulf Coast Addiction Technology Transfer Centerwww.gcattc.net
There is no conflict of interest
Data Sources• Community Epidemiology Work Group (NIDA)• Treatment admission records (TEDS-DSHS)• Emergency room data (DAWN)• Price, purity, supply, trafficking data (DEA)• Surveys (National & DSHS)• Forensic laboratory tests by DEA and DPS• Maxwell, J. C et al. (2006). Drug use and
risk of HIV/AIDS on the Mexico-U.S. Border: A comparison of treatment admissions in both countries. Drug and Alcohol Dependence.
• Maxwell, J. C. Substance Abuse Trends in Texas: June 2006. at www.gcattc.net.
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
U.s. Treatment Admissions by Primary Substance of Abuse: 1992-2005
0
10
20
30
40
50
60
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
AlcoholHeroinOther opiatesMarijuanaCocaineStimulantsOther drugs
Source: SAMHSA
California Treatment Admissions by Primary Substance of Abuse:
1992-2005
0
10
20
30
40
50
92 93 94 95 96 97 98 99 00 01 02 03 04 05
Alcohol Crack Powder Cocaine Marijuana Heroin Stimulants
Source: SAMHSA
# Exhibits Identified by Toxicology Labs in U.S: 2000-2005
0%
10%
20%
30%
40%
50%
2000 2001 2002 2003 2004 2005
Cocaine
Marijuana
Methamphet &Amphet
Heroin
Source: NFLIS
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
Drugs Identified by NFLIS Laboratories by Region: 2005
0
10
20
30
40
50
Perc
ent
West Midwest Northeast South
Marijuana Cocaine Methamphetamine Heroin
Substances Identified by California Labs: 2005
0%
20%
40%
60%
80%
100%
San Diego Los Angeles SanFrancisco
Statewide
Cannabis Methamphetamine Cocaine Heroin
Source: SAMHSA
1998 Miami DMP SamplesSouthwest Asian 2.1 % Pure
Southeast Asian 2.3 % Pure
South American 19.2 % Pure
HeroinHeroin
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
Opiates
• Black tar heroin, few mentions of stronger “white” heroin west of the Mississippi.
• “Cheese” is Tylenol PM and 1% heroin. Kids mix it up themselves. Concentrated in a few Dallas schools.
• Fentanyl is patches in the West, not the rogue powder seen in the Northeast (where heroin is also a white powder).
Heroin Sources and Supply Routes
Sources of Heroin Seized in US Based on Net Weight:1989-2004
0
20
40
60
80
100
1989
1991
1993
1995
1997
1999
2001
2003
SEAsianSWAsianMexicanSo. American
DEA Heroin Signature Program
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
Average Purity of Heroin Samples in the US:
1992-2004
0%
20%
40%
60%
80%
100%
SoutheastAsian
SouthwestAsian
Mexican SouthAmerican
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003DEA Heroin Signature Program
50%31%
11%
10%
51%48%
34%
16%
14%
24% 16%
41%
14%39% 28%
43%
28%52%
16%
WestAverage Purity: 26%Mexican
EastAverage Purity: 42%So. American
Heroin Purity: 2004
25%
53%
OTHER OPIATESAbuse of different opiates varies by
region.Problem with methadone pain pills (as
compared to diskettes and syrup used in narcotic treatment programs). Codeine cough syrup and rap music.Kids like pills because easy to get from
home, not illegal, cheap, claim it’s prescribed for them if caught, fewer side effects than street drugs, less stigma, parents won’t get as upset as if using illicits, etc. (From Partnership for a Drug Free America’s PATS Survey).
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
24 or more
6-9
<6
Incomplete data 12-15
Other Opiate Treatment Admissions per 100,000 by State, TEDS: 1993
KEY YEAR: 199310-11 16+
Source: SAMHSA
24 or more
6-9
<6
Incomplete data 12-15
Other Opiate Treatment Admissions per 100,000 by State, TEDS: 1997
KEY YEAR: 199310-11 16+
Source: SAMHSA
16 or more< 6
6-912-15
Other Opiate Treatment Admissions per 100,000 by State, TEDS: 2004
KEY YEAR: 1992
10-11
Source: SAMHSA
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
Other Opiate Items Identified in Toxicology Labs by Region: NFLIS,
2005
24121789684
14270
7140
23471482
3164
986
34163848
826
02000400060008000
10000120001400016000
West South Northeast Midwest
Hydrocodone Oxycodone MethadoneSource: NFLIS
ARCOS Retail Drug Distribution by Drug Code for the U.S: 1997-2004
0
5,000,000
10,000,000
15,000,000
20,000,000
25,000,000
30,000,000
35,000,000
1997 1998 1999 2000 2001 2002 2003 2004
Oxycodone Hydrocodone Methadone
Source: DEA
Treatment Admissions Nationwide by Primary Substance. TEDS: 1992-2004
02468
1012141618
1992
1994
1996
1998
2000
2002
2004
Other OpiatesIllicit MethadoneHeroin
Source: SAMHSA
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
Characteristics of Heroin and Other Opiate Treatment Admissions Nationwide, TEDS: 2004
0
20
40
60
80
100
% Ma
le
% Whit
e
% Bla
ck
% Hispanic
Av. A
ge
% ID
U
% Or
al
Other Opiates Heroin
Source: SAMHSA
Methadone-Related Unintentional Poisoning Deaths: 1999-2003 from National Center for Health Statistics, National Vital Statistics
System
623778
1158
1911
2452
0
500
1000
1500
2000
2500
3000
1999 2000 2001 2002 2003
ARCOS Methadone Grams Distributed by Type: 2000-2005
0200400600800
10001200140016001800
2000 2001 2002 2003 2004 2005
Tablets Diskettes Liquid
Source: DEA
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
COCAINEStill Around—
with New Users
Cocaine• Methamphetamine outselling cocaine and crack in some areas in Texas; coke dealers now fronting cocaine to compete—or shifting to selling Ice.
• Purity of cocaine increasing.• Still around with new users.• Proportion of crack treatment admissions who are Anglo or Hispanic continues to increase.
• Injecting crack.
Race-Ethnicity of US Cocaine Admissions: 1992 v. 2004
0%
20%
40%
60%
80%
100%
Crack-92
Crack-04
IDU-92
IDU-04
Inhale-92
Inhale-04
Black White Hispanic
Source: SAMHSA
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
30%
35%19%
25%
28% 35%
12%
9%9%
26%
Cocaine Admissions inU.S. and Mexican Border States: 2003
DOWNERS
• Potentiate low-quality heroin (and seen in heroin overdoses)
• Come down from speed or cocaine trips
• Dependence among females• Kids like alprazolam (Four Bars).
Benzodiazepines Identified by Toxicology Labs in the US:
2000-2005
0.0%0.2%0.4%0.6%0.8%1.0%1.2%1.4%1.6%
Alprazolam Diazepam Clonazepam
2000
2001
2002
2003
2004
2005
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
MARIJUANA• Fairly stable.• Influence of Blunts and Wraps• Use with Fry, PCP, DANK, crack, cough syrup, honey, etc., continues.
• Continuing references to pot and PCP and embalming fluid (ether).
• CJ v. Non-CJ treatment admissions
• Primos--marijuana joint and crack.• Fry, Amp--joint and embalming fluid (PCP?)
• Fry Sticks & Fry Squares--$10 each.• Fry Sweets--blunts in embalming fluid.• Sweet Houses--sell ready-mades.• Candy Blunts--cigarillos in codeine cough syrup.
• Sherms--menthol cigarettes in embalming fluid.
% Texas Secondary Students Who Had Used Any Illicit Drug in the Past
Month, by Ethnicity: 1988-2004
0%
5%
10%
15%
20%
25%
1988
1990
1992
1994
1996
1998
2000
2002
2004
AnglosAfrican AmericansHispanics
Source: DSHS
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
Addiction Severity Index Problems of Texans Treated with Primary Marijuana
Problem: 2005
0% 20% 40% 60% 80%
Sickness
Employment
Family
Social
Emotional
Sub. Abuse
Non-CJ ReferralCJ Referral
Source: DSHS
Cannabis Treatment Outcomes Among Texas Clients
• Criminal justice admissions to treatment were less impaired, more likely to complete treatment (42% v. 34%), and abstinent from cannabis at follow-up ( 76% v. 66%).
• 55% of all clients met criteria for cannabis dependence.
• CJ clients received less intensive services.• Although DSM-IV underreported, voluntary
more likely to have mood depressive disorder and be prescribed medications for mental health problems.
J. Copeland & J. Maxwell, under review, 2006.
Alcohol
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
Percentage of Texas Secondary Students Who Reported They Normally Consumed Five or More Drinks at One Time, by
Gender: 2000–2004
22% 22%20%
32%30%
26%
0%
5%
10%
15%20%
25%
30%
35%
2000 2002 2004
GirlsBoys
Liu, L. Texas School Survey of Substance Use Among Students in Grades 7-12, DSHS.
Primary Problem Substance of Texas DUI Admissions to
Treatment
Alcohol
Heroin
Other Opiates
Amphet/ Meth
Powder Cocaine
Cannabis
Crack Cocaine
Other
1996 2005
66%75%
Maxwell, Impaired Drivers at Admission to Substance Abuse Treatment, RSA Poster, 2006.
2% 7%1%
4%
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
Methamphetamine
Sources of Amphetamine-Type Substances
Sources of ephedrineMajor producers of methamphetamine
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
Methamphetamine Use in Past Month Among Persons Ages 12 or Older, by Dependence and
Abuse: NSDUH 2002-2005
433
10163
357
158
92
237
216
130
255
154
103
0
100
200
300
400
500
600
700
# P
ast
Mon
th U
sers
(in T
hous
ands
)
2002 2003 2004 2005
StimulantDependence/AbuseOther Illicit DrugDependence/AbuseNo Illicit DrugDependence/Abuse
597 607 583
Source: SAMHSA
512
4 Most Frequently Identified Drugs by NFLIS Toxicology Laboratories
0%
10%
20%
30%
40%
Methamphetamine Cannabis Cocaine Heroin
2000 2001 2002 2003 2004 2005
Source: NFLIS
Normal Course of a Drug Epidemic(Texas Cocaine Admissions: 1983-2004)
0
5
10
15
20
25
30
1983
1985
1987
1989
1991
1993
1995
1997
1999
2001
2003
CrackPowder
Outbreak Endemic
Hyperendemic
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
The Methamphetamine Epidemic:TEDS Admissions/100,000: 1992-2004
0
50
100
150
200
250
300
1992
1994
1996
1998
2000
2002
2004
ArkansasHawaiiIowaCaliforniaGeorgiaConnecticutWashington
It keeps going up
Source: SAMHSA
Stages of Meth Epidemic?• Early Stages—Ice in gay and party scene; powder
meth via overnight express from California; crack in urban areas.
• Middle Stages—Mom & Pop cookers and large problem in rural areas; crack still strong in urban areas; Mexican meth starts being trucked in to urban areas.
• Late Stages—primary problem for treatment admissions; spreads across racial/ethnic groups; Ice is dominant form and powder supply decreases; increasing types of traffickers (criminal groups, ethnic gangs, outlaw bikers).
Race-Ethnicity of US Methamphetamine Admissions:
1992 v. 2004
0%
20%
40%
60%
80%
100%
Smoke-92
Smoke-04
IDU-92
IDU-04
Inhale-92
Inhale-04
Black White Hispanic
Source: SAMHSA
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
Routes of Administration of Methamphetamine of Clients in US
Programs: 1993-2004
010203040506070
1993
1995
1997
1999
2001
2003
OralSmokingInhalationInjection
Source: SAMHSA
% Methamphetamine/Amphetamine and All Other U.S. Admissions by
Urbanization: 2004
05
101520
2530
3540
LargeCentralMetro
LargeFringeMetro
SmallMetro
Non-Metro w/
City
Non-Metro
w/o City
Perc
ent
MethamphetamineAll Others
SAMHSA DASIS Report, 27, 2006 Large is 1 million or more population; Small is MSA with less than 1 million, & Non-Metro is city of 10,000 or more
U.S. Methamphetamine/Amphetamine Admissions by Route of Administration &
Urbanization: 2004
7 11 9 9 916 15 13 16 19
15 14 25 24
62 60 54 50 48
24
0%10%20%30%40%50%60%70%80%90%
100%
LargeCentralMetro
Large FringeMetro
Small Metro Non-Metrow/ City
Non-Metrow/o City
Perc
ent
SmokingInjection
InhalationOther
SAMHSA DASIS Report, 27, 2006. Large is 1 million or more population; Small is MSA with less than 1 million, & Non-Metro is city of 10,000 or more
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
U.S. Methamphetamine/Amphetamine Admissions by Race/Ethnicity &
Urbanization: 2004
5677 78 86 87
5
3 21 1
28
14 6 411 6 9 7 811
0%10%20%30%40%50%60%70%80%90%
100%
LargeCentralMetro
Large FringeMetro
Small Metro Non-Metrow/ City
Non-Metrow/o City
Perc
ent
OtherHispanic
BlackWhite
SAMHSA DASIS Report, 27, 2006. Large is 1 million or more population; Small is MSA with less than 1 million, & Non-Metro is city of 10,000 or more
> 5835 - 58
< 1212 - 35
No data
Primary Amphetamine/MethamphetamineTEDS Admission Rates: 1997
(per 100,000 aged 12 and over)
Source: SAMHSA
> 5835 - 58
< 1212 - 35
No data
Primary Amphetamine/MethamphetamineTEDS Admission Rates: 2003
(per 100,000 aged 12 and over)
Source: SAMHSA
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
> 5835 - 58
< 1212 - 35
No data
Primary Amphetamine/MethamphetamineTEDS Admission Rates: 2004
(per 100,000 aged 12 and over)
Source: SAMHSA
40%
18%3%
14%
13% 7%
31%
10%4%
9%
Methamphetamine Admissions inU.S. and Mexican Border States: 2003
Areas to Watch• Use of meth on the job (Work Force needs)
• Truckers, day laborers, people working long hours and boring jobs.
• Risky sexual behaviors• Heterosexuals & homosexuals.• Party people • Immigrants/migrants away from home and
families.• Increasing criminal distribution
• Traffickers following the migrant trail.• More organized and criminal gangs.
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
Club Drugs• Problems identified early: MDMA in 1985, GHB
in 1990,Ketamine in 1991, Rohypnol in 1993, but slow responses.
• Research studies underway but are incomplete and can be problematic.
• Use of Internet to obtain information from pro & anti-drug sites (BUT information can be erroneous, untested, outdated, or extreme). And trends move around the world through the Internet.
• Problems testing & identifying various drugs.• Lack of detox & treatment protocols.• Misperception that all club drugs are alike.
Substances Identified by Labs Participating in the National Forensic Laboratory Identification System:
1997-2005
0%
20%
40%
60%
80%
100%
1997
1999
2001
2003
2005
MDMAHeroinMethamphetamineCocaineCannabis
Source: NFLIS
Party Drugs Identified by U.S. Toxicology Labs: 2003-2005
0
2000
4000
6000
8000
10000
12000
14000
LSD MDMA PCP Ketamine GHB, GBL,1-4BD
2003 2004 2005
Source: NFLIS
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
Admissions to Texas Treatment Programs by Primary, Secondary or Tertiary Problem with a Club Drug:
1988-2005
0
100
200
300
400
500
600
700
800
900
1988
1990
1992
1994
1996
1998
2000
2002
2004
EcstasyGHBHallucinogens
KetamineRohypnolPCP
Source: DSHS
Admissions to Texas Treatment Programs With a 1st, 2nd, or 3rd Problem With a Club
Drug: 2005
0%10%20%30%40%50%60%70%80%90%
100%
Ecstasy GHB Halluc PCP Rohypnol
0
5
10
15
20
25
30
35
Ave
rage
Age
White Black Hispanic AgeSource: DSHS
Race/Ethnicity of Texas DSHS Clients Admitted with a Problem with
Ecstasy: 1990-2006
0%10%20%30%40%50%60%70%80%90%
100%
1990
1992
1994
1996
1998
2000
2002
2004
2006
WhiteHispanicBlack
Source: DSHS
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
LSD and Mushrooms
• LSD low dose and more prevalent than we think?
• Mushrooms are more popular than LSD? Need to start watching for them.
GHB, GBL, 1-4BD“Fantasy”
SPECIAL ANNOUNCEMENTS FROM MARK/JLF(updated 12-11-01)
SHOP OUR CATALOGDISCLAIMER AND INFORMATION
"JLF sells poisonous-non-consumable items, consisting of various raw materials and related merchandise used for art, hobby, science, industry, and/or religion. Products include Amanita muscaria ("Fly Agaric") mushrooms, Claviceps purpurea ("Ergot Fungus") sclerotia , Trichocereus pachanoi ("San Pedro") cactus, Psilocybin mushroom spores and kits, Papaver somniferum ("Opium Poppy") pods, Argyreia nervosa ("Hawaiian Baby Woodrose") seeds, Anadenanthera colubrina ("Cohoba") seeds, and many other ethnobotanicals. Also pure compounds such as yohimbine, L-tryptophan, etc."
JLF Poisonous Non-ConsumablesP.O. Box 184Elizabethtown, IN 47232
DISSOCIATIVE DRUGS: PCP, Ketamine, DXMDistort perceptions of sight
and sound and produce feelings of detachment, but not
hallucinations (Zombie effect)
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
Phencyclidine
• PCP, Angel Dust, Killer Weed• Dissolved in embalming fluid or ether (“Fry,” “Amp,” “Water, Water”).
• Swallowed, sniffed, smoked on joints dipped in “Fry”.
• Menthol cigarettes are dipped into liquid PCP or blunts are laced with powdered PCP.
NDARC Study of Ketamine Users*
• N=100; well-educated; older group of party drug users.
• Some had access because in medical field.• Used with MDMA, MDA & amphetamines.• Many had regular negative side effects such
as inability to speak, blurred vision, lack of coordination.
• Issue for warnings: Usually unpleasant side effects seen by some as “positive” and encouraged experimentation.
*Dillon, Copeland, Jansen, Patterns of Use and Harms Associated with Non-Medical Ketamine Use, Drug and Alcohol Dependence 69 2003) 23-28.
What isWhat is DxMDxM? ? DextromethorphanDextromethorphan is a is a psychoactive drug found in common over the counter psychoactive drug found in common over the counter cough medicines.cough medicines.
Source: www.http:third-plateau.lycaeum.org/beginner/index.html
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
•• ““RobotripRobotrip”” –– high dosages can produce high dosages can produce hallucinogenic effects hallucinogenic effects
•• Part of family of psychoactive compounds called Part of family of psychoactive compounds called ““dissociative anesthetics.dissociative anesthetics.””
•• Some effects have been described as similar to Some effects have been described as similar to those of ketamine (Special K) and PCP.those of ketamine (Special K) and PCP.
• The DxM experience is described as occurring on levels, or plateaus depending on the amount of the dose taken.
• Each plateau is different from another. There are 4 major plateaus + a fifth one that is generally unpleasant and involves a possible trip to the hospital
Source: www.http:third-plateau.lycaeum.org/beginner/index.html
DXM Calculator
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
Carisoprodol• “Ds”, “Dance,” Las Vegas Cocktail (with
hydrocodone), “Soma Coma” (with codeine).• Reported as problem by CEWG members in
Washington, South Florida, and Texas.• Texas PCC abuse calls from 1998 to 2003—39%
involved only carisoprodol. More likely males, adolescents, happened at other residences, schools, public areas; serious medical outcomes
• 2004 Texas deaths with mention of carisoprodol: 60% male, 93% white, av. age 41. Only 3 of 87 were just carisoprodol; the rest also involved other substances, especially hydrocodone and alprazolam.
Inhalants
% Texas Secondary Students Who Had Used Inhalants Ever or in the
Past Month, by Grade: 2004
0%
5%
10%
15%
20%
25%
Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12
Lifetime Use Past-Month Use
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
Percentage of Texas Students Who Had Ever Used Inhalants, by Grade and
Number of Different Types Used: 2004
0%
5%
10%
15%
20%
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 1
0
Grade 1
1
Grade 1
2
4+ Types 2-3 Types 1 Type
% Texas Reform & Secondary School Students Who Had Ever Used Specific Inhalants: 2000-2001
61%
41%
17%
14%
13%
11%
7%
6%
8%
6%
2%
2%
4%
4%
5%
8%
0% 10% 20% 30% 40% 50% 60% 70%
Spray Paint
Gasoline
Freon
Octane Booster
Lacquer/Toluene
Aerosol Sprays
Glue
Correction Fluid
Secondary SchoolReform School
Age Groups of Inhalant Abusers As Seen in National Data Sets
46% 52%
21%
16%31%
18%
18%
7%
24%
21% 9%37%
0%
20%
40%
60%
80%
100%
TEDS Tmt.-2004 NSDUH Survey-2005 PY DAWN Eds--2005
12--17 18--25 26--34 35+
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
Occupation by Type of Inhalant Mention, Texas Deaths: 1988-1998
42%49%
16%
37% 5%
4%
10%22%
40%
0%
20%
40%
60%
80%
100%
Freon CHC Toluene
Blue CollarMechanicsStudent
Percent of AIDS Cases Reported by Selected Modes of Exposure: 1987-2005
0%10%20%30%40%50%60%70%80%90%
1987
1990
1993
1996
1999
2002
2005
MSM
IDU
M-M & IDU
Hetero
Texas Male and Female AIDS Cases by Race/Ethnicity: 1999-2005
0%
20%
40%
60%
80%
100%
1987
1989
1991
1993
1995
1997
1999
2001
2003
2005
Hispanic MaleBlack MaleWhite MaleHispanic FemaleBlack FemaleWhite Female
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
WWW.GCATTC.NET
• Anesthesia doses 2-10 mg/km; recreational doses 50-100 mg.
• Unsafe sexual behavior associated with frequent use of Ketamine. Use at gay circuit parties of concern.
• Taken in cyclical binges similar to cocaine or methamphetamine.
• Available as powder to snort or as liquid to inject; used with “puffers” to get exact dosing.
• Users can become psychologically dependent but no evidence of physiologic withdrawal syndrome.
SPECIAL K (Ketamine)
Conclusions from NSDUH: Nonmedical Use of Rx Pain Relievers
• Increases in lifetime users, but current users relatively stable
• Ages 18-25 had highest rates for all pain relievers reviewed
• Little variation in rates across States, regions, metro/non-metro areas
• Most OxyContin users (lifetime) also used other opiates
Source: SAMHSA
Current Trends in Drug Abuse--2006
Jane Maxwell, UT CSWR, 512 232-0610
Conclusions from DAWN: Nonmedical Use of Opioid Pain
Relievers• ED visits in 2004 > 150,000 (131k-185k)
– Oxycodone, hydrocodone, methadone > fentanyl, morphine, propoxyphene
– Polydrug use is typical– About half of oxycodone products are
SR type• Patients aged 21-54 had highest visit rates• Rates vary across metro areas examined• Majority of patients treated and released
Source: SAMHSA