Although still at high levels, cocaine/crack indicators decreased in 10 CEWG sites, remained stable or mixed in 9, and increased in 2 (Atlanta and Seattle). In 2000, rates of emergency room cocaine mentions were higher than those for heroin/morphine in 16 sites, and were higher in all CEWG sites than rates for marijuana and methamphetamine. Adult arrestees were more likely to test positive for cocaine than opiates in 2000; in the sites where both men and women were tested, women were more likely to test positive for cocaine than marijuana. Year 2000 treatment admissions indicated that crack accounted for a substantially greater percentage of primary admissions than powder cocaine in all CEWG sites. However, indicators suggest that crack use has decreased as powder cocaine has become more available in Denver, Miami/South Florida, Phoenix, the Texas border, and Washington, D.C.
CEWG indicators for heroin/morphine abuse increased in 2000 in 15 CEWG sites, remained stable in 2, and decreased in 4. The decreases were reported in Honolulu, Los Angeles, San Francisco, and Seattle-areas where Mexican black tar heroin is the primary type available. Boston, New York, Newark, and Philadelphia report that heroin is relatively cheap, widely available, and of high purity. In 2000, heroin/morphine emergency room mentions were higher than those for cocaine in Baltimore, Newark, San Diego, and San Francisco and higher than rates for marijuana and methamphetmine in eight other CEWG sites. Heroin treatment admissions were especially high in Baltimore (64.3 percent), Boston (69.1 percent), and Newark (83.8 percent), and were more than half of the primary illicit drug admissions in Los Angeles and San Francisco. Among adult arrestees, particularly high rates of opiate-positive tests occurred in Chicago, New York, and Philadelphia. Heroin purity levels are highest east of the Mississippi, where South American heroin dominates.
Misuse of Prescription Opiates
Indicators of the illicit use of prescription narcotics, particularly oxycodone and hydrocodone, increased in all 14 of the CEWG sites that report on these drugs. Emergency room mentions of oxycodone combinations were highest in Philadelphia, Boston, and Phoenix. Mentions for hydrocodone combinations were highest in Los Angeles and Detroit. Deaths involving hydrocodone, oxycodone, or both were reported in Atlanta, Detroit, Miami, Philadelphia, and Texas. Abuse of codeine (in pill and cough syrup forms) was reported as a problem in six CEWG sites, particularly in Detroit.
Marijuana use indicators increased in 12 CEWG sites, remained stable or mixed in 8, and decreased in 1 (Atlanta). Marijuana emergency room mentions, arrests, and treatment admissions have been increasing. In 2000, emergency room mentions for marijuana increased significantly in seven CEWG sites. In Minneapolis, 49 percent of treatment admissions in 2000 were for primary abuse of marijuana; in Miami, New Orleans, St. Louis, and Seattle, marijuana admissions ranged from 31 to 37 percent. Among adult arrestees, the percentage of males testing marijuana-positive were higher than those testing cocaine-positive in 13 CEWG sites.
Methampetamine use indicators increased in six of the seven CEWG areas that typically have high rates of emergency room methamphetamine mentions and/or high percentages of methamphetamine treatment admissions. These are: Denver, Hawaii, Los Angeles, Phoenix, San Diego, and Seattle. Increases in indicators were also reported in Atlanta, Minneapolis/St. Paul, St. Louis, and cities in Texas. San Francisco was the only CEWG site reporting a decrease in methamphetamine indicators in 2000. Sites reporting increases in methamphetamine availability and use, but still at low levels, were New York, Chicago, Detroit, Philadelphia, and Washington, D.C. Methamphetamine treatment admissions were especially high in Hawaii (46.6 percent) and San Diego (45.3 percent). Among adult arrestees in 2000, the highest methamphetamine-positive rates were among men and women in Honolulu, San Diego, Phoenix, Los Angeles, and Seattle. Availability of methamphetamine decreased in Chicago and San Francisco. Purity levels were close to 100 percent in Honolulu and Phoenix.
MDMA (methylenedioxymethamphetamine; often called Ecstasy) indicators increased in 19 CEWG sites in 2000 and remained stable in 2 (New Orleans and Newark). Emergency room mentions increased significantly for MDMA in 14 CEWG sites. Although still small, the number of persons being admitted for treatment of primary MDMA abuse is increasing in Denver, Minneapolis/St. Paul, and Texas. Deaths associated with MDMA were reported in seven CEWG sites. Most MDMA pills are produced in Belgium and the Netherlands, but there have been reports of attempts to establish clandestine MDMA labs in CEWG sites such as Minneapolis, San Diego, and areas of Michigan and South Florida.
Emerging Drugs: PCP
Although PCP indicators suggest abuse of this drug was not widespread in 2000, there was evidence of increased abuse in some CEWG areas. Rates of emergency room PCP mentions increased significantly between 1999 and 2000 in eight CEWG sites. Sites with the highest emergency room PCP mentions were Chicago, Philadelphia, Los Angeles, Seattle, and Washington, D.C. Los Angeles reported 50 PCP-related deaths in 2000 and Philadelphia reported 22.
Treatment admissions for primary PCP abuse accounted for less than 1 percent of admissions in most CEWG sites, but did increase in Newark and Los Angeles. Only small percentages of arrestees tested PCP-positive in 2000, with the highest (4.8 percent) among adult male arrestees in Houston.