United Way of Broward County Commission on Substance Abuse. Drug Abuse Trends in Broward County, Florida Annual Report: June 2015

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1 Drug Abuse Trends in Brward Cunty, Flrida Annual Reprt: June 2015

2 TABLE OF CONTENTS SECTION I. INTRODUCTION... 2 SECTION I A. REPORT HIGHLIGHTS... 2 SECTION I B. AREA DESCRIPTION... 3 SECTION I C. DATA SOURCES... 3 SECTION II. EMERGING DRUGS and PATTERS f DRUG USE... 4 NEW ISSUES and SUBSTANCES with SIGNIFICANT INCREASES in INDICATORS f ABUSE SYNTHETIC CATHINONES ( FLAKKA and MOLLY )... 4 HEROIN and NONMEDICAL USE f PRESCRIPTION OPIOIDS... 7 SYNTHETIC CANNABINOIDS ( FAKE MARIJUANA ) METHAMPHETAMINE/AMPHETAMINES VAPING SECTION III. UPDATE n CONTINUING DRUG USE PROBLEMS MAJOR SUBSTANCES WITH ONGOING but STABLE INDICATORS OF ABUSE COCAINE/CRACK MARIJUANA/CANNABIS NONMEDICAL USE OF PRESCRIPTION BENZODIAZEPINES SECTION IV. APPENDIX with DATA TABLES MS EXCEL WORKSHEETS AVAILABLE ONLINE AT 1

3 Brward Cunty, Flrida Drug Epidemilgy Netwrk Annual Reprt - June 2015 James N. Hall Epidemilgist Center fr Applied Research n Substance Use and Health Disparities Nva Sutheastern University Sectin I. Highlights Synthetic cathinne (e.g., ethylne, alpha-pvp, and methylne) crime lab cases in Sutheastern Flrida during 2014 ttaled 1,811 representing a 46-percent increase ver the previus year and accunting fr 16 percent f such reprts natinwide and 54 percent f thse in Flrida. Alpha-PVP is sld as Flakka in the regin and is attributed t 27 deaths in Brward Cunty between September 2014 and June 2, 2015 and numerus incidents f excited delirium medical emergencies and bizarre behavir. In the first fur mnths f 2015 Brward Cunty crime lab cases fr alpha-pvp (n= 400 +) mre than duble the ttal fr all f 2014 (n=190). An Opiate epidemic invlving herin and the nnmedical misuse f pharmaceutical piids is increasing in Brward Cunty with rising numbers f primary treatment admissins and crime lab cases. Herin deaths increased between 2013 and 2014 as thse fr ther piates declined. Nne-the-less the prprtin f herin cnsequences amng all substances is lwer in Sutheastern Flrida than in mst ther areas f the natin. Synthetic Cannabinid crime lab cases ttaled 228 during 2014 in the three Sutheast Flrida cunties representing a 57-percent increase ver the previus year and just 11 percent f the 2014 reprts Statewide. There were just 2 Pisn Infrmatin Center expsure calls fr THChmlgs in Brward Cunty during calendar year 2014 but 10 in the first fur mnths f Ccaine remains a majr drug prblem acrss the regin and in Brward Cunty, yet there were stable numbers f ccaine-related deaths and treatment admissins between 2013 and While significantly belw the rates and numbers reprted in the US West and the Atlanta, Gergia metr area in the East, methamphetamine deaths, treatment admissins, and crime lab reprts increased in Flrida during 2014 cntinuing a trend in rising cnsequences since Nearly 60 percent f marijuana primary treatment clients in Brward Cunty are belw the age f 18 years. MDMA has dramatically decreased in recent years as the drug detected in ecstasy r Mllys. Benzdiazepine-related deaths have decreased 37-percent Statewide since 2010 and a prjected 73-percent decline in Brward Cunty based n the first half f Injecting drug use (IDU) is the rute f administratin fr 83 percent f herin treatment clients in Brward Cunty and nearly half f thse whse primary drug is a prescriptin piid as well as 24 percent f methamphetamine treatment clients. Increasingly e-cigarette and ther vaprizing devices are reprted fr use f marijuana, methamphetamine, and new psychactive synthetic drugs including alpha-pvp ( Flakka ). 2

4 Sectin I. Area Descriptin The ttal ppulatin f Brward Cunty is 1,784,889. Thse age 21 years r lder cmprise 74 percent f the ppulatin and 26 percent are Hispanic r Latin. White, Nn-Hispanics make up 42 percent f the Cunty s residents while 26 percent are Black, Nn-Hispanic. Asians accunt fr 3.3 percent and 2.3 percent are f ther racial/ethnic grups. The median husehld incme is $51, and 14.3 percent are peple whse incme in the past year was belw the pverty level. The Natinal Survey n Drug Use and Health estimates that there are 78,769 current (past 30-days) users f marijuana in the Cunty and 41,692 current users f an illicit drug ther than marijuana. Sectin IC. Data Surces Flrida Department f Law enfrcement: Flrida Medical Examiners Cmmissin Interim and Annual reprts n Drugs Detected in Deceased Persns in Flrida January June 2014 Flrida Department f Children and Families: Primary Drug Treatment Admissins in Brward Cunty Brward Behaviral Health Calitin: Drug Treatment Admissins in Brward Cunty Flrida Department f Children and Families: Flrida Yuth Substance Abuse Surveys Flrida Agency fr Health Care Administratin: Opiid Pisning Hspitalizatin Cases Flrida Pisn Infrmatin Center expsure calls fr calendar year 2014 and January-April 2015 US Drug Enfrcement Administratin: Natinal Frensic Labratry Infrmatin System (NFLIS): Sutheastern Flrida crime lab cases 2014 data Queried: March 23, 2015 Center fr Disease Cntrl and Preventin: 2011 and 2013 Yuth Risk Behavir Surveys (YRBS) Flrida Department f Health: Diagnsis f HIV and Hepatitis B and C fr Brward Cunty U.S. Census Bureau: : Five-Year American Cmmunity Survey Demgraphic and Sci-Ecnmic Characteristics f the Sutheastern Flrida Metrplitan Statistical Area (MSA) cmprised f Brward, Palm Beach, and Miami-Dade Cunties US Substance Abuse and Mental Health Administratin: Substate Estimates frm the Natinal Survey n Drug Use and Health (NSDUH) The United Way f Brward Cunty s Cmmissin n Substance Abuse Surveillance Supprt Cmmittee and Flakka Cmmunity Actin Team 3

5 Sectin II. Emerging Drugs and Patterns f Drug Use This sectin f the reprt explres new issues and substances with significant increases in their indicatrs f abuse between the tw mst current reprting perids generally 2013 vs Synthetic Cathinnes The mst dramatic emerging drug prblem in Brward Cunty in 2015 is the secnd generatin synthetic cathinne, alpha-pvp, sld using the street name Flakka rather than the term gravel as fund in mst ther parts f the cuntry. Cathinnes are man-made drugs chemically designed t mimic and be mre ptent than the stimulant in the Khat plant fund in Africa and the Middle East. Drugs frm the first generatin f synthetic cathinnes were knwn as bath salt stimulants and are nw illegal as is alpha-pvp. Flakka is a cllquial Hispanic wrd referring t a slender, elegant, and beautiful wman wh charms all. But this charmer is a killer. There have been 27 cnfirmed r presumed deaths amng alpha-pvp users in just Brward Cunty (Ft. Lauderdale area) between September 2014 and June 2, 2015 half f which have ccurred since April 24 alng with 3 deaths frm ethylne, the latest synthetic cathinne t appear. Numerus cases f excited delirium amng Flakka users have been bradcast arund the wrld. Brward Cunty hspitals are reprting up t an estimated 20 alpha-pvp verdse r excited delirium emergency department cases per day since March Excited delirium is a syndrme f seriusly elevated bdy temperature (r hyperthermia) as well as a breakdwn f muscle tissue that leads t the release f muscle fiber cntents int the bld (r rhabdmylysis) and kidney failure. It is ften linked t vilent behavir by paranid users with super human strength wh are cnvinced that are being chased by imaginary animals, plice, r peple wh are trying t kill them. Excited delirium can als result in death. Sld in quantities as small as 1/10 th f a gram fr as little as $3.00 t $5.00 it is highly prfitable fr the dealers whse actual cst is very lw. Alpha-PVP is sld ver the internet frm China fr abut $1,500 per kilgram and shipped by wrld-wide express services t lcal mid-level dealers in packages cntaining frm 1 t 5 kilgrams. A single kilgram prvides up t 10,000 dses at a 1/10 th f a gram which selling fr $5.00 each will yield $50,000 in sales r a prfit f $48,500. Hwever it als requires high vlume in sales. Yet with a retail price f $5.00, mst anyne can affrd it and with a highly addictive drug repeat business is assured. Thus yunger and prer ppulatins are targeted as custmers. It is being actively sld t and by hmeless persns. There were 132 synthetic cathinne deaths in Flrida during 2013 including 31 where the drug was cnsidered t be a cause f death. There were an additinal 72 medical examiner ccurrences in the first half f 2014 with 19 attributed as being the cause f death. As previusly cited, there have been 30 synthetic cathinne deaths (alpha-pvp, ethylne) in Brward Cunty between late 2014 and the end f May

6 In all f Flrida, there were 25 Flrida Pisn Infrmatin Center expsure calls fr alpha-pvp in the first 4 mnths f 2015; these included 13 in Brward Cunty, 10 in Palm Beach Cunty, and 2 calls frm Miami-Dade Cunty. Expsure calls invlve cases usually frm a hspital emergency department where a patient is experiencing adverse cnsequences after smking r ingesting a substance, but the cunt f expsure calls are fewer than the actual number f cases. In Sutheastern Flrida, there were 1,811 crime lab reprts fr synthetic cathinnes in 2014, up frm 1,242 in 2013, 496 in 2012, and 74 in Amng the 2014 crime lab reprts there were 659 fr ethylne, 576 fr alpha-pvp, 471 fr methylne, 53 fr dimethylne (bk-mddma), 24 fr butylne, 17 fr MDPV, 6 fr 4-MEC, 3 fr dibutylne, 2 fr brephedrne (4-BMC). Ethylne and methylne are mstly sld as Mlly capsules. There were nly 86 crime lab cases fr MDMA in 2014 dwn frm 299 in 2011 in Sutheastern Flrida. Statewide the number declined frm 1,352 in 2010 t 150 in

7 Natinally the number f MDMA crime lab cases declined frm ver 23,000 in 2010 t 4,000 in 2014 while synthetic cathinne crime lab cases increase frm 699 t 11,822. 6

8 Herin and Nnmedical Use f Prescriptin Opiids Frm 2000 t 2010 there was a dramatic increase in the availability f diverted pharmaceutical piids and deaths linked t their nnmedical misuse as well as primary piid addictin treatment admissins. The prblems were reprted Statewide with Brward and Palm Beach Cunties having the highest number f cnsequences. Numerus new laws and regulatins tk effect beginning in 2010 alng with the tamper-resistant refrmulatin f high dse extended release piids fr which the cllective impacts are reflected in declining piid deaths beginning in At the same time herin deaths began t increase sharply frm 2012 t 2014 acrss Flrida, rising 403-percent frm 62 in 2011 t a prjected 312 in 2014 based n reprted cases frm the first half f that year. In Brward Cunty, herin deaths increased 633-percent frm 3 in 2011 t 22 prjected fr 2014 based n the first half the year. While herin cnsequences are fewer in Flrida than in ther states and areas f the cuntry, the sharp escalatin in its use, treatment admissin, and deaths in Flrida alng with stable and high levels f prescriptin piid indicatrs cnstitute an piate epidemic. In 2010 there were 6,608 piids detected in deceased persn in Flrida. That tll steadily decline 23-percent t 5,085 by 2013 and then stabilized t a prjected 5,106 piid ccurrences in 2014 based n the first half f that year. Seventy percent f the 2014 deaths are related t 5 f the 11 piids tracked by the Flrida Medical Examiners Cmmissin. Thse 5 are mrphine, xycdne, hydrcdne, methadne, and fentanyl ttaling 1,778 medical examiner ccurrences in the first six mnths f 2014 acrss Flrida and 104 in Brward Cunty. Drug ccurrences include reprts where the drug was detected in a decedent and cnsidered t be present at the time f death plus thse cases when the drug was determined t be a cause f death. 7

9 8

10 There were 5,917 hspital admissins fr nn-fatal piid pisnings (verdses) in Flrida during 2013, the mst current reprting year. Amng these patients 88 percent did nt have a diagnsis f an piid dependency and were cnsidered t be legally prescribed users f these medicatins. There were 401 such hspital admissins in Brward Cunty during 2013 with 83 percent being withut an piid dependency admissin. The number f these hspital admissins peaked in 2011 in the State f Flrida at 6,464 and in Brward Cunty in 2009 with 561 admissins. There were 686 admissins fr piates ther than herin reprted as primary treatment admissins in Brward Cunty during 2014 up frm 586 in 2013 but fewer than 1,260 in 2012 and 1,459 in The 2014 admissins accunted fr 10.7 percent f all addictin treatment primary admissins. Females accunted fr 56 percent f the prescriptin piid treatment clients and 15 percent were between 18 and 25 years f age, 32 percent were aged 26-34, and 23 percent were 35 and lder, yet the age f 30 percent f these clients was nt reprted. Injecting drug use was the primary rute f administratin fr half f these clients. Herin accunted fr an additinal 3.3 percent f the 2014 primary admissins fr a cmbined rate f 14 percent fr all piates (herin and piids) dwn frm 27 percent in

11 There were 1,774 prescriptin piid crime labratry reprts, r 6 percent f the 26,992 ttal primary, secndary, and tertiary NFLIS reprts fr Miami-Dade, Brward, and Palm Beach Cunties cmbined in This categry f drugs ranked furth amng all substances analyzed in the three cunties in The number f prescriptin piid crime labratry reprts increased 87-percent between 2013 and In the first six mnths f 2014 there were 156 herin-related deaths acrss Flrida including 11 in Brward Cunty. The lcal herin decedents included 1 wh was aged 18-24, 4 between 25 and 34 years f age, 4 aged 35-50, and 2 mre lder than 50. There were an additinal 39 mrphine deaths in Brward Cunty in the first half f Because herin rapidly metablizes t mrphine in the bdy, it is pssible that many f the mrphine deaths may be related t herin abuse. 10

12 There were 212 admissins fr herin reprted as primary treatment admissins in Brward Cunty during 2014, up frm 128 in 2013 but fewer than the 292 in Males accunted fr 57 percent f the lcal herin clients in One patient was under 18 years f age and 19 percent were between 18 and 25 years f age, 46 percent were 26-34, and 34 percent were aged 35 and lder. Injecting was the primary rute f administratin fr 83 percent f the hern clients. There were 1,333 herin crime labratry reprts, r 5 percent f the 26,992 ttal primary, secndary, and tertiary NFLIS reprts fr Miami-Dade, Brward, and Palm Beach Cunties cmbined in This categry f drugs ranked sixth amng all substances analyzed in the three cunties in The number f herin crime labratry reprts increased 44-percent between 2013 and Synthetic Cannabinids The availability f unregulated synthetic cannabinids increased via retail sale thrughut 2010 and the first half f Their use was mstly amng thse wh were subject t frequent drug testing that did nt identify these prducts. Hwever, drug tests are nw available fr their detectin fr sme but nt all f these ever changing substances. Als, the five synthetic cannabinids that were federally scheduled in 2011 were made illegal by the 2011 Flrida Legislature, which als banned ther cannabinids in There were 175 expsure calls statewide t Flrida Pisn Infrmatin Centers in 2014 fr varius synthetic cannabinids (e.g., K2 r Spice ), dwn frm 194 in 2013 and 537 in 2012 and 517 calls in Amng the calls in 2014, 25 were frm Miami-Dade Cunty, 2 were frm Brward Cunty, and 3 were frm Palm Beach Cunty. In the first 4 mnths f 2015, there were 88 pisn expsure calls fr synthetic cannabinids in all f Flrida as cmpared t 34 in the first fur mnths f 2014 and 78 in the 11

13 same time perid during Of the expsure calls frm January thrugh April 2015, 14 were frm Miami-Dade, 10 were frm Brward, and 1 was frm Palm Beach Cunty. Natinally there have been 1,900 Pisn Infrmatin Center expsure calls fr synthetic cathinnes between January and April 2015 with high numbers reprted in Luisiana, Mississippi, and Alabama. There were als 2 Synthetic Cannabinid deaths in the first half f 2014 acrss Flrida with 1 f the ccurrences being cnsidered a cause f death cmpared t 26 such ccurrences in calendar year 2013 f which 13 were cnsidered t be a cause f death, Acrss all f Flrida the number f crime lab reprts fr synthetic cannabinids increase frm 9 in 2010 t 1,996 in Jn Sutheastern Flrida there were 228 crime lab reprts fr synthetic cannabinids in 2014, up frm 145 in 2013, 190 in 2012, and 19 in Amng the 14 different synthetic cannabinids reprted in 2014 were 88 items fr XLR-11, 55 fr AB-Fubinaca, 26 fr PB-22, 20 fr Tetrahydrcannabinls, 17 fr AB-Pinaca, 5 fr AB-Chminaca, 5 fr UR-144, 3 fr 5-Flur AMB, 3 fr THJ 2201, 2 fr AM-2201, as well as ne each fr 5F-PB-22, AKB48 N, JWH-018, and JWH-122. Methamphetamine/Amphetamines Indicatrs f methamphetamine abuse reflect cntinuing increases in the drug s use in 2014 and 2015, yet remained at lw levels relative t ther substances and ther areas f the natin. Methamphetamine was cited as the primary drug fr addictin treatment by 76 clients in 12

14 Sutheastern Flrida during Hwever private treatment cunselrs cntinued t reprt a resurgence in methamphetamine abuse amng men wh have sex with men beginning in It is suspected that the methamphetamine being used lcally is prduced in Mexic. Dmestic clandestine labratry prductin in Flrida mstly appears still t be in the nrth and central parts f the State using the 2-liter sda bttles shake and bake methd that yields a relatively small amunt f methamphetamine fr persnal use by the ck and fr sharing with thse wh may have helped supply the precursr, pseudephedrine. Methamphetamine was detected amng 109 deceased persns during the first half f 2014 statewide in Flrida, cmpared with 81 in the first half f 2013 and 169 fr the full year f Methamphetamine was cnsidered a cause f death in 40 (37 percent) f the cases during the first half f There were als 132 reprts f amphetamine detected amng decedents acrss Flrida in the first 6 mnths f 2014, cmpared t 111 such ccurrences in the first half f Amphetamine was cnsidered the cause f death in 28 (r 21 percent) f the cases in the first half f There were 37 primary treatment admissins fr methamphetamine in Brward Cunty during Males accunted fr 84 percent f the clients. One f the patients was belw 18 years f age; 16 percent were between 18 and 25, 38 percent were between 26 and 34 while 43 were age 35 r lder. There were als 28 primary treatment admissins fr amphetamine in Brward Cunty during There were 387 methamphetamine crime labratry reprts, r 1 percent f the 26,992 ttal primary, secndary, and tertiary NFLIS reprts fr Miami-Dade, Brward, and Palm Beach Cunties cmbined in Methamphetamine ranked seventh amng all substances analyzed in the three cunties in The number f methamphetamine crime labratry reprts increased 83-percent between 2013 and There were als 306 amphetamine crime labratry reprts, r 1 percent f the 2014 ttal ranking eighth amng all substances and representing a 410-percent increase frm the 60 amphetamine crime lab reprts in Vaping The Oxfrd English Dictinary s wrd f the year fr 2014 was vape used t describe inhaling and exhaling vaprs prduced by an electrnic cigarette r similar device. Usage f the wrd dubled last year. While mst use f vaprizing devices are fr liquid nictine, illicit drug are increasing being vaped including marijuana, methamphetamine, alpha-pvp ( Flakka ), crushed and liquefied pharmaceuticals. An even mre advanced vaping deliver system fr marijuana wax r budder is called dabbing and uses a special water pipe with metal that can withstand extreme temperatures frm a prpane trch. 13

15 - Sectin III. Update n Cntinuing Drug Use Prblems This sectin f the reprt mnitrs the mst current available data n issues related t majr substances with nging but generally stable indicatrs f abuse between the tw mst current reprting perids 2013 vs Ccaine/Crack The prprtin f indicatrs fr cnsequences f ccaine use in Sutheastern Flrida as cmpared t ther drugs cntinues t be amng the highest rates in the Natin. The relatively steady decline in ccaine prblems frm 2007 t 2010 stabilized thrugh Hwever the numbers f deaths in which ccaine was detected increased in all f Flrida in the first half f 2014 as well as in Brward and Palm Beach Cunties while remaining stable in Miami-Dade Cunty. The percent f deaths cnsidered t be caused by ccaine amng the ttal number f cases where the drug was detected als increased acrss the State and in the regin. Bth the number and prprtin f primary treatment admissins fr ccaine amng all substances increased in Miami-Dade Cunty between 2013 and 2014 while remaining stable in Brward Cunty. The majrity f ccaine-related deaths and addictin treatment admissins were amng thse lder than 35 years. Many f the indicatrs reflected ccaine use in cmbinatin with ther drugs, including a significant majrity f ccaine-related deaths in Flrida and the three Sutheastern cunties. 14

16 There were 51 deaths related t ccaine abuse in Brward Cunty in the first half f 2014, fr an annualized rate f 102 ccurrences, similar t the 105 in all f Ccaine was fund in cmbinatin with anther drug in 80 percent f the 2014 cases. Ccaine was detected at a lethal level in 71 percent f the Brward Cunty cases in the first half f One f the 2014 ccainerelated fatalities was yunger than 18; 12 percent were age 18 25; 25 percent were 26 34; 37 percent were 35 50; and 24 percent were lder than 50. Brward Cunty s number f ccaine-related deaths ranked fifth amng the 24 medical examiner districts in the State during the first half f In Brward Cunty, there were 298 primary admissins fr ccaine smking (crack) and an additinal 173 fr pwder ccaine, accunting fr a ttal f 471 (r 7.4 percent) f the 6,382 publicly funded primary treatment admissins prgrams (including 929 fr alchl) in These ttals represent a mdest decrease in the prprtin f ccaine primary admissins frm 2013 (n=478), when ccaine accunted fr 8.8 percent f all admissins. Males accunted fr 62 percent f the 2014 clients; 61 percent (n=286) were age 35 r lder; and 4 percent (n=19) were age 17 r yunger. Ccaine cntinued t be the mst cmmnly analyzed substance by lcal crime labratries. It accunted fr 8,942 NFLIS reprts, r 33 percent f the 26,992 ttal primary, secndary, and tertiary crime labratry reprts fr Miami-Dade, Brward, and Palm Beach Cunties 15

17 cmbined in This represents a 12-percent decline cmpared t the 10,147 ccaine crime labratry reprts in Prjectins frm the Natinal Survey n Drug Use and Health (NSDUH) Substate Data estimate that there were 24,271 users f ccaine in the past year aged 12 and abve living in Brward Cunty r 8.5 percent f the estimated 283,287 past year ccaine users Statewide. Marijuana/Cannabis Marijuana remains the number ne primary substance fr addictin treatment in Brward Cunty in 2014 and ranks secnd after alchl in Miami-Dade and third in Palm Beach Cunty behind alchl and prescriptin piids. Treatment admissins fr marijuana in prprtin t ther substances declined in Brward and Miami-Dade Cunties between 2010 and 2014, a trend bserved natinally. Cnsequences f marijuana use and addictin cntinued at high levels, particularly amng adlescents and yung adults. Cannabinids were detected in 492 deaths statewide in Flrida during the first half f 2014, a 23-percent increase frm the 401 ccurrences during the first six mnths f One f the ccurrences was cnsidered t be a cause f death. In Brward Cunty, there were 2,578 primary admissins fr marijuana during 2014 (r 40 percent) f the 6,382 primary treatment admissins. The 2014 prprtin f marijuana admissins was belw that frm 2013, when the drug accunted fr 46.4 percent f all admissins. Males accunted fr 72 percent f the 2013 clients; 59 percent were yunger than 18; 22 percent were age 18 25; 13 percent were 26 34; and 6 percent were 35 r lder. Cannabis/THC (tetrahydrcannabinl) accunted fr 4,587 crime labratry reprts, r 17 percent f the 26,992 ttal primary, secndary, and tertiary NFLIS reprts fr Miami-Dade, Brward, and Palm Beach Cunties cmbined in This ttal decreased 13-percent frm the number f marijuana crime labratry cases in As in previus years, marijuana ranked secnd amng all substances analyzed in the three cunties. Prjectins frm the NSDUH estimate that there were 78,769 current (past 30 day) marijuana users aged 12 and abve living in Brward Cunty. The estimate fr Miami-Dade and Mnre (The Flrida Keys) Cunties was 106,346 and an additinal 59,321 in Palm Beach Cunty fr a ttal f 244,436 fr these fur Sutheastern Flrida cunties r 25.8 percent f the 947,386 past mnth users Statewide. The average annual number f first time marijuana users ttaled 59,955 in the fur Sutheastern Flrida cunties accrding t the NSDUH Substate Data. There were n significant difference in the current use f marijuana amng high schl students between 2011 and 2013 in the Sutheastern Flrida MSA accrding t the Yuth Risk Behavir Survey results. Hwever, the Flrida Yuth Substance Abuse Surveys revealed the rate f Brward Cunty high schl students reprting past 30 day use f marijuana increased frm 15.3 percent in 2010 t 19 percent in 2012 and then declined t 16 percent 16

18 in The rate fr middle schl students remained relatively stable frm 2010 t 2014 while ging frm 4.3 percent in 2010 t 3.7 percent in 2012 and then back up t 4.1 percent in Nnmedical Use f Prescriptin Benzdiazepines Benzdiazepines in general and specifically alprazlam (Xanax ) cntinued as a substantial prblem in Sutheastern Flrida, particularly when used nn-medically in cmbinatin with ther pharmaceuticals, alchl, and illicit drugs. There were 1,954 reprts f a benzdiazepine present in deceased persns acrss Flrida in the first half f 2014, representing a 15-percent decrease in the ttal number (n=2,287) f benzdiazepine ccurrences cmpared with the first half f 2013 and a 25-percent decrease since the first half f 2012 (n=2,622). The prjected 3,908 Flrida benzdiazepine deaths fr all f 2014 represent a 37-percent decline frm the 6,188 ttal in Of the benzdiazepine ccurrences in the first half f 2014, 41 percent were cnsidered a cause f death. Amng the benzdiazepine medical examiner (ME) reprts statewide, 577 were attributed t alprazlam, 302 t nrdiazepam (Nrdaz ), 270 were fr diazepam (Valium );

19 fr temazepam (Restril, and Nrmisn ), and 574 were attributed t benzdiazepines. 6 ther Acrss the 3 cunties f the Sutheastern Flrida MSA, there were 125 reprts f alprazlam detected in deceased persns during the first half f 2014, f which 52 percent were cnsidered lethal. There were als 62 reprts f diazepam detected in deceased persns with 42 percent cnsidered t be the cause f death. Brward Cunty reprted 29 alprazlam deaths and 13 fr diazepam in the first half f 2014 fr a prjected ttal f 84 fr the entire year representing a 73- percent decline frm the 2010 annual ttal (n=315). There were 101 admissins fr benzdiazepines reprted as primary treatment admissins in Brward Cunty, 99 in Miami-Dade Cunty and 143 in Palm Beach Cunty during Females accunted fr 61 percent f the 2014 benzdiazepine clients in Brward Cunty and 56 percent f clients acrss the regin. Prescriptin benzdiazepines accunted fr 1,521 crime labratry reprts, r 6 percent f the 26,992 ttal primary, secndary, and tertiary NFLIS reprts fr Miami-Dade, Brward, and Palm Beach Cunties cmbined in This categry f drugs ranked fifth amng all substances analyzed in the three cunties in The number f prescriptin benzdiazepine crime labratry reprts increased 79-percent between 2013 and

20 Drug Abuse Trends in Brward Cunty, Flrida: June 2015 Appendix MS EXCEL WORKSHEETS AVAILABLE ONLINE AT Demgraphic and Sci-Ecnmic Characteristics Prevalence f Drug Use Natinal Survey n Drug Use and Health (NSDUH) Substate Data Prevalence f Drug Use by Age Grups NSDUH Substate Data Prevalence f Drug Use Brward High Schl Students Yuth Risk Behavir Survey (YRBS) Trends in Treatment Admissins by Primary Drug Brward Cunty Prfile f 2014 Treatment Admissins by Primary Drug in Brward Cunty CDC&P Drug Pisning Deaths Opiid Pisning Hspitalizatin with and withut a Dependency Diagnsis HIV/AIDS and Hepatitis Cases HIV/AIDS and Hepatitis Cases by Transmissin Categry Natinal Frensic Labratry Infrmatin System (NFLIS) Crime Lab Cases NFLIS Crime Lab Cases fr Nvel Psychactive Drugs (NPS) Synthetic Cathinnes, Cannabinids, and Phenethylamines Drug-Related Deaths reprted by Flrida Medical Examiners Cmmissin January t June 2014 Flrida Pisn Infrmatin Center Expsure and Infrmatin Calls 2014 and January-April

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