The Community Epidemiology Work Group (CEWG) — a network of local substance abuse experts — reported semiannually on drug trends and emerging issues in major metropolitan areas and several states across the United States, and was supported by the National Institute on Drug Abuse (NIDA) from 1976 to 2014. Area representatives reported the most recent drug use trends for three counties in California — San Diego, San Francisco and Los Angeles — for the first half of 2013 in the January 2014 Epidemiologic Trends in Drug Abuse.
Although the CEWG is no longer active, the latest Epidemiologic Trends in Drug Abuse report identified and assessed emerging drug abuse patterns, trends and issues for specific drugs of abuse (e.g., prescription opioids, heroin, cocaine, etc.). One of the key findings of this report was the gradual increase in heroin abuse in San Diego County. The “gradual increases in all heroin indicators, accompanied by a growing local concern about overdose deaths involving heroin and morphine and transitions by users from prescription opioids to heroin,” said Karla D. Wagner, Ph.D., assistant professor at the University of California, San Diego (UCSD).
In addition, notable increases in methamphetamine abuse occurred in Los Angeles, San Diego and San Francisco in the first half of 2013 compared to the previous year. There was a continuing decline in cocaine abuse in the Bay Area, and continuing low, stable cocaine indicators in San Diego, for the first half of 2013. On the other hand, cocaine indicators were mixed for Los Angeles — about 7 percent of drug treatment admissions were due to crack or powder cocaine abuse or dependence and 18 percent of all drugs seized and analyzed by the National Forensic Laboratory Information System (NFLIS) contained cocaine — in 2013.
The National Drug Early Warning System
The National Drug Early Warning System (NDEWS) was established in August 2014 and continues to monitor drug trends in many of the CEWG’s former sentinel community sites and reports national drug trends as new issues emerge. Annual reports prepared by Sentinel Community Epidemiologists (SCEs) provide an overview of drug use, emerging drugs and patterns of drug use for each of the 12 Sentinel Community Sites (SCS), including Los Angeles County and San Francisco. The most recent NDEWS Sentinel Community Site Profile 2015 reports for San Francisco and Los Angeles County indicated that there were several unique differences in drug abuse trends and drug-related problems for Northern and Southern California in 2014.
Drug abuse trends in Los Angeles
In Los Angeles County, the most frequently reported illicit substances were marijuana, heroin and methamphetamine, according to Mary-Lynn Brecht, Ph.D., a research statistician for the University of California, Los Angeles (UCLA). Based on the data from the 2010-2012 National Survey on Drug Use and Health (NSDUH), 21 percent of Los Angeles County residents over the age of 12 reported binge drinking, 8 percent reported marijuana use and 3 percent reported illicit drug use in the past month. Five percent of Los Angeles County residents over the age of 12 reported taking pain relievers for nonmedical reasons and two percent reported using cocaine in the past year. Seven percent of Los Angeles County residents abused or were dependent on alcohol and 3 percent abused or were dependent on illicit drugs.
Treatment admissions substantially declined from 2013 to 2014, although drug treatment admissions for heroin and methamphetamine increased from the previous year. There were a total of 32,826 substance abuse treatment admissions in 2014, and the primary drugs of abuse at admissions were:
- Heroin (30.1 percent)
- Methamphetamine (24.6 percent)
- Marijuana (17.5 percent)
- Alcohol (16.0 percent)
Of all drugs seized and analyzed by law enforcement in Los Angeles County in 2014 by the National Forensic Laboratory Information System (NFLIS), the majority of drug reports (38.5 percent) were for methamphetamine, followed by cannabis (28.2 percent), cocaine (15.4 percent), heroin (6.5 percent) and 3,4-methylednedioxymethamphetamine (MDMA) (1.1 percent).
Brecht reported that the high availability of methamphetamine and prevalence of methamphetamine-related problems (e.g., substance abuse treatment admissions) continued to be problematic for Los Angeles County, accounting for the largest percentage of drugs seized and identified by law enforcement seizures and that methamphetamine was the primary drug responsible for nonfatal emergency department visits in Los Angeles County in 2014.
Drug abuse trends in San Francisco
In the City and County of San Francisco (CCSF), opioids, methamphetamine, cocaine and alcohol use remained the most problematic substance of abuse, reported Phillip O. Coffin, M.D., M.I.A., the director of Substance Use Research in the Center for Public Health Research at the San Francisco Department of Public Health. Based on the 2010-2012 NSDUH data, 25 percent of CCSF residents over the age of 12 reported binge drinking, 13 percent reported marijuana use and five percent reported other illicit drug use in the past month. Four percent reported cocaine use and 5 percent reported the nonmedical use of prescription pain relievers in the past year.
Eleven percent of residents abused or were dependent on alcohol and 3 percent abused or were dependent on illicit drugs. Heroin has been growing as a major problem in San Francisco since 2011, as evidenced by an increase in the number of substance use treatment admissions due to heroin as well as the number of NFLIS drug reports for heroin seizures and overdose reversals with naloxone.
There were a total of 10,689 substance abuse treatment admissions in CCSF in 2014, and the most frequent cause of substance use treatment admission was alcohol, with 2,500 treatment episodes per year. The major primary drugs of abuse reported at admissions were:
- Heroin (n = 4,045)
- Alcohol (n = 2,378)
- Methamphetamine (n = 1,524)
- Cocaine/Crack (n = 1,205)
Of all drugs seized and analyzed by law enforcement in 2014, 29 percent of all NFLIS reports were for opioids and one-third of those reports were for heroin. Following cannabis, the second-most detected drug in NFLIS items seized and analyzed was methamphetamine. In San Francisco, the most frequent cause of admissions to substance use treatment was alcohol, with about 2,500 treatment episodes per year.
Overall, these drug abuse trends and emerging patterns indicated that alcohol and drug abuse is a considerable problem in both Northern and Southern California. While these key findings indicate that there were significant differences in the drug abuse patterns and trends reported for Los Angeles and San Francisco, in San Diego, illicit drug abuse or dependence remains one of the most significant causes of morbidity and mortality in the state of California, leading to hospitalizations, chronic medical problems and death when left untreated.
Sovereign Health of California offers comprehensive behavioral health treatment programs for patients with alcohol and drug addiction. For more information about the treatment programs offered at Sovereign Health of California, please contact our 24/7 helpline to speak to a member of our team.
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About the author
Amanda Habermann is a writer for the Sovereign Health Group. A graduate of California Lutheran University, she received her M.S. in clinical psychology with an emphasis in psychiatric rehabilitation. She brings to the team her background in research, testing and assessment, diagnosis and recovery techniques. For more information and other inquiries about this article, contact the author at firstname.lastname@example.org.
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