Issues Impacting
Broward Youth
September 2014
Drug Abuse Patterns and
Trends Update
James N. Hall, Epidemiologist
Center for Applied Research on
Substance Use and Health Disparities
Nova Southeastern University
Alcohol Use in Past 30-Days
% 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
48 alcohol in a row within a couple of hours in past 30-days
44 44 44
44
40
42
38
43 41
18%
37
30
22
20
23
17
20 21 20
18
21 21
1 Drink
5+ Drinks
18
14
8%
1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013
Source: CDC Youth Online High School YRBS Broward County, FL 1991-2013
BrowardPrevention.org
Current (past 30-day) Alcohol Use Among
% Reporting Current Use
Broward County Middle and High School Students
2000-2012
50
45 44
40
35
30
25
19.8
20
15
10
5
0
2000
39.9
20.1
36
34.1
34.1
31.3
24
18.7
High School
2002
37.3
2004
16.8
14.8
Middle School
2006
2008
2010
11.2
2012
Source: Florida Youth Substance Abuse Surveys 2000-2012
Current (past 30-day) Binge Drinking Among
Broward County Middle & High School Students
2000-20012
% Reporting Current Use
25
22.8
20
20.3
17.2
17
15
10
18.8
16.8
16.8
High School
8.9
6.9
Middle School
8.8
5.6
5
5
4.4
4.4
0
2000
2002
2004
2006
2008
2010
2012
Source: Florida Youth Substance Abuse Surveys 2000-2012
Current Alcohol Use Among Broward
Middle and High School Students
by Gender 2000-2012
% Reporting Use Past 30 Days
34
32
32.8
30.8
Female
30.9
30
28
Male
30.3
29.6
28.5
28.4
28.8
27
27.8
26
26
24.8
24
24.4
22
21.2
20
2000
2002
2004
2006
2008
2010
2012
Source: Florida Dept. of Children & Families
Florida Youth Substance Abuse Surveys 2000-2012
Age of Alcohol Onset and
Any Lifetime Alcohol Dependency
% Alcohol Dependent
among Adults Aged 18 and Older
50%
47% 45%
38%
40%
32%
30%
28%
20%
15%
17%
10%
11% 9%
0%
13
14
15
16
17
18
19
20
21
Age Began Drinking
Source: National Epidemiologic Survey on
Alcohol and Related Conditions Sample = 43,093
Percent of Broward County High School Students
Reporting Alcohol Use by Age 13 or Younger
2000-2012
% Reporting Use by Age 13
45
40
40.7 38.4
36.9
40.1
35
More than a
Sip or Two
31.8
30
25.5
24
25
20
15
10
8.7
6.5
5.8
5.9
5.5
5
4.6
4.9
Drinking at
least Once a
Month
0
2000
2002
2004
2006
2008
2010
2012
Source: Florida Youth Substance Abuse Surveys 2000-2012
Marijuana Data Bank
2014
•
•
•
•
Consumption
Consequences
Contributing Factors
Colorado
Types of Drugs Used by Past Month
Illicit Drug Users Aged 12 or Older: 2013
Source: 2013 National Survey on Drug Use and Health
Marijuana
Only
n= 15,728,000
16.6
%
64.0
%
19.4
%
Marijuana
and Some
Other Drug
n= 4,082,000
Only Drug is
Other Than
Marijuana
n= 4,763,000
24,573,000 Illicit Drug Users (9.4%)
Annual Numbers of New Users of
Marijuana USA: 1966-2012
Sources: National Household
Survey on Drug Use 1966-2001
and National Survey on Drug
Use and Health 2002-2012
Thousands of New Users
4,000
1973
3,500
1978
3,000
2012
2.4 million
2001
2,500
All Ages
2,000
Under 18
1,500
57.3 %
(1.4 million
1,000
1990
500
in 2012)
0
1966
1971
1976
1981
1986
1991
1996
2001
2006
2011
Percent Reporting Current Use
Percent of High School Students Reporting Any Past 30-Day
Marijuana Use
USA & Broward County: 1991-2013
30
26.7
26.2
25.3
23.9
23.7 23.1 23.4
25
22.4
20.2 19.7
22.9
22.1
21.8
20
17.7
20.8
20.9
14.7 17.9 19.1 19
17.9 17.3 17
15
10
13.5
Broward
USA
5
0
1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013
Source: Centers for Disease Control and Prevention: Youth Risk Behavior Surveillance
Past 30 Day Use of Marijuana among Broward County high school Students
From YRBS (Odd # Years) and FYSAS (even # Years) 1999-2013
23.7
% of high School Students reporting Past 30 Day Use
25
20.9
20
22.9
22.1
21.8
17.9
17.3
17
19
15
17.2
13.9
10
5
0
14.5
14
11.4
FYSAS
YRBS
15.3
Sources: Youth Risk
Behavior Surveillance
System (US CDC&P)
and Florida Youth
Substance Abuse
Survey (FL-DCF)
Percent of Broward High School Students Reporting Any Past
30-Day Marijuana Use
By Demographic Groups: 2009-2013
Percent Reporting Current Use
35
30
25
Hispanic
29.9
28.4
27.6
23.7
20
19.9
15
15.8
27.9
27.2
25.7
22.1
17.9
27
26.7
24.5
22.9
18.8
18.4
15.1
White Non-Hispanic
Male
All HS Students
Female
Black Non-Hispanic
10
2009
2011
2013
Source: Centers for Disease Control and Prevention: Youth Risk Behavior Surveillance
Current (past 30-day) Marijuana Use Among Broward
% Reporting Current Use
County Middle and High School Students
2000-2012
20
18 17.2
16
14
12
10
8
4.5
6
4
2
0
2000
19
13.9 14.5
14
15.3
11.4
High School
5.2
Middle School
5
2.5
2002
2004
2006
4.3
3.5
3.7
2008
2010
Source: Florida Youth Substance Abuse Surveys 2000-2012
2012
Percent of Broward County High School Students
Reporting Marijuana Use by Age 13 or Younger
2000-2012
% Reporting Use by Age 13
18
16.7%
16
14
11% 10.5%
9.4%
12
10
9.7%
8.1% 8%
8
6
4
2
0
2000
2002
2004
2006
2008
2010
2012
Source: Florida Youth Substance Abuse Surveys 2000-2012
Addiction is a Developmental Disease:
It Starts Early
57%
100
36%
Percent of
First Time
Marijuana
Users
By Age
5.5%
10
1.5%
1
Child
Teen
<12
12-17
Young Adult
18-25
Adult
>25
Source: US Dept HHS: SAMHSA National Survey on Drug Use & Health 2011
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.)
% Past Year Depdence/Abuse
Percent of Past Year Drug Dependence or Abuse
Among Adults Aged 18 or Older
By Age of First Marijuana Use: 2011
14%
12.7%
12%
14 Years or
Younger
10%
8%
18 or Older
6%
4%
2.2%
2%
0%
14 yrs. Or Younger
18 or Older
Age of First Marijuana Use
Source: SAMHSA-National Surveys on Drug Use and Health 2011
Percent of Past Year Serious Mental Illness
Among Lifetime Marijuana Users Aged 18 or Older
By Age of First Marijuana Use: 2002 and 2003
Before 12 Yrs
25%
% Past Year SMI
21.0%
20%
12-14 Yrs
15-17 Yrs
17.4%
18 or Older
15%
12.2%
10.5%
10%
5%
0%
< 12 yrs.
12-14 yrs.
15-17 yrs. 18 or Older
Age of First Marijuana Use
Source: SAMHSA-National Surveys on Drug Use and Health 2002-2003
Perceived Attitudes about Marijuana Among
Broward County Middle and High School
% Reporting Current Use
Students 2000-2012
100
90
80
70
60
50
40
30
20
10
0
Wrong to Smoke Marijuana
Seen as Cool to Use
80.5
58
29.9
81
81.3
58.2
61.4
29.4
10.5
12.4
2000
2002
33.3
10.9
2004
Regular Use Harmful
Trying Marijuana Harmful
84.5
80.9
80.3
74.4
65.1
58.9
36.1
54.8
48
31.4
9.8
11.3
2006
2008
30.6
25.7
15.7
14.9
2010
2012
Source: Florida Youth Substance Abuse Surveys 2000-2012
Percent of high school students having ridden
or driven in the past 30 days with or as driver
having used marijuana or alcohol
RODE with Driver who had used
marijuana or alcohol
% Reporting
25
Marijuana
25.4
Alcohol
27.0
24.5
21.4
20
Alcohol
25
20.5
18.4
15
10
20
15
10
5
5
0
0
Florida
Marijuana
30
% Reporting
30
DROVE after using marijuana or
drinking alcohol
Miami-Dade Broward
11.2
10.8
8.1
Florida
9
10.9
7
Miami-Dade Broward
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
20%
18%
16%
14%
12%
10%
8%
6%
4%
2%
0%
15.1 %
12.4 %
5.3 %
Florida
Lifetime
Broward
Lifetime
3.9%
Florida Past Broward Past
30 Days
30 Days
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)
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 Medicine
US Food and Drug Administration
• Clinical Trials
• FDA Medical Review
• FDA Medical Panel Approval
Kevin Sabet, Ph.D.
Or Go To
www.youtube.com and
Search “Commission on
Substance Abuse”
Responding to
an Epidemic
Rx Nonmedical Use in Florida
2000 -2013
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
CS-II Dispensing Limits & OxyContin Tamper Resistant
# “Cause of Death” Occurrences
900
801
715
800
652
700
600
500
476 465
400
337 336
533
380
640
Strike Force
House Bill 7095
Takes effect
607
340 336 358
300
176
200 153 147 160 142 139
100 141 129 136 129
152
110
0
Oxycodone
Methadone
350 392 343
279
274
341
239
268 Morphine
201 176
238 221
144
136 171 118
126 158
Hydrocodone
Source: FDLE – Drugs Identified In Deceased Persons by Florida Medical Examiners
Jan 2008 - Jun 2013 Reports
# of Drugs Detected Among Decedents
Number of Nonmedical Rx Opioids and
Benzodiazepine Reports Detected among Decedents
in Florida 2005 – 2x1h2013
7,000
6,000
5,000
4,000
3,000
2,000
1,000
Opioids
6,608 6,333
6,006
Benzodiazepines
5,454
5,489
6,188
5,059
5,947
5,290
4,416
4,035
5,184
4,574
4,340
Strike
4,167
Force
2,973 3,339
2,608
House Bill 7095
CS-II Dispensing Limits and
OxyContin Tamper Resistant
Takes effect
0
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
3,000
2,864
5 Prescribers &
5 Pharmacies
51-%
Decrease
Level 5
1,097
500
514
Level 7
1,415
Level 6
427
Level 8
Source: 2012-2013 Annual Report
Florida’s Prescription Drug
Monitoring Program (PDMP)
Levels 9,
10
15
178
Hydromorphone (e.g., Dilaudid®)
2013 ARCOS Grams Sold
Per 100/Population
1 FLORIDA
2 DELAWARE
3 VERMONT
GRAMS/
100K POP
270,718.70 1,439.89
500
414
10,501.64 1,169.53
6,099.61
974.78
4 CONNECTICUT
34,362.81
961.44
5 VIRGINIA
67,026.15
837.72
400
# of Deaths
STATE
TOTAL
GRAMS
Hydromorphone
Related-Deaths in
Florida
253
300
200
199
212
213
6 MONTANA
NEW
7 HAMPSHIRE
8,049.45
813.56
10,389.74
789.21
8 MARYLAND
43,353.71
750.9
9 WASHINGTON
48,346.19
718.95
2008 2009 2010 2011 2012
10 OREGON
27,172.92
709.28
Source: Florida Medical
Examiners Commission
Source: US DEA ARCOS 3 Report 4 March 5, 2014
100
0
# Heroin Occurrences
Exhibit 5
400
350
300
250
200
150
100
50
0
Number of Heroin-related Deaths
in Florida: 2000 – 2x1h2013
Florida
328 326
276
Miami-Dade
261
Broward
180
122
61
17
53 50
49
46
32
39
35
96
22 20
18 17
13
110
132
111
117
58
26
38
30
26
4
17
8
5
62
15
3
140
33
36
9
4
SOURCE: Florida Medical Examiners Commission Reports 2000-2013
Top 10 Most Frequently Identified Drugs of Total Reports
from South Florida Crime Labs Reports CY 2013
Drug
2013
% Δ vs. 2012
Cocaine
10,147
Down 11 %
Marijuana/Cannabis/THC
5,276
Down 2 %
Methylone (N-Methyl-3,4Methylenedioxycathinone) 1,194
Up 208 %
Hallucinogen
984
Up 88 %
Rx Opioids
933
Down 4 %
Heroin
925
Up 33 %
Rx Benzodiazepines
Methamphetamine
Phenylimidothiazole Isomer
Caffeine
All Other Analyzed Drugs
Total
849
211
154
131
2,272
23,069
Down 4 %
Up 24 %
Down 37 %
Down 45 %
Down 18 %
Down 3 %
SOURCE: US DEA: National Forensic Laboratory Information System DQS on May 9, 2014
1400
1242
1200
Synthetic
Cannabinoids
Synthetic
Cathinones
Other Emerging
Synthetics
1000
800
600
400
200
0
386
43
19
2011
428
361
145
144
190
2012
2013
15
Emerging Psychoactive
10
Substances
2011–2013
5
0
South
Florida
Crime Labs
Reports
12
10
6
3
1
13
11
10
4
Number of Different Drugs
2011
2012
Synthetic
Cannabinoids
Synthetic
Cathinones
Other Emerging
Synthetics
2013
SOURCE: US DEA: National Forensic Laboratory Information System DQS on May 9, 2014
“Ecstasy” and “Mollys” Items Identified in DEA’s
NFLIS Toxicology Labs: 2004- 2013
Number of Items
25000
23114
MDMA
24330
23332
22720
21790
20000
Methylone
*
15000
14134
10749
10337
10000
9495
4411
5000
9985
5147
5367
10
24
11
1
15
28
3752
0
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Source: US Drug Enforcement Administration –
National Forensic Laboratories Information System (NFLIS)
*The synthetic cathinones mephedrone and methylone act on the brain like MDMA
(DIED)
Fake Drugs; Real Poisons
www.drugfreebroward.org
Click On -Data Central
Presentations: October 2012