community epidemiology report fall 2014 south florida drug abuse trends update
TRANSCRIPT
Community Epidemiology Report
Fall 2014
South Florida Drug Abuse Trends Update
James N. Hall, EpidemiologistCenter for Applied Research on Substance Use and Health DisparitiesNova Southeastern University
MiamiMiami--
DadeDade
BrowardBroward
Palm Palm
BeachBeach
Flagler
Highlands
Hardee
Polk
Martin
St. Lucie
Okeechobee
Indian River
PutnamAlachua
Bradf
ordUnionColu
mbia
Gilchrist
Levy
Dixie
Suwannee
Hamilton
St.JohnsClay
Duval
Nas sau
Baker
Pinellas
Pasco
Manatee
Hillsborough
Bre va rd
Osceola
Orange
Seminole
Collier
HendryLee
Glades
De SotoSarasota
Palm Beach
LakeSumter
Hernando
Citrus
Marion
Taylor
Madison
Jeffe
rson
Wakulla
Leon
Franklin
Liberty
Gadsden
Jacks on
Calhoun
Gulf
BayW
ashing
ton
Escambia
Santa Rosa
Okaloosa
Walton
Broward
Dade
Holmes
Monroe
Volusia
Lafayette
Charlotte
1.8 Million
1.4 Million
2.6 Million
19.5Million
US Census Bureau2013 Population Estimates
South Florida Most Recent Indicator Changes
• Marijuana: Down – Grow House “Wax” • Cocaine: Stable, Mostly Modest Declines• Rx Opioids: Deaths Declining Hydromorphone • Benzodiazepines: Deaths Declining• Methylone as Mollys: Escalating
• Other Emerging Synthetic Drugs • Heroin: Increases related to Rx Opioids crackdown• Methamphetamine: Increasing among MSM et al
• MDMA: Disappearing• Muscle Relaxants: Declining
HIG
H
Mod
erat
eLo
wer
Levels of Indicator Intensity: HIGH Moderate Lower
Fall 2014
South Florida Key Findings 2014
• # 1 Key Change: There has been significant progress in reducing RX drug diversion along with moderate declines in consequences related to the nonmedical use of pharmaceuticals in most of Florida. However the availability of Hydromorphone (e.g. Dilaudid®) and deaths related to its misuse are rapidly rising.
Fall 2014
• # 2 Key Change: Methylone along with other hallucinogens are the fastest rising drugs analyzed by South Florida crime labs. There were 1,194 methylone crime lab items, mostly sold as “Mollys,” compared to only 54 MDMA reports in 2013.
Percent of Primary Addiction Treatment Admissions by Substance 2007-2012:
State of Florida
2007 2008 2009 2010 2011 201205
101520253035
28.4 28.8 28.2 24.1
27.8
31.6
22.3
18.4
14.5 11.2
8.5 8.2
28.830.6 31.3 29.9
25.1 23
8.3
10.8
16.1
23.927.5 25.1
2.7 2.5 2.2 2.2 2.23.2
9.5
8.9 7.7 8.7
8.9 8.9
Alcohol
Cocaine
Marijuana
Rx Opioids
Heroin
All Other
Perc
ent o
f All
Adm
issi
ons
Source: Substance Abuse and Mental Health Services Administration’s Center for Behavioral Health Statistics and Quality: Treatment Episode Data Set as provided by the Florida Department of Children and Families as of May 8, 2014.
Marijuana
AlcoholCocaine
Rx Opioids
All OtherHeroin
Exhibit 4 Top 10 Most Frequently Identified Drugs of Total Reports from South Florida Crime Labs Reports CY 20131
Drug 2013 % Δ vs. 2012Cocaine 10,147 Down 11 % Marijuana/Cannabis/THC 5,276 Down 2 %Methylone (N-Methyl-3,4-Methylenedioxycathinone) 1,194 Up 208 % Hallucinogen 984 Up 88 % Rx Opioids 933 Down 4 %Heroin 925 Up 33 % Rx Benzodiazepines 849 Down 4 %Methamphetamine 211 Up 24 %Phenylimidothiazole Isomer 154 Down 37 %Caffeine 131 Down 45 %All Other Analyzed Drugs 2,272 Down 18 % Total 23,069 Down 3 %
1Data are for January–December 2013 and include primary, secondary, and tertiary reports. SOURCE: NFLIS, DEA, data retrieved May 9, 2014
Miami MSA includesPalm Beach, Broward,and Miami-Dade Counties
Number of Cocaine Reports Detected Among Decedents in Florida: 2000 - 2013
NUMBER of COCAINE
OCCURRENCESIncluding
“Present” &“Cause of
Death”
SOURCE: Florida Medical Examiners Commission Interim Report Jan-June 2013
0
1,000
2,000
1,105
1,3071,614 1,702 1,943 2,052 2,179
1,7911,462
1,402
1,444
1,318
1,336
State of Florida
2X0
50
100
150
200
250
300
94
121138 120 136 150 157
146 135 127
115
129
82
125
113
147 151
197 191168
143 126106
182
87
100Broward
Palm Beach
Number of Cocaine Reports Detected Among Decedents in Florida: 2000 - 2013
NUMBER of COCAINE
OCCURRENCESIncluding
“Present” &“Cause of
Death”
SOURCE: Florida Medical Examiners Commission Interim Report Jan-June 2013
20012002
20032004
20052006
20072008
20092010
20112012
2X1H...0
50
100
150
200
250
300
149 151
189
160 162 182
281
201
155
198184
198
238
94
121 138120
136150 157
146135 127
115
129
82
125
113
147151
197 191
168
143126
106
182
87
100
Miami-DadeBroward
Palm Beach
Cocaine TrendsRelated Deaths 2012 2 X 1h2013 Δ 2012 vs. x1h2013
State of Florida 1,318 1,336 Up 1 %
Palm Beach County 87 100 Up 15 %
Broward County 129 82 Down 36 %
So FL Crime Labs 2012 2013 Δ 2012 vs. 2013
3 SE FL Counties 11,411 10,147 Down 11 %
Primary Treatment 2011 2012 Δ 2011 vs. 2012
State of Florida 8.5 % 8.2 % Down 4 %
Rx Nonmedical Use in Florida2000 -2013
Responding to an Epidemic
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 2011 - 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
Source: FDLE – Drugs Identified In Deceased Persons by Florida Medical Examiners Jan 2008 - Jun 2013 Reports
# “C
ause
of D
eath
” O
ccur
renc
es
1H'082H'08
1H'092H'09
1H'102H'10
1H'112H'11
1H'122H'12
2x1H'13
0
100
200
300
400
500
600
700
800
900
476 465533
652715
801
607
640
392343
279337 336
380340 336 358
341350
274
238 221153 147 160 142
110152
144201 176
239 268
141 129 136 129
139 176
136 171118 126 158
Oxycodone
Methadone
Morphine
Hydrocodone
House Bill 7095Takes effect
CS-II Dispensing Limits & OxyContin Tamper Resistant Strike Force
Exhibit 6 Number of Nonmedical Rx Opioids and Benzodiazepine Reports Detected among Decedents in Florida 2005 – 2x1h2013
# of
Dru
gs D
etec
ted
Amon
g D
eced
ents
20052006
20072008
20092010
20112012
2X1h20130
1,000
2,000
3,000
4,000
5,000
6,000
7,000
4,0354,416
5,059 5,4546,006
6,608 6,333
5,4895,290
2,608 2,973 3,3394,167
4,340
6,188 5,947
5,184 4,574
OpioidsBenzodiazepines
House Bill 7095Takes effect CS-II Dispensing Limits and
OxyContin Tamper Resistant
Strike Force
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
Level 5
Level 6
Level 7
Level 8
Levels 9, 1015Source: 2012-2013 Annual Report
Florida’s Prescription Drug Monitoring Program (PDMP)
3,000
500
5 Prescribers &5 Pharmacies 2,864
1,4151,097
427
514
178
51-% Decrease
Grams of Oxycodone Sales in Florida Per 100,000 Population
2009 2010 2011 2012 20130
10,000
20,000
30,000
40,000
50,000
60,000
70,000 63325
2880821614
Grams Sold Per 100,000 Population
National Rank Among States and Territories
# 1
# 19
# 22
Source: US Drug Enforcement Administration – ARCOSAutomation of Reports and Consolidated Orders System
Gra
ms
of O
xyco
done
Sol
d pe
r 100
,000
Hydromorphone (eg., Dilaudid®)
STATETOTAL
GRAMSGRAMS/
100K POP
1 FLORIDA 270,718.70 1,439.892 DELAWARE 10,501.64 1,169.53
3 VERMONT 6,099.61 974.78
4 CONNECTICUT 34,362.81 961.44
5 VIRGINIA 67,026.15 837.72
6 MONTANA 8,049.45 813.56
7NEW HAMPSHIRE 10,389.74 789.21
8 MARYLAND 43,353.71 750.9
9 WASHINGTON 48,346.19 718.95
10 OREGON 27,172.92 709.282008 2009 2010 2011 2012 2013
050
100150200250300350400450500
199212 213
253
414
440
Hydromorphone Related-Deaths in Flor-
ida
# of
Dea
ths
2013 ARCOS Grams Sold Per 100/Population
Source: US DEA ARCOS 3 Report 4 March 5, 2014Source: Florida Medical Examiners Commission
South Florida
Crime Lab Cases
Up 950-%
2011-2013
2 X1H
Exhibit 4 Top 10 Most Frequently Identified Drugs of Total Reports from South Florida Crime Labs Reports CY 20131
Drug 2013 % Δ vs. 2012Cocaine 10,147 Down 11 % Marijuana/Cannabis/THC 5,276 Down 2 %Methylone (N-Methyl-3,4-Methylenedioxycathinone) 1,194 Up 208 % Hallucinogen 984 Up 88 % Rx Opioids 933 Down 4 %Heroin 925 Up 33 % Rx Benzodiazepines 849 Down 4 %Methamphetamine 211 Up 24 %Phenylimidothiazole Isomer 154 Down 37 %Caffeine 131 Down 45 %All Other Analyzed Drugs 2,272 Down 18 % Total 23,069 Down 3 %
1Data are for January–December 2013 and include primary, secondary, and tertiary reports. SOURCE: NFLIS, DEA, data retrieved May 9, 2014
Number of Heroin Deaths in Florida: 2000 – 2x1h2013
20002001
20022003
20042005
20062007
20082009
20102011
2012
2x1h2013
0
50
100
150
200
250
300
350
276
328 326
261
180
12296
110132
111
58 62
117140
15
57
3627
26
17 8 10 6 6 4 126 20
61
39
4632
18
22 20 2638 30 26
1533 36
FloridaPalm BeachBrowardMiami-Dade
# H
eroi
n D
eath
s
SOURCE: Florida Medical Examiners Commission Reports 2000-2013
Number of Heroin Deaths in Florida: 2000 – 2x1h2013
20002001
20022003
20042005
20062007
20082009
20102011
2012
2x1h2013
0
10
20
30
40
50
60
70
15
57
36
2726
17
8
10
6 6 4
12
6
2017
5350 49
35
1713
4
17
85
3
9
4
61
39
46
32
18
2220
26
38
3026
15
3336
Series1
Palm Beach
Broward
Miami-Dade
# H
eroi
n D
eath
s
SOURCE: Florida Medical Examiners Commission Reports 2000-2013
Heroin TrendsRelated Deaths 2012 2 x 1H 2013 Δ 2012 vs. 2X1h 2013
State of Florida 117 140 Up 20 %
Palm Beach County 6 20 Up 233 %
Broward County 9 4 Down 56 %
So FL Crime Labs 2012 2013 Δ 2012 vs. 2013
3 SE FL Counties 696 925 Up 33 %
Primary Treatment 2011 2012 Δ 2011 vs. 2012
State of Florida 2.2 % 3.2 % Up 45 %
Top 10 Most Frequently Identified Drugs of Total Reports from South Florida Crime Labs Reports CY 20131
Drug 2013 % Δ vs. 2012Cocaine 10,147 Down 11 % Marijuana/Cannabis/THC 5,276 Down 2 %Methylone (N-Methyl-3,4-Methylenedioxycathinone) 1,194 Up 208 % Hallucinogen 984 Up 88 % Rx Opioids 933 Down 4 %Heroin 925 Up 33 % Rx Benzodiazepines 849 Down 4 %Methamphetamine 211 Up 24 %Phenylimidothiazole Isomer 154 Down 37 %Caffeine 131 Down 45 %All Other Analyzed Drugs 2,272 Down 18 % Total 23,069 Down 3 %
Source: US DEA – National Forensic Laboratory Information System as of May 9, 2014
Methylone isbeta-ketone MDMA
Molly
2004 2005 2006 2007 2008 2009 2010 2011 2012 20130
5000
10000
15000
20000
25000
9495
14134
2179024330
22720 23332
23114
10337
53673752
10 24 11 1 15 28
4411 5147
107499985
“Ecstasy” and “Mollys” Items Identified in DEA’s NFLIS Toxicology Labs: 2004- 2013
MDMA
Methylone
Source: US Drug Enforcement Administration – National Forensic Laboratories Information System (NFLIS)
*The synthetic cathinones mephedrone and methylone act on the brain like MDMA
*
Nu
mb
er
of
Ite
ms
South Florida
Crime Labs Reports
SOURCE: US DEA: National Forensic Laboratory Information System DQS on May 9, 2014
Emerging Psychoactive Substances 2011–2013
2011 2012 20130
200
400
600
800
1000
1200
1400
19 19014543
428
1242
386 361
144
Synthetic CannabinoidsSynthetic CathinonesOther Emerging Synthetics
2011 2012 201302468
101214
1
1011
3 4
106
12 13 Synthetic Cannabinoids
Synthetic Cathinones
Other Emerging Synthetics
Number of Different Drugs
Current (past 30-day) Marijuana Use Among Broward County Middle and High School Students
2000-2012
Source: Florida Youth Substance Abuse Surveys 2000-2012
2000 2002 2004 2006 2008 2010 201202468
101214161820
17.2
13.9 14.5
11.414 15.3
19
4.5 5.2 5
2.5 3.5 4.3
3.7
High School Middle School
% R
ep
ort
ing
Cu
rre
nt
Us
e
Percent of Broward County High School Students Reporting Marijuana Use by Age 13 or Younger
2000-2012
2000 2002 2004 2006 2008 2010 20120
2
4
6
8
10
12
14
16
18 16.7%
11% 10.5%9.4%
8.1% 8%9.7%
Source: Florida Youth Substance Abuse Surveys 2000-2012
% R
epo
rtin
g U
se
by
Ag
e 1
3
Current (past 30-day) Marijuana Use Among Palm Beach County Middle and High School Students
2000-2012
Source: Florida Youth Substance Abuse Surveys 2000-2012
2000 2002 2004 2006 2008 2010 20120
5
10
15
20
25 22.720.7
17.8 17.3 17.4
22.7
20.6
65.5
3.35.2
3.86
2.7
High School Middle School
% R
ep
ort
ing
Cu
rre
nt
Us
e
Percent of Palm Beach County High School Students Reporting Marijuana Use by Age 13 or
Younger 2000-2012
2000 2002 2004 2006 2008 2010 20120
2
4
6
8
10
12
14
11%
13.6% 13.2%12.1%
8.9%
11%12.4%
Source: Florida Youth Substance Abuse Surveys 2000-2012
% R
epo
rtin
g U
se
by
Ag
e 1
3
Addiction is a Developmental Disease: It Starts Early
1
10
100
Child Teen Young Adult Adult
57%
1.5%
5.5%
<12 12-17 18-25 >25
36%
Fi r
st M
ari j
uan
a U
se,
(Pe r
c en
t o
f I n
i tia
tes)
Source: US Dept HHS: SAMHSA National Survey on Drug Use & Health 2011
Percent of First TimeMarijuana UsersBy Age
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.)
Percent of Past Year Drug Dependence or Abuse Among Adults Aged 18 or Older
By Age of First Marijuana Use: 2011
12.7%
2.2%
0%
2%
4%
6%
8%
10%
12%
14%
Age of First Marijuana Use
% P
as
t Y
ea
r D
ep
de
nc
e/A
bu
se
14 Years orYounger
18 or Older
Source: SAMHSA-National Surveys on Drug Use and Health 2011
14 yrs. Or Younger 18 or Older
Percent of Past Year Serious Mental Illness Among Lifetime Marijuana Users Aged 18 or Older
By Age of First Marijuana Use: 2002 and 2003
21.0%
17.4%
12.2% 10.5%
0%
5%
10%
15%
20%
25%
Age of First Marijuana Use
% P
as
t Y
ea
r S
MI
Before 12 Yrs
12-14 Yrs
15-17 Yrs
18 or Older
Source: SAMHSA-National Surveys on Drug Use and Health 2002-2003
< 12 yrs. 12-14 yrs. 15-17 yrs. 18 or Older
Percent of high school students having ridden or driven in the past 30 days with or as driver
having used marijuana or alcoholRODE with Driver who had used
marijuana or alcohol
Florida Plam Beach Broward0
5
10
15
20
25
30
25.4 25.727.0
21.4 20.618.4
Marijuana Alcohol
DROVE after using marijuana or drinking alcohol
Florida Palm Beach Broward0
5
10
15
20
25
30
11.2 12.3 10.98.1
107%
Rep
ortin
g
% R
epor
ting
Source: FL-DCF - 2012 Florida Youth Substance Abuse Survey
Percent of High School Males Reporting Having Used Synthetic Marijuana Florida and
Broward County - 2012
Florid
a Life
time
Broward
Lifetime
Florid
a Pas
t 30 Day
s
Broward
Past 3
0 Days
0%
4%
8%
12%
16%
20%15.1 %
12.4 %
5.3 % 3.9%
Source: Florida Youth Substance Abuse Survey 2012
Percent of High School Males Reporting Having Used Synthetic Marijuana Florida and
Palm Beach County - 2012
Florida Life-time
Palm Beach Lifetime
Florida Past 30 Days
Palm Beach Past 30 Days
0%2%4%6%8%
10%12%14%16%18%20%
15.1 % 14.6 %
5.3 % 4.7%
Source: Florida Youth Substance Abuse Survey 2012
Number of Synthetic Cannabinoids Poison Control Exposure Calls
2012 2013 Jan-Apr 2014
Source: Florida Poison Information Center – Miami 1-800-222-1222
Synthetic Cannabinoids
Poison Exposure Calls
# of Poison Exposure
Calls Jan-Dec 2012
# of Poison Exposure
Calls Jan-Dec 2013
# of Poison Exposure
Calls Jan-Apr 2014
State of Florida 537* 194** 34
Broward County 37 7 0
Miami-Dade County 45 9 3
Palm Beach County 24 6 0
* The total of 537 includes 271 calls in January-April 2012 ** The total of 194 includes 78 calls in January-April 2013
29.2
Marijuana Trends
So FL Crime Labs 2012 2013 Δ 2012 vs. 2013
3 SE FL Counties 5,388 5,276 Down 2 %
Detected in ME Decedents
2012 2 x 1H 2013 Δ 2012 vs. 2X1h 2013
State of Florida 767 802 Up 5 %
Primary Treatment 2011 2012 Δ 2011 vs. 2012
State of Florida 25.1 % 23 % Down 8 %
“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.
• 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)
The Question for Doctors……..
How a Bill becomes Law
How a Pill becomes MedicineUS Food and Drug Administration• Clinical Trials• FDA Medical Review• FDA Medical Panel Approval
Denver Area Colorado USA0
2
4
6
8
10
12
14
16
7.887.29
6.05
9.628.56
6.01
12.2
11.18
6.58
13.45
11.66
7.01
2004-062006-082008-102010-12
Percent
Source:
National Survey on DrugUse and HealthSubstate Data
Marijuana Use in the Past Month Age 12 and Above: Comparison of 2004-06, 2006-08, 2008-10 & 2010-12 NSDUH: Metro Denver vs. Colorado vs. USA
Denver Area Colorado USA0
5
10
15
20
25
30
35
40
45
30.6132.03
39.15
26.8228.84
38.18
21.9924.2
34.7
19.6322.1
31.82
2004-062006-082008-102010-12
Percent
Perception of Great Risk of Smoking Marijuana Once a Month: Comparison of 2004-2006, 2006-2008, 2008-2010, & 2010-2012
NSDUH: Denver Metro vs. Colorado vs. USA
Source: National Survey on DrugUse and HealthSubstate Data
Do you know anyone with a Medical Marijuana License/Card?
Denver Public Schools 2011-12 school year
Yes, 36%
No, 64%
No Marijuana Use in Past 30 Days
The range of all students answered yes, rose from
19% among 6th graders to 51% among 12th graders.
Yes, 80%
No, 20%
Used Marijuana in Past 30 Days
Current (past 30-day) Alcohol Use Among Palm Beach County Middle and High School Students
2000-2012
Source: Florida Youth Substance Abuse Surveys 2000-2012
2000 2002 2004 2006 2008 2010 20120
10
20
30
40
50
60
40 38.8
48.3 46.342.2
41.8
3825.6
21.818.4 19.8
16.5 19.1
11.9High School Middle School
% R
ep
ort
ing
Cu
rre
nt
Us
e
Current (past 30-day) Binge Drinking Among Palm Beach County Middle & High School Students
2000-20012
Source: Florida Youth Substance Abuse Surveys 2000-2012
2000 2002 2004 2006 2008 2010 20120
5
10
15
20
25
30
22.1 22.3 22.325.1
21.8 2118.1
10.5 9.47.2
9.2
5.96.6
4.2
High School
Middle School
% R
ep
ort
ing
Cu
rre
nt
Us
e
Current Alcohol Use Among Palm Beach High County School Students by Gender 2006-2012
2000 2006 2008 2010 201220
22
24
26
28
30
32
34
36
38
32.7 33.832.4
31.6
26.8
31.2
36.8
29.9
33.1
27.8
Male Female
% R
ep
ort
ing
Use P
ast
30
D
ays
Source: Florida Dept. of Children & Families Florida Youth Substance Abuse Surveys 2006-2012
Note: Rates by Gender not available for 2002 to 2004
Percent of Palm Beach County High School Students Reporting Alcohol Use by
Age 13 or Younger 2000-2012
2000 2002 2004 2006 2008 2010 20120
5
10
15
20
25
30
35
40
45 41.838.4
43.3
36.333.2
27.325.4
11.9
7.2 6 4.3 5.2 5.9 5.4
More than a Sip or Two
Drinking at least Once a Month
Source: Florida Youth Substance Abuse Surveys 2000-2012
% R
epo
rtin
g U
se
by
Ag
e 1
3
Age of Alcohol Onset and Any L ifetime Alcohol Dependency
among Adults Aged 18 and Older
47% 45%
38%32%
28%
15% 17%11% 9%
0%
10%
20%
30%
40%
50%
13 14 15 16 17 18 19 20 21
Age Began Drinking
Source: National Epidemiologic Survey on Alcohol and Related Conditions Sample = 43,093
% A
lcoh
ol D
epen
den
t
Methamphetamine Arrests Broward County, FL: Jan 2010–July 2014 n=168
2010 2011 2012 2013 1st H 20114
0%10%20%30%40%
10%17% 17%
38%
18%
Percent By Year
1% 7%
28%64%
Percent By Race/Gender
Black FemaleWhite FemaleBlack MaleWhite Male< 20 20's 30's 40's 50's 60's
0%5%
10%15%20%25%30%35%
2%
35%
26% 27%
9%
1%
Percent By Age
Methamphetamine Trends
So FL Crime Labs 2012 2013 Δ 2012 vs. 2013
3 SE FL Counties 170 211 Up 24 %
Related Deaths 2012 2 x 1H 2013 Δ 2012 vs. 2X1h 2013
State of Florida 146 162 Up 11 %
Primary Treatment 2011 2012 Δ 2011 vs. 2012
State of Florida 1.6 % 2 % Up 25 %
Percent of Addiction Treatment Clients Reporting Injecting Drug Use by Primary Drug at Admission:
State of Florida 2012
Sources: US SAMHSA Treatment Episode Data Sets (TEDS) for Statewide 2012
Treatment Primary Drug
State of Florida
%
Heroin 82 %Prescription Opioid 36 %Methamphetamine 27 %Cocaine 5 %
SBIRT• Screening
• Brief Intervention
• Referral to Treatment
What is SBIRT?
SBIRT is a comprehensive, integrated, public health approach to the delivery of early intervention and treatment services• For persons with substance use disorders and • Those who are at risk of developing these
disorders
Primary care centers, trauma centers, and other community settings provide opportunities for early intervention with at-risk substance users.
SBIRT: Review of Key Terms
Screening: Very brief set of questions that identifies risk of substance use related problems.
Brief Intervention: Brief counseling that raises awareness of risks and motivates client toward acknowledgement of problem.
Referral: Procedures to help patients access specialized care.
SBIRT Goals Increase access to care for persons with substance use disorders and those at risk of substance use disorders. Foster a continuum of care by integrating
prevention, intervention, and treatment services. Improve linkages between health care services and alcohol/drug treatment services.
http://beta.samhsa.gov/sbirt