2. Issues Impacting Broward Youth September 2014 Drug Abuse Patterns and Trends Update

3. James N. Hall, Epidemiologist Center for Applied Research on Substance Use and Health Disparities Nova Southeastern University

4. Alcohol Use in Past 30-Days Source: CDC Youth Online High School YRBS Broward County, FL 1991-2013 18% 8% BrowardPrevention.org

5. Current (past 30-day) Alcohol Use Among Broward County Middle and High School Students 2000-2012 Source: Florida Youth Substance Abuse Surveys 2000-2012

6. Current (past 30-day) Binge Drinking Among Broward County Middle & High School Students 2000-20012 Source: Florida Youth Substance Abuse Surveys 2000-2012

7. Current Alcohol Use Among Broward Middle and High School Students by Gender 2000-2012 Source: Florida Dept. of Children & Families Florida Youth Substance Abuse Surveys 2000-2012

9. Percent of Broward County High School Students Reporting Alcohol Use by Age 13 or Younger 2000-2012 Source: Florida Youth Substance Abuse Surveys 2000-2012 % Reporting Use by Age 13

10. Marijuana Data Bank 2014 Consumption Consequences Contributing Factors Colorado

11. Types of Drugs Used by Past Month Illicit Drug Users Aged 12 or Older: 2013 Marijuana and Some Other Drug n= 4,082,000 Marijuana Only n= 15,728,000 Only Drug is Other Than Marijuana n= 4,763,000 24,573,000 Illicit Drug Users (9.4%) Source: 2013 National Survey on Drug Use and Health

12. Annual Numbers of New Users of Marijuana USA: 1966-2012 Thousands of New Users All Ages Sources: National Household Survey on Drug Use 1966-2001 and National Survey on Drug Use and Health 2002-2012 1973 1978 1990 2001 Under 18 57.3 % ( 1.4 million in 2012) 2012 2.4 million

13. Percent of High School Students Reporting Any Past 30-Day Marijuana Use USA & Broward County: 1991-2013 Source: Centers for Disease Control and Prevention: Youth Risk Behavior Surveillance Percent Reporting Current Use

14. % of high School Students reporting Past 30 Day Use Past 30 Day Use of Marijuana among Broward County high school Students From YRBS (Odd # Years) and FYSAS (even # Years) 1999-2013 Sources: Youth Risk Behavior Surveillance System (US CDC&P) and Florida Youth Substance Abuse Survey (FL-DCF)

15. Percent Reporting Current Use Source: Centers for Disease Control and Prevention: Youth Risk Behavior Surveillance Percent of Broward High School Students Reporting Any Past 30-Day Marijuana Use By Demographic Groups: 2009-2013

16. Current (past 30-day) Marijuana Use Among Broward County Middle and High School Students 2000-2012 Source: Florida Youth Substance Abuse Surveys 2000-2012

17. Percent of Broward County High School Students Reporting Marijuana Use by Age 13 or Younger 2000-2012 Source: Florida Youth Substance Abuse Surveys 2000-2012 % Reporting Use by Age 13

18. Addiction is a Developmental Disease: It Starts Early 57% 1.5% 5.5% <12 12-17 18-25>25 36% First Marijuana Use, (Percent of Initiates) Source: US Dept HHS: SAMHSA National Survey on Drug Use & Health 2011 Percent of First Time Marijuana Users By Age

19. 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.)

20. Percent of Past Year Drug Dependence or Abuse Among Adults Aged 18 or Older By Age of First Marijuana Use: 2011 Source: SAMHSA-National Surveys on Drug Use and Health 2011 14 yrs. Or Younger 18 or Older

21. Percent of Past Year Serious Mental Illness Among Lifetime Marijuana Users Aged 18 or Older By Age of First Marijuana Use: 2002 and 2003 Source: SAMHSA-National Surveys on Drug Use and Health 2002-2003 < 12 yrs. 12-14 yrs. 15-17 yrs. 18 or Older

22. Perceived Attitudes about Marijuana Among Broward County Middle and High School Students 2000-2012 Source: Florida Youth Substance Abuse Surveys 2000-2012

23. 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 DROVE after using marijuana or drinking alcohol % Reporting Source: FL-DCF - 2012 Florida Youth Substance Abuse Survey

24. “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.

25. Percent of High School Males Reporting Having Used Synthetic Marijuana Florida and Broward County - 2012 Source: Florida Youth Substance Abuse Survey 2012

27. 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)

28. 2006 to 2011 USA up 13 % Colorado Up 44% Ages 12-17 years 2006 -2011 Source: SAMHSA-National Survey on Drug Use and Health 2011

32. The Question for Doctors……..

33. How a Bill becomes Law How a Pill becomes Medicine US Food and Drug Administration Clinical Trials FDA Medical Review FDA Medical Panel Approval

34. Kevin Sabet, Ph.D. www.youtube.com/watch?v=VwqlNfXYcOY Or Go To www.youtube.comwww.youtube.com and Search “Commission on Substance Abuse”

35. Rx Nonmedical Use in Florida 2000 -2013 Responding to an Epidemic

36. 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.

37. Lethal 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 # “Cause of Death” Occurrences House Bill 7095 Takes effect CS-II Dispensing Limits & OxyContin Tamper Resistant Strike Force

38. Number of Nonmedical Rx Opioids and Benzodiazepine Reports Detected among Decedents in Florida 2005 – 2x1h2013 # of Drugs Detected Among Decedents House Bill 7095 Takes 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

39. 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, 10 15 Source: 2012-2013 Annual Report Florida’s Prescription Drug Monitoring Program (PDMP) 3,000 500 5 Prescribers & 5 Pharmacies 2,864 1,415 1,097 427 514 178 51-% Decrease

40. Hydromorphone (e.g., Dilaudid ® ) STATE TOTAL GRAMS GRAMS/ 100K POP 1FLORIDA270,718.701,439.89 2DELAWARE10,501.641,169.53 3VERMONT6,099.61974.78 4CONNECTICUT34,362.81961.44 5VIRGINIA67,026.15837.72 6MONTANA8,049.45813.56 7 NEW HAMPSHIRE10,389.74789.21 8MARYLAND43,353.71750.9 9WASHINGTON48,346.19718.95 10OREGON27,172.92709.28 # of Deaths 2013 ARCOS Grams Sold Per 100/Population Source: US DEA ARCOS 3 Report 4 March 5, 2014 Source: Florida Medical Examiners Commission South Florida Crime Lab Cases Up 950-% 2011-2013

41. Exhibit 5 Number of Heroin-related Deaths in Florida: 2000 – 2x1h2013 SOURCE: Florida Medical Examiners Commission Reports 2000-2013 # Heroin Occurrences

42. 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-3,4- 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 DQS on May 9, 2014

44. South Florida Crime Labs Reports SOURCE: US DEA: National Forensic Laboratory Information System DQS on May 9, 2014 Emerging Psychoactive Substances 2011–2013 Number of Different Drugs

45. * The synthetic cathinones mephedrone and methylone act on the brain like MDMA * Number of Items

46. (DIED) Fake Drugs; Real Poisons www.drugfreebroward.org Click On -Data Central Presentations: October 2012