1. Drug Trends in Washington State & King County Caleb J. Banta-Green MPH MSW Alcohol & Drug Abuse Institute University of Washington http://adai.washington.edu Substance Abuse Research Forum October 26, 2004 Seattle WA

2. 2 Overview Washington survey data Treatment admissions Drugs seized by law enforcement Drug use in Northwest jails Drug-involved ER visits and Deaths in King County Focus Prescription Opiates Methamphetamine Infectious Diseases and Injection Drug Use Conclusion

3. 3 Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2002. NOTE: Binge Alcohol Use is defined as drinking five or more drinks on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days.

4. 4 NOTE: Any Illicit Drug includes marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or any prescription-type psychotherapeutic used nonmedically. Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2002.

5. 5 Treatment Data Utility as drug trends measure Only a partial measure of drug use and treatment demand Also need to consider: –Shifts in priorities, policies, practices –Caseloads –Treatment retention (longer retention fewer open slots) –Treatment availability- facilities, slots, beds, modalities, staffing –Funding availability –Wait lists –Private treatment utilization

6. 6 Note- Treatment admissions totaled 43,269 in 1993 and 49,415 in 2003 BRFSS data do not show a decrease in chronic or binge drinking Source: Treatment Episode Data Set (TEDS), Data provided by the WA St. Div of Alcohol & Substance Abuse to TEDS

7. 7 Source: Treatment Episode Data Set (TEDS)

8. 8

9. 9 Data in these figures represent 93% of drugs tested in each region Seattle Lab 3,212 items; WA Labs, excluding Seattle, 12,332 items Source: National Forensic Lab Information System, Used With Permission. Based upon data from the Washington State Patrol Forensic Toxicology Laboratory. WA State Patrol Drug Seizure Testing, 2003

10. 10

11. 11 Alcohol induced deaths include chronic and acute conditions in these data

12. 12 Detailed Death and Emergency Department Data Are Available Only for King County

13. 13 Street Drug Involved Deaths, King County Note: These drugs have been coded consistently over time,

14. 14 Duplicated data, most deaths involve multiple drugs Alcohol data excluded Drug Involved Deaths, King County ’97-’03

15. 15 E.D. Mentions of Alcohol & Illicit Drugs, King & Snohomish Counties Source: Drug Abuse Warning Network, Office of Applied Studies

16. 16 E.D. Mentions of Prescription Drugs, King & Snohomish Counties Source: Drug Abuse Warning Network, Office of Applied Studies

17. 17

18. 18 Prescription Opioid Trends Increases in Emergency Department visits and Deaths in which prescription opiates are mentioned or identified 1997-2002, King County The majority of cases involve multiple drugs, assigning causation to a particular drug very difficult Appears to be an increase in appropriate and inappropriate use of these drugs across WA

19. 19

20. 20

21. 21 Source: DEA ARCOS http://www.deadiversion.usdoj.gov/arcos/index.html Data does not include methadone dispensed and administered at opiate substitution treatment clinics.

22. 22 Methamphetamine Manufacturing and Dump Sites Methamphetamine is the only drug, other than marijuana, that is manufactured in WA State Increasing control of precursor chemicals, such as pseudoephedrine, appears to have helped decrease manufacturing Chemicals used in manufacturing are dangerous to people and the environment

23. 23 Labs and/or dump sites have been found in every county in WA Source: WA St. Dept of Ecology

24. 24 Meth. Labs & Dumpsites Trend ’01-’02

25. 25 Infectious Diseases & Injection Drug Use

26. 26 Newly Diagnosed HIV Cases 2001-’03 Exposure Categories Newly Diagnosed HIV cases in King County = 947, WA except King= 534 * Cases diagnosed with HIV infection between January 2001 and December 2003, and reported to PHSKC or WA DOH as of 3/31/04.

27. 27 HIV infection among non-MSM/IDU in King County remains low HIV incidence (<.05%/year) HIV prevalence (1-2%) MSM/IDU 14% HIV prevalence MSM/IDU Meth. Users 47% HIV prevalence Source: Public Health-Seattle & King County

28. 28 Hepatitis in King County Unchanged in recent years Hep B among IDU –70% prevalence of markers (total # of people) –10% incidence annually (new cases) Hep C among IDU –85% prevalence –21% incidence annually Source: Public Health-Seattle & King County

29. 29 Injection Drug Use Approximately 1/3 of those admitted to drug treatment are or have been an injection drug user Needle Exchange Key informants in counties adjacent to those with needle exchanges report regular use of their neighbors’ exchanges At least 5,353,158 syringes were exchanged in Washington in 2003 (WA St. Dept of Health, SHARE) Needle exchanges are available in the following counties:

30. 30 Needle Exchanges

31. 31 Conclusion Alcohol is the predominant drug of use and abuse in the State Marijuana is the most common illicit drug used Heroin and Cocaine continue to be major drugs of abuse, with substantial morbidity and mortality Over the past 5-10 years use and abuse of Methamphetamine and Prescription opiates have increased, with increasing morbidity and mortality

32. 32 adai.washington.edu http://depts.washington.edu/adai/wa/

33. 33 Drug Use Epidemiology Reports