1. Statewide Epidemiology Workgroup March 16, 2011

2. National Survey on Drug Use and Health (NSDUH) Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA)

3. NSDUH is the primary source of information on the prevalence, patterns, and consequences of alcohol, tobacco and illegal drug use and abuse in the general civilian non- institutionalized population, aged 12 and older. In the combined surveys for 2006 through 2008, data were collected from 204,408 respondents with a design intended to obtain representative samples from all 50 states and the District of Columbia.

5. *Low precision; no estimate reported.

9. *Low precision; no estimate.

11. Low precision; no estimate.

15. Crash Data from the Maryland Automated Accident Reporting System (MAARS) Traffic Safety Analysis Division, Office of Traffic and Safety, Maryland State Highway Administration (SHA)

16. All crashes resulting in a vehicle being towed away, personal injury, or fatality are reported. The state, county, or local law enforcement officer who first arrives at the scene of a reportable accident records the crash data. Typically within 10 days the accident report is submitted to the Maryland State Police Central Records Division for transfer into the Maryland Automated Accident Reporting System (MAARS) database files; within 30 days, the data is uploaded to the Maryland State Highway Administration's database and the Maryland State Police database

20. Uniform Crime Report Maryland State Police

21. The Maryland Uniform Crime Reporting (UCR) Program establishes a method to collect, evaluate and process uniform statistical data on crime statewide.

22. There were 215,921 total crime incidents reported in 2009 compared to 233,566 in 2008. Violent crime decreased five percent and property crime decreased eight percent in 2009.

23. Nationwide Estimates from The Economic Costs of Alcohol and Drug Abuse in the United States – 1992 About 30 percent of murders and aggravated assaults, 23 percent of rapes and 3 percent of robberies are alcohol-related. About 30 percent of breaking and entering and larceny/theft, and 7 percent of motor- vehicle thefts are drug-related.

28. Arrests in Maryland decreased six percent in 2009. There were 285,788 arrests reported in 2009 compared to 303,270 in 2008. Arrests for drug offenses totaled 51,898 in 2009, a ten percent decrease from 2008. In 2009, 23,518 persons were arrested for driving while intoxicated, a two percent decline from 2008.

33. There were 1,978 arrests of juveniles for sale or manufacture of illegal drugs in Maryland during 2009, a 17 percent decline from the previous year. Arrests of juveniles for possession of illegal drugs decreased by 15 percent during 2009 for a total of 4,563. Juvenile arrests for DWI and liquor law violations totaled 1,436 during 2009, declining by less than one percent from 2008.

39. Maryland Public School Suspensions Maryland State Department of Education Division of Accountability and Assessment

40. Data reflect the number of combined in-school and out-of- school suspension incidents in each local school system during the 2009-10 school year, which are categorized in eight major groupings including Dangerous Substance-Related.

45. SYNAR Survey of Retail Tobacco Outlets in Maryland Maryland Alcohol and Drug Abuse Administration (ADAA), Maryland Department of Health and Mental Hygiene (DHMH)

46. In accordance with Federal tobacco regulations, states are required to conduct annual random and unannounced inspections of stores and vending machines to ensure that laws prohibiting sales of tobacco products to minors are being enforced and to demonstrate that sales to minors are decreasing. Each year a random sample of 10 percent is drawn from the list of licensed tobacco outlets provided by the Office of the Comptroller of Maryland. Compliance is measured by retailers’ positive response to youth workers’ requests for tobacco products.

49. Maryland Youth Risk Behavior Survey (YRBS) Maryland State Department of Education (MSDE) and the U.S. Centers for Disease Control and Prevention (CDC)

50. The Maryland YRBS is part of the Youth Risk Behavior Surveillance System (YRBSS) developed in 1990 by the U.S. Centers for Disease Control and Prevention (CDC) to monitor behaviors that affect morbidity and mortality among high-school-age youth. In the spring of 2009, the Maryland YRBS was administered to students in a representative sample of Maryland public-high-school classrooms. The law requires the survey to be administered every two years. A total of 1,644 students in 30 Maryland public high schools completed the survey, resulting in a 78% response rate. The 2009 Maryland YRBS results are representative of all Maryland’s public-school students in grades 9 through 12.

52. Behavioral Risk Factor Surveillance System Maryland Department of Health and Mental Hygiene (DHMH) and U.S. Centers for Disease Control and Prevention (CDC)

53. The Maryland Behavioral Risk Factor Surveillance System (BRFSS) is funded by the U.S. Centers for Disease Control and Prevention. The emphasis of this survey is on health-related behaviors in the Maryland adult population with a specific focus on behaviors and conditions that place Maryland adults at risk for chronic diseases, injuries, and preventable infectious diseases. The survey is part of a surveillance effort conducted by the Maryland Department of Health and Mental Hygiene in cooperation with the Centers for Disease Control and Prevention. Annual sample size for this survey is approximately 4,400 interviews.

55. Alcohol and Drug-Induced Deaths Vital Statistics Administration, Maryland Department of Health and Mental Hygiene (DHMH)

56. Alcohol-induced deaths include the following International Classification of Disease, Tenth Revision (ICD-10) category codes: F10, G31.2, G62.1, I42.6, K29.2, K70, R78.0, X45, and Y15. Drug-induced deaths include the following codes: F11.0-F11.5, F11.7-F11.9, F12.0-F12.5, F12.7-F12.9, F13.0-F13.5, F13.7-F13.9, F14.0- F14.5, F14.7-F14.9, F15.0-F15.5, F15.7-F15.9, F16.0-F16.5, F16.7-F16.9, F17.0, F17.3-F17.5, F17.7-F17.9, F18.0-F18.5, F18.7-f18.9, F19.0- F19.5, F19.7-F19.8, X40-X44, X60-X64, X85, and Y10-Y14.

60. Intoxication Deaths Maryland Office of the Chief Medical Examiner (OCME)

61. The OCME is responsible for investigating all deaths in Maryland caused by violence, suicide, or injury; sudden deaths in apparently healthy individuals; and deaths that are suspicious or unusual. Intoxication deaths are those in which the OCME-determined cause of death included the word “intoxication”. In 90 percent of the intoxication deaths from 2006 to 2010 the manner of death (accident/suicide/homicide) was reported as undetermined, and multiple substances were involved in 40 percent or more of intoxication deaths.

64. Substance-Abuse Treatment Admissions Maryland Alcohol and Drug Abuse Administration (ADAA), Maryland Department of Health and Mental Hygiene (DHMH)

65. All publicly-funded Maryland alcohol and drug-abuse-treatment providers are required to report information on admissions to and discharges from treatment via the Web-based Statewide Maryland Automated Record Tracking (SMART) system. During 2010 35,246 individuals accounted for 43,431 recorded admissions to State-funded treatment, a 2.6 percent increase from the previous year.

66. From CY 2007 to 2010 Oxycodone-related admissions increased 130 percent and total prescription-opiate-related admissions doubled. Benzodiazepine-related treatment admissions increased by 94 percent, PCP by 35 percent and marijuana by 7 percent. During 2010 heroin-related admissions increased 8 percent from the previous year; alcohol-related admissions were level. Cocaine-related admissions fell by 26 percent over the four years.

79. HIV Surveillance Data Infectious Disease and Environmental Health Administration, Maryland Department of Health and Mental Hygiene (DHMH)

80. Physicians are required by law to report patients with HIV or AIDS diagnoses and infants born to HIV positive mothers. Hospitals, nursing homes, hospice facilities, medical clinics in correctional facilities, inpatient psychiatric facilities and inpatient drug rehabilitation facilities are required to report patients in their care with HIV or AIDS diagnoses. Laboratory directors are required to report patients with laboratory results indicating HIV infection.

81. About 24 percent of Maryland HIV cases diagnosed in 2008 were categorized as having been exposed through injecting drug use; this percentage has declined steadily from about 47 percent of those diagnosed in 2001. About 40 percent of those living with an HIV diagnosis in 2008 were reported as having been exposed through injecting drug use.