ODATAS Report: Drug Abuse Scioto County

January 2012 Report Cincinnati Region ODATAS

Ohio Substance Abuse Monitoring Network

Drug Abuse Trends in the Cincinnati Region

From June 2011 to January 2012

Regional Epidemiologist:
Jan Scaglione, BS, MT, PharmD, DABAT

OSAM Staff:
R. Thomas Sherba, PhD, MPH, LPCC
OSAM Principal Investigator
Rick Massatti, MSW Research Administrator, OSAM Coordinator
John R. Kasich, Governor
Orman Hall, Director

My entry is a summary of the ODATAS (Ohio Department of Alcohol & Drug Addiction Services) report that includes Scioto County. I have taken all of the information in this entry from that report. Please use this post to acquaint yourself with current drug abuse and trends occurring in the area.

Information saves lives. I hope that something here helps you understand a need and compels you to react to it. Fighting drug abuse seems overwhelming; however, many now are choosing to stand together and to combat this health epidemic. We need your support to reach our goal of 100% commitment. Thank you.

Please refer to the complete document here: http://www.odadas.state.oh.us/public/ContentLinks.aspx?SectionID=dcb941ba-f72b-4b9e-b30f-fb8d4a6bb652

The Drugs

Bath Salts:

Continues to be highly available and slight increase even though they were scheduled as controlled substances and banned for sale in Ohio in October

Hamilton County Coroner’s Crime Lab reported the number of bath salts cases they process has increased during the past six months. In addition, the BCI London Crime Lab noted that

since the ban on the sale of bath salts went into effect, the formally scheduled substances of MDPV and methylone are almost never seen any more in samples of bath salts, rather
dozens of non-controlled analogs have taken their place.

A participant described the effects produced by bath salts as being, “as strong as cocaine.” Another participant stated, “I heard people went to the nut ward and everything [after using these drugs].”

Crack Cocaine:

Continues to be highly available – higher availability of crack than powder

Treatment providers described crack cocaine as a social drug among younger users, appealing to this population because of the drug’s low cost.

A participant stated, “[Quality of crack cocaine] it’s either really good or garbage." Another participant stated that quality is dependent on the time of month: “First of month ... bad, middle of month ... better, end of month ... good quality ... it [crack cocaine] has cyclic quality."

Participants also reported commonly re-cooking crack cocaine with the intent to ‘purify’ the drug for smoking. One participant said, “When you cook the crack down, it tastes better."

Participants believed that typical users of crack cocaine are more likely to be in their later teen years and that users may start as early as 16 years of age. In contrast, treatment providers described typical crack cocaine users as older individuals, between 35-45 years of age. One treatment provider said, “In the 80s people started [crack cocaine use] younger ... but now it seems like users are older."

Law enforcement also stated that they encounter crack cocaine use most often among African-Americans or among economically disadvantaged Whites.

Reportedly, crack cocaine is commonly used in combination with alcohol, heroin, marijuana and sedative-hypnotics. A participant explained the rationale for using crack cocaine

with other drugs: “I won’t smoke crack unless I have heroin to come down with."

Heroin:

Increased in availability – black tar and powder delivered to user's door

Law enforcement cited that the demand for heroin has been driven by the reformulation of OxyContin® and the high cost for prescription opioids.

A participant reported, “Lots of young kids ... they told me heroin was the easiest to get … prescription pills are overpriced; you can get high three to four times off $20 heroin ... more economically feasible.”

While many types of heroin were said to be available in the region, participants and law

enforcement continued to name Mexican brown powdered heroin as most available. Participants in rural Lawrence and Jackson counties, however, reported black tar heroin as most available. Reportedly, the availability of heroin, regardless of type, had increased during the previous six months.

A participant reported, “[Black] tar or powder [heroin] ... I used to have to get downtown

[Cincinnati] every day from Clermont County ... now I can get it delivered to my door.” Another participant reported, “Lately I’ve seen more white powder [heroin].”

Participants reported that the most common way to use heroin continues to be intravenous injection, and law enforcement believed injection use has increased during the past six months.

Participants stated that first-time heroin use occurs as young as 13-14 years of age, typically after prescription opioid use or abuse. Participants cited that first-time heroin users or those described as, “needle-phobic” are more likely to snort or smoke heroin than intravenously inject. A participant commented, “I met someone who smoked it [heroin] for the first time a couple of months ago ... I was scared of that stuff ... needles ... I smoke it.”

Law enforcement reported higher use by Whites, aged 18-50 years, with dealers more likely to be African-American.

Treatment providers also described the typical heroin user as White, and between 18-60 years of age, with more use being seen in the 18-25 age range. Treatment providers stated that increased use of heroin by young African-American males new to heroin is something that has changed during the past six months.

Reportedly, heroin is commonly used in combination with alcohol, crack cocaine, marijuana, powdered cocaine and sedative-hypnotics. Participants reported that both forms of cocaine are used with heroin to speedball. The use of methamphetamine and heroin together, while not common, was described as another form of speedball. A participant explained that speedball with methamphetamine makes, “the up and down lasts days.”

Marijuana:

Continues to be highly available, extremely easy to get

Law enforcement described an increasing number of shipments of high-grade marijuana being transported by mail. Officials believed Mexican cartels were growing highly potent marijuana in Ohio because of the temperate climate and good soil; however no one has been arrested in connection with the growing operation.

A participant stated, “Marijuana is not a drug,” meaning that the drug is so widely available that one would think marijuana to be legal. Participants commonly said statements such

as, “Everybody loves Mary Jane [marijuana].”

Participants described first time users to be as young as 10-11 years of age. Similarly, treatment providers described first time users of marijuana to be as young as 10-13 years of age, with people using marijuana up into their 70s. Law enforcement stated that traffickers of marijuana are usually people 14-15 years of age, but are more typically people ages 18-50 years.

No gender or ethnic bias was noted by any of the groups interviewed. Participants stated that marijuana is commonly used in combination with alcohol, cocaine and tobacco.

Prescription Opioids:

Availability remained about the same

Participants reported availability increases for Opana® and Roxicodone®; law enforcement reported increases for OxyIR® (“perc 30”) and Opana,® and attributed the success of abuse-deterrent technology in the new formulation of OxyContin® as having pushed users to these drugs as well as to heroin.  


 

Participants identified Lortab®, OxyContin®, Percocet®, Roxicodone® and Vicodin® as the most popular prescription opioids in terms of widespread use. Participants and community professionals also reported an increase in availability and use of Opana®.

Participants reported that the availability of prescription opioids had remained the same, at

high levels, during the previous six months. Participants also stated that the diversion of the 40 mg wafers of methadone from treatment centers had increased. The BCI London Crime Lab reported that the number of prescription opioid cases it processed had remained the same during the previous six months; however, noted increases in the number of lab-processed cases existed for Dilaudid®, Opana® and Percocet®.

Participants reported that initial access to prescription opioids is more likely from legitimate prescriptions written by physicians than from other sources. Once an individual becomes addicted, then other sources such as emergency rooms, pain clinics or street dealers are often used to obtain prescription opioids.

A participant reported, “You can get ‘em [prescription opioids] from Texas, Florida, Louisiana, and Mexico ... dealers, pill mills, doctor shoppers.”

Obtaining prescription opioids from emergency rooms was noted as being more difficult now than in the past. One participant said, “Can’t get [prescription opioids] as easy from ED [emergency departments] ... can’t get as many [as in the past].”

Participants also continued to describe buying prescription opioids from older people who have prescriptions. A participant described obtaining prescription opioids from older people who have legitimate prescriptions, “Can get them [prescription opioids] from older people who sell to younger people ... either they have a different drug they like or they hold back some and just sell part of it.” A law enforcement official corroborated this statement: “Older people are selling prescriptions ... to pay rent, heating bills … elderly sell the pills [prescription opioids] to younger people, maybe selling only one-half of the prescription.”

Participants describe typical users of prescription opioids as more likely to be White than any other race or ethnicity. Treatment providers reported that users of prescription opioids were more likely to be White and female. Participants described first-time users to be as young as 11-12 years of age, and more likely to obtain prescription opioids from medicine cabinets in their home or in the homes of relatives or friends and “pharm parties.”

Reportedly, prescription opioids are commonly used in combination with alcohol and sedative hypnotics. Participants described the use of prescription opioids with crack cocaine, heroin and marijuana as less common.

Participants and treatment providers observed that addiction to prescription opioids is more likely to occur after legitimate use for a pain-related condition.

Sedative-Hypnotics:

Continues to be highly available

As in the previous reporting period, sedative-hypnotics (benzodiazepines, barbiturates and muscle relaxants) remain highly available in the region. Professionals identified Xanax® as the most popular sedative hypnotic in terms of widespread use.

Reportedly, many different types of sedative-hypnotics are currently sold on the region’s streets.

Participants described a normal user as more often female and white, while citing first time

users of sedative-hypnotics as young as 14-15 years of age. A participant explained, “Middle-schoolers use these [sedative-hypnotics].”

Participants described access to young users through medicine cabinets or friends as more likely than obtaining sedative-hypnotics from street dealers.

According to participants, sedative-hypnotics are commonly used in combination with alcohol, heroin and prescription opioids (methadone) to “boost” the high. Treatment providers also reported that alcohol, marijuana and prescription opioids are commonly used in combination with sedative-hypnotics.

Synthetic Marijuana:

Now highly available but not reported on during the past reporting period

Synthetic marijuana is highly available in the region. Much like bath salts, participants and community professionals described high availability of synthetic marijuana, even after the statewide ban of these products went into effect in October. Treatment providers reported use of synthetic marijuana by individuals attempting to pass drug testing.

A treatment provider explained, “It’s hard to catch synthetic drug abuse because drug screens are expensive for them ... they [users] boldly tell you they’re using because they know it won’t show up on a normal drug screen.”

The BCI London Crime Lab and the Hamilton County Coroner’s Crime Lab reported that
the number of synthetic marijuana cases they process has increased during the past six months. More recent data from the BCI London Crime Lab indicated that the five formally
scheduled substances are almost never seen anymore; rather dozens of non-controlled structural analogs have taken their place.

Methamphetamine:

Variable availability with likely decrease in city regions, higher in rural communities

Participants reported that methamphetamine was available in powdered and crystal forms, and continued to be locally produced.


Participants and law enforcement cited that most methamphetamine is produced using anhydrous ammonia and pseudoephedrine. Law enforcement also stated that the labs discovered are typically small-scale and mostly limited to the “one pot” method of manufacture. Law enforcement believed the decrease in methamphetamine is linked to lower pseudoephedrine availability with increased scrutiny by pharmacies using MethCheck® (pseudoephedrine sales tracking system).

A treatment provider stated, “There was so much [media] coverage on the dangers [of methamphetamine manufacture and use] … and it [methamphetamine availability] seemed to decrease after that.”

Participants describe the typical user of methamphetamine as more likely to be male and White; they described first-time users as late teens, approximately 18 years of age, but the typical user was described as, “early-20s up to the 40s.” A treatment provider noted, “Couples tended to use it [methamphetamine] together.” Law enforcement reported higher methamphetamine use among poor or Appalachian communities.

Reportedly, methamphetamine is often used in combination with alcohol, heroin and marijuana.

Other Drugs

Derivatives containing BZP, MDA, and/or TFMPP) remain highly available in the region. Participants most often reported the current availability of Ecstasy as ‘10’ on a scale of ‘0’ (not available, impossible to get) to ‘10’ (highly available). A profile for a typical Ecstasy user did not emerge from the data.

Participants reported the following prescription stimulants as highly available to street-level users: Adderall®, Concerta®, and Vyvanse®. Community professionals described the typical prescription stimulant user as White, aged late teens to early-20s, coinciding with the typical age of a college student.

Participants also reported abuse of OTC cough and cold medicines containing dextromethorphan (Robitussin® DM, Coricidin® HBP cough/ cold). Treatment providers reported that users took high doses of OTC medicines to hallucinate. Participants and treatment providers reported that young adults in high school and college were most likely to abuse OTC cough and cold medicines. Community professionals also described prescription promethazine-codeine syrup as something that individuals in the 18-25 year age group have abused during the past six months. Reportedly, the street jargon, or slang, associated with the mixing of the pharmaceutical cough syrup and Jolly Ranchers candies is“sizzurp.”


Participants reported low to moderate use of inhalants, citing the use of computer duster, nitrous oxide, Freon, paint and Pam® cooking spray as common products abused.Community professionals reported low inhalant abuse among their clients, but described computer duster products as most commonly used for inhalant abuse.

Oregon Before and After Addiction Photos