Revised November 2013
Drug Use in Philadelphia, Pennsylvania: June 2013
Suet T. Lim, Ph.D., Roland C. Lamb, M.A., and Marvin F. Levine, M.S.W.
Summary of Key Findings for the 2012 Reporting Period:
- Continuing increases in heroin treatment admissions, mortality data, and heroin reports from seized and analyzed drug items.
- Polydrug use
During 2012, indicators of drug use in Philadelphia were mixed. Depending on the indicator (market, treatment, criminal justice, or mortality), alcohol, heroin, marijuana, and cocaine ranked consistently as the most frequently reported or detected drugs of abuse. Indicators for heroin and cocaine suggested increased use.
Despite decreases in reports, alcohol and marijuana retained their top rankings as primary drugs of choice among treatment admissions. As the most frequently detected drug from the National Forensic Laboratory Information System (NFLIS) data for Philadelphia County, marijuana accounted for 32.9 percent of all positive drug reports in 2012. There was no change in the criminal justice indicator data, with 30.0 percent of individuals entering probation or parole for the first time in 2012 testing positive for marijuana, similar to 2011.
In the 3 years prior to 2012, cocaine and marijuana had alternated as having the first or second highest percentages of NFLIS positive reports. In 2012, cocaine ranked second, following a large decrease in the proportion of positive reports (from 33 percent in 2011 to 27 percent in 2012). However, treatment data showed a slight increase, from 10.2 to 11.6 percent between 2011 and 2012, while mortality data showed a large increase (from 26.5 percent in 2011 to 39.0 percent in 2012) among all Medical Examiner Office (MEO) cases with the presence of drugs. Data from the Adult Probation and Parole Department (APPD) indicated cocaine use was stable among this population, and it remained the second most frequently detected drug in APPD urinalysis. It would appear that cocaine remained one of the more popular street drugs in Philadelphia, despite less availability. It consistently ranked fourth as primary drug of choice for treatment admissions, after alcohol, heroin, and marijuana. Smoking continued as the preferred route of administration for cocaine.
Alcohol remained the overwhelming primary drug of choice among treatment admissions (39.7 percent); alcohol also led among detections in mortality cases with the presence of drugs (20 percent in 2011 and 26.7 percent in 2012).
Data from different sources indicated increasing use of heroin/morphine. At 36.8 percent, heroin/morphine ranked second as the most frequently detected drug for mortality cases with a presence of drugs. Among deaths caused by alcohol and/or drug intoxication, heroin/morphine was the most frequently detected drug (57.7 percent). Heroin represented the third most frequent positive reports from the NFLIS data, with a small increase in 2012. Of note, the proportion of treatment admissions with heroin as the primary drug of choice showed a large increase (from 17.7 percent in 2011 to 24.0 percent in 2012), ranking it second among total admissions for the first time. The reported preferred route of administration shifted from injection (59.1 percent in 2011) to other (74.0 percent in 2012), which included oral ingestion. \
Prescription and over-the-counter drugs
Treatment admissions for other opiates experienced a substantial decline during this period, but mortality cases with any prescription opioid detected increased from 51.6 percent in 2011 to 65.5 percent in 2012). Oxycodone ranked fourth in NFLIS data, with a lower proportion of positive reports in 2012 than in 2011. The number and percent of mortality cases with oxycodone detected declined in 2012, dropping from fourth to fifth in rank. Treatment and mortality indicators showed increases in the use of benzodiazepines. As secondary and tertiary mentions, benzodiazepines moved into the top five drugs used, with marijuana and cocaine as the primary drugs of choice. Alprazolam remained the benzodiazepine of choice; it was the most commonly detected benzodiazepine among MEO cases with a presence of drugs. Additionally, there was an increase in positive reports in the NFLIS data. Detection of antipsychotic and over-the-counter drugs, such as antihistamines, showed large increases in the mortality indicator. MEO cases with antipsychotic-class drugs increased to 9 percent, following a decrease in 2011. Antihistamine-class drugs were detected in 39 percent of mortality cases, up from 13 percent in 2011. There was a very large increase in the proportion of treatment admissions with over-the-counter drugs (unspecified) as primary and secondary drugs of choice.
PCP (phencyclidine) had more consistent indicators, with slight declines in the proportions admitted for treatment and testing positive for APPD urinalysis, as well as a decline in the proportion of MEO cases.
Methamphetamine and other amphetamines have historically been low-level drugs in Philadelphia, and they remained so in 2012. In contrast to NFLIS reports for the Nation, these speed-type drugs have not appeared among the top 10 positive reports in the past 4 years.
Trend data in HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome) transmission showed a slight increase in cases associated with injection drug use in 2012. The rates of HIV/AIDS and newly diagnosed HIV cases showed a clear decline in transmission risk associated with sharing infected needles.