Revised February 2014
Drug Abuse Patterns and Trends in Miami-Dade and Broward Counties, Florida—Update: January 2014
James N. Hall
Overview of Findings: The key finding identified in 2013 is the outbreak of a “heroin epidemic” in South Florida and particularly in Miami-Dade County. Other key findings in the first half of 2013 are a substantial (nearly 300-percent) increase from the first half of 2012 in drug reports for the synthetic cathinone, methylone, sold as “Mollys,” among seized drug items analyzed by National Forensic Laboratory Information System (NFLIS) laboratories, along with the appearance of 37 different emerging psychoactive drugs.
Updated Drug Abuse Trends and Emerging Patterns
Cocaine: While cocaine-related deaths declined by 9 percent statewide between 2011 and 2012 (from n=1,444 deaths to n=1,318), they increased by 8 percent in Miami-Dade County (from n=184 deaths to n=198) and by 12 percent in Broward County (from n=115 deaths to n=129) during that same period. Cocaine was considered the cause of death in 57 percent of the 129 Broward County deaths in which the drug was detected during 2012 and in 38 percent of the 198 deaths in which cocaine was detected in Miami-Dade County in that year. At least one other drug was also found to be present in all cocaine-related deaths in both counties. Primary cocaine treatment admissions for both powder and crack cocaine in Miami-Dade County declined from 28 percent of all admissions (including alcohol) in calendar year (CY) 2009, to 23 percent in CY 2012, before dropping to 14 percent in the first half of 2013. In Broward County, primary cocaine treatment admissions declined from 14 percent of all admissions in CY 2009, to 10 percent in CY 2012, and to 9 percent in the first 6 months of 2013. Cocaine reports accounted for 44 percent of all primary, secondary, and tertiary drug reports among drug items analyzed in NFLIS laboratories in Miami-Dade, Broward, and Palm Beach Counties (three counties in the Miami Metropolitan Statistical Area [MSA]) during the first half of 2013; this represented a decrease from 49 percent in the first half of 2012.
Heroin indicators, which historically have been at relatively low levels compared with other drugs of abuse in South Florida, rose sharply since the last reporting period. Heroin deaths increased by 89 percent across Florida between 2011 and 2012 (from n=62 deaths to n=117), while they rose by 120 percent in Miami-Dade County (from n=15 deaths in 2011 to n=33 in 2012). Heroin deaths in Broward County, while relatively few in number, tripled from 3 to 9 in the same 2-year period. Primary heroin treatment admissions increased from 4 percent of all substance abuse admissions in CY 2012 to 8 percent in the first half of 2013 in Miami-Dade County, while they were stable, at 5 percent of total admissions, in Broward County in both time periods. Heroin reports among drug items seized and analyzed by NFLIS laboratories in South Florida in the first half of 2013 totaled 389, representing 3.3 percent of total drug reports. This was an increase from 2.7 percent in the first half of 2012. The rapid rise in heroin indicators constitutes an “epidemic outbreak,” particularly in Miami-Dade County, according to the area representative.
Prescription Opioids/Opiates Other Than Heroin: In Florida, in 2012, 4,944 persons died with 1 or more prescription drugs detected in those decedents; this represented a 10-percent decrease from the previous year. In Miami-Dade County, the number of prescription opioid drug-related deaths increased by 13 percent (from n=312 to n=353 deaths), while they declined by 19 percent in Broward County (from n=431 deaths to n=351). A total of 187 occurrences of 4 different prescription opioids were detected among decedents in Miami-Dade County during 2012, representing a 7-percent increase from 2011. The 258 such occurrences in Broward County in 2012 constituted a 21-percent decline from the previous year. A total of 568 primary prescription opioid treatment admissions were observed in Broward County during the first half of 2013; there were 127 such admissions in Miami-Dade County in the same period. The Broward County admissions were 9 percent lower than in the first half of 2012, and the Miami-Dade County admissions were 10 percent higher. Injection drug use was the preferred route of administration for 55 percent of the Broward County prescription opioid treatment clients in 2012 and 21 percent of clients in Miami-Dade County. The 481 drug reports for prescription opioids among drug items seized and analyzed by NFLIS laboratories in the first half of 2013 in the South Florida counties of the Miami MSA (Miami-Dade, Broward, and Palm Beach) represented a modest 2-percent decline from the proportion of prescription opioid reports identified among analyzed drug items in the first half of 2012.
Benzodiazepines: The 5,184 reports of the presence of a benzodiazepine in deceased persons across Florida in 2012 represented a 13-percent decrease, compared with 2011, and included 1,417 occurrences for alprazolam (e.g., Xanax®), 820 for nordiazepam (e.g., Nordaz®), and 770 for diazepam (e.g., Valium®). Over the same 2-year period statewide, total alprazolam occurrences decreased by 25 percent; those for nordiazepam decreased by 9 percent; and diazepam occurrences declined by 14 percent. In Miami-Dade County, deaths with alprazolam or diazepam detected decreased by 8 percent in the period, totaling 55 in 2012. Such deaths declined by 35 percent in Broward County, where they totaled 98 in 2012. Numbers of primary treatment admissions for benzodiazepines and proportions of drug reports identified as benzodiazepines among drug items analyzed in NFLIS laboratories in the first half of 2013 remained stable from the first half of 2012.
Methamphetamine: Numbers of primary methamphetamine treatment admissions in 2013 remained very low and stable in both South Florida counties. However, statewide in Florida, deaths caused by methamphetamine totaled 68 in 2012; this represented a 39-percent increase over the previous year. The 150 methamphetamine reports among drug items analyzed in NFLIS laboratories in South Florida in the first half of 2013 accounted for 1.3 percent of all drug reports; this was an 85-percent increase from the 81 reports (0.6 percent of the total drug reports) for methamphetamine in the first half of 2012.
Marijuana/Cannabis and Synthetic Cannabinoids (Cannabimimetics): Primary marijuana treatment admissions declined in both South Florida counties in this reporting period, from 39 percent of Miami-Dade County clients in CY 2012 to 28 percent in the first half of 2013, and from 30 percent of Broward County clients in CY 2012 to 19 percent in 2012. Reports for marijuana/cannabis among drug items analyzed by NFLIS laboratories numbered 2,747 (23.0 percent of the total) in the first 6 months of 2013. This proportion was stable, compared with the 22.7 percent of total drug reports (n=2,864) in the first half of 2012. Marijuana/cannabis ranked second in frequency among all drug reports for substances analyzed by NFLIS forensic laboratories in the first half of 2013, as it did in the first half of 2012. Six different chemicals were identified among the 73 South Florida drug reports identified as synthetic cannabinoids (cannabimimetics) among drug items analyzed in NFLIS laboratories in the first half of 2013, compared with 10 different substances identified in 190 drug reports in CY 2012.
Other Drugs: In the first half of 2013, 38 drug reports were identified as MDMA or “ecstasy” (3,4-methylenedioxymethamphetamine) among drug items analyzed by South Florida (Miami MSA) NFLIS laboratories during the first half of 2013 (representing 0.3 percent of total drug reports), compared with 76 such drug reports (0.6 percent of the total) in the first half of 2012. While capsules sold as “Mollys” are represented to buyers as pure MDMA, the area representative reported that they actually contain methylone (3,4-methylenedioxymethcathinone). In the first half of 2013, 611 drug reports among analyzed drug items contained methylone. Methylone ranked third among all drug reports from seized drug items analyzed in South Florida NFLIS laboratories in the 2013 reporting period. In the first half of 2013, 37 different emerging psychoactive substances were identified among NFLIS drug reports (including cannabimimetics, synthetic [substituted] cathinones, 2C phenethylamines, piperazines, and tryptamines). In addition to the 73 drug reports identified as cannabimimetics, 647 drug reports were identified as synthetic (substituted) cathinones (including the 611 methylone samples) and 11 drug reports identified as 2C phenethylamines among drug items analyzed in the first half of 2013.
Data Sources: Drug-related death data are from the Florida Medical Examiners Commission 2012 Report on Drugs Identified in Deceased Persons by Florida Medical Examiners, from the Florida Department of Law Enforcement, released August 2013. Treatment data by primary drug of abuse at admission for the first half of 2013 are from the Florida Department of Children and Families (FL-DCF) for all publicly funded treatment programs. Crime laboratory data on drug reports identified among drug items analyzed in area forensic laboratories were provided for the Miami/Fort Lauderdale/Pompano Beach MSA by NFLIS, Drug Enforcement Administration, for January–June 2013.
For inquiries regarding this report, please contact James N. Hall, Epidemiologist, Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, 13584 S.W. 114 Terrace, Miami, FL 33186, Phone: 786-547-7249, E-mail: firstname.lastname@example.org.