PULSE CHECK PULSE CHECK

Special Topic:

The Impact of September 11

Trends in Drug Abuse

July–December 2001 Reporting Period

Executive Office of the President

Office of National Drug Control Policy

April 2002

Special Topic:

The Impact of September 11

Trends in Drug Abuse

July–December 2001 Reporting Period

Executive Office of the President

Office of National Drug Control Policy

April 2002
PULSE CHECK

Trends in Drug Abuse

April 2002

Executive Office of the President

Office of National Drug Control Policy

Washington, DC 20503

NCJ 193398
ACKNOWLEDGEMENTS

ACKNOWLEDGEMENTS

The Office of National Drug Control Policy (ONDCP) acknowledges the contributions made by the 75 Pulse

Check sources who voluntarily prepared for and participated in the in-depth discussions that are the basis for

this report. Their names (unless they requested anonymity) appear in an appendix. Information presented in

this publication reflects the views of those sources, and not necessarily those of the Federal Government.

Marcia Meth and Rebecca Chalmers of Johnson, Bassin & Shaw, Inc., produce the Pulse Check for ONDCP,

under Contract Number 282-98-0011, Task Order Number 10. Anne McDonald Pritchett, Office of Planning

and Budget, ONDCP, serves as the project director and editor for Pulse Check.

All material in this publication is in the public domain and may be reproduced or copied without permission

from ONDCP. Citation of the source is appreciated. The U.S. Government does not endorse or favor any 

specific commercial product. Trade or proprietary names appearing in this publication are used only because

they are considered essential in the context of the information reported.

This issue and previous issues of Pulse Check are available online at <www.whitehousedrugpolicy.gov>. 
CONTENTS

Pulse Check: April 2002 page iii

CONTENTS

Highlights. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Special Topic: The Impact of September 11. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Heroin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Crack Cocaine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

Powder Cocaine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

Marijuana . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Methamphetamine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

Diverted Synthetic Opioids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

Ecstasy and Club Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

Appendix 1: Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

Appendix 2: Population Demographics in the 20 Pulse Check Sites. . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

Appendix 3: National-Level Data Sources Available in the 20 Pulse Check Sites . . . . . . . . . . . . . . . . . . 71

Appendix 4: Pulse Check Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72

Appendix 5: List of Discussion Areas by Source Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74

EXHIBITS

Highlights

Exhibit 1. How serious is the perceived drug problem in the 20 Pulse Check communities (fall 2001)? . . . . . . . . . . . . .1

Exhibit 2. How has the perceived drug problem changed (spring 2001 vs fall 2001)? . . . . . . . . . . . . . . . . . . . . . . . . . .1

Exhibit 3. What are the most serious drug problems in the 20 Pulse Check sites, by type of source? . . . . . . . . . . . . . . .2

Exhibit 4. What are the most serious drug problems in the 20 Pulse Check sites, by number of sources and sites? . . . . .2

Exhibit 5. What new problems have emerged or intensified during fall 2001? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

Exhibit 6. In what other crimes are illicit drug sellers involved across Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . .4

Exhibit 7. How has the perceived drug problem changed (spring 2001 vs fall 2001)? . . . . . . . . . . . . . . . . . . . . . . . . . .5
CONTENTS

page iv Pulse Check: April 2002

Special Topic: The Impact of September 11

Exhibit 1. How have availability of and demand for illegal drugs reportedly changed across the 20 Pulse Check

cities since September 11th? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

Heroin

Exhibit 1. How available is heroin across the 20 Pulse Check cities (fall 2001)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Exhibit 2. How has overall heroin availability changed (spring 2001 vs fall 2001)? . . . . . . . . . . . . . . . . . . . . . . . . . .14

Exhibit 3. Which heroin varieties have changed in availability (spring 2001 vs fall 2001)? . . . . . . . . . . . . . . . . . . . . .14

Exhibit 4. What are the prices and purity levels of different types of heroin in 19 Pulse Check cities? . . . . . . . . . . . . .15

Exhibit 5. How is heroin referred to, and what types of heroin predominate, in different regions of the country? . . . .16

Exhibit 6. How likely are heroin sellers to use their own drug? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

Exhibit 7. What other drugs do heroin dealers sell? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Exhibit 8. What demographic groups predominate among heroin users, according to 

different Pulse Check sources? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

Exhibit 9. How do users administer heroin? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22

Crack Cocaine

Exhibit 1. How available is crack cocaine across the 20 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25

Exhibit 2. How has crack cocaine availability changed (spring 2001 vs fall 2001)? . . . . . . . . . . . . . . . . . . . . . . . . . . .26

Exhibit 3. What are crack cocaine price levels in the 20 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

Exhibit 4. How is crack cocaine referred to across different regions of the country? . . . . . . . . . . . . . . . . . . . . . . . . .28

Exhibit 5. What age group is most likely to use crack? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29

Exhibit 6. Which genders are the predominant users of specific drugs in the 20 Pulse Check cities? . . . . . . . . . . . . . .30

Exhibit 7. What racial/ethnic group is most likely to use crack? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31

Powder Cocaine

Exhibit 1. How available is powder cocaine across the 20 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33

Exhibit 2. How has powder cocaine availability changed (spring 2001 vs fall 2001)? . . . . . . . . . . . . . . . . . . . . . . . . .34

Exhibit 3. How much do grams and "eightballs" of powder cocaine cost in 15 Pulse Check cities? . . . . . . . . . . . . . . . .34

Exhibit 4. How is powder cocaine referred to across different regions of the country? . . . . . . . . . . . . . . . . . . . . . . . .35

Exhibit 5. What racial/ethnic group is most likely to use specific drugs? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36

Exhibit 6. What other drugs do powder cocaine users take? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38

Marijuana

Exhibit 1. How available is marijuana across the 20 Pulse Check cities (fall 2001)? . . . . . . . . . . . . . . . . . . . . . . . . . .39

Exhibit 2. How has marijuana availability changed (spring 2001 vs fall 2001)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39

Exhibit 3. Which marijuana varieties have changed in availability (spring 2001 vs fall 2001)? . . . . . . . . . . . . . . . . . . .40

Exhibit 4. How much does marijuana cost in 19 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41

Exhibit 5. How is marijuana referred to in different regions of the country? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42

Exhibit 6. What age group is most likely to use marijuana? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43
CONTENTS

Pulse Check: April 2002 page v

Exhibit 7. Where are drug users most likely to reside? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43

Exhibit 8. How are different drug users referred to treatment? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45

Methamphetamine

Exhibit 1. How available is methamphetamine across the 20 Pulse Check cities (fall 2001)? . . . . . . . . . . . . . . . . . . . .47

Exhibit 2. How has methamphetamine availability changed (spring 2001 vs fall 2001)? . . . . . . . . . . . . . . . . . . . . . . .48

Exhibit 3. How much does methamphetamine cost in 14 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

Exhibit 4. How is methamphetamine referred to in different regions of the country? . . . . . . . . . . . . . . . . . . . . . . . . .49

Diverted Synthetic Opioids

Exhibit 1. Where are the diversion and abuse of OxyContin® emerging across the 20 Pulse Check cities? . . . . . . . . . .53

Exhibit 2. How available is diverted OxyContin® across the 20 Pulse Check cities (fall 2001)? . . . . . . . . . . . . . . . . .54

Exhibit 3. How has diverted OxyContin® availability changed (spring 2001 vs fall 2001) . . . . . . . . . . . . . . . . . . . . .55

Exhibit 4. How has the number of novice OxyContin® treatment clients changed (spring 2001 vs fall 2001)? . . . . . .56

Ecstasy and Club Drugs

Exhibit 1. Where is ecstasy emerging across the 20 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59

Exhibit 2. How available are ecstasy and GHB across the 20 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . .60

Exhibit 3. Has ecstasy or GHB availability changed across the 20 Pulse Check cities (spring 2001 vs fall 2001)? . . . . .60

Exhibit 4. How are club drugs and club drug combinations referred to across Pulse Check cities? . . . . . . . . . . . . . . . .61

Exhibit 5. How are ecstasy pills labeled in reporting Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .62

Exhibit 6. How much does a pill (one dose) of ecstasy cost in 18 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . .62

Exhibit 7. Has the number of novice ecstasy users in treatment changed (spring 2001 vs fall 2001)? . . . . . . . . . . . . . .64

Exhibit 8. What are club drug prices? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65

Exhibit 9. What are the predominant characteristics of club drug sellers and sales? . . . . . . . . . . . . . . . . . . . . . . . . . .66

Exhibit 10. What are the predominant characteristics of club drug users and use? . . . . . . . . . . . . . . . . . . . . . . . . . . .66
page vi Pulse Check: April 2002

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HIGHLIGHTS

Pulse Check: April 2002 page 1

PULSE CHECK HIGHLIGHTS✛

This report is based on discussions with 75 epidemiologists, ethnographers, law enforcement officials, and methadone and

non-methadone treatment providers from 20 Pulse Check sites. Telephone discussions with these individuals, conducted

between November 2001 and January 2002, reveal that overall, when comparing spring and fall 2001, the majority of

Pulse Check sources believe their communities’ drug abuse problem to be very serious but stable. (Exhibits 1 and 2)

Exhibit 2.

How has the perceived drug

problem changed (spring 2001

vs fall 2001)?

Sources: Law enforcement, epidemiologic/

ethnographic, and treatment respondents

Somewhat

Worse

Much

Worse

Less

Serious

Percent (N=75)

Same

100

90

80

70

60

50

40

30

20

10

0

Exhibit 1.

How serious is the perceived

drug problem in the 20 Pulse

Check communities (fall 2001)?

Sources: Law enforcement, epidemiologic/

ethnographic, and treatment respondents

Somewhat

Serious Very

Serious Not Very

Serious

Percent (N=75)

100

90

80

70

60

50

40

30

20

10

0

The illicit drug situation is characterized by several key features:

➤ The September 11 terrorist attacks and subsequent events had varied

short- and long-term effects on illegal drug availability, trafficking routes

and modes, local marketing strategies, and use patterns in 16 of the 20

sites.

➤ Heroin has surpassed crack as the drug associated with the most serious 

consequences, as perceived by 27 sources in 17 sites. (Exhibits 3 and 4)

➤ The number of female heroin users has increased in four cities, where

sources are increasingly seeing gender equity among a number of chronic

drug users.

➤ Marijuana remains the most widely abused illicit drug, as reported by 35

sources in 18 sites. Sources in two sites report it as the drug with the most

serious consequences. (Exhibits 3 and 4)

➤ Methamphetamine continues to be reported as an emerging problem in 

several sites. (Exhibit 5) Furthermore, 14 sources in 8 cities consider it

the drug contributing to the most serious consequences, doubling from

only 4 cities since the last Pulse Check, and replacing crack in 2 instances.

(Exhibits 3 and 4)

➤ Most respondents continue to link methamphetamine sellers to domestic

violence, more so than with any other drug. (Exhibit 6)

➤ The emerging diversion and abuse problem involving OxyContin®, a 

controlled-release formulation of the pharmaceutical opiate oxycodone, 

has spread to all but two sites and is associated with serious consequences.

(Exhibits 5 and 7)

➤ OxyContin® abuse and diverted sales continue to emerge in the rave and

nightclub scenes in seven cities: Boston, Detroit, Memphis, Miami, New

Orleans, Philadelphia, and Sioux Falls.

➤ “Ecstasy” (methylenedioxymethamphetamine or MDMA) continues to 

be an emerging problem in the majority of sites. (Exhibit 5)

✛The following symbols appear throughout these Highlights to indicate type of respondent: L

Law enforcement respondent, EEpidemiologic/ethnographic

respondent, NNon-methadone treatment respondent, and MMethadone treatment respondent.
HIGHLIGHTS

page 2 Pulse Check: April 2002

# After September 11, availability of

illegal drugs, particularly heroin,

declined in 12 cities: Baltimore,

Columbia (SC), Denver, Detroit,

El Paso, Honolulu, Memphis,

Miami, New Orleans, New York,

Seattle, and Sioux Falls.

# Because heroin availability declined

after September 11, heroin users

are increasingly substituting 

prescription drugs for heroin in

Baltimore, Columbia (SC), El Paso,

and New York.

# Heightened security at U.S. points

of entry may have changed drug

trafficking modes or routes in

seven cities: Denver, Honolulu,

Miami, New York, Portland (ME),

St. Louis, and Seattle.

# Signs of increased drug abuse

were described in nine cities:

Boston, Columbia (SC), Honolulu,

Miami, New York, Portland (ME),

St. Louis, Seattle, and Washington,

DC. These signs include increases

in demand for treatment, requests

for services, and attempts to selfmedicate illicitly for anxiety or

depression.

# Trafficking shifts in some border

areas, such as Detroit, Portland

(ME), and El Paso, were only short

term and soon reverted to “business as usual.” Similarly, shortterm market effects, such as price

gouging, “super sales,” and drug

adulteration, were reported in

Boston, Miami, New York, and

Washington, DC.

Exhibit 3. What are the most serious drug problems in the 20 Pulse Check

sites, by type of source?*

Most commonly abused?* Most serious consequences?

City L E N L E N M 

Boston, MA MJ MJ H HCl Crack H Benzos

New York, NY MJ MJ Crack H Crack Crack Crack

Philadelphia, PA MJ MJ H H H H H

Portland, ME MJ MJ H H+Pharm. Oxy H Oxy

opiates

Baltimore, MD NR H NR NR H NR Alcohol

Columbia, SC Crack MJ MJ Crack Crack MJ H

El Paso, TX MJ MJ Cocaine N/A Crack H Cocaine

Memphis, TN Meth MJ NR Meth Crack NR NR

Miami, FL Crack MJ Crack Oxy H Crack Benzos

New Orleans, LA Crack Crack Crack H Crack Crack Oxy

Washington, DC Crack MJ Crack Crack H Crack H

Chicago, IL Crack MJ H Crack H Crack H

Detroit, MI MJ MJ Crack H H Crack H

St. Louis, MO MJ MJ MJ Crack Crack Meth H

Sioux Falls, SD MJ MJ Alcohol Meth Meth Alcohol Meth

+MJ +MJ

Billings, MT Meth MJ MJ Meth Meth Meth Meth

Denver, CO MJ MJ Meth HCl HCl Meth H

Honolulu, HI MJ Meth NR Meth Meth NR H 

Los Angeles, CA Crack MJ MJ Crack H Meth H

Seattle, WA MJ MJ MJ Meth H Cocaine H

West South Northeast Midwest

*Heroin is almost always, by definition, the most commonly used drug in methadone programs, 

so methadone treatment sources are excluded from this question.

Note: HCl = Powder cocaine; MJ = Marijuana; H = Heroin; Meth = Methamphetamine; 

Benzos = Benzodiazepines; Oxy = OxyContin®; Cocaine = unspecified whether crack or HCl;

NR= nonrespondent

Exhibit 4. What are the most serious drug problems in the 20 Pulse Check

sites, by number of sources and sites?

Drug Most commonly abused?* Most serious consequences?

No. of sources No. of sites No. of sources No. of sites

Heroin 5 5 27 17

Crack 12 8 19 12

Powder cocaine 1 1 5 4

Marijuana 35 18 1 1

Methamphetamine 4 4 14 8

Diverted OxyContin® 00 53

Benzodiazepines 0 0 2 2

Alcohol 1 1 2 2

*Methadone treatment sources are excluded from this count.

Sources: Law enforcement, epidemiologic/ethnographic, non-methadone treatment, and

methadone treatment respondents

HIGHLIGHTS FROM THE SPECIAL

TOPIC SECTION: THE IMPACT OF

SEPTEMBER 11
HIGHLIGHTS BY SPECIFIC

ILLICIT DRUG

The 75 discussions also yielded key

findings about heroin, crack, powder

cocaine, marijuana, methamphetamine,

synthetic opioids, and ecstasy.

HEROIN

# Availability increased in only seven

sites (Boston, Chicago, Detroit, El

Paso, Miami, New Orleans, and

Portland [ME]), declined in two

(Denver and Honolulu), and

remained stable elsewhere.

Increases generally involve highpurity South American

(Colombian) white heroin, which

remains the most common.

Mexican black tar still predominates in the West.

# Street-level prices are generally stable, except for increases in Denver

and Seattle and declines in El Paso

and Washington, DC. Purity levels

are also generally stable, except for

increases in Boston, El Paso, and

Portland and declines in Denver,

New Orleans, and Seattle.

# Drug sales increasingly involve

referrals, beepers, cell phones, 

prearranged meeting places, home

deliveries, and multi-tiered market

structures.

# Use is increasing among younger

people. Many are suburban

Whites, particularly in areas

around Baltimore, Chicago,

Denver, St. Louis, and Washington,

DC.

# Female users are increasing in

some cities (Denver, Memphis,

New Orleans, and Portland [ME]).

HIGHLIGHTS

Pulse Check: April 2002 page 3

Exhibit 5. What new problems have emerged or intensified during fall

2001?

OxyContin® Ecstasy/Club Drugs Methamphetamine

Baltimore, MDE

Billings, MTL,N

Boston, MAL,E,N

Columbia, SCE,N

Denver, COM

Detroit, MIE

El Paso, TXM

Honolulu, HIL,M

Los Angeles, CAM

Memphis, TNL,E

Miami, FLL,E

New Orleans, LAL

New York, NYM

Philadelphia, PAL,M,N

Portland, MEL,M

St. Louis, MOM,N

Seattle, WAN

Sioux Falls, SDE

Baltimore, MDE

Billings, MTN

Boston, MAL

Chicago, ILL

Denver, COL

Detroit, MIE

El Paso, TXE

Honolulu, HIE

Los Angeles, CAL,E

Memphis, TNL,E

New Orleans, LAL (Ketamine)

New York, NYE,N

Philadelphia, PAL

Portland, MEL,E

Sioux Falls, SDN

Washington, DCE,N

Billings, MTN

Chicago, ILM,N

Columbia, SCL

Detroit, MIN

Memphis, TNE

New Orleans, LAM

Seattle, WAL

Sioux Falls, SDE,N

Washington, DCE

Benzodiazepines: Los Angeles, CAL; Seattle, WAE

Clonidine (Catapres®): Baltimore, MDM

Dextromethorphan (sold as ecstasy): Memphis, TNE

Diverted methadone: Detroit, MIE; Portland, MEE

Diverted pharmaceuticals: Boston, MAE

Fentanyl*: Boston, MAE,M

Hallucinogens: Los Angeles, CAL

Herbal supplements: Memphis, TNE

Heroin: Billings, MTN; Boston, MAE (ODs); 

Denver, COE (young White suburbanite 

deaths); Memphis, TNE

Injecting: Sioux Falls, SDN

Khat**: Boston, MAL

PCP: Washington, DCE

Billings, MTE

Chicago, ILE

Columbia, SCM

Denver, CON

Detroit, MIL,M

El Paso, TXL,N

Los Angeles, CAN

Miami, FL M,N

New Orleans, LAE,N

New York, NYL

Portland, MEN

St. Louis, MOL

Seattle, WAM

Sioux Falls, SDL

Washington, DCL,M

Other Emerging Drug Problems None

*Fentanyl is a powerful synthetic opiate often confused with heroin, responsible for overdose

deaths, and often found in patch form.

**Khat is a natural stimulant from the Catha Edulis plant, found in a flowering evergreen tree or

large shrub from East Africa and Southern Arabia. Its leaves contain psychoactive ingredients

structurally and chemically similar to d-amphetamine.
HIGHLIGHTS

page 4 Pulse Check: April 2002

# Although injecting still predominates, snorting and smoking have

increased in many sites, often

among younger users in suburban

areas. In Boston and New York,

however, some people are shifting

from snorting to injecting.

CRACK COCAINE

# Availability remains generally wide

and stable. Increases are perceived

in only three cities (Chicago,

Detroit, and El Paso) and declines

in another three (Boston, Denver,

and Honolulu).

# Street-level prices are generally 

stable.

# Only a few sales scene changes are

reported. In Columbia, SC, for

example, young marijuana users

increasingly sell crack.

# Crack continues to be sold mainly

in central city areas, but suburban

and rural areas are sometimes mentioned. In Memphis, sales are moving from the city into the suburbs

and rural areas.

# Billings is the only site where adolescent users have increased.

# Nearly half of the sources report

males and females as equally likely

to use crack—more so than any

other illicit drug except ecstasy, as

reported previously.

# Crack-marijuana combinations

have declined in Baltimore and

Boston but increased in Memphis.

POWDER COCAINE

# Availability remains wide, with

increases in only three cities

(Columbia [SC]), El Paso, and

Portland [ME]) and declines in

two (Honolulu and Washington,

DC).

# Price and purity levels are stable.

# Although powder cocaine is sold

primarily in central city locations,

it is more likely than crack to be

sold in suburban or rural areas.

Use is up in suburbs around

Memphis and New Orleans and in

Denver’s rural areas.

# Like heroin users, powder cocaine

users tend to be White males,

older than 30. Only a few changes

are reported in user characteristics.

For example, in a Columbia, SC,

treatment program, female adolescent novice users have been

increasing. The source notes that

“the perceived risk of cocaine is

dropping among the clients.”

MARIJUANA

# Availability remains wide. Only

four increases (in Boston,

Columbia [SC], Denver, and

Honolulu) and only one decline

(in Chicago) are reported.

# Indoor hydroponic growing operations have increased in Boston,

Memphis, and Philadelphia.

# Prices are stable except for a slight

increase in Portland, ME, and a

decline in El Paso.

# Users are becoming younger 

(sometimes younger than 13) in

Billings, Boston, Chicago, Columbia

(SC), Miami, Philadelphia, and

Sioux Falls. Female users have

increased in New Orleans,

Philadelphia, and Sioux Falls.

# Flavored blunt wraps are a 

commercial product recently 

Exhibit 6.

In what other crimes are methamphetamine and other illicit drug sellers

involved across Pulse Check cities?

Sources: Law enforcement and epidemiologic/ethnographic respondents

Methamphetamine

Heroin

Crack

Powder cocaine

Marijana

Domestic

violence

(N=37)

38%

Violent

crimes

(N=73)

Gang-related crimes

(N=65)

Nonviolent

crimes

(N=85)

Prostitution

(N=53)

9%

18%

19%

13%
introduced in New York and

Philadelphia. These tobacco 

leaves are moister, fresher, slower

burning, and viewed as less messy

than gutted cigars.

# Five treatment sources (in

Columbia [SC], El Paso, Miami,

Seattle, and Washington, DC)

mention clients who smoke joints

that, without their knowledge,

have been laced with crack.

# Compared with other drug users,

marijuana users are still more likely

to reside in all locations (central

city, suburban, and rural areas).

METHAMPHETAMINE

# Methamphetamine has replaced

crack as the most serious drug

problem according to sources in

Memphis and St. Louis and has

replaced heroin according to the

law enforcement source in Seattle.

# Methamphetamine remains available predominantly in the West.

However, availability has increased

in all regions.

# The number of users has increased

in nine cities: Billings, Columbia

(SC), Denver, Memphis, Miami,

New Orleans, St. Louis, Seattle, and

Washington, DC.

# As reported previously, most

respondents link methamphetamine sellers to domestic violence,

more so than any other drug.

# Several user characteristics have

changed: females increased in Honolulu and Memphis; adults (>30

years) increased in Memphis and

Washington, DC, and adolescents

increased in Honolulu and Los

Angeles; and Hispanics increased

in Los Angeles and New York.

DIVERTED SYNTHETIC OPIODS

# Oxycontin® was the synthetic 

opioid most frequently mentioned

by Pulse Check sources as being

diverted.

# Nearly half of law enforcement

and epidemiologic/ethnographic

sources report increased availability of diverted OxyContin®.

Availability is highest in the

Northeast and South.

# Diversion of OxyContin® has

intensified in Billings (an emerging

illegal market), Boston (increased

pharmacy robberies), and New

York (street sales reported for the

first time).

# Diversion and abuse of OxyContin® are not limited to rural

areas: central city, suburban, and

rural areas are mentioned equally

by sources across all sites.

# Abuse of OxyContin® has

increased in 13 sites: Billings,

Boston, Columbia (SC), Denver,

Honolulu, Los Angeles, Memphis,

New Orleans, Philadelphia,

Portland (ME), St. Louis, Seattle,

and Sioux Falls. 

# OxyContin® abusers remain 

predominantly young adults

(18–30 years) or adults (older 

than 30). However, adolescent

(13–17 years) abusers predominate 

in Columbia (SC), New Orleans,

and Sioux Falls, and they are

emerging in Boston. 

# Heroin is often substituted for

OxyContin®, particularly in 

eastern cities. By contrast, in 

some cities, heroin users may be

switching to OxyContin®. In

Miami, it is often sold in the 

same neighborhoods as crack.

HIGHLIGHTS

Pulse Check: April 2002 page 5

Exhibit 7. How has the perceived drug problem changed (spring 2001 vs fall 2001)?

Boston, MAL

Boston, MAM

Columbia, SCE

Columbia, SCL

Columbia, SCM

Memphis, TNL

Portland, MEL

Portland, MEM

Portland, MEN

Washington, DCM

Powder cocaine 

Benzodiazepines

Crack 

Marijuana

Heroin 

Crack

Heroin/Pharmaceutical

opiates 

Heroin/Other opiates

Cocaine 

Crack 

Marijuana

Crack

Marijuana

Crack

OxyContin®

Methamphetamine

Marijuana

Heroin

Heroin

Heroin

Boston, MAL

Memphis, TNL

Miami, FLE

Miami, FLL

Portland, MEL

Portland, MEE

Portland, MEM

St. Louis, MON,M

Seattle, WAL

Crack 

Crack 

OxyContin® 

Cocaine

Pharmaceutical

opiates

Heroin 

Benzodiazepines

Crack 

Heroin 

Powder cocaine

Methamphetamine

Heroin

OxyContin®

Heroin/Pharmaceutical

opiates

(OxyContin®)

OxyContin®

OxyContin®

Methamphetamine

Methamphetamine

Where has the drug with the “the most serious

consequences” changed?

Site/Source Spring 2001 Fall 2001

Where has the “the most commonly abused drug”

changed?

Site/Source Spring 2001 Fall 2001
page 6 Pulse Check: April 2002

# In some sites, abusers of

OxyContin® are often current or

former abusers of other prescription drugs, typically benzodiazepines or opiates.

ECSTASY AND CLUB DRUGS

# Ecstasy continues to be the most

available club drug, followed by

gamma hydroxybutyrate (GHB),

ketamine, and Rohyphol® (flunitrazepam). Ecstasy availability 

continues to increase in most sites,

while other club drug availability 

is mostly stable.

# Sales and use settings continue to

expand from raves, nightclubs/

bars, and private residences and

parties to streets and in or around

high schools. 

# User and seller populations also

continue to expand and now

include non-Whites and Hispanics.

Additionally, adolescent sellers and

users have increased in many cities. 

# Heroin, crack, and powder cocaine

are now sold and used with ecstasy.

# Two new precursors to GHB

(GHV [gamma hydroxyvalerate]

and GVL [gamma valeroactone])

are being sold as nutritional 

supplements in health food 

stores, on the Internet, at raves,

and in nightclubs/bars.
INTRODUCTION

Pulse Check: April 2002 page 7

INTRODUCTION

Since 1992, the Office of National

Drug Control Policy (ONDCP) has

published the Pulse Check, a source

for timely information on drug abuse

and drug markets. The report aims to

describe chronic drug users, emerging

drugs, new routes of administration,

varying use patterns, changing

demand for treatment, drug-related

criminal activity, drug markets, and

shifts in supply and distribution patterns. Pulse

Check regularly addresses four drugs of serious

concern: heroin, crack

cocaine/powder cocaine,

marijuana, and methamphetamine. Additionally,

due to their spread

across the country, Pulse

Check continues to

monitor the problems of

“ecstasy” (methylenedioxy-methamphetamine

or MDMA) and other

club drugs, as well as

the diversion and abuse

of OxyContin®, a controlled-release formulation of the

pharmaceutical opiate oxycodone.

The Pulse Check is not designed to be

used as a law enforcement tool but

rather to be a research report presenting findings on drug use patterns and

drug markets as reported by ethnographers, epidemiologists, treatment

providers, and law enforcement officials. With regards to race and ethnicity, just as the National Household

Survey on Drug Abuse and other

national data sources report findings

by race and ethnicity, sources contributing to the Pulse Check are asked

to describe the age, ethnicity, and

gender of illegal drug users and those

who sell drugs and any changes in

these characteristics. The information

provided to Pulse Check reflects the

observations of the sources, and their

descriptions are purely for determining the size, scope, and diversity of

the drug problem. The intent of the

Pulse Check has been and continues

to be merely to describe patterns in

illicit drug use and illicit drug markets

that are emerging in local communities.

Use and Interpretation of Pulse

Check Information

By contacting professionals from three

different disciplines—ethnography/

epidemiology, law enforcement, and

treatment—a rich picture of the

changing drug abuse situation emerges.

Though this approach offers substantial strengths in timeliness and depth,

Pulse Check is not intended as a 

quantitative measure of the prevalence

of drug abuse or its consequences. Any

interpretation or conclusion drawn

from Pulse Check must be viewed 

carefully and in conjunction with other

more quantifiable direct and indirect

measures of the drug abuse problem.

More specifically, several of the 

limitations of Pulse Check are briefly

discussed below.

Pulse Check focuses on the drug abuse

situation in 20 specific sites throughout the Nation. Though considerable

effort was made to select sites across a

broad range of geographic areas,

including Census regions and divisions,

urban and rural States,

racial/ethnic coverage,

and high intensity drug

trafficking areas, Pulse

Check cannot be

viewed as a national

study, and information

cannot be reasonably

aggregated up to a

national level.

Of the 80 sources

identified and recruited across the three disciplines, 75 provided

information for this

Pulse Check issue.

The information presented in this

report is based solely on the observations and perceptions of those 75 individuals. These individuals may not be

knowledgeable about every aspect of

the drug abuse situation in their sites,

and they may have biases based on

their experiences and exposures.

Due to the comprehensive nature of

the telephone discussions, sources

were asked to discuss only areas in

which they were thoroughly knowledgeable. Thus, the total number (N)

of respondents to any one question

might be less than 75.

The 20 Pulse Check Sites
INTRODUCTION

page 8 Pulse Check: April 2002

Any contradictory reports within an

individual site are not necessarily a

Pulse Check limitation. Just as the site

sampling methodology was designed

to reflect the country’s geographic

and population diversity, recruiting

four sources per site was incorporated

into the design to reflect diversity

within each of the 20 sites. For example, a law enforcement source in one

site might perceive cocaine to be the

community’s most serious problem,

while an ethnographic source at that

same site might consider the most

serious problem to be heroin. And

they would both be right—because

each might come in contact with 

different populations or each might

deal with a specific geographic 

neighborhood. 

Information from treatment sources is

particularly susceptible to variance

because some facilities target specific

populations. Furthermore, treatment

providers from methadone and nonmethadone programs are likely to

have very different perspectives on

their communities’ drug problems

because their respective clientele 

differ in the nature of their drug

problems and in their demographic

characteristics. It is for this reason

that two treatment sources were

selected from each of the 20 sites—

one from a methadone program, and

one from a non-methadone program. 

Taken together, all four sources at

each site provide a richer picture of

the drug problem’s nature. 

Current Sources and Reporting

Periods

The current report includes information gathered during November 2001

through January 2002 from telephone

conversations with 75 sources, representing 20 sites across the various

regions of the country. These individuals discussed their perceptions of the

drug abuse situation as it was during

the fall months of 2001 and in comparison to a period 6 months earlier,

during spring 2001.

The law enforcement sources who

provided information include 19 

narcotics officers from local police

departments, field office agents of the

Drug Enforcement Administration

(DEA), and representatives of High

Intensity Drug Trafficking Areas

(HIDTAs). The law enforcement

source from Baltimore was unable to

participate in this round of discussions.

The epidemiologists and ethnographers are 20 researchers associated

either with local health departments,

university-based research groups, or

other community health organizations. Some of those 20 individuals

are qualitative researchers who

employ ethnographic techniques to

obtain observational data directly

from the drug user’s world; others

are epidemiologists who access both

qualitative and quantitative data. 

The treatment sources are 36 providers

from 19 non-methadone programs and

17 methadone programs across the 20

sites. Those providers include two 

non-methadone sources each from

Billings and Sioux Falls because those

cities do not have methadone programs. They do not include another

four individuals who were unable to

participate in this round of discussions:

the methadone treatment source from

Memphis; and the non-methadone

treatment sources from Baltimore,

Honolulu, and Memphis.

These sources offer a wealth of 

information that, when taken together,

provides a comprehensive snapshot of

drug abuse patterns in communities

across the country. Further, these

individuals provide expertise that can

alert policy makers to any short-term

changes or newly emerging problems

concerning specific drugs, drug users,

and drug sellers.

The appendices at the end of this

report provide a list of these sources,

describe the methodology used to

select them, and discuss the content

of the approximately 1-hour conversations held with them. 
SPECIAL TOPIC: THE IMPACT OF SEPTEMBER 11

Pulse Check: April 2002 page 9

As the Nation deals with the wideranging effects of the September 11

attacks and subsequent events, several

data sources have begun to show the

impact upon drug abuse. For example, according to data provided by

NDCHealth (NYSE:NDC, an Atlantabased healthcare information services

company), new prescriptions (retail

and mail-order) for several categories

of drugs increased sharply between

early September and early October

2001: benzodiazepines increased 11

percent nationally, 14 percent in

Washington, DC, and 23 percent in

New York City; antidepressants

increased 3 percent, 12 percent, and

18 percent, respectively, for the three

areas; and sleep aids (nonbarbiturates,

sedatives, and others) increased a dramatic 11 percent, 14 percent, and 26

percent, respectively.

In an effort to continue assessing the

terrorist attacks’ impact on drug

abuse (short term and long term),

ONDCP explored the issue during

the 75 Pulse Check phone discussions

conducted from late November 2001

through early January 2002. Sources

in all but four cities—Billings, Chicago,

Los Angeles, and Philadelphia—

described combinations of diverse

effects, such as disruptions in drug

trafficking patterns, anxiety among

patients already in treatment for drug

abuse, increased treatment admissions

among youth, and increased diversion

and abuse of prescription drugs. 

Loosely categorized, the described

effects can be summarized in four

overall findings: 

! Availability of illegal drugs, 

particularly heroin, declined in 

12 of the 20 Pulse Check cities:

Baltimore, Columbia (SC), Denver,

Detroit, El Paso, Honolulu,

Memphis, Miami, New Orleans,

New York, Seattle, and Sioux Falls.

(Exhibit 1)

! Drug trafficking modes or routes

have shifted in 6 of the 20 cities:

Honolulu, Miami, New York, Portland (ME), St. Louis, and Seattle.

! Some short-term changes in local

marketing strategies were noted in

Boston, Miami, New York, and

Washington, DC.

! Signs of increased drug abuse 

were described in 9 of the 20

cities: Boston, Columbia (SC),

Honolulu, Miami, New York,

Portland (ME), St. Louis, Seattle,

and Washington, DC. These signs

include increases in demand for

treatment. (Exhibit 1)

Changes in Illegal Drug

Availability, Trafficking Patterns,

and Market Strategies

Heightened security since September

11 at U.S. airports, borders, and

other points of entry may have

caused declines in the availability of

✛The following symbols appear throughout this chapter to indicate type of respondent: L

Law

enforcement respondent, E

Epidemiologic/ethnographic respondent, NNon-methadone treatment

respondent, and MMethadone treatment respondent.

SEPTEMBER 11 AND ITS AFTERMATH: ASSESSING THE IMPACT ON DRUG ABUSE✛

M,N

L,M,N

L N

L,E,M

N

E

M

N

L,E,M

E

M

L

N

L

L

N

Billings

Exhibit 1. 

How have availability of and demand* for illegal drugs reportedly

changed** across the 20 Pulse Check cities since September 11?

Availability of illegal drugs declined and demand* increased

Availability of one or more illegal drugs (typically includes heroin) declined

Demand* for illegal drugs increased

No changes reported in availability of or demand for illegal drugs

*“Increased demand,” in this case, reflects any increases in the number of treatment admissions,

requests for services, and attempts to self-medicate for anxiety or depression.

**Changes do not reflect any short-term effects that disappeared within the first few weeks after

September 11.
SPECIAL TOPIC: THE IMPACT OF SEPTEMBER 11

page 10 Pulse Check: April 2002

illegal drugs (especially heroin) on the

streets of many Pulse Check cities:

! Baltimore, MDE

: During the period

immediately after September 11,

no changes in the illegal drug trade

were observed; however, by late

September, heroin started to “dry

up on the street.” Moreover, drugrelated violence increased during

late September and early October

due, in part, to declining heroin

availability. The problem was

reportedly compounded when law

enforcement resources were shifted away from street drug activity

and toward terrorist prevention

activities.

! Columbia, SCN,M: Heroin availability has declined, and prices

have increased.

! Denver, COL,E: Heroin availability

has declined slightly because fewer

drugs are coming across the

Mexican border, and heroin users

are reportedly having more difficulty finding the drug on the street.

Drug trafficking has also been

slightly limited due to airport security. Furthermore, heroin and powder

cocaine prices have increased, and

their purities have declined. 

! Detroit, MIE

: In general, drugs are

less available.

! El Paso, TXN: Because fewer 

people are smuggling heroin from

Mexico due to increased border

security since September 11, its

availability has decreased.

! Honolulu, HIL,E,M: The Honolulu

drug trade’s dependence on air

traffic is evidenced by how drugs

dried up on the street during the

days following September 11,

when all planes were grounded.

Even through air travel has

resumed, heroin and cocaine

seizures and availability remain

lower than pre-September 11 

levels because, with heightened

security, fewer people are smuggling the drugs via the airport.

Additionally, methadone clinics

report an increase in client intake

since September 11, suggesting a

decline in heroin availability on

the street.

! Memphis, TNL

: Heroin, crack, and

powder cocaine availability has

declined, most likely because law

enforcement officials have intercepted these drug shipments more

often and because post offices and

packages are more scrutinized since

the anthrax threats began. 

! Miami, FLL,E: The law enforcement

source suggests that increased airport security has led to reduced

heroin trafficking activities. Reportedly, street-level heroin, crack, and

powder cocaine have been harder

to obtain since September 11, but

marijuana continues to be widely

available because much of it is 

produced locally. The Miami epidemiologic source concurs that

clients in some treatment facilities

have reported some shortages of 

illegal drugs.

! New Orleans, LAN: Drug availability, in general, has declined.

! New York, NYL,E: The law enforcement source suggests that since

September 11 cocaine has been

harder to obtain. Additionally,

according to street researchers,

prices for heroin, crack, powder

cocaine, and marijuana have

remained level with pre-September

11 prices, but the quantity of

drugs sold per sale has declined.

Moreover, the cost of diverted

prescription drugs, such as Elavil®

(amitriptyline, an antidepressant),

has increased from $2–$3 to $5.

Increases in security and police

activity have disrupted the flow of

drugs from suppliers to dealers to

users: suppliers cannot get their

normal supply of drugs; dealers’

supplies are in turn restricted; and

users are paying more because their

bags contain reduced amounts. 

! Seattle, WAM: Due to increased

border security, heroin and cocaine

availability has declined. Furthermore, when users cannot obtain

the drugs, they often go to treatment, and admissions to the

methadone clinics have increased

since September 11. 

! Sioux Falls, SDL

: Undercover operations with high-level methamphetamine dealers suggest that drugs are

harder to obtain due to increased

U.S. border control, and prices for

larger amounts of the drug have

increased. However, the number of

small local methamphetamine labs

has increased recently, perhaps to

compensate for the lower levels of

methamphetamine entering the

United States.

In addition to reduced availability of

illegal drugs, heightened security at

U.S. points of entry may have altered

drug trafficking modes or routes in

many Pulse Check cities:

! Honolulu, HIL,E: Law enforcement

efforts are beginning to focus more

on mail and marine smuggling

because fewer people are smuggling heroin and cocaine via the

airport.
SPECIAL TOPIC: THE IMPACT OF SEPTEMBER 11

Pulse Check: April 2002 page 11

! Miami, FLE

: Some drug trafficking

has shifted from air to sea via

cruise ships.

! New York, NYL

: Trafficking 

shipments planned for the city

prior to September 11 have shifted

to other cities, such as Seattle (via

vehicle from Canada) or Baltimore

(via air). 

! Portland, MEL,E and Seattle, WAL

:

Heroin and cocaine traffickers are

making fewer trips across the

Canadian border due to increased

law enforcement security, but they

are smuggling larger amounts of

drugs per trip. 

! St. Louis, MOL

: Drug smugglers

are more often using trains and

buses to transport drugs than they

were before September 11; according to sellers in custody, traffickers

are avoiding air transport due to

heightened airport security. 

Some drug trafficking shifts immediately after September 11 were just

short term. In Detroit, for example,

according to the law enforcement

source, the supply of illegal drugs

from Canada declined because of

increased security at the border a few

weeks after the September 11 attacks,

but has returned to previous levels.

Similarly, in El Paso, according to the

epidemiologic source, the drug supply

declined on the streets, even for

crack, due to heightened border 

control measures immediately after

September 11; however, soon thereafter, it was “business as usual.” In

Portland (ME) according to the law

enforcement source, shortly after the

September 11 attacks, the influx of

drugs declined, but by December, the

supply of illegal drugs resumed to

pre-September 11 levels. Even in

Washington, DC, where local drug

dealers were more cautious about

bringing drugs in shortly after

September 11 due to heightened

security at entry points, by December,

the local drug trade returned to preSeptember 11 levels.

The September 11 terrorist attacks

also had short-term effects on local

illegal drug market strategies, such as

price gouging, as reported in several

Pulse Check cities:

! Boston, MAE

: Two weeks after the

attacks, the purity levels of heroin

and powder cocaine dropped

sharply, and a few dealers blamed

this drop on the attacks.

! Miami, FLE

: In a few cases, dealers

have been trying to price gouge,

but not because of any apparent

major drug shortage.

! New York, NYE

: According to

street researchers, immediately

after September 11, drug dealers

(especially heroin dealers) took

advantage of the situation and

operated openly in the street. One

user commented that, “the day of

the disaster, it was like a super-sale

day.” This pattern continued in

some areas. Moreover, several

days after the disaster, a street

researcher in The Bronx observed

heroin users waiting in line in the

street to purchase their drugs. 

! Washington, DCE

: Heroin and

crack availability and purity

declined for about 4–6 weeks after

the attacks. Marijuana, methamphetamine, and ecstasy were also

less available for a week or two,

possibly due to transportation 

difficulties.

Changes in Illegal Drug Use

Patterns and Demand

Because heroin availability has

declined in many Pulse Check cities

since September 11, heroin users 

are increasingly substituting diverted

prescription drugs for heroin in some

cities:

! Baltimore, MDE

: An emergency

department nurse noticed more

overdoses from drugs other than

heroin, particularly OxyContin®

and other prescription opiates.

This source suggests that the shift

is related to the decline in heroin

availability after September 11. 

! Columbia, SCM: Diverted

OxyContin® use has increased

due to the declining availability 

of heroin. 

! El Paso, TXN: Heroin addicts 

are increasingly substituting

Rohypnol® (flunitrazepam) for

heroin because it has been easier

than heroin to smuggle across the

Mexican border since September

11 and is, thus, more accessible.

! New York, NYM: An in-house staff

survey in the large program where

the Pulse Check methadone treatment source is situated showed

notable increases since September

11 in the abuse of prescription

New anti-terrorist laws may affect

illegal drug marketing practices. 

St. LouisL

: New wiretap laws are 

affecting how illegal drug dealers are

using cell phones. They are being more

cautious, “dropping” phones more 

frequently, changing phones, using 

several different phones, and watching

what they say over the phones.
SPECIAL TOPIC: THE IMPACT OF SEPTEMBER 11

page 12 Pulse Check: April 2002

drugs, in people seeking more medications while in treatment, and in

people requesting prescriptions for

such medications. Additionally,

increases were noted in secondary

use of substances such as cocaine.

The number of treatment admissions

or requests for services increased in

the following cities after the September 11 attacks, suggesting a possible

increase in drug use, a decline in drug

availability on the street, or both:

! Columbia, SCN,M 

! Honolulu, HIM 

! New York, NYE

! Seattle, WAN,M

! Washington, DCN

Additional indicators of increased

demand or declining drug availability

include an increased number of calls

from those in need of drug treatment

in Columbia (SC) (according to the

methadone treatment source) and an

increase in treatment program retention rates in El Paso (according to the

epidemiologic source). 

Many Pulse Check sources report

increases in drug use, sometimes

among people who are self-medicating

for anxiety or depression associated

with the September 11 attacks: 

! Boston, MAM: Since September 11,

clients in treatment report to have

increasingly combined heroin and

cocaine in “speedballs.” 

! Columbia, SCM: Use of all illicit

drugs has increased, and the 

general mood of illicit drug users

is that “they’re going for broke,”

and that since the attacks they

“have nothing to lose.” 

! Miami, FLE

: According to anecdotal

information from pharmacists and

mental health and treatment professionals, both legitimate and illegal

use of prescription drugs have

increased since September 11,

mostly involving people seeking

benzodiazepines and sleep aids in

an attempt to self-medicate and

deal with added stress. 

! Portland, MEN: Depression and

hopelessness have intensified among

older clients who were already

depressed before September 11, and

whatever drugs those clients were

using, they tended to use more of

them after September 11. In some

cases, the events triggered users to

seek substance abuse treatment. 

! St. Louis, MON: Use of methamphetamine, diverted OxyContin®,

ecstasy, and alcohol has increased

and may be due to people seeking

to self-medicate after the events on

September 11. 

Pulse Check sources also report an

increase in social and psychological

problems among drug treatment

clients following September 11.

Treatment sources in many cities,

including Boston, Billings, Portland

(ME), and Washington, DC, report

increased levels of anxiety, depression,

and hopelessness among treatment

clients. Additionally, sources in Boston,

Columbia (SC), Detroit, El Paso,

Portland (ME), Seattle, and Washington, DC, also mention increases since

September 11 in the numbers of

relapses among chronic drug users.

Increases in Treatment Demand: 

A Closer Look

New York, NYE

: An outreach worker

states that since September 11 the 

number of people reporting for detoxification has increased markedly. Most

detoxification programs in the city have

become full.

Seattle, WAN: Requests for mental

health services increased 35 percent

since September 11, with 20 percent of

these for substance abuse treatment.

Effects on Youth Who Use Drugs:

! Los Angeles, CAL

: Club drug seizures have increased, as has the popularity and 

number of raves. “It is plausible that adolescents and young adults are using club

drugs and attending raves in order to shake off September 11.”

! Portland, MEN: Younger clients associate the events of September 11 with taking

ecstasy: “We hate the world we’re growing into, so we might as well party.”

! Sioux Falls, SDE

: In a school district with more than 18,000 middle school and high

school students, the number of adolescents (13–17 years) admitted to inpatient settings for substance abuse treatment (typically involving methamphetamine or heavy

marijuana use) has increased sharply since September 11. Many of these admissions

are court ordered, but many youth are also voluntarily coming forward. Thus, it is

difficult to determine whether youth have increased their drug use or are getting

caught more frequently. Additionally, since September 11, an increase has been noted

among youth in suicidal thoughts and depression issues in conjunction with their 

substance abuse.
HEROIN✛

Heroin has surpassed crack as the drug

associated with the most serious consequences—that is, medically, legally,

societally, or otherwise—as perceived

by 27 sources in 17 sites: Boston, New

York, Philadelphia, and Portland (ME)

in the Northeast; Baltimore, Columbia

(SC), El Paso, Miami, New Orleans,

and Washington, DC, in the South;

Chicago, Detroit, and St. Louis in the

Midwest; and Denver, Honolulu, Los

Angeles, and Seattle in the West. In

five of those cities—Baltimore, Boston,

Chicago, Philadelphia, and Portland—

sources also consider heroin the most

widely used illicit drug (methadone

treatment sources, however, are

excluded from that count because

heroin is, by definition the most commonly used drug in their programs).

Compared with the last Pulse Check

reporting period, the Miami epidemiologic source believes that heroin has

replaced diverted OxyContin® as the

drug with the most serious consequences. Two sources in Portland, ME,

believe that heroin has replaced either

other opiates or cocaine as the most

commonly abused drug, and the

Washington, DC, methadone treatment

source believes it has replaced crack as

such. Additionally, some aspect of

heroin abuse is considered as an emerging problem in four cities: Billings,

Boston, Denver, and Memphis.

HEROIN: THE DRUG

How available is heroin, in 

its various forms, across the

country? (Exhibits 1, 2, and 3)

Approximately half of the Pulse Check

law enforcement sources (10 of 19)

and epidemiologic/ethnographic

sources (11 of 20) consider heroin 

to be widely available in their communities. Sources in the Northeast and

South are about twice as likely to

report wide availability as their counterparts in the Midwest and West.

As in the past two Pulse Check

reports, high-purity snortable South

American (Colombian) white heroin

is the most common type, cited as

widely available by law enforcement

and epidemiologic/ethnographic

sources in 10 cities across the

Northeast, South, and Midwest

(Baltimore, Boston, Chicago,

Columbia [SC], Detroit, Miami,

Philadelphia, Portland [ME], New

York, and Washington, DC). Mexican

black tar, a lower purity, injectable

heroin, is ranked as widely available

by sources in six cities, mostly in the

West (Denver, Honolulu, El Paso, Los

Angeles, St. Louis, and Seattle); and

sources in four of those cities (Denver,

El Paso, Los Angeles, and St. Louis)

similarly rate Mexican brown heroin

Exhibit 1.

How available is heroin across the 20 Pulse Check cities (fall 2001)?

HEROIN

Pulse Check: April 2002 page 13

Seattle

St. Louis

Sioux Falls

Memphis Columbia

New York City

Boston

Washington, DC

Portland

Denver

El Paso

Los

Angeles

Honolulu

Philadelphia

Miami

Detroit

Chicago

Baltimore

New

Orleans

Seattle

St.

Louis

Sioux Falls

Memphis Columbia

New York City

Boston

Washington, DC

Portland

Denver

El Paso

Los

Angeles

Honolulu

Philadelphia

Miami

Detroit

Chicago

Baltimore

New

Orleans

Billings

Billings

*The law enforcement source in Baltimore did not respond.

According to epidemiologic/ethnographic sources (N=20)...

According to law enforcement sources (N=19)*...

Widely Somewhat Not Very Not

Available Available Available Available

✛The following symbols appear throughout this chapter to indicate type of respondent: L

Law enforcement respondent, EEpidemiologic/ethnographic

respondent, NNon-methadone treatment respondent, and MMethadone treatment respondent.
as widely available. Southeast Asian

heroin is considered widely available

in only two cities (New Orleans and

Washington, DC), and Southwest

Asian heroin is the least common

form, with wide availability reported

only in New Orleans.

Heroin availability remained stable

between spring and fall 2001, according to the majority of law enforcement (15 of 19) and epidemiologic/

ethnographic (14 of 20) sources.

Increases are reported in only seven

sites across the Northeast, South, and

Midwest, while declines are reported

in two sites, both in the West. Similarly,

the various forms of heroin remain

generally stable in availability, with

any exceptions listed in exhibit 3.

The St. Louis epidemiologic source,

who has been monitoring the possible

introduction of white Nigerian heroin

into the city, reports no more seizures

since the last Pulse Check.

How pure is heroin across the

country? (Exhibit 4) According to

law enforcement and epidemiologic/

ethnographic sources, street-level

Colombian heroin ranges from a low

of 40 to 90 percent, with both

extremes reported in Philadelphia.

Street-level Mexican black tar heroin

purity ranges from 14 percent in

Seattle to 70 percent in Billings.

Purity levels have remained generally

stable since the last reporting period,

except for increases in Boston, El

Paso, and Portland (ME) and declines

in Denver, New Orleans, and Seattle.

A wide range of heroin adulterants

continue to be reported by law

enforcement and epidemiologic/

ethnographic sources, particularly in

the Northeast and South. The most

recent harmful adulterants reported

are cocaine in Portland (ME), a roach

spray in New York, and a shaving of

ecstasy enclosed in a bag of heroin in

New York. 

What are street-level heroin

prices across the country?

(Exhibit 4) As reported in the last

Pulse Check, sales units of 0.1 gram

still cost as little as $4 for Colombian

heroin in Boston to as much as $120

for Mexican black tar in Seattle. Prices

are generally stable since the last

reporting period, except for increases

in Denver and Seattle and declines in

Exhibit 2.

How has overall heroin availability changed (spring 2001 vs

fall 2001)?*

HEROIN

page 14 Pulse Check: April 2002

Exhibit 3.

Which heroin varieties have

changed in availability (spring

2001 vs fall 2001)?*

*The Baltimore law enforcement source did

not respond.

Colombian

Boston, MAE

Chicago, ILL,E

Detroit, MIL

El Paso, TXL

Miami, FLE

New Orleans, LAL

Portland, MEE

Mexican black tar

El Paso, TXE

New Orleans, LAE

Southeast Asian

Detroit, MIE

New Orleans, LAL,E

Southwest Asian

Chicago, ILE

Detroit, MIE

New Orleans, LAL

New York, NYL

Colombian

Denver, COL

Honolulu, HIL

St. Louis, MOL

Mexican black tar

Honolulu, HIE

New York, NYE

Southeast Asian

Baltimore, MDE

Chicago, ILE

Honolulu, HIL

New York, NYE

St. Louis, MOL

Southwest Asian

Baltimore, MDE

Honolulu, HIL

New York, NYE

*The Baltimore law enforcement source did

not respond.

Boston, MA E

Chicago, ILL

Detroit, MIL

El Paso, TXE

Miami, FLE

New Orleans, LAE

Portland, MEE

Baltimore, MDE

Boston, MA L

Billings, MTL,E

Chicago, ILE

Columbia, SCL,E

Denver, COE

Detroit, MIE

El Paso, TXL

Los Angeles, CAL,E

Memphis, TNL,E

Miami, FLL

New Orleans, LAL

New York, NYL,E

Philadelphia, PAL,E

St. Louis, MOL,E

Portland, MEL

Seattle, WAL,E

Sioux Falls, SDL,E

Washington, DCL,E

Denver, COL

Honolulu, HIL,E
HEROIN

Pulse Check: April 2002 page 15

Exhibit 4. What are the prices and purity levels of different types of heroin in 19 Pulse Check cities?* 

MOST COMMON STREET UNIT 1 GRAM

City/Source Unit Size Purity/Change** Price/Change** Purity/Change** Price/Change**

Baltimore, MDE capsule NR NR/NR $10/↔

Boston, MAL “bundle” 0.1 gm 80%+/↑ $4–$6/↔

Chicago, ILL “hit” 0.2 gm NR/NR $20/↔ NR/NR $150/↔

Columbia, SCL “bindle” 0.2 gm 62%/↔ $20–$25/↔ NR/NR $125–$130/↔

“bundle” 2 gm NR/NR $225/↔

Detroit, MIL “dime” 0.1 gm NR/NR $10/↔ NR/NR $100–$150/↔

Miami, FLL NR 1 gm NR/NR $120/↓

Miami, FLE “bag” NR NR/↔ $10/↔ NR/↔ $150–$200/↔

New York, NYL “bag” 1 hit 80–90%/↔ $10–$14/↔

New York, NYE “bag” 0.1 gm 60%+/↔ $10/↔

Philadelphia, PAL “bag” 0.3 gm 40–90%/↔ $10–$20/↔

“bundle” 10–13 bags 40%/↔ $100–$120/↔ 70–75%/↔ $85–$95/↔

Philadelphia, PAE “hit” NR 73%/NR $10/NR

Portland, MEL “bag” 0.1 gm 70%+/↑ $25–$30/↔

“bundle” 1 gm 70%+/↑ NR/NR

Billings, MTL “bindle” 1 gm 50–70%/↔ $260/↔

Denver, COL “balloon” 0.2 gm 20–30/↓ $25–$30/↑

Denver, COE NR 1 gm 36%/↔ $50–$100/↔

El Paso, TXL NR 0.1 gm NR/NR $20/↔

El Paso, TXE “dime”, “dieme” 2-3 person hit NR/↑ $2.50–$3.00/↓

Honolulu, HIL “bindle” 0.1 gm NR/NR $50–$75/↔ NR/NR $150–$300/↔

Honolulu, HIE “paper” 0.25 gm NR/NR $50–$75/↔

NR 0.25 oz NR/NR $750/↔

Los Angeles, CAL “hit” 0.25 gm NR/NR $30–$35/↔ NR/↑ $90–$100/↓

Memphis, TNL NR 0.1 gm NR/NR $50–$50/↔ NR/NR $400–$450/↓

Seattle, WAL NR 0.1 gm 14–58%/↔ $90–$120/NR

Seattle, WAE NR 1 mg 21%/↓ $1.15/↑ NR/↔ $30–$50/↔

St. Louis, MOL NR 1 gm NR/NR $100/↔

Boston, MAE “bag” (powder) 0.1 gm NR/NR $10/↔

“bundle” (powder) 10-bag NR/NR $60–$80/↔

Chicago, ILE “dime bag” NR NR/NR $10/↔

Detroit, MIE “hit” (white) NR 10–50%/↔ $10–$12/↔

“bundle” (white) NR 10–50%/↔ $100–$150/↔

New Orleans, LAL “hit” .45 gm 7%/↓ $20–$25/↔

“paper” 0.12 gm 7%/↓ $10/↔

Washington, DCL “dime bag” (white) 50–75 mg 10–15%/↔ $10/↔ 60–70%/↔ $120–$140/↔

Washington, DCE “scramble” (white) bag 23%/↔ $10/↔

“bone” or “raw” bag 40–80%/↔ $30–$40/↔

“scramble” (white) 1 mg 23%/↔ $1.05/↓ 23%/NR $120–$150/↔

Sources: Law enforcement and epidemiologic/ethnographic respondents

*Respondents in Sioux Falls did not provide this information. **Arrows indicate up, down, or stable between spring and fall 2001. 

NR= not reported South American (Colombian) white Mexican black or brown tar Unspecified

El Paso and Washington, DC. A few

other shifts, however, are noted:

# Baltimore, MDE

: White heroin is

being sold in larger capsules than

during the last reporting period.

Thus, even though capsule prices

have increased from $6 (or two for

$10) to $10, actual prices have

remained fairly stable.

# Chicago, ILE

: The price range 

for a gram of white powder has

widened, from $100–$200 

during the last reporting period 

to $60–$275 during the current

period.

# Los Angeles, CAL

: The price range

for a 0.25 gram “hit” has narrowed,

from $20–$40 to $30–$35.

# New York, NYL

: Cheaper

Southwest Asian heroin is about 

to pose a significant challenge to

Colombian heroin.
HEROIN

page 16 Pulse Check: April 2002

How is heroin referred to across

the country? (Exhibit 5) Street

names and dealer brand names proliferate in the Northeast and the South

and are rarer in the Midwest and the

West. Since the last Pulse Check,

many of the more recent brand or

street names relate to the September

11 terrorist attacks, particularly in

New York (“twin towers,” “9/11,”

“world trade center,” and “WTC”)

and in Washington, DC (“bin laden”).

“Red devil” and “bulldog” are new

street names in Portland (ME), and

pink heart logos are new in Columbia

(SC). In Philadelphia, where brand

names change frequently, 18 new ones

have been identified since the previous

reporting period (including “old navy,”

“bomb,” “one way,” “life,” and “one

hundred percent”). Brand names also

change frequently in Washington, DC,

typically when a dealer’s product gets

a bad reputation or becomes too well

known by law enforcement. In Boston

and Detroit, however, dealers are

using fewer brands or labels than in

the past for fear that drugs can be

traced back to them. 

How is heroin packaged? The

most common packaging across 

the country, as reported in the last

Pulse Check, continues to be plastic,

cellophane, glassine, or coin bags,

often the “zipper” type. These bags

sometimes come in colors for dealer

identification, as reported in Boston,

Portland (ME), and Washington, DC,

while in Chicago some bags have a

small candy or popcorn kernel inside

to identify the sellers and the heroin

purity. Other common packaging

includes plastic or cellophane wrap,

wax paper, foil, and balloons. Some

unusual packaging is reported during

this period: condoms in New York;

watertight “seal-a-meal” type of closures, small enough to be swallowed, in

some of Boston’s outlying communities

(such as Lawrence and Lowell) and in

Portland (ME); balloons that can be

put into a cheek and swallowed if necessary in El Paso; brown packaging

tape inside of duct tape in Billings;

and “speedwrapping,” in Boston,

which involves 10 untaped bags laid

on top of one another, rolled, and

held together with a rubber band.

Since the last Pulse Check, the

Baltimore ethnographic source reports

fewer cellophane bags on the street.

HEROIN: THE SELLERS

Who sells heroin? (Exhibit 6) Law

enforcement sources tend to report

heroin dealers as young adults (18–30

years) who work independently. Adults

older than 30, however, are reported

as the predominant sellers in Billings,

Honolulu, and Washington, DC, while

dealers in El Paso and Portland (ME)

are equally likely to be from either age

group. Organized sales structures are

reported in Chicago, Denver, Memphis, Miami, and Seattle, while both

independent and organized dealers

operate in El Paso and Philadelphia. 

Epidemiologic/ethnographic sources

are more likely than their law

enforcement counterparts to report

more than one kind of sales structure,

sometimes quite separate but sometimes intricately related, as in the 

following examples:

# Boston, MAE

: Two distinct groups

sell heroin: independents, who

tend to be older adults and are

Exhibit 5. 

How is heroin referred to, and what types of heroin predominate, in different regions of the country?*

WEST

H, dope, smack, stuff,

tar, chiva, treat, black

tar, bindle, s--t, junk,

spoon, girl, dujre

H, boy, dope, smack, big H, horse, dog food, s--t, heron, train, 747, doogie, stuff, chiva, carga, foil, papers, jerry springer, he, manteca, joint 

(bag of dope), billie (bag of dope), scramble (lower purity), bone (higher purity), raw (higher purity), negro, doozy, tammy, diesel, white, mud, bin laden

Murder one, white dragon, no limit, the real one, playboy, skull and crossbones, pluto, pink hearts

H, boy, 

dope, smack, 

blow, horse, 

china white, cap,

junk, hayron, stuff, 

raw, buttons, snotty 

(or getting snotty)

H, boy, dope, smack, horse, diesel, dees,

heron, packets, dimes, china white, manteca

(=lard), mantecilla (=butter), pabajo

(=down), let it in, high party, sick call, dead

president, NBA, spider, flying high, y2k, high

class, blue, top drool, hot party, sin city, sosa,

twin towers, polo, monkey business, lexus,

heavyweight, playboy, MVP, creeper, powder,

tomohawk, rush, double nut, one way, alan

iverson, bat boy, magum 357, bingo, exposition, trinidad, hot water, red devil, bull dog

9/11 world trade center, son of sam, WTC,

old navy, bomb, scorpion, one way, life, cobra,

one hundred percent, monster dose

MIDWEST NORTHEAST

SOUTH

Mostly Mexican

black tar available

Mostly Colombian

white available

Heroin type varies

*Italics refer to dealer brands, which are sometimes interchanged with user street names. Bolded names are new this reporting period.

Sources: Law enforcement, epidemiologic/ethnographic, and treatment respondents
HEROIN

Pulse Check: April 2002 page 17

very likely to use the drug; and

organized dealers who are generally younger adults and are only

somewhat likely to use the drug.

The organized dealers use beepers

and pagers, arrange meetings with

clients, and hire steady middlemen

and runners on bikes. A third sales

system consists of addicts who act

as liaisons: they spend their days

procuring heroin for other users

and, in the process, increase the

price or take some heroin “off 

the top.”

# Denver, COE

: Mexican nationals

control polydrug distribution to

small autonomous street sellers,

with little oversight once the drugs

get on the street.

# Honolulu, HIE

: On Oahu, sellers

tend to be older and independent.

On Hawaii, Maui, and Kauai, they

tend to be adolescents who are

flown in from Mexico, stay for 3

or 4 months, and then leave.

# New Orleans, LAE

: A series of

loose connections consist of dealers

who have four or five sellers each. 

# Washington, DCE

: Independent

addicts tend to be older adults

who sell heroin in order to support their habits, while organized

“crews” of younger adults are not

very likely to use the drug.

Since the last Pulse Check, no major

changes are reported among the 

sellers in the various cities, with one

possible exception: the Baltimore

ethnographic source mentions 

unsubstantiated reports of some

“young guys” trying to take over 

part of the market.

How is street-level heroin sold?

Caution and wariness rule drug sales

in many cities: referrals, beepers, cell

phones, prearranged meeting places,

home deliveries, and multi-tiered market structures are playing increasing

roles, as in the following examples:

# Boston, MAL,E: Sales continue to

go more underground than in the

past, with more beeper use and

home deliveries. Sellers have a customer list, with a small clientele.

# Baltimore, MDE

: Sellers won’t sell

to anyone they don’t know. Instead

of hand-to-hand sales, a system of

“touters” and “runners” adds layers

between the buyer and seller. The

touter deals directly with the buyer,

receiving money and handing over

the drugs; the runner deals with the

seller (although sometimes the

touters and runners are the same,

depending on the complexity of a

particular market). Most runners

are young males on miniature 

bicycles. Therefore, in some 

neighborhoods, police patrol areas

on bicycles.

# Chicago, ILL

: In order to reduce

risk, several layers of people are

often involved in a drug sale. In

some locations, especially in public

housing areas, the buyer asks for

the drug on one floor, pays on the

next floor, and then is told by

someone where to go to obtain the

drug. Some open drug markets,

however, still exist in certain neighborhoods.

# El Paso, TXL,E: Sellers are “very

paranoid” and won’t sell to

strangers. A buyer needs a contact

to make introductions. Cell phones

and drive-by meetings are common,

and open-air markets are rare.

# New Orleans, LAE

: Deliveries and

meetings are commonly arranged

via beepers, cell phones, and home

phones. Code words are used over

the phone to designate names and

locations. Street sellers use referrals.

# Seattle, WAL

: Buyers need to know

where to go. Beepers and cell phones

are common. Open-air markets are

relatively confined and limited in

number, but they still exist.

Exhibit 6. 

How likely are heroin sellers to

use their own drug?*

Boston

MA

New York

NY

Philadelphia

PA

Portland

ME

Baltimore

MD

Columbia

SC

El Paso

TX

Memphis

TN

Miami

FL

New Orleans

LA

Washington

DC

Chicago

IL

Detroit

MI

St. Louis

MO

Billings

MT

Denver

CO

Honolulu

HI

Los Angeles

CA

Seattle

WA

Not very

Somewhat

Very

Sources: Law enforcement and 

epidemiologic/ethnologic respondents

*Any missing bar implies that one source did

not provide this information. Neither source

in Sioux Falls provided this information.

Law enforcement

sources

Epidemiologic/ethnographic sources

Northeast South Midwest West
HEROIN

page 18 Pulse Check: April 2002

By contrast, in some cities heroin

sales are still more open. Washington,

DC, for example, has more than 100

open-air markets, and sellers approach

potential customers. In certain

Philadelphia neighborhoods, one can

simply drive by, roll down the car

window, and buy drugs hand-to-hand. 

What other drugs do heroin 

dealers sell? (Exhibit 7) Heroin

dealers continue to sell additional

drugs in nearly every Pulse Check city.

Only a few changes are reported since

the last Pulse Check:

# Baltimore, MDE

: Marijuana, while

not regularly distributed by heroin

sellers, is reported as occasionally

“floating in and out” during this

reporting period.

# Boston, MAE

: Sales of both 

heroin and crack, which used to 

be rare, have increased during the

past year.

# New York, NYL,E: The trend

toward polydrug sales continues.

Ecstasy is increasingly being sold

by heroin dealers, along with their

other staples: crack, powder

cocaine, and marijuana. An

increasing number of arrests

involve all five drugs.

# St. Louis, MOE

: Instead of the onestop-shops reported in the last

Pulse Check, with heroin, crack,

and marijuana sold “as if in a

candy store,” now it is more common for buyers to place an order

for other drugs ahead of time.

# Washington, DCL

: Many crack

dealers are thinking of switching

to heroin because they don’t have

to sell as much to make the same

profit and because the penalties

are not as strict.

What type of crimes are related

to the heroin sales scene?

According to law enforcement and 

epidemiologic/ethnographic sources,

heroin sellers in 12 Pulse Check cities

engage in some form of violent

crime: Boston, New York, and Philadelphia in the Northeast; Baltimore,

El Paso, Memphis, New Orleans, and

Washington, DC, in the South;

Chicago, Detroit, and St. Louis in the

Midwest; and Denver in the West.

Sometimes, these crimes are related

to turf protection (Baltimore) and

involve internal killings (New

Orleans). Other specific violent

crimes mentioned include gun sales

(Philadelphia), robberies (New

Orleans), assaults (New York), and

use of weapons (St. Louis). The

Boston ethnographer, however, notes

that drug-related violence has been

declining over the last few years.

Gang-related activities are reported

by law enforcement or epidemiologic/

ethnographic sources in all four regions:

New York in the East; Baltimore, El

Paso, and Memphis in the South;

Chicago and Detroit in the Midwest;

and Denver and Seattle in the West. 

Prostitution, on the part of either

users or sellers, is reported by law

enforcement or epidemiologic/ethnographic sources in all Pulse Check

cities except for Billings, Miami,

Seattle, and Washington, DC.

Heroin sellers, users, or both often

engage in numerous other forms of

nonviolent crimes, as reported by law

enforcement or epidemiologic/ethnographic sources in all Pulse Check

cities except Chicago and Memphis.

Typical crimes, often on the part of

the users, include burglaries, petty

Exhibit 7. What other drugs do heroin dealers sell?*

Boston, MA $

New York, NY $$$ Ecstasy

Philadelphia, PA $

Portland, ME OxyContin® 

Other pharmaceutical opiates

Baltimore, MD $ $

Columbia, SC $

El Paso, TX $$$ Rohypnol

Memphis, TN Morphine, hydromorphone

(Dilaudid®), other opiates

Miami, FL $ $ Ecstasy

New Orleans, LA $$$

Washington, DC $ $

Chicago, IL $ $

Detroit, MI $ $

St. Louis, MO $$$

Billings, MT $ Methamphetamine

Denver, CO $$$ Methamphetamine

Honolulu, HI $ $ Methamphetamine

Los Angeles, CA $ $

Seattle, WA $$$

Powder Mari- No other

City Crack Cocaine juana Other drug sold

Northeast Midwest West South

Sources: Law enforcement and epidemiologic/ethnographic respondents

*Respondents in El Paso, Los Angeles, and Sioux Falls did not provide this information.
HEROIN

Pulse Check: April 2002 page 19

larceny, and thefts (Billings, Los

Angeles, New York, Philadelphia, and

St. Louis); shoplifting (El Paso and

Washington, DC—in the latter, meat

shoplifting is a common activity, with

the perpetrators commonly called

“cattle rustlers”); panhandling (New

York); disorderly conduct (New

York); car theft (El Paso); and check

cashing (Detroit). Nonviolent crimes

specific to sellers include pharmaceutical diversion (Portland, ME) and

money laundering (Miami). 

Where is heroin sold? Law

enforcement and epidemiologic/ 

ethnographic sources generally agree

that most heroin sales take place in

central city areas, as reported in past

Pulse Checks. Additionally, suburban

or rural areas are occasionally mentioned in El Paso, Memphis, Miami,

New York, Portland (ME), and St.

Louis. In Philadelphia, suburbanites

often buy heroin from central city

dealers, and then resell the drug in

the suburbs. Conversely, people from

Boston often travel to outlying cities

(such as Lawrence and Lowell) to buy

heroin because purity is higher there

than in the city.

Sales on the street are reported by 

all 18 law enforcement sources who

discussed this question (the Sioux

Falls source did not). The next most

commonly reported sales settings are

public housing developments (in all

sites except Detroit and Portland) and

private residences (in 14 sites). Less

than half of the sources name other

sales settings: 

# Crack houses: All sites in the

Northeast except Portland;

Columbia (SC), Memphis, and

Miami in the South; only Chicago

in the Midwest; and Honolulu and

Los Angeles in the West.

# Inside cars: All sites in the

Northeast except Philadelphia;

Memphis, Miami, and Washington,

DC, in the South; and all sites in

the West except Los Angeles.

# Playgrounds or parks: Boston and

New York in the Northeast;

Memphis and Washington, DC, in

the South; Chicago and St. Louis

in the Midwest; and Billings and

Honolulu in the West.

# Nightclubs or bars: New York in

the Northeast; Memphis and Miami

in the South; Chicago and St. Louis

in the Midwest; and Billings,

Honolulu, and Seattle in the West.

# Private parties: Boston and New

York in the Northeast; Memphis and

Miami in the South; St. Louis in the

Midwest; and Billings in the West.

# Hotels or motels: New York in the

Northeast; Memphis and Miami in

the South; St. Louis in the Midwest;

and Billings, Denver, and Los

Angeles in the West.

# Around alcohol or drug treatment

clinics: New York and Philadelphia

in the Northeast; Memphis and

Washington, DC, in the South; St.

Louis in the Midwest; and

Honolulu in the West.

# In or around schools: New York in

the Northeast; Miami and

Washington, DC, in the South;

Chicago and St. Louis in the

Midwest; and Billings in the West.

The settings least commonly mentioned by law enforcement sources are

raves (in Billings, Miami, New York,

and Portland [ME]), college campuses

(in Billings, Miami, New York, and

Seattle), in or around shopping malls

(in Billings, Miami, New York, and St.

Louis), in or around supermarkets (in

Billings, Columbia [SC], and New York),

and in alleyways (in Philadelphia). The

Boston ethnographic source adds that

benzodiazepines, rather than heroin,

are sold around drug or alcohol treatment clinics. 

Only a few changes in sales settings

are reported since the last Pulse Check:

# Baltimore, MDE

: Law enforcement

efforts are causing sellers and users

to keep shifting their street locations.

# Honolulu, HIE

: Heroin sales and

use in beach parks have recently

declined because police have been

clearing those areas. Some of this

market disruption is a side effect

of more police using laptop computers: they tend to write their

reports in beach parks.

# Washington, DCL,E: Recent media

coverage has focused on the visible

sales of drugs, usually pills (particularly pharmaceutical opiates), but

sometimes heroin. Many such sales

have historically taken place around

treatment clinics. Legislative efforts

are under way to stiffen penalties

for selling drugs near treatment clinics, similar to penalties for selling

within 1,000 feet of schools, public

housing, parks, and playgrounds.

HEROIN: THE USERS

Who uses heroin? (Exhibit 8)

Overall, as reported in previous Pulse

Checks, the predominant heroin users

tend to be White males, older than 30,

who live in central city areas. However, as the table shows, much variation occurs across the different sites

and source categories. Furthermore,

younger adults (18–30 years) are frequently named as the predominant

group or else constitute substantial

proportions of users. Clients in
HEROIN

page 20 Pulse Check: April 2002

methadone programs are more likely

than those in non-methadone programs

to be high school graduates and to be

employed.

According to epidemiologic/ethnographic sources, the most noticeable

shifts since the last Pulse Check

involve increasing heroin use among

younger people, many of whom are

suburban Whites:

# Baltimore, MDE

: While users in

the central city are primarily older

adults (>30 years), those in the

suburbs are primarily young adults

(18–30). Adolescent users (<18)

continue to increase in suburbs.

# Chicago, ILE

: Heroin users are 

primarily young adult Black males

of low socioeconomic background,

who reside in the central city.

However, an emerging group is

reported, also young adult males,

but they are White, low and middle

socioeconomic, suburban residents.

# Denver, COE

: While the predominant users continue to be White

male older adults in the central

city, an emerging group continues

to grow: White male suburban

high school students and young

adults. Eight deaths in a recent 6-

Exhibit 8. 

What demographic groups predominate among heroin users, according to different Pulse Check sources?*

Age Race/Ethnicity Residence

City E N M E N M E N M 

Boston, MA >30 18–30 >30 Whites Whites Whites Central city Central city Suburbs

New York, NY >30 >30 >30 Hispanics Black; Hispanics Hispanics Central city Central city Central city

Philadelphia, PA 18–30;>30 18–30 18–30 Whites Whites; Blacks Whites; Blacks Central city Central city Central city

Portland, ME >30 18–30 >30 Whites Whites Whites Central city Central city All

Baltimore, MD >30 NR >30 Whites NR Blacks Central city NR Central city

Columbia, SC >30 Low numbers 18–30 Whites; Blacks Low numbers Whites Central city Low numbers Suburbs

El Paso, TX 18–30 >30 18–30 Hispanics Hispanics Hispanics Central city Central city; Central city

Suburbs

Memphis, TN 18–30;>30 NR NR Whites NR NR Central city NR NR

Miami, FL 18–30 >30 18-30; Whites Hispanics White; Central city Central city Central city

>30 Hispanics

New Orleans, LA >30 18–30;>30 18–30 Blacks Blacks Whites Central city Central city Suburbs

Washington, DC >30 18–30 >30 Blacks Blacks Blacks Central city Central city Central city

Chicago, IL 18–30 >30 >30 Blacks Blacks Blacks Central city Central city Central city

Detroit, MD >30 18–30 >30 Whites Blacks Blacks Central city; Central city Central city

Suburbs

St. Louis, MO 18–30;>30 18–30 >30 White, Blacks Blacks; Whites Central city Central city; Suburbs

Hispanic Suburbs

Sioux Falls, 18–30 18–30 NA Whites Whites NA Suburbs; Central city NA 

SD** Low numbers Low numbers Rural Low numbers

Billings, MT** 13–17 18–30 NA Whites Whites; NA Central city Central city; NA

American Indians rural

18–30 Whites Central city

Denver, CO >30 >30 18–30 Whites Whites Whites Central city Suburbs Central city

Honolulu, HI >30 NR 18–30 Whites NR Whites Central city NR Central city

Los Angeles, 18–30 Low numbers >30 Whites; Low numbers Blacks; Suburbs Low numbers Central city

CA Hispanics Hispanics

Seattle, WA >30 18–30 >30 Whites Whites Whites Central city Suburbs Central city

West South Northeast Midwest

Sources: Epidemiologic/ethnographic (E), non-methadone treatment (N), and methadone treatment (M) respondents

*Shaded boxes indicate that a given heroin-using racial/ethnic group is overrepresented relative to that city’s general population. Not all sources,

however, had this information available.

**Billings and Sioux Falls have no methadone programs, so two non-methadone sources reported from each.
HEROIN

Pulse Check: April 2002 page 21

month period involved users from

that emerging group.

# St. Louis, MOE

: Older users are

low socioeconomic central city 

residents; younger users have more

diverse socioeconomic status and

live both in the central city and the

suburbs.

# Washington, DCE

: In addition to

the predominant adult user group,

an emerging young adult group of

snorters has two subgroups: suburban, mid-socioeconomic Whites;

and central city, low-socioeconomic Blacks. Heroin users of all ages,

however, are increasingly moving

to the suburbs.

Increases among young people are

not, however, limited to the suburbs:

# Boston, MAE

: Aside from the 

traditional aging cohort of midsocioeconomic blue-collar Whites

in their thirties, several populations

of younger users have continued to

emerge over the past few years:

younger adult blue-collar Whites

who are switching to heroin after

abusing prescription pills (mostly

the Percocet® form of oxycodone);

the late-teenage sons and younger

brothers of the oxycodone abusers

who are going straight to heroin

abuse; and Hispanic users in their

twenties, who live in the central

city, in the suburbs, and in surrounding cities (Lowell and Lynne)

and also sell heroin.

# Chicago, ILE

: Young adults, who

are the predominant heroin users,

seem to getting even younger as a

group.

# Miami, FLE

: Heroin is showing up

in adolescent fatalities.

# New Orleans, LAE

: Increases are

reported in both the >30 group,

suggesting an aging cohort, and in

the 20–24 group.

# Portland, MEE

: While adults (>30)

are the predominant users, a

younger (16–22 years) group continues to emerge. Their numbers,

however, remain low. Another 

possible new user group to watch

for are older OxyContin® users

who might switch to heroin.

Similarly, several treatment sources

report that although heroin-using

clients in their programs are most

likely to be older than 30, users in

their twenties are increasing:

# Billings, MTN

# Boston, MAM

# Portland, MEM

# St. Louis, MOM

Other residence shifts and variations

are noted:

# Billings, MTN: Whites, who reside

in the central city, and American

Indians, who tend to live in rural

areas, are equally likely to use

heroin.

# Memphis, TNE

: In the last Pulse

Check, heroin users were reported

as residing primarily in central city

areas. However, with the increasing spread to the suburbs, users are

now equally likely to reside in

either area.

# New Orleans, LAE

: Three major

housing projects were recently

torn down, and their residents

were relocated throughout the

area. As a result, treatment, arrest,

and crime numbers have declined

but not because the problem has

declined: rather it has been scattered, along with any relevant

data. These shifts are expected to

turn up in various datasets over

the next 6 months.

Besides the increases among Whites

in some suburban areas, only one

other racial/ethnic shift is reported:

according to the Philadelphia epidemiologic source, Hispanics are

increasingly using heroin. Whites,

however, are still the predominant

users in that city.

Males are generally more likely to use

heroin than females. Several Pulse

Check sources, however, report that

both sexes are equally likely to use:

the epidemiologic/ethnographic

sources in Los Angeles, Memphis, and

Sioux Falls; the non-methadone treatment sources in Chicago, Denver,

Detroit, Portland (ME), St. Louis, and

Washington, DC; and the methadone

treatment sources in Baltimore,

Chicago, Columbia (SC), New

Orleans, and Seattle. Furthermore,

women are increasingly using heroin

in some cities:

# Denver, COM: While the majority

of heroin-using clients are males,

they are increasingly moving

toward an even gender split.

Two shifts in Chicago...

The non-methadone treatment source

notes two recent increases among 

heroin clients:

➤ The number with comorbid illnesses, such as depression, suicidal, anxiety, and some psychosis

➤ The number of treatment referrals

of people who have been serving

hard time in the penitentiary
HEROIN

page 22 Pulse Check: April 2002

# Memphis, TNE

: In the last Pulse

Check, heroin users were reported

as predominantly males; however,

with an increase in female users, the

two genders are now evenly split.

# New OrleansE

: Females continue

to increase.

# Portland, MEE

: Males continue to

predominate, but an increase

among females has been noted

since the last Pulse Check, particularly in the homeless population.

How do users administer heroin?

(Exhibit 9) As reported in past Pulse

Check issues, injecting remains the

most commonly reported route of

administration overall. Snorting, however, does predominate in many sites,

particularly in the Northeast and

Midwest. Since the last Pulse Check

reporting period, snorting and smoking

have increased in some sites, often

among younger users and in suburban,

rather than central city, areas:

# Baltimore, MDE

: While injecting

predominates in central city areas,

snorting (“bipping”) predominates

in the suburbs.

# Boston, MAE

: The emerging group

of young Hispanic users tend to

snort heroin. By contrast, the 

older users have a long history of

injection: sometimes their veins

collapse, so they inject under the

skin or into a muscle, making

them prone to infections.

# Boston, MAM: More snorting is

reported among younger users.

# Denver, COE,M: Injection remains

the predominant route, but snorting

and smoking are more common

among the emerging group of

young adults in the suburbs.

# Honolulu, HIE

: “Chasing the 

dragon” is occasionally reported.

# Miami, FLM: Younger clients are

more likely to snort because of

AIDS concerns.

# New Orleans, LAL,E: Snorting has

increased slightly since the last

reporting period, but injecting, by

far, remains the predominant route

of administration.

# New York, NYN: Snorting continues an upward trend.

# Philadelphia, PAM: Snorting 

continues to increase because of

increased purity.

# St. Louis, MOE

: Snorting predominates among younger users, while

injecting is more common among

older ones. In rural areas, however, injection still predominates.

# Washington, DCE

: While injecting

predominates, snorting and smoking have increased.

Some people, however, are shifting

from snorting to injecting:

# Boston, MAN: The program’s

snorting-to-injecting ratio since the

last reporting period has changed

from 70:30 to 55:45. This increase

in injecting might be due either to

declining purity or increased 

tolerance.

# New York, NYE

: Young people in

the suburbs continue to shift from

snorting to injecting. In the city,

however, this trend is not being

seen. One explanation is that more

drugs are available and it is easier

to “hustle” drugs in the city,

whereas on Long Island these

young users have to “make do”

with what they’ve got unless they

want to make the trip into the city.

By injecting, they “get more bang

for the buck” when they don’t

have enough drugs to satisfy 

their needs.

What other drugs do heroin

users take? In some cities, polydrug

use is the norm. In Philadelphia, for

example, the non-methadone source

explains that all clients are polydrug

users: they use whatever they can get

Exhibit 9.

How do users administer heroin?

Boston, MAE,M* Boston, MAN,M*

New York, NYM New York, NYE,N

Philadelphia, PAN Philadelphia, PAE,M

Portland, MEE,M Portland, MEN

Baltimore, MDE,M Miami, FLM*

Columbia, SCE,M New Orleans, LAN

*

El Paso, TXE,N,M Washington, DCN

Memphis, TNE

Miami, FLE,N,M*

New Orleans, 

LAE,N*,M

Washington, DCE,M

Chicago, ILM Chicago, ILE,N

Detroit, MIM Detroit, MIE*,N

Sioux Falls, SDE*,N* Sioux Falls, SDE*,N*

St. Louis, MOE*,N,M St. Louis, MOE*

Billings, MTN,M Billings, MTE

Denver, COE,N,M

Honolulu, HIE,M

Los Angeles, CAE,M

Seattle, WAE,N,M

Injecting is most Snorting is most 

common in... common in...

*Respondent considers injecting and 

snorting as approximately equal.

NOTE: The Columbia (SC), Los Angeles, and

one of the Sioux Falls non-methadone treatment sources did not provide this information. Northeast Midwest West South

Pilot needle program in New York...

New York, NYE

: In a program piloted in

February 2001, pharmacies can voluntarily decide to sell needles. It is still too

early to assess the impact.
HEROIN

Pulse Check: April 2002 page 23

their hands on, whatever is available.

Heroin and crack are the most common drugs used in that city, as in

many others. Several shifts and variations are reported in cocaine use by

heroin addicts, particularly in the

Northeast and South: 

# Baltimore, MDE

: While “speedball” (heroin plus powder cocaine)

injecting is common, older, more

chronic users avoid cocaine use.

# Boston, MAE

: The predominant

older users inject speedballs containing crack or, if available, powder cocaine. Use of alcohol and

cocaine is emerging among young

Hispanics.

# Denver, COE

: The predominant,

older, heroin-using group uses

powder cocaine in speedballs; the

emerging users tend to use cocaine

less frequently and sequentially

with heroin.

# El Paso, TXE

: The combination of

heroin plus powder cocaine is

known as a “belushi.”

# Memphis, TNE

: The only heroin

combination reported in the last

Pulse Check involved crack (speedballs). During this reporting period,

however, powder cocaine has been

replacing crack in speedballs.

# Miami, FLE

: Heroin and powder

cocaine are usually injected in

speedball combinations; however,

snorting a line of each is also

reported.

# Portland, MEE

: Speedballs are no

longer reported.

# Philadelphia, PAE

: Heroin users

are experimenting more with 

powder cocaine.

# Washington, DC E

: The emerging

young adult users also occasionally

use powder cocaine and crack.

Several sources report changes in 

prescription drug abuse among heroin

addicts:

# Baltimore, MDE

: Because heroin

availability is down since the last

Pulse Check, abuse of benzodiazepines, such alprazolam

(Xanax®), and prescription opiates has increased.

# Boston, MAE

: The emerging

group of young blue-collar Whites

often shift into heroin use from

oxycodone, other oral opioids,

and benzodiazepines. Recent

increases in heroin overdose 

mortality are related to polydrug abuse, particularly involving

clonazepam (Klonopin®).

# Memphis, TNE

: The opioid hydromorphone (Dilaudid®) is reported

during this period as either combined with heroin or taken immediately afterwards as a “chaser.”

Several other drugs (including

methamphetamine, amphetamines,

and PCP) are similarly reported.

# New YorkM: Interest in and abuse

of diverted OxyContin® has

increased. Abuse of benzodazepines,

amitriptyline (Elavil®, an antidepressant), and phenobarbital continues.

# Portland, MEE

: Methadone is

increasingly reported as a heroin

substitute.

# Seattle, WAE

: Sequential swallowing of clonazepam or alprazolam

with heroin has increased since the

last Pulse Check.

# Washington, DCE

: Hydromorphone

and diverted OxyContin® are

sometimes used as heroin substitutes,

while alprazolam, clonazepam, and

other diverted pharmaceuticals are

used either to boost or “take off

the rough edges from” heroin.

A few shifts involve use of marijuana:

# Denver, COE

: The emerging group

uses marijuana as a secondary

drug.

# New OrleansL

: Younger users are

lacing marijuana cigarettes with

heroin.

# Washington, DCE

: The emerging

young adult group take marijuana

sequentially.

The Miami epidemiologic source

notes that heroin is sometimes used

to “parachute down” after using

ecstasy. Ecstasy is not cited by any

other source.

Where and with whom is heroin

used? Heroin use continues to take

place primarily in private, small

group settings, according to the

majority of epidemiologic/ethnographic, non-methadone treatment,

and methadone treatment sources.

Several changes or interesting 

observations are noted since the last

Pulse Check:

# Boston, MAE

: The most common

use settings are private residences

and public restrooms. Group use is

more common than solo use for

several reasons: poor users tend to

pool their resources; more affluent

users see it as a social drug; and

when people use heroin in groups,

fatalities are less likely to occur. 

# Boston, MAM: The emerging

group of younger clients are starting to use heroin in more public

settings.
HEROIN

page 24 Pulse Check: April 2002

# El Paso, TXE

: Multigenerational

use and sales within families are

common in this city, whose unique

culture is apparent in all aspects of

how drugs are sold and used.

# Honolulu, HIE

: Heroin users 

commonly use in public, but public

use has declined.

# Memphis, TNE

: Heroin users are

increasingly taking the drug privately, in small groups: during the

last Pulse Check reporting period,

public and private use were equally

likely; during the current period,

private use predominates. In the

last Pulse Check, solo use was

reported as predominant; now,

users are equally likely to take

heroin both while alone and in

groups, among friends.

# Miami, FLN: Emerging use 

settings include clubs, parks, 

parties, and hotels/motels.

# New Orleans, LAE

: Before their

recent demolition, abandoned

areas around housing projects

were frequently the scene of heroin use. Now use is shifting to the

back rooms of private residences,

particularly porches in backs of

“shotgun houses” (a type of housing design with a series of rooms

connected without any hallways).

HEROIN: THE COMMUNITY

How do heroin clients wind up in

treatment? Heroin users in methadone programs are much more likely

to be self-referred than court referred

(as reported by 14 versus 4 sources).

Conversely, those in non-methadone

programs are much more likely to be

court referrals than self-referrals (12

versus 5 sources).

How available is methadone

treatment in Pulse Check communities? Methadone maintenance

is still not available in Billings or

Sioux Falls. As reported in the last

Pulse Check, in the remaining cities,

about half of the epidemiologic/

ethnographic sources—mainly in the

South—consider methadone to be

available in selected areas only, while

the other half consider it to be available throughout their areas. About

half (9 of 17) of those sources report

waiting lists for admission to public

methadone programs, while the other

8 report adequate capacity. Only one

epidemiologic source (in Honolulu)

reports a waiting list for private

methadone treatment, while the

Baltimore source reports that private

programs have too much capacity.

Since the last Pulse Check reporting

period, public methadone treatment

has become more available in

Chicago and somewhat more available in Baltimore and Washington,

DC. Private methadone treatment has

become more available in Chicago,

Detroit, and Portland (ME), and

somewhat more available in Denver

and Seattle. Public program slot

capacity has declined somewhat in

Boston and Detroit and increased

greatly in Baltimore; private capacity

has increased somewhat in Columbia

(SC) and Seattle and increased greatly

in Denver and Portland.
CRACK COCAINE✛

Crack is named as the drug with the

most serious consequences in Pulse

Check communities by 19 sources in

12 cities: Boston and New York in the

Northeast; Columbia (SC), El Paso,

Memphis, Miami, New Orleans, 

and Washington, DC, in the South;

Chicago, Detroit, and St. Louis in 

the Midwest; and Los Angeles in the

West. In eight of those cities—

Chicago, Columbia, Detroit, Los

Angeles, Miami, New Orleans, New

York, and Washington, DC—sources

also consider crack the most widely

used illicit drug.

Compared with the last Pulse Check

reporting period, the Boston law

enforcement source believes that

powder cocaine has replaced crack 

as the drug with the most serious 

consequences, the Miami law enforcement source believes that diverted

OxyContin® has done so, and sources

in Memphis and St. Louis perceive

that methamphetamine has done so.

The Memphis law enforcement source

also believes that methamphetamine

has replaced crack as that community’s

most widely used illicit drug. Conversely, the Boston methadone treatment

source believes that crack has replaced

benzodiazepines as the most commonly abused drug, and the Columbia law

enforcement source believes that it has

replaced marijuana.

CRACK: THE DRUG

How available is crack cocaine

across the country? (Exhibits 1

and 2) The majority of law enforcement (14 of 19) and epidemiologic/

ethnographic (12 of 20) Pulse Check

sources consider crack to be widely

available in their communities.

Sources in 10 cities describe it as

“somewhat available”: Boston and

Portland (ME) in the Northeast;

Columbia (SC) and El Paso in the

South; Chicago and Sioux Falls in the

Midwest; and Billings, Denver, Los

Angeles, and Seattle in the West. The

Billings epidemiologic source is the

only one who describes it as “not

very available.”

According to the majority of law

enforcement and epidemiologic/

ethnographic sources, crack availability

remained stable between spring and

fall 2001, with increases perceived in

only three cities (Chicago, Detroit,

and El Paso) and declines in another

three (Boston, Denver, and Honolulu). In Washington, DC, after 

dipping briefly, crack availability has

returned to earlier levels.

Exhibit 1.

How available is crack cocaine across the 20 Pulse Check cities (fall 2001)?

CRACK COCAINE

Pulse Check: April 2002 page 25

Seattle

St.

Louis

Sioux

Falls

Memphis Columbia

New York City

Boston

Washington, DC

Portland

Denver

El Paso

Los

Angeles

Honolulu

Philadelphia

Miami

Detroit

Chicago

Baltimore

New

Orleans

Seattle

Sioux

Falls

Memphis

St.

Louis

Columbia

New York City

Boston

Washington, DC

Portland

El Paso

Los

Angeles

Honolulu

Philadelphia

Miami

Detroit

Chicago

New

Orleans

Baltimore

Billings

Billings

Denver

According to epidemiologists/ethnographers (N=20)...

According to law enforcement sources (N=19)...*

*The Baltimore law enforcement source did not respond.

Widely Available Somewhat Available

Not Very Available Not Available

✛The following symbols appear throughout this chapter to indicate type of respondent: L

Law enforcement respondent, EEpidemiologic/ethnographic

respondent, NNon-methadone treatment respondent, and MMethadone treatment respondent.
How and where is crack cocaine

made? Crack continues to be

processed locally in many Pulse Check

communities, either by users or by

local distributors, as noted in previous Pulse Check issues. In Billings,

Portland (ME), and Sioux Falls, 

however, law enforcement sources

report that crack is processed before

arriving in the community. Crack in

Sioux Falls used to come from

California, but for the past year or

two has been coming mostly from

Kansas City and Omaha. In

Denver, all crack used to be

processed locally, but now only

small quantities are, while larger

quantities come in preprocessed

from Mexico. Both local and outside

crack are also reported in Los Angeles

and Washington, DC. 

The New York ethnographic source

notes that different dealers cook

crack with different substances. More

users there are starting to cook their

own crack because quality varies from

seller to seller and has generally

declined since the last Pulse Check

reporting period. 

What are crack cocaine prices

and purity levels across the

country? (Exhibit 3) As the table

shows, street-level prices have

remained generally stable across the

country since the last Pulse Check

reporting period. Rocks still tend to

be sold in sizes of approximately 0.1

and 0.2 grams and sell for approximately $10 and $20, respectively,

according to law enforcement and

epidemiologic/ethnographic sources.

Gram prices, like street prices, have

also remained stable between spring

and fall 2001. About half the Pulse

Check law enforcement sources 

report on gram prices for crack

cocaine in their communities:

" Billings, MT: $125–$150 

" Chicago, IL: $123

" Columbia, SC: $100

" Honolulu, HI: $100–$250

" Los Angeles, CA: $80

" New Orleans, LA: $40–$50

" New York, NY: $24–$30 

" Seattle, WA: $100

" Washington, DC: $100 

Only a few street-level purity percentages are reported:

" Billings, MTL

: 50–70 percent pure

" Denver, COL

: 40–50 percent per

rock (down)

" Los Angeles, CAE

: 80–85 percent,

unit unspecified (stable)

" New York, NYL

: 58 percent per

rock (stable)

" Philadelphia, PAL

: 80 percent per

rock (stable)

" Portland, MEL

: 80 percent per

rock (stable)

" Washington, DCL

: 30–60 percent

per “dime bag” (stable)

How is crack referred to across

the country? (Exhibit 4) As reported in the last Pulse Check, slang

names for crack seem particularly

common in the South and, to a

lesser extent, in the Northeast.

They are rare in the Midwest

and the West. One of the few

new names mentioned is

“CDs,” as reported by the

Philadelphia law enforcement

source.

How is crack packaged and 

marketed? The most commonly

reported packaging, across all four

regions, remains small plastic, cellophane, glassine, or coin bags, often

the “zipper” type. Loose rocks are the

next most common, followed by vials.

Foil packaging is mentioned only

occasionally, as are balloons and 

folded bindles of paper or other

material. Since the last Pulse Check,

one of the few changes reported is in

St. Louis, where the epidemiologic

source reports foil wrapping for the

first time, in addition to the cellophane bags and loose rocks reported

previously. The New York ethnographic source continues to report a

movement away from vials, which

used to dominate crack packaging,

and toward cellophane baggies whose

colors represent different groups or

individual distributors. Conversely,

the Baltimore ethnographic source

reports that the most common form

of packaging is vials whose different

color tops represent different dealers. 

CRACK COCAINE

page 26 Pulse Check: April 2002

Exhibit 2.

How has crack cocaine availability changed (spring 2001 vs

fall 2001)?*

Chicago, ILL

Detroit, MIL

El Paso, TXE

Baltimore, MDE

Billings, MTL,E

Boston, MAL

Chicago, ILE

Columbia, SCL,E

Detroit, MIE

El Paso, TXL

Los Angeles, CAL,E

Memphis, TNL,E

Miami, FLL,E

New Orleans, LAL,E

New York, NYL,E

Philadelphia, PAL,E

Portland, MEL,E

St. Louis, MOL,E

Seattle, WAL,E

Sioux Falls, SDL,E

Washington, DCL,E

Boston, MAE

Denver, COL,E

Honolulu, HIL,E

*The Baltimore law enforcement source did

not respond.
CRACK COCAINE

Pulse Check: April 2002 page 27

CRACK: THE SELLERS

Who sells crack? Young adults 

(18–30 years) continue to be the 

predominant crack sellers in nearly all

Pulse Check cities, according to law

enforcement and epidemiologic/

ethnographic sources. Additionally,

adolescents sometimes sell crack (as

in Baltimore, Chicago, Columbia

[SC], Detroit, Los Angeles, and

Seattle), as do older adults (in Boston,

Detroit, and Sioux Falls). As reported

in previous issues, these individuals

sometimes operate independently and

sometimes as part of an organized

sales structure, while some cities have

both types of structures. Little has

changed since the last Pulse Check,

with only a few exceptions: 

" Columbia, SCL

: Marijuana users in

their teens to early twenties are

increasingly becoming involved in

crack sales.

" Denver, COL

: Mexican nationals

are bringing in larger amounts,

and local distributors in the Black

community are becoming organized

and are selling larger quantities.

" Memphis, TNE

: Crack sales are

becoming less organized, with

more independent sellers reported.

As reported in the last Pulse Check,

crack sellers are somewhat or very

likely to use their own drug, according

to the majority (13 of 17) law enforcement sources who discussed this 

question; epidemiologic/ethnographic

sources, however, generally consider

crack sellers as less likely to do so.

How is street-level crack sold?

Crack sales are conducted in ways 

similar to those described for heroin:

hand-to-hand sales are commonly 

mentioned, as are sales involving 

beepers or cell phones, runners, 

Exhibit 3.

What are crack cocaine price levels in the 20 Pulse Check cities?

MOST COMMON STREET UNIT

City/Source Unit Size Price/Change**

Boston, MAL “jum” (small rock) 0.1 gm $10/↔

Boston, MAE “bump,” rock, “jum” NR $20, $40, $50/↔

New York, NYL rock NR $7–$10/↔

vial NR $20/↔

New York, NYE vial, rock NR $10/↔

Philadelphia, PAL rock 0.5–0.7 oz $5–$10/↔

Philadelphia, PAE rock NR $5/↔

Portland, MEL rock 0.1–0.5 oz $50/↔

Baltimore, MDE rock in a vial NR $5–$10/NR

El Paso, TXL rock 0.25 gm $20/↔

El Paso, TXE rock NR $20/↔

Memphis, TNL rock 0.2 gm $20/↔

Memphis, TNE rock NR $5–$20/↔

Miami, FLL rock NR $10–$20/NR

Miami, FLE rock NR $10–$20/↔

New Orleans, LAL rock 0.48 gm $20/↔

rock NR $10/↔

Washington, DCL “dime bag” 75 mg $10/↔

Washington, DCE rock NR NR/↔

“eightball” NR $125–$130/NR

Chicago, ILL rock 0.2 gm $20–$25/↔

Chicago, ILE rock NR $5–$20/↔

Detroit, MIL rock 0.1 gm $10/↔

Detroit, MIE rock NR $20/↔

St. Louis, MOL rock NR $20/↔

Sioux Falls, SDL small rock 0.3–0.5 gm $100/↔

Billings, MTL NR 0.25 gm NR/NR

Denver, COL rock 0.1–0.2 gm $25–$45/↑

Denver, COE rock NR $20–$30/↔

NR 1 oz $800–$1,200/↔

Honolulu, HIL rock 0.25 gm $25–$30/↔

Honolulu, HIE NR 0.25 gm $25–$30/↔

NR 0.25 oz $400/↔

Los Angeles, CAL rock 0.2 gm $20/↔

Los Angeles, CAE NR NR NR/NR

Seattle, WAE rock 0.1–0.125 gm $20/↔

rock 0.2–0.25 gm $40/↔

Sources: Law enforcement and epidemiologic/ethnographic respondents

*Respondents in Sioux Falls did not provide this information. 

**Arrows indicate up, down, or stable between spring and fall 2001.

NR= not reported Northeast South West Midwest

“Black tops are good today”: Changing colors, changing preferences, 

changing locations...

Baltimore, MDE

: Different color tops on vials represent different dealers. Each day, users

select their “color of the day” (that is, where and from whom they buy crack) based upon

word of mouth and the word of “touters,” who stand out on street and advertise the

drug. Recommendations and preferences change on a daily basis, and touters move from

location to location because of shifting law enforcement presence.
CRACK COCAINE

page 28 Pulse Check: April 2002

prearranged meetings, deliveries, and

referrals. Some variations, however,

are reported. In Philadelphia, for

example, crack is often exchanged for

money, sexual favors, or merchandise.

And in Chicago, the seller sometimes

holds a rock in the mouth and transfers it to the buyer’s mouth. 

Only three changes are noted since

the last Pulse Check reporting period.

Beepers are increasingly used in

Boston as sales continue to move

more underground. Similarly, electronic communications are increasingly used in Los Angeles. And

Columbia (SC) street sellers who deal

in crack and marijuana are becoming

more cautious about to whom they

sell, probably because of increased

law enforcement pressure—typically,

they no longer sell to buyers in cars.

What type of crimes are related

to the crack sales scene? Crack

sellers are frequently involved in 

violent crime, as reported by the

majority of law enforcement (12 of

16) and epidemiologic/ethnographic

(10 of 13) sources who discussed this

question. Some of the crimes specified

include turf wars (in Sioux Falls 

and Washington, DC), assaults and

robberies (in New York), and armed

robberies and holdups (in St. Louis

and Sioux Falls). Nearly every source

who mentions violent crime also

mentions gang-related activities. 

The vast majority of sources also

mention prostitution and nonviolent

crimes. Some sources specify the nonviolent crimes: larcenies, robberies,

car break-ins, and increased counterfeiting in Columbia, SC; burglaries

and car thefts in Sioux Falls; thefts

and burglaries in Billings; petty theft

in Boston; and intimidation in New

York. Domestic violence is mentioned

in Boston, El Paso, Honolulu,

Memphis, New York, and St. Louis.

Users, as well as sellers, are often

mentioned in relation to some of

these crimes.

Where is crack cocaine sold?

Central city areas, as reported in the

last Pulse Check, are the most common locations for crack sales.

Suburban areas (or both central city

and suburban areas), however, are

mentioned by law enforcement or

epidemiologic/ethnographic sources

in Detroit, El Paso, Miami, and Los

Angeles. All three types of areas—

central city, suburban and rural—are

named in Billings, Memphis, New

York, and Portland (ME). The vast

majority of sources report that crack

is sold both indoors and outdoors.

Only a few changes are reported since

the last reporting period:

" Boston, MAE

: Crack sales have

moved more indoors.

" Detroit, MIL

: Indoor versus 

outdoor sales vary, depending on

the season and on the dealer.

" Memphis, TNE

: Crack sales are

moving out of the city and into the

suburbs and rural areas.

Only one source reports any changes

in the specific settings for crack sales.

In Memphis, the epidemiologic

source notes two new settings: restaurants, where “the cook does the dealing, and the customers and waiters

smoke crack in the back” (particularly

in the suburbs); and shelters and

group homes, where prescription pills

are sometimes bartered for crack.

Other specific settings for crack sales

have not changed since the last Pulse

Check. Public housing developments,

private residences, cars, and crack

houses are still mentioned by law

enforcement and epidemiologic/

ethnographic sources in nearly every

city. Private parties, nightclubs/bars,

parks/playgrounds, in or around

schools, and hotels/motels are 

mentioned in approximately half of

the cities. Less commonly mentioned 

settings are college campuses (in

seven cities), in or around shopping

malls (six cities), around drug or 

alcohol treatment clinics (six cities),

raves (in Billings, Miami, Honolulu,

Exhibit 4. 

How is crack cocaine referred to across different regions of the country?

WEST

Rock, crack, girl, lady, ready rock, bump, crumb, monkey

nut (a big rock), yam, (big rock), 20, hard, I wanna be a

rock star, twinkie, one bomb (100 rocks), stones, purple Ma’a (rock caps, real tops, candy, cookie in Samoan)

Rock, crack, soup,

soap, the pipe

Rock, crack, hard

stuff, bumper,

bopper, eightball,

stones

Rock, crack, jum (small

rock), CDs, freebase, basa,

blotter, electric kool-aid,

purple haze, window pane,

ice cubes.

MIDWEST NORTHEAST

SOUTH

Sources: Law enforcement, epidemiologic/ethnographic, and treatment respondents
CRACK COCAINE

Pulse Check: April 2002 page 29

and New York), and in or near supermarkets (in Columbia, Miami, New

York, and Philadelphia ). New York

has the widest range of crack sales

settings, followed by Memphis 

and Philadelphia. 

What other drugs do crack 

dealers sell? Polydrug sales among

crack sellers appear to be on the

decline: compared with the last Pulse

Check, more law enforcement sources

(8 versus 10) and more epidemiologic/

ethnographic sources (3 versus 6)

report that no other drugs are sold.

Three increases are reported, however,

since the last Pulse Check: 

" Memphis, TNE

: In addition to

powder cocaine, as reported 

previously, crack dealers are 

also selling marijuana during 

the current reporting period.

" Miami, FLL

: Diverted OxyContin® is now available in the

same places where crack is sold. 

" Washington, DCL

: In addition to

marijuana, as reported previously,

crack dealers are also selling ecstasy.

New York crack sellers still sell the

widest range of drugs, including 

heroin, powder cocaine, marijuana,

and ecstasy.

CRACK: THE USERS

Who uses crack? (Exhibits 5, 6,

and 7) The majority of epidemiologic/ethnographic and treatment

sources report that crack users are

most likely to be young adults (18–30

years), central city residents, from

low socioeconomic backgrounds,

with a few variations in some cities 

as shown in the exhibits. Methadone

treatment sources tend to report

older users than non-methadone

treatment sources. Blacks are twice as

likely as Whites to be reported as the

predominant user group. Although

males are the predominant users

according to slightly more than half

the sources, nearly half report that

males and females are equally likely

to use crack—more so than any other

illicit drug except ecstasy, as reported

in the last Pulse Check. Nearly all

methadone treatment sources report

that crack users in their programs

have completed high school; by contrast, the majority of non-methadone

sources report that crack-using clients

have only completed junior high.

Crack users tend to be unemployed,

according to both kinds of Pulse

Check treatment sources.

Many sources, like the Boston ethnographic source, report a static pool of

users that is neither growing nor

shrinking. Others, like the one from

the New York methadone program,

note a slight decline in overall use.

Overall, crack users have remained

relatively stable as a group since the

last Pulse Check reporting period,

with only a few minor changes and

interesting variations in age, gender,

race/ethnicity, and residence area.

How do users take crack? Crack

is nearly always smoked. However,

isolated cases of injection are occasionally reported: 

" Baltimore, MDE

: When injectors

can’t find powder cocaine, they

recook crack and inject it.

Exhibit 5. 

What age group is most likely to use crack?

Adolescents (<18) Young Adults (18–30) Adults (>30)

Boston, MAE,N New York, NYM

New York, NYE,N

Philadelphia, PAE,N

Portland, MEE,N

New Orleans, LAE Baltimore, MDE Baltimore, MDM

Columbia, SCM Columbia, SCE

El Paso, TXE,N Memphis, TNE

Memphis, TNE Miami, FLE

Miami, FLN New Orleans, LAN

New Orleans, LAN,M Washington, DCE,M

Washington, DCN

Sioux Falls, SDN Chicago, ILN Chicago, ILE,M

Detroit, MIE,N Detroit, MIE,M

Sioux Falls, SDE St. Louis, MON,M

St. Louis, MOE

Billings, MTN Billings, MTE,N Denver, COE,N

Los Angeles, CAN Honolulu, HIE,M Los Angeles, CAE

Los Angeles, CAM

Seattle, WAE,N,M

Sources: Epidemiologic/ethnographic (E), non-methadone treatment (N), and methadone

treatment (M) respondents

Note: Some sources name more than one age group. Northeast South Midwest West
CRACK COCAINE

page 30 Pulse Check: April 2002

" Boston, MAE

: Heroin addicts

smoke crack, but primary “speedballers” inject it.

" Sioux Falls, SDN: Clients occasionally inject crack.

" Washington, DCE

: Cocaine injectors

are finding it increasingly difficult

to find powder cocaine, so they are

increasingly shooting crack instead.

The majority of non-methadone 

treatment sources continue to report

that crack users in their programs

tend to take the drug daily, while less

frequent usage is reported in Denver,

Los Angeles, Portland (ME), St. Louis,

Sioux Falls, and Seattle. As reported

in the last Pulse Check, crack users in

methadone programs appear to take

the drug less frequently than those in

non-methadone programs: daily use

in methadone programs is reported

only in Baltimore, Chicago, and Los

Angeles.

What other drugs do crack users

take? Since the last Pulse Check, several changes are reported in the kind

of other drugs and drug combinations

taken by crack users: 

" Baltimore, MDE

: The use of

“woolies” (crack combined with

marijuana, usually in a joint but

sometimes in a blunt) has declined

slightly.

" Billings, MTN: Clients are increasingly abusing prescription drugs 

with crack.

" Boston, MAE

: “Oolies” (marijuana

joints laced with crack or powder

cocaine) have been replaced by

sequential use of marijuana and

cocaine (either form).

Exhibit 6. Which genders are the predominant users of specific drugs 

in the 20 Pulse Check cities?

Male Female Split evenly

Heroin Powder Cocaine

Number of respondents

Marijuana Crack Methamphetamine Ecstasy

Source: Epidemiologic/ethnographic respondents

20

15

10

5

0

Since the last Pulse Check reporting period, only a few changes are 

reported in crack user characteristics:

Age changes:

➤ Billings, MTN: Crack use has

increased, especially among adolescent

users in treatment.

➤ Denver, COE

: The population 

continues to age.

➤ Washington, DCE

: While the predominant group is older than 30, 

an emerging group of young adults

(18–30 years) who smoke crack in

marijuana joints (“wooties”) is 

occasionally reported.

Gender distribution changes:

➤ Columbia, SCE

: Crack users have

declined overall in number, particularly females: during the last Pulse

Check reporting period, males and

females were equally likely to smoke

the drug; during the current period,

males outnumber females.

➤ Seattle, WAE

: In the last Pulse Check,

crack users were reported as evenly

split between males and females.

However, the number of males

involved in crack-related deaths and

emergency department mentions has

increased somewhat recently.

Conversely, cocaine-positive urinalyses

have declined among male arrestees.

➤ New Orleans, LAE

: Female crack

users have increased slightly.

Race/ethnicity distribution change:

➤ Philadelphia, PAE

: Hispanic representation, which is second to Black 

representation, has leveled off.

Residence changes:

➤ Billings, MTN: White crack users

tend to reside in the central city;

American Indian users generally live 

in rural areas.

➤ Honolulu, HIE

: Crack use has

increased slightly in suburban areas,

possibly among a slightly younger

group than those in the central city,

where most crack users still reside.

➤ Memphis, TNE

: While crack users

reside primarily in central city areas,

suburban crack users are increasingly

emerging as a polysubstance user

group.

➤ St. Louis, MOE

: Older users tend to

be low-socioeconomic central city 

residents; younger users are more

diverse socioeconomically and live

both in the suburbs and central 

city areas.
CRACK COCAINE

Pulse Check: April 2002 page 31

" Honolulu, HIE

: Sometimes crack is

used as an alternative to methamphetamine, but methamphetamine

is usually cheaper.

" Memphis, TNE

: Two new 

phenomena are crack combined

with marijuana in a blunt (“sherman stick”) or with alcohol. The

drug is also sometimes taken

sequentially with pharmaceutical

pills, particularly alprazolam.

" Seattle, WAE

: Benzodiazepines are

emerging as a kind of drug taken

by the crack-using population to

“take the edge off.”

" St. Louis, MOM: After using crack,

many clients are using a variety of

health food products and diuretics

in an effort to “cleanse the system”

before urinalysis.

" Washington, DCE

: Crack smoked

in marijuana joints (“wooties”) is

occasionally reported.

Where and with whom is crack

used? As reported in past issues,

crack generally tends to be used

indoors, in private, and in small

groups or among friends, according

to the majority of epidemiologic/ 

ethnographic and treatment sources.

A few minor changes in settings or

contexts since the last Pulse Check are

reported in a handful of cities: 

" Honolulu, HIE

: Like the heroin

market, the crack market on beach

parks has been disrupted as a side

effect of police typing reports in

beach parks on their new laptop

computers.

" Memphis, TNE

: Crack is increasingly used in public and within

groups since the last Pulse Check

reporting period, when private

and solo use were more predominant.

" New Orleans, LAE

: Raves have 

disappeared since a controversial

theater was shut down last year

and its owner recently tried, 

heavily fined, and not allowed to

reopen.

" Washington, DCE

: Some seasonal

fluctuations are reported, with

more use in alleyways as the

weather gets warmer.

Exhibit 7.

What racial/ethnic group is most likely to use crack?*

City E N M 

Boston, MA Blacks Whites NR

New York, NY Blacks Blacks Hispanics

Philadelphia, PA Blacks Whites; Blacks; Hispanics Numbers low

Portland, ME Whites Hispanics Numbers low

Baltimore, MD Blacks NR Blacks

Columbia, SC Blacks Numbers low Blacks

El Paso, TX Blacks Black; Hispanics Numbers low

Memphis, TN Blacks NR NR

Miami, FL Blacks Blacks NR

New Orleans, LA Blacks Blacks Whites

Washington, DC Blacks Blacks Blacks

Chicago, IL Blacks Blacks Blacks 

Detroit, MI Whites Blacks Blacks

St. Louis, MO Blacks Blacks Whites

Sioux Falls, SD** Whites Whites NA 

Numbers low

Billings, MT** Whites Whites; American Indians NA

Whites

Denver, CO Whites Black Numbers low

Honolulu, HI Whites; Asians NR Whites

Los Angeles, CA Blacks Hispanics Blacks; Hispanics

Seattle, WA Blacks Whites Whites

West South Northeast Midwest

Sources: Epidemiologic/ethnographic (E), non-methadone treatment (N), and methadone 

treatment (M) respondents

*Shaded boxes indicate that a given heroin-using racial/ethnic group is overrepresented relative to

that city’s general population. Not all sources, however, had this information available.

**Billings and Sioux Falls have no methadone programs, so two non-methadone sources reported

from each.
page 32 Pulse Check: April 2002

This page intentionally left blank.
POWDER COCAINE✛

Two sources in Denver (law enforcement and epidemiologic) and one in

Boston (law enforcement) are the

only ones who name powder cocaine

as the drug with the most serious

consequences, whether medically,

legally, societally, or otherwise. Two

additional sources (in El Paso and

Seattle) mention cocaine without 

distinguishing between crack and

powder. No single source names 

powder cocaine as the most widely

abused drug.

Compared with the last Pulse Check,

the Boston law enforcement source

perceives that powder cocaine has

replaced crack as the drug with the

most serious consequences but that

marijuana has replaced powder cocaine

as the most widely abused drug.

How available is powder cocaine

across the country? (Exhibits 1

and 2) The majority of the Pulse

Check law enforcement sources (14

of 19) and nearly half of the epidemiologic/ethnographic sources (9 of 20)

consider powder cocaine widely 

available in their communities. The

remaining sources describe it as

“somewhat available,” with four

exceptions: sources in Chicago, Los

Angeles, and St. Louis describe it as

“not very available”; and one source

in Honolulu believes powder cocaine

is not available at all. The Washington,

DC, epidemiologic source elaborates

that the drug is somewhat available 

in clubs but not very available on 

the street.

According to the majority of law

enforcement and epidemiologic/

ethnographic sources, powder cocaine

availability remained stable between

spring and fall 2001, with increases

perceived in only three cities

(Columbia [SC], El Paso, and

Portland [ME]) and declines in two

(Honolulu and Washington, DC).

What are powder cocaine prices

and purity levels across the

country? (Exhibit 3) Although prices

range widely across the country, the

most common gram price, as reported

in the last Pulse Check, is still approximately $100. Only one price change

is reported since the last issue: a

slight decline in Memphis, which has

the lowest gram price of all the sites. 

Gram purity levels have increased in

Portland (ME) and declined in Denver.

“Eightball” (1/8 ounce) purity levels

have increased in Washing-ton, DC,

and declined in Seattle. 

POWDER COCAINE

Pulse Check: April 2002 page 33

Exhibit 1.

How available is powder cocaine across the 20 Pulse Check cities 

(fall 2001)?

Seattle Sioux Falls

Memphis

St. Louis

Columbia

New York City

Boston

Washington, DC

Portland

Denver

El Paso

Los

Angeles

Honolulu

Philadelphia

Miami

Detroit

Chicago

New

Orleans

Baltimore

Billings

Seattle

Sioux

Falls

Memphis Columbia

New York City

Boston

Washington, DC

Portland

Denver

El Paso

Los

Angeles

Honolulu

Philadelphia

Miami

Detroit

Chicago

New

Orleans

Baltimore

Billings

St.

Louis

According to epidemiologists/ethnographers (N=20)...

According to law enforcement sources (N=19)*...

Widely Available Somewhat Available

Not Very Available

*The law enforcement source in Baltimore did not respond.

Not Available

✛The following symbols appear throughout this chapter to indicate type of respondent: L

Law enforcement respondent, EEpidemiologic/ethnographic

respondent, NNon-methadone treatment respondent, and MMethadone treatment respondent.
Ounce-level purity in Miami has

declined due to increasing use of

adulterants, such as caffeine (new this

reporting period) and “any white

powder.” “Any powder” is also

reported in Chicago, and a wide

range of other adulterants are reported elsewhere: inositol (a crystalline

stereoisomeric cyclic alcohol) in El

Paso and St. Louis; manitol (similar to

inositol) in El Paso and Memphis;

baby laxatives in Baltimore and

Memphis; chalk, laundry detergent,

procaine (an herbal supplement ingredient), and rat poison in Memphis;

meat tenderizer (which leads to severe

skin abscesses) in Boston; corn starch

and crushed vitamin C in El Paso; and

talcum or baby powder in Billings, El

Paso, and Washington, DC.

How is powder cocaine referred

to and packaged across the

country? (Exhibit 4) “Yao,” reported

by the methadone treatment source in

Seattle, is one of the few new slang

names mentioned since the last Pulse

Check. As in the past, and as in the

case of crack, slang names seem to

proliferate among users in the South

more than in the other regions. 

Various types of plastic bags are still

the most common packaging, and no

packaging changes are reported since

the last Pulse Check. Other commonly

reported forms include tinfoil, vials,

capsules, and balloons. Some more

unusual forms are reported: bricks

(wax paper bound with brown sticky

wrapping tape), perfume containers,

and motor oil jugs in Billings; 

page 34 Pulse Check: April 2002

POWDER COCAINE

Exhibit 3. 

How much do grams and “eightballs” of powder cocaine cost in 15

Pulse Check cities?*

“EIGHTBALLS”

GRAMS (1/8 OUNCE)

City Price/Change** Purity/Change** Price/Change Purity/Change

Boston, MAL $60/↔ 60%/NR $200–$250/↔ 60%/↔

Boston, MAE $40/↔ NR/NR $180/↔ NR/NR

New York, NYL $28–$30/↔ 75%/↔

Philadelphia, PAL $100–$125/↔ 60–80%/↔ $120/NR 60–80%/↔

Portland, MEL $80–$100/NR 40–60%/↑

Memphis, TNL $20/↓ NR/NR

Memphis, TNE $45–$100/↔ NR/NR

Miami, FLE $20/↔ NR/NR

Washington, DCL $100/↔ 30–60%/↔

Washington, DCE $50–$100/NR NR/NR $150–$335/↑ NR/NR

Chicago, ILL $125/↔ NR/NR

Chicago, ILE NR/NR 50–140%/↔

Detroit, MIL $75–$100/↔ NR/↔

Detroit, MIE $75–$125/NR NR/↔

St. Louis, MOL $100/↔ NR/NR

Sioux Falls, SDL $100/↔ ↔/NR $275/↔ NR/NR

Billings, MTL $100/↔ 50–70%/↔

Denver, COL $100/↔ 20–40%/↓

Denver, COE $80–$100/↔ 50–90%/↔

Honolulu, HIL $100–$120/↔ NR/NR

Honolulu, HIE $250–$350/NR NR/NR

Los Angeles, CAL $80–$85/↔ 80%/↔

Seattle, WAL $80–$100/NR 57–58%/↔

Seattle, WAE $30/↔ NR/↔ $80–$100/↔ NR/↔

Sources: Law enforcement (L) and epidemiologic/ethnographic (E) respondents

*Respondents in Baltimore, Billings, El Paso, and New Orleans did not provide this information.

**Arrows indicate up, down, or stable between spring and fall 2001. 

NR= not reported Northeast South West Midwest

Exhibit 2.

How has powder cocaine availability changed (spring 2001 vs

fall 2001)?*

*The Baltimore law enforcement source did

not respond.

Columbia, SCL

El Paso, TXE

Portland, MEL

Honolulu, HIL

Washington, DCE

Baltimore, MDE

Billings, MTL,E

Boston, MAL,E

Chicago, ILL,E

Columbia, SCE

Denver, COL,E

Detroit, MIL,E

El Paso, TXL

Honolulu, HIE

Los Angeles, CAL,E

Memphis, TNL,E

Miami, FLL,E

New Orleans, LAL,E

New York, NYL,E

Philadelphia, PAL,E

Portland, MEE

St. Louis, MOL,E

Seattle, WAL,E

Sioux Falls, SDL,E

Washington, DCL
vacuum-sealed plastic in Denver;

“pony packs” (folded pieces of paper)

and cigarette packs in Memphis; and 

dollar bills in New York (if a $20 bag

is packaged in a dollar bill, the price

goes up to $21). Fewer labels or

logos are reported during this period

than in the past: in Denver, plastic

wrapping sometimes has scorpions or

stars; in Memphis, labels are used

only on large (kilogram) amounts;

and in Miami, some logos appear on

bags sold in head shops. 

POWDER COCAINE: THE SELLERS

Who sells powder cocaine? Young

adults (18–30 years), either exclusively

or with another age group, are named

as powder cocaine sellers by all law

enforcement and epidemiologic/ethnographic sources except for one: the El

Paso epidemiologic source names

adults older than 30 as the predominant sellers. Older adults (along with

younger adults) also sell the drug in

Boston, Chicago, and Portland (ME),

while adolescents sell it in Baltimore,

Chicago, and Los Angeles. 

As noted in the last Pulse Check, law

enforcement sources tend to report

that powder cocaine sellers operate

independently, while epidemiologic/ 

ethnographic sources tend to report

both independent and organized sales

structures. Only one change is reported: the Memphis epidemiologic

source notes that independent sellers

have increased, while sales groups

appear less organized. 

Law enforcement sources generally

believe that powder cocaine dealers

are either very likely or somewhat

likely to use their own drug. Only in

two cities do they believe that dealers

are not very likely to do so: in Denver

and Miami. Four epidemiologic/

ethnographic sources believe that

dealers are not very likely to use their

drug: in Baltimore, Boston, Denver,

and New Orleans. Only one change

is reported since the last Pulse Check:

the Memphis epidemiologic source

reports that dealers are less likely to

use their drug than before. 

What type of crimes are related

to the powder cocaine scene?

Powder cocaine dealers are less likely

to be involved in violent crime than

crack dealers, according to law

enforcement sources (8 versus 12)

and epidemiologic/ethnographic

sources (6 versus 10). Similarly, 

gang-related activity and prostitution

are less frequently associated with

powder cocaine than with crack.

Domestic violence, however, is

named more frequently in relation to

powder cocaine than to crack: in

nine cities (Boston, Detroit, El Paso,

Honolulu, Memphis, New York,

Portland [ME], St. Louis, and Sioux

Falls) versus six. In discussing powder

cocaine, sources tend to name nonviolent crime slightly more often than

violent crime. Some specify the

crimes: shoplifting in Boston; burglary

or theft in Billings, El Paso, and

Memphis; auto thefts, break-ins, and

larcenies in Columbia, SC; residing as

or transporting illegal aliens in El

Paso; money laundering in Miami;

and domestic disputes in Sioux Falls.

What other drugs do powder

cocaine dealers sell? Powder

cocaine dealers also sell marijuana in

15 of the 20 Pulse Check cities (the 5

exceptions are Baltimore, Chicago,

New Orleans, Philadelphia, and

Washington, DC), according to law

enforcement and epidemiologic/

ethnographic sources. They sell crack

in nine cities (including five in the

South), heroin in seven (including

three in the West), ecstasy or other

club drugs in another seven (five of

which are in the South), and

methamphetamine in four (three of

which are in the West). 

POWDER COCAINE

Pulse Check: April 2002 page 35

A fine distinction...

New York still has the widest range of

drugs obtainable at single locations—

heroin, crack, powder cocaine, marijuana,

and ecstasy—but the ethnographic

source notes a fine distinction: it is

heroin sellers who sell all five drugs.

Dealers who specialize in any of the

other drugs don’t necessarily sell anything but that drug.

Exhibit 4. 

How is powder cocaine referred to across different regions of the country?

WEST

Coke, blow, flake,

girl, big C, toot,

white, nose candy,

product, snow, sugar,

powder, white boy,

yao, fast white lady

Coke, blow, girl,

powder, white,

snow, shirt 

MIDWEST NORTHEAST

SOUTH

Coke, blow, flake, girl, product,

nose candy, snow, flave, lady,

toot, pariba, cola, powder, 

perico (parrot), dope

Coke, blow, flake, white, white girl, white girlfriend,

snow white, snow, white lady, white horse, white pants,

soda, blanca, coco, aspirin, sal (salt), soft, toot, bird,

coca, shake, candy sugar, she, lady, angel dust, powder

(dime pack), perico (half gram)

Coke,

flake

Sources: Law enforcement, treatment, and epidemiologic/ethnographic respondents
Compared with the last Pulse Check,

marijuana sales by powder cocaine

dealers are newly reported in Boston,

El Paso, Los Angeles, Memphis, and

Portland (ME). Ecstasy or other club

drugs are newly reported in Columbia

(SC), El Paso, and Washington, DC.

Sometimes the drug sold is driven by

the sales setting: in Columbia, for

example, ecstasy and powder cocaine

are only likely to be sold together in

nightclubs, while marijuana is more

likely to be sold with powder cocaine

on the street. Similarly, in New Orleans,

powder cocaine sellers also sell heroin

in central city areas, but in the suburbs

they sell only powder cocaine.

Where is powder cocaine sold?

Powder cocaine is sold primarily in

central city locations in the majority

of Pulse Check cities, as reported in

past issues. Other types of locations,

however, are more frequently reported for powder cocaine sales than for

crack sales. Suburban areas (or both

central city and suburban areas) are

mentioned in Boston, Los Angeles,

New Orleans, and Seattle, while all

three types of areas—central city, 

suburban, and rural—are named in

Chicago, Denver, Detroit, El Paso,

Miami, New York, and Portland

(ME). The only change mentioned

since the last Pulse Check is in

Memphis, where the epidemiologic

source notes that powder cocaine

sales are moving out of the city and

into the suburbs and rural areas. 

Powder cocaine is equally likely to be

sold either indoors or outdoors,

according to about half of the law

enforcement (9 of 19) and epidemiologic/ethnographic (7 of 13) sources

who provided this information. In the

remaining cities, indoor sales are

reported more often than outdoor

sales. Outdoor sales, however, still 

predominate in Miami, New Orleans,

Philadelphia, and Sioux Falls. The specific settings for powder cocaine sales

are as varied as those for heroin and

crack, with no changes reported since

the last Pulse Check. In Memphis,

however, while the types of selling

locations have not changed, powder

cocaine is sold in more places overall.

POWDER COCAINE: THE USERS

Who uses powder cocaine?

(Exhibit 5) Like heroin users, powder

cocaine users tend to be White males,

older than 30, who live in central city

areas—particularly as reported by

epidemiologic/ethnographic sources.

More variations are reported by 

POWDER COCAINE

page 36 Pulse Check: April 2002

Exhibit 5. 

What racial/ethnic group is most likely to use specific drugs?*

Heroin Crack Powder Cocaine

City E N E N E N

Boston, MA Whites Whites Blacks Whites Whites Whites

New York, NY Hispanics Blacks; Blacks Blacks Blacks Blacks;

Hispanics Hispanics

Philadelphia, PA Whites Whites; Blacks Whites; NR NR

Blacks Blacks;

Hispanics

Portland, ME Whites Whites Whites Hispanics Whites Whites

Baltimore, MD Whites NR Blacks NR Blacks; NR

Hispanics

Columbia, SC Whites; Numbers Blacks Numbers Whites; Whites

Blacks Low Low Blacks

El Paso, TX Hispanics Hispanics Blacks Blacks; Whites; Hispanics

Hispanics Hispanics

Memphis, TN Whites NR Blacks NR Whites; NR

Blacks

Miami, FL Whites Hispanics Blacks Blacks Whites Hispanics

New Orleans, LA Blacks Blacks Blacks Blacks Whites NR

Washington, DC Blacks Blacks Blacks Blacks Blacks Blacks

Chicago, IL Blacks Blacks Blacks Blacks Blacks Blacks;

Hispanics

Detroit, MI Whites Blacks Whites Blacks Whites Blacks

St. Louis, MO Whites; Blacks; Blacks Blacks Whites Whites

Blacks Hispanics

Sioux Falls, SD** Whites Whites Whites Whites Whites Whites;

Numbers Numbers American

Low Low Indians

Billings, MT** Whites Whites; Whites Whites; Whites Whites

American American

Indians Indians

Whites Whites

Denver, CO Whites Whites Whites Blacks Whites Blacks

Honolulu, HI Whites NR Whites; NR NR NR

Asians

Los Angeles, CA Whites; Numbers Blacks Hispanics Whites Hispanics

Hispanics Low

Seattle, WA Whites Whites Blacks Whites Whites Whites

West South Northeast Midwest

Sources: Epidemiologic/ethnographic (E) and non-methadone treatment (N) respondents

*Shaded boxes indicate that a given drug-using population is overrepresented relative to that

city’s general population. Not all sources, however, had this information available.

**Billings and Sioux Falls have no methadone treatment programs, so two non-methadone

sources reported from each.
treatment sources. For example, nonmethadone treatment sources seem to

report younger users: adolescents are

the predominant powder cocaine

users among clients in the Columbia

(SC), Los Angeles, and Sioux Falls

non-methadone programs, and young

adults (18–30 years) are the predominant users in another six programs.

Methadone treatment sources are

more likely than other sources to

mention female users of powder

cocaine: 7 out of 12 responding

methadone treatment sources report

that males and females are equally

likely to use the drug. Racial/

ethnic distributions among powder

cocaine users, as the table shows and

as reported in past Pulse Checks, are

more similar to those of heroin users

than to those of crack users.

How do powder cocaine users

take their drug? Snorting remains

the primary route of administration

for cocaine powder according to all

but four sources: injecting is named

as the predominant route by the

Washington, DC, epidemiologic

source, the El Paso non-methadone

treatment source, and the methadone

treatment sources in Baltimore and 

El Paso. Injecting or smoking are also

occasionally mentioned elsewhere as

a minority choice. The Boston ethnographic source names two other

unusual, but not new, routes of

administration and rituals: local 

affluent college students sometimes

slit vitamin E capsules, pack them

densely with powder cocaine, and use

them as suppositories; and both

males and females sometimes rub

powder cocaine into the genitalia,

claiming that the anesthetic effects 

on the mucous membranes alters the

sexual experience.

Only a few changes in route of

administration are reported since the

last Pulse Check:

# Denver, COE

: A resurgence in

snorting powder cocaine as

opposed to crack smoking is

reported.

# El Paso, TXE

: While snorting 

predominates, users often progress

from snorting to smoking to

injecting.

POWDER COCAINE

Pulse Check: April 2002 page 37

Since the last Pulse Check reporting period, only a few changes are 

reported in the age, gender, race/ethnicity, and residence area of users: 

Age:

Race/

Ethnicity:

Gender:

Residence:

➤ Boston, MAN: Young adults and older adults are equally likely to use

powder cocaine—during the last Pulse Check reporting period, only

young adults were named as the predominant group. This change, 

however, might simply be a case of the older clients increasingly 

admitting to powder cocaine use.

➤ Columbia, SCE

: Young adults and older adults are equally likely to use

powder cocaine—again, a change from the last Pulse Check, when only

young adults were named as the predominant group. But this change

could be just a random fluctuation because the numbers are small, since

most cocaine use involves crack rather than powder.

➤ Washington, DCE

: While the predominant users are Black adult (>30

years) male injectors, an emerging group is reported: young adult

(18–30 years) White male snorters.

➤ Columbia, SCE

: Whites and Blacks are equally likely to use powder

cocaine. During the last Pulse Check reporting period, only Blacks were

named as the predominant group. Again, the numbers are small, so this

change could be just a random fluctuation.

➤ Denver, COE

: Hispanic users of powder cocaine are overrepresented

relative to the general population, and their representation in treatment

has increased slightly since the last Pulse Check. Whites, however, are

still the predominant users.

➤ Philadelphia, PAE

: Hispanic representation has increased. However,

Whites are still the predominant powder cocaine users.

➤ Columbia, SCN: While users are predominantly adolescent males, the

number of female novice users has been increasing. It is possible that

they are not using more, but rather they are admitting to use because,

as the Pulse Check source states, “the perceived risk of cocaine is 

dropping among the clients.”

➤ Denver, COE

: Although powder cocaine users reside primarily in 

central city areas, some users reside in the suburbs, and increases are

reported in rural areas since the last Pulse Check.

➤ Memphis, TNE

: With the increasing use of powder cocaine in suburban

areas, the suburbs have now overtaken central city areas (as reported in

the last Pulse Check) as the predominant place of residence.

➤ New Orleans, LAE

: In addition to central city areas, much powder

cocaine use also takes place in the suburbs. Treatment figures show 

particular increases in East Baton Rouge.
POWDER COCAINE

page 38 Pulse Check: April 2002

# New Orleans, LAE

: While the 

predominant users are Whites who

snort the drug, some Blacks report

smoking the drug, suggesting they

might be turning it into crack.

# St. Louis, MOE

: A slight (2 percent) recent increase in smoking

among patients admitted for

cocaine (unspecified) use might

indicate an increase in use of 

powder cocaine. However, crack

continues to account for at least

90 percent of cocaine use.

What other drugs do powder

cocaine users take? (Exhibit 6)

Heroin combined with powder

cocaine is often referred to as a

“speedball.” In El Paso, it is also

known as a “belushi.” In addition to

the epidemiologic/ethnographic and

non-methadone treatment sources

listed in the table, this combination is

also reported, not surprisingly, by the

majority of methadone treatment

sources. Interestingly, however, none

of the methadone treatment sources

report the combination of marijuana

and powder cocaine. That combination, sometimes referred to as a

“primo,” is also known as a “p-dog”

in Los Angeles and as a “coolie” in

New York. The Boston ethnographic

source notes that, since the last Pulse

Check, “oolies” (joints laced with

crack or powder cocaine) are gone,

and instead, marijuana and cocaine

(either form) are used sequentially. 

Oral opioids (including diverted

OxyContin® and Percocet®) are

mentioned only by the Boston ethnographic source. The other drugs listed—benzodiazepines, methamphetamine, and ecstasy—are more likely to

be taken sequentially, as a substitute,

or as a secondary drug, rather than in

combination with powder cocaine.

For example, in Billings, powder

cocaine is incidental to methamphetamine use. In St. Louis, powder

cocaine users are increasingly substituting methamphetamine because it

has become more available. In Miami,

ecstasy users often begin their evening

with a line of cocaine.

Where and with whom is powder

cocaine used? As reported previously, powder cocaine still tends to be

used indoors, in private, and in small

groups among friends, although

methadone treatment sources report

more solitary use than do other

sources. Private residences remain the

most commonly reported specific use

settings, followed, in descending

order, by parties, cars, nightclubs or

bars, and public housing developments. 

Compared with the last Pulse Check

reporting period, only two changes in

specific use settings are reported. The

Memphis epidemiologic source

reports that powder cocaine use has

increased on college campuses, and it

is sold in more places in general. In

Sioux Falls, the epidemiologic source

believes that use in hotel/motel settings

may be increasing: during several

recent methamphetamine lab busts in

such venues, users were also found to

be in possession of powder cocaine.

Exhibit 6.

What other drugs do powder cocaine users take?

Powder Powder Powder Powder Powder

Cocaine+ Cocaine+ Cocaine+Ben- Cocaine+Meth- Cocaine+

Marijuana Heroin zodiazepines amphetamine Ecstasy

Baltimore, MDE

Billings, MTN

Boston, MAE

Chicago, ILE

Denver, COE

Detroit, MIE

El Paso, TXE,N

Los Angeles,CAE,N

Memphis, TNE

Miami, FLE

New York, NYE

Philadelphia, PAE

Portland, MEE

St. Louis, MOE,N

Sioux Falls, SDN

Washington,DCE,N

Baltimore, MDE

Billings, MTE

Boston, MAE

Chicago, ILE,N

Denver, COE

El Paso, TXE,N

Miami, FLE

New York, NYE

Philadelphia, PAE

Seattle, WAE

Washington, DCE

Boston, MAE,N

Memphis, TNE

Portland, MEE

Billings, MTE

St. Louis, MON

Miami, FLE

Portland, MEN

Non-methadone vs methadone

clients: How often do they use

powder cocaine?

Clients in non-methadone treatment

programs are more likely to use powder cocaine on a daily basis than those

in methadone treatment programs.

Those in methadone programs are

more likely to binge intermittently. Sources: Epidemiologic/ethnographic (E) and non-methadone treatment (N) respondents
MARIJUANA

Pulse Check: April 2002 page 39

MARIJUANA✛

Baltimore and New Orleans are the

only two cities where no Pulse Check

source names marijuana as their community’s most widely abused drug. In

the other 18 Pulse Check cities, 35

law enforcement, epidemiologic/

ethnographic, and non-methadone

treatment sources name marijuana as

such. By contrast, Columbia, SC, is

the only city where a source (nonmethadone) considers marijuana to 

be the drug contributing to the most

serious consequences.

Compared with the last Pulse Check

reporting period, the Boston law

enforcement source believes that marijuana has replaced powder cocaine as

the most widely abused illicit drug,

the Columbia (SC) epidemiologic

source believes it has replaced crack,

and the Portland (ME) law enforcement source believes it has replaced

heroin and pharmaceutical opiates.

Conversely, the Columbia law

enforcement source believes that

crack has replaced marijuana as such.

MARIJUANA: THE DRUG

How available is marijuana, in 

its various forms, across the

country? (Exhibits 1, 2, and 3) All

but one of the 39 responding law

enforcement and epidemiologic/

ethnographic sources consider 

marijuana widely available in their

communities, similar to reports in the

last two Pulse Check issues. The

exception is in Chicago, where the

law enforcement source considers the

drug not very available. Moreover,

that source is the only one who 

perceives a decline in marijuana availability between spring and fall 2001.

Only four increases are perceived (in

Boston, Columbia [SC], Denver, and

Honolulu). Similarly, the numerous

varieties have remained generally 

stable in availability, with only a few

shifts as noted in exhibit 3.

As reported in the last Pulse Check,

locally produced commercial grade

marijuana remains the most common

variety, ranked as widely available by

23 law enforcement and epidemiologic/ethnographic sources in all but 4 of

the 20 Pulse Check cities: Boston,

Chicago, Detroit, and El Paso. 

Exhibit 1.

How available is marijuana across the 20 Pulse Check cities (fall 2001)?*

Seattle

St.

Louis

Sioux

Falls

Memphis Columbia

New York City

Boston

Washington, DC

Portland

Denver

El Paso

Los

Angeles

Honolulu

Philadelphia

Miami

Detroit

Chicago

Baltimore

New

Orleans

Billings

According to law enforcement and epidemiologic/ethnographic sources...

Widely Available, according to both source types

*The law enforcement source in Baltimore did not respond.

Widely Available, according to the epidemiologic/ethnographic source; not very

available according to the law enforcement source

✛The following symbols appear throughout this chapter to indicate type of respondent: L

Law enforcement respondent, EEpidemiologic/ethnographic

respondent, NNon-methadone treatment respondent, and MMethadone treatment respondent.

Exhibit 2.

How has marijuana availability

changed (spring 2001 vs fall

2001)?*

Boston, MAE

Columbia, SCE

Denver, COL

Honolulu, HIE

Chicago, ILL

Baltimore, MDE

Billings, MTL,E

Boston, MAL

Chicago, ILE

Columbia, SCL

Denver, COE

Detroit, MIL,E

El Paso, TXL,E

Honolulu, HIL

Los Angeles, CAL,E

Memphis, TNL,E

Miami, FLL,E

New Orleans, LAL,E

New York, NYL,E

Philadelphia, PAL,E

Portland, MEL,E

St. Louis, MOL,E

Seattle, WAL,E

Sioux Falls, SDL,E

Washington, DCL,E

*The Baltimore law enforcement source did

not respond.
MARIJUANA

page 40 Pulse Check: April 2002

Mexican commercial grade marijuana

is the second most common variety,

cited as widely available by 19

sources in 14 cities: Boston, New

York, and Philadelphia in the Northeast; Baltimore, Columbia (SC), El

Paso, Memphis, and New Orleans in

the South; Detroit, St. Louis, and

Sioux Falls in the Midwest; and

Billings, Denver, and Los Angeles in

the West. Sinsemilla (seedless marijuana) is the third most common variety,

with wide availability cited by 13

sources in 10 cities: New York and

Portland (ME) in the Northeast;

Memphis, Miami, and New Orleans in

the South; St. Louis in the Midwest;

and Billings, Denver, Honolulu, and

Seattle in the West. 

Hydroponically grown marijuana is

considered widely available by seven

sources in six cities (Boston, Memphis,

Miami, New York, Seattle, and

Washington, DC). As reported in the

last Pulse Check, British Columbian

(“BC bud”) is least commonly considered widely available, with only three

sources reporting it as such (in

Baltimore, Billings, and New York).

How is domestic marijuana

grown? The majority of responding

law enforcement sources (10 of 17)

report that local marijuana is grown

indoors. Epidemiologic/ethnographic

sources generally report both indoor

and outdoor operations. Some changes

in local “grows” are reported: 

" Boston, MAL

: While most marijuana comes from Canada via Hell’s

Angels, the number of local indoor

“hydrogrows” has increased, as

have the amounts grown and the

tetrahydrocannabinol (THC) levels.

" Detroit, MIL

: Increasingly, plants

are started indoors and subsequently moved outdoors.

" Memphis, TNL

: Some soil grows

are reported, but more indoor

grows of hydroponic are reported

than in the past.

" Philadelphia, PAL

: While most

marijuana is not grown locally, the

number of indoor hydroponic

grows is increasing.

" Portland, MEL

: Large outdoor

grows of high-grade marijuana are

reported in the summer. Organized

groups with small plots are reportedly getting together in order to

bypass laws aimed at large plots.

Maine has become a competitive

supply source for New England

and Canada.

What are street-level prices,

purity levels, and adulterants

across the country? (Exhibit 4)

Except for a slight increase in

Portland, ME, and a decline in El

Paso, all prices listed in the table

remained stable between spring and

fall 2001. Only a few THC levels are

reported: 12 percent per 1/4 ounce of

“hydro” in Miami; 4–6 percent per

ounce of Mexican commercial and

>15 percent for an ounce of BC bud

in Denver; 4–6 percent per joint or

“dime bag” of Mexican in Los

Angeles; and 15–22 percent per gram

of sinsemilla in Honolulu. 

Five treatment sources—in Columbia

(SC), El Paso, Miami, Seattle, and

Washington, DC—mention clients

who smoke joints that, without their

knowledge, have been laced with

crack. Sometimes the clients realize it

afterward, and sometimes they just

assume they have bought especially

potent marijuana. In El Paso, both

heroin and cocaine have shown up in

drug tests, even though the clients,

who admit to marijuana use, swear

they have not used the other drugs.

Staff are inclined to believe these

clients because when they stop their

marijuana use, their urine tests clean. 

Exhibit 3.

Which marijuana varieties have

changed in availability (spring

2001 vs fall 2001)?*

Sinsemilla

Boston, MAE

Chicago, ILL

Local commercial grade

Honolulu, HIE

Mexican

Boston, MAE

Denver, COL

BC bud

Los Angeles, CAE

Hydroponic

Boston, MAL,E

Memphis, TNL

New York, NYE

Washington, DCL

Sinsemilla

Denver, COL

Memphis, TNE

Local commercial grade

Chicago, ILL

New Orleans, LAL

Mexican

Chicago, ILL

Seattle, WAE

BC bud

Honolulu, HIE

Memphis, TNE

Hydroponic

Columbia, SCL

New Orleans, LAL

*The Baltimore law enforcement source did

not respond.
MARIJUANA

Pulse Check: April 2002 page 41

Instances of cocaine-lacing, as well as

PCP-lacing, have also been increasing

in Washington, DC. PCP adulteration

is also reported in Chicago. The New

York ethnographic source reports that

when dealers cook crack, they take

the leftover water and add it to 

marijuana to enhance it: the final

product is called “elo.” Pesticides are

mentioned as adulterants in Memphis.

Some more benign adulterants are

reported, including oregano, parsley,

and tea flakes. In El Paso, dealers sell

marijuana cut with oregano to new

users only.

How is marijuana referred to and

packaged across the country?

(Exhibit 5) Among the many slang

terms for marijuana or marijuana

smoking across Pulse Check sites, a

few new ones are reported: “blaxing”

(a high school term for smoking) in

Boston; “rugs” in Columbia, SC;

“hay” in Memphis; “macaroni” in

Miami, where “macaroni and cheese”

refers to a $5 pack of marijuana and

a “dime” bag of cocaine; “purple

haze” in New York; and “LG” (lime

green) and “chiefing” (smoking) in 

St. Louis. In some cities, slang names

sometimes refer to the type of marijuana, while dealer brand names

often refer to the place of origin, but

the two often overlap. In Washington,

DC, for example, some dealer designations include “northern lights” (for

marijuana from Canada), “Jamaican”

(from Jamaica), and “bubble gum”

(from Tennessee).

Plastic zipper or sandwich bags

remain the most common marijuana

packaging, as reported in previous

Pulse Checks. The only reported

change is in Columbia, SC, where the

law enforcement source reports that

marijuana used to be rolled up in tinfoil but now tends to be sold in small

zipper “head shop” bags of various

sizes and colors.

MARIJUANA: THE SELLERS

Who sells marijuana? Law

enforcement and epidemiologic/

ethnographic sources generally name

young adults (18–30 years) as the

predominant marijuana sellers in

their communities. Older adults

(>30), however, are named in

Portland (ME), while adolescents 

Exhibit 4. How much does marijuana cost in 19 Pulse Check cities?*

MOST COMMON STREET UNIT 1 OUNCE

City/Source Type Unit Price/Change** Price/Change**

Boston, MAL Sinsemilla 1 oz $80–$100/↔

Boston, MAE NR Bag $20/↔

NR “Elbow” $300–$350/↔

New York, NYL Commercial 1 oz $100–$200/↔

Sinsemilla and Hydro 1 oz $300–$1,200/↔

New York, NYE Hydro Bag $20/↔

Bio Bag $10/NR

Philadelphia, PAL Commercial 1 oz $150–$200/↔

Philadelphia, PAE NR Bag $10/↔

Portland, MEL High grade 1 oz $175–$225/↑

Columbia, SCL Mexican or 

Local commercial 3–4 g $10/↔ $180/↔

El Paso, TXL Mexican commercial 1/4 oz $20/↔

El Paso, TXE NR Baggie $20/↓

Memphis, TNL NR 1/4 oz $25/↔ $100/↔

Memphis, TNE NR 1/8 oz $15–$20/↔

Miami, FLE Hydro 1/4 oz $100–$200/↔ $150–$200/↔

New Orleans, LAL SW commercial Joint $5/↔ $500/↔

Washington, DCE Commercial Blunt $10–$20/↔ $100/↔

“Kindbud” or Hydro 1 bag $10–$20/↔ $480/↔

Chicago, ILE NR Bag $5–$10/↔ $100–$200/↔

Detroit, MIL NR Bag (1 g) $10/↔

Sioux Falls, SDL Mexican commercial 1/4 lb $350–$450/↔ $100–$200/↔

St. Louis, MOL NR Bag $20/↔ $100/↔

Billings, MTL Sinsemilla 1 oz $100/↔

Denver, COL Commercial 1 oz $50/↔

Denver, COE Mexican commercial 1 oz $200/↔

Local hydroponic 1 oz $200–$400/↔

BC bud 1 oz $600/↔

Honolulu, HIL Sinsemilla 1 g $25/↔

Honolulu, HIE NR Joint $5–$20/↔

NR 1 g $25/↔ $400–$800/↔

Los Angeles, CAL Mexican commercial Joint $10/↔ $200–$250/NR

Los Angeles, CAE Mexican, Local, 

and Hydro Joint $10/NR NR

Seattle, WAE Local hydroponic 1 g $15–$25/↔

Local hydroponic 1/8 oz $40–$50/↔ $325–$400/↔

*Respondents in Baltimore did not provide this information.

**Arrows indicate up, down, or stable between spring and fall 2001.

NOTE: Respondents generally did not provide purity levels. 

NR= not reported Northeast South West Midwest
MARIJUANA

page 42 Pulse Check: April 2002

are named in Baltimore and New

Orleans. In some cities, such as

Billings, Boston, Denver, El Paso, Los

Angeles, and St. Louis, two or more

age groups are named. These sellers

are very or somewhat likely to use

their own drug, according to nearly

every law enforcement and epidemiologic/ethnographic source. They are

more likely to be involved in nonviolent crimes, such as thefts, than in

violent crimes. And, as reported in

past Pulse Checks, they are more 

likely to operate independently than

as part of organized operations.

However, organizations with varying

degrees of structure do exist in several

cities. Since the last reporting period,

only a few changes are reported:

" Denver, COL

: While young adults

are the primary sellers, older adults

are emerging as a new seller group.

" Miami, FLL

: An emerging group of

sellers is reported: Cuban refugees

who are beginning to set up marijuana grow houses.

" Portland, MEL

: The somewhat

loose organization of older adult

sellers is becoming more organized.

Some younger adults, however,

operate independently.

" Washington, DCE

: The number 

of organized “crews” has been

decreasing, as has marijuana trafficking in general, because selling

1⁄2 pound or more of marijuana is

now considered a felony, rather

than a misdemeanor.

What other drugs do marijuana

dealers sell? Law enforcement and

epidemiologic/ethnographic sources

continue to report that crack and

powder cocaine are the drugs most

commonly sold by marijuana dealers

(in Boston, Billings, Columbia (SC),

Denver, Detroit, Honolulu, Los

Angeles, Memphis, Miami, New

Orleans, New York, St. Louis, and

Sioux Falls). Additionally, marijuana

is sold with ecstasy (in Boston,

Honolulu, Memphis, Miami, and

New York), with heroin (in Denver,

New Orleans, New York, and St.

Louis), with methamphetamine (in

Denver, Honolulu, and Sioux Falls),

with Rohypnol® (in El Paso), with 

prescription pills (in Memphis), and

with PCP (in New Orleans). In

Baltimore, heroin is only occasionally

sold with marijuana, “when they

come across a deal,” according to the

ethnographic source. In Chicago,

heroin and cocaine are sometimes

sold on the same street as marijuana,

but not by the same person.

Where is marijuana sold? As

reported in past Pulse Checks, marijuana, more than other drugs, tends

to be sold both indoors and outdoors

and in all types of geographic areas—

central city, suburban, and rural. The

specific sales settings remain varied,

with only a handful of changes since

the last Pulse Check:

" Honolulu, HIE

: Marijuana sales

have declined in public housing

developments because of increased

police efforts in those areas, with

major “cleanups” and “walkthroughs” over the past 18 months.

" Memphis, TNE

: Marijuana availability in distribution networks has

increased in several areas, particularly in less overt settings, such as in

nightclubs, at shopping malls, over

the Internet, in playgrounds and

parks, at private parties, in hotels/

motels, around supermarkets, inside

cars, and in the workplace.

" Miami, FLE

: Marijuana transactions, like cocaine and ecstasy

transactions, used to be conducted

primarily in private homes, but

have been gradually shifting to

prearranged rendezvous, deliveries,

and exchanges.

MARIJUANA: THE USERS

Who uses marijuana? (Exhibits 6,

7, and 8) The differences between the

Pulse Check source categories are

most apparent with regard to the

marijuana user populations they

describe. For example, epidemiologic/ 

ethnographic sources tend to report

Exhibit 5. 

How is marijuana referred to in different regions of the country?

WEST

Grass, weed, pot, dope, bud, 

ragweed, skunkweed, good s--t,

crack, ganga, chronic, BC bud,

triple A (for BC bud), kindbud,

swag, herb, skunk, mary jane

Grass, weed, pot,

green, bud, reefer,

blunt, LG (lime

green), hydro,

chiefing

MIDWEST NORTHEAST

SOUTH

Grass, weed, pot, dope, smoke,

blunts, bud, reefer, herb, homegrown, roach, joint, ganga, bone,

mary jane, jay, chronic, hash, hash

oil, doobie, loose shake, purple

haze, sins, hydro, blaxing, organic

Grass, weed, pot, dope, smoke, bud, thc, herb, mota, mary

jane, mary, jane, green, blunt, kryptonite, krippy, fire,

hydro, marijuan, blow, hay, kindbud, kb, week, trees, nugs,

rugs, ganja, macaroni, macaroni and cheese (marijuana and

cocaine), sigs, wacky, northern lights, bubble gum

Grass, weed, kona gold, kauai

electric, maui wowie, pakaloco

(crazy tobacco), chronic

Sources: Law enforcement, epidemiologic/ethnographic, and treatment respondents
MARIJUANA

Pulse Check: April 2002 page 43

that marijuana users are most likely

to be males, are equally likely to be

either adolescents (13–17 years) or

young adults (18–30), and are equally

likely to reside in central city, suburban, and rural areas. Non-methadone

treatment sources, however, tend to

report that users are predominantly

young adult males who live in the

central city. By contrast, methadone

treatment sources tend to describe

users who are older than 30 years,

are equally likely to be either males

or females, and most commonly

reside in the central city. Furthermore, methadone treatment sources

are more likely than their nonmethadone counterparts to report

that marijuana users have completed

high school.

The different sources, however, are

more uniform in reporting racial/ethnic distributions: Whites and Blacks

tend to be the predominant marijuana

users in approximately equal numbers

of cities, according to all the sources.

Similarly, all sources generally agree

that marijuana use cuts across all

socioeconomic groups, although, during this reporting period, low socioeconomic status is slightly more represented than high and middle status.

Compared with users of other drugs,

marijuana users are more likely to

reside in all locations (central city,

suburban, and rural areas), according

to epidemiologic/ethnographic

sources in nine cities: Chicago,

Denver, Detroit, Honolulu, Memphis,

New Orleans, Portland (ME), St.

Louis, and Seattle. They are also

more likely than users of other drugs

to be referred to treatment through

courts or the criminal justice system,

schools, and employers, according to

non-methadone treatment sources. 

How do marijuana users take

marijuana? As reported in the last

Pulse Check, joints remain the most

common vehicle for smoking marijuana. However, blunts (hollowed-out

cigars filled with marijuana) are more

common than joints in many cities, as

reported by epidemiologic/ethnographic

and non-methadone treatment sources.

According to methadone treatment

sources, however, Baltimore is the only

city where blunts are more common

than joints. Other, less commonly

reported delivery systems include pipes

and bongs (in Denver, El Paso, Los

Angeles, Miami, St. Louis, and

Seattle), bowls with four or five pipes

(in Seattle), and baked brownies (in

Honolulu and Portland [ME]). Small

pipes are known as “one-hitters” in St.

Louis. In Philadelphia, blunts are

sometimes dipped in honey.

Several epidemiologic/ethnographic

sources note changes in blunt or 

joint use since the last Pulse Check

reporting period:

" Boston, MA: Because anti-tobacco

laws are being increasingly enforced,

blunt use over the past year has

declined among adolescents, who

Exhibit 6.

What age group is most likely to use marijuana?

Note: In some cities, more than one age group is named.

Epidemiologic/Ethnographic

Sources (N=20)

Non-Methadone Treatment

Sources (N=17)

Methadone Treatment

Sources (N=14)

Preadolescents (<13 years)

Adolescents (13–17 years)

Young Adults (18–30 years)

Older Adults (>30 years)

Number of Respondents 15

10

5

0

Exhibit 7.

Where are drug users most likely to reside?

Marijuana Ecstasy Powder Cocaine Crack Heroin

Sources: Epidemiologic/ethnographic respondents

Note: Some respondents list two areas per city.

Rural Areas

Suburbs

Central City

All Areas

Number of Respondents (N=20) 20

15

10

5

0
MARIJUANA

page 44 Pulse Check: April 2002

find it easier to buy joint rolling

paper than to buy tobacco products.

Blunts are still common, however,

among users in their twenties and

thirties.

" Memphis, TN: Blunts have slightly

overtaken joints as the predominant vehicle of marijuana administration since the last Pulse Check

reporting period.

" Miami, FL: Marijuana is now

smoked primarily in pipes and

bongs, representing a shift over

the past few years. Joints have

become rarer because they involve

more people and are thus more

detectable; blunts have become

less popular because they are too

expensive.

" New Orleans, LA: Marijuana is

smoked predominantly in joints,

but blunts are occasionally reported (although they are not called

blunts), mostly among out-oftowners.

" New York, NY: When blunts first

appeared on the scene, users

would gut commercial cigars and

refill them with marijuana. Soon

thereafter, users began rolling their

own blunts in frontal leaves, which

were available in two colors. They

Marijuana users, as a group, have changed in several ways since the last Pulse Check reporting period: 

Age:

Gender:

Race:

Socioeconomic Status:

Residence:

➤ Billings, MTN: Marijuana users are becoming younger—some initiate use as early as 8 years. 

➤ Boston, MAE

: Many marijuana users older than 30 are “maturing out”—a term used by Charles Winnick in 1964 to

describe giving up drugs because other things become more important. Young adults are the predominant users, but use

is not uncommon among adolescents as young as 13 years.

➤ Chicago, ILL

: The program is seeing more adolescent marijuana users because it is changing in order to include them.

➤ Columbia, SCE

: While adolescents are the predominant user group, the number of young adults has increased slightly

since the last Pulse Check reporting period, possibly due to random fluctuations.

➤ Miami, FLE

: The emerging group of preadolescents (<13 years) perceive regular marijuana use as less harmful than do

older youth, possibly because debates over medical marijuana are sending mixed messages to youth. According to the

State school survey, middle school (sixth, seventh, and eighth grade) marijuana use has increased. 

➤ Memphis, TNE

: Marijuana use appears evenly distributed among adolescents, young adults, and older adults. An

increase, however, is noted among older adults.

➤ Philadelphia, PAE

: More younger and fewer older people are initiating marijuana use. 

➤ New Orleans, LAE

: Females have been increasingly using marijuana: they now nearly equal the number of male users. 

➤ Philadelphia, PAE

: Females continue to increase among marijuana users. 

➤ Sioux Falls, SDE

: A new user group is reported: White preadolescent (<13 years) suburban girls from middle 

socioeconomic backgrounds who smoke joints at home, at private parties, and in hotel/motel settings. 

➤ Columbia, SCE

: The percentage of users who are White has increased slightly since the last Pulse Check reporting 

period. However, Whites remain underrepresented, and users are still more likely to be Black.

➤ Memphis, TNE

: In a reversal since the last Pulse Check, Blacks, rather than Whites, are the predominant marijuana user

group.

➤ Washington, DCE

: Hispanic users have increased, but Black central city users still predominate, followed by White 

middle-socioeconomic clubgoers. 

➤ Philadelphia, PAE

: Users are predominantly from low socioeconomic backgrounds, but those from mid-socioeconomic

backgrounds are increasing. 

➤ Boston, MAE

: Marijuana use is increasing in rural areas, but central city and suburban areas still predominate.

➤ Memphis, TNE

: With people increasingly moving to the suburbs and rural areas, marijuana users are equally likely to

reside in those areas as well as in the central city—which was the predominant area reported in the last Pulse Check.
MARIJUANA

Pulse Check: April 2002 page 45

then switched to an unrolled wrap

sold in a plastic bag. The latest

development is a rolled commercial wrap, packaged in cellophane

similar to a small cigar, that comes

in flavors such as cognac and

chocolate. These wraps are commercially available for $1 apiece in

stores and on the Internet.

" Philadelphia, PA: The blunt wrap,

a new product introduced in

October 2001, is a tobacco leaf

that is moister, fresher, slower

burning, and less messy than gutted cigars, whose preparation

requires sharp objects or fingernails. A five-pack sells for $2 over

the Internet and in stores, and one

wrap sells for $1 on street corners.

Wraps come in several flavors,

including vanilla, chocolate, and

honey. They are known on the

street as “snoop dogs” or

“snoops,” after the person who

first promoted the product.

What other drugs do marijuana

users take? As reported in past

Pulse Checks, some marijuana users

take a wide range of additional

drugs—including crack, powder

cocaine, heroin, PCP, ecstasy, and

even embalming fluid—sometimes

sequentially and sometimes in combination. Since the last report, several

changes are reported in this aspect of

marijuana use:

" Baltimore, MDE

: According to

unconfirmed reports, marijuana

and ecstasy are being used 

sequentially.

" Boston, MAE

: Minority high

school students are increasingly

using both marijuana and ecstasy.

" Boston, MAM: Some clients are

using marijuana as a mild substitute for heroin, sometimes to 

manage anger.

" Boston, MAN: To enhance poorer

quality marijuana, some clients are

alternately using marijuana and

powder cocaine.

" Columbia, SCN: Using marijuana

and ecstasy sequentially, while not

a new practice, is increasingly

reported. The use of “wets”—

marijuana plus embalming fluid—

is becoming increasingly routine. 

" Memphis, TNE

: Increased marijuana

use is part of a general increase in

polydrug use. Users seem to be in

constant search of another drug

that will create a slightly different

effect. Several substances are

newly reported during this period

as taken in combination with or

sequentially with marijuana: alcohol, prescription drugs (particularly

benzodiazepines), and powder

cocaine. “Sherman sticks” are the

name for the newly reported 

combination of marijuana plus

powder cocaine.

" Miami, FLL

: Younger users are 

lacing marijuana cigarettes with

heroin.

" Seattle, WAE

: The practice of combining marijuana with embalming

fluid is becoming more rare.

" Sioux Falls, SDE

: Several users who

were combining marijuana with a

substance called “red rock” thought

they had bought opium: testing,

however, showed that the substance

was actually methamphetamine.

Where and with whom is marijuana used? Epidemiologic/ethnographic and non-methadone treatment sources tend to report that marijuana is equally likely to be used

either publicly or privately.

Methadone treatment sources, however, tend to report more private

than public use. They also generally

report that users smoke marijuana

while alone, while non-methadone

treatment sources tend to report

more small-group use. The majority

of epidemiologic/ethnographic

sources, however, report that solo

and small-group use are equally likely.

Only a few sources describe any

changes in where or with whom 

marijuana users smoke their drug:

" Billings, MTE

: Raves have

increased, but they are still generally drug free: users tend to smoke

Exhibit 8.

How are different drug users referred to treatment?

Sources: Non-methadone treatment respondents

NOTE: Many respondents list more than one referral source.

Alcohol/Drug Abuse

Health Care Provider

Court/Criminal Justice

Marijuana Heroin

Individual

School Employer Health Care

Provider

Number of Respondents (N=19) 20

15

10

5

0

Crack
MARIJUANA

page 46 Pulse Check: April 2002

marijuana in the car on the way to

and from the raves.

" Memphis, TNE

: Marijuana is

increasingly used in private and

while alone. Public use and social

use were reported as predominant

during the last Pulse Check reporting

period; during the current period,

however, marijuana is equally likely to be used both in public and in

private, both while alone and in

groups among friends.

" New Orleans, LAE

: Two shifts have

occurred. On the one hand, use

has declined around schools

because of new stricter laws. On

the other hand, overt smoking has

increased, even near treatment

centers and police facilities.

" Philadelphia, PAE

: For the first

time, marijuana use is reported at

“speakeasies.” These organized

events, which take place in private

residences where participants need

to know someone to get in, usually

involve jazz music, a pool table,

card games, a room for sex, and

staged fights. Participants are 

predominantly older (>30 years)

Blacks. Until recently, substance

use at these events was usually limited to alcohol (moonshine).
METHAMPHETAMINE

Pulse Check: April 2002 page 47

METHAMPHETAMINE✛

Methamphetamine continues to be

considered the most widely abused

drug by the law enforcement source

in Billings, the epidemiologic source

in Honolulu, and the non-methadone

treatment source in Denver. Since the

last reporting period, one additional

source (this time in the South) reports

it as the most widely abused drug: the

Memphis law enforcement source.

Although it is considered the most

widely abused drug in only 4 cities,

14 sources in 8 Pulse Check cities

(Billings, Denver, Honolulu, Los

Angeles, Memphis, St. Louis, Seattle,

and Sioux Falls), mostly western, 

consider it the drug contributing to

the most serious consequences. Four

of those sources from four cities (Los

Angeles, Memphis, St. Louis, and

Seattle) have been added since the last

Pulse Check. Furthermore, methamphetamine is reportedly emerging or

continuing to trend upward in

Columbia (SC), New Orleans, Seattle,

and Sioux Falls. 

METHAMPHETAMINE: THE DRUG

How available is methamphetamine, in its various forms,

across the country? (Exhibits 1

and 2) Similar to reports in the last

Pulse Check, more than half (22 of

39) of law enforcement and epidemiologic/ethnographic respondents

report methamphetamine as widely or

somewhat available. Availability varies

widely by region. In the West, it 

continues to be widely available

according to all but one source (the

epidemiologic source in Billings); in

the Midwest, it ranges from not very

available (in Chicago) to widely 

available (in Sioux Falls); in the

South, it ranges from not very 

available to widely available; and in

the Northeast, it is not very available,

according to nearly all respondents.

Since the last reporting period,

methamphetamine availability

increased according to 13 law

enforcement and epidemiologic/

ethnographic respondents in 11 Pulse

Check cities: Boston, Chicago (where

it increased in the North Side gay

community), Columbia (SC), Denver,

Detroit, Los Angeles, Miami, New

York, Portland (ME), Sioux Falls, 

Seattle

St. Louis

Sioux

Falls

Memphis Columbia

New York City

Boston

Washington, DC

Portland

Denver

El Paso

Los

Angeles

Honolulu

Philadelphia

Miami

Detroit

Chicago

Baltimore

New

Orleans

Seattle

St. Louis

Memphis Columbia

New York City

Boston

Washington, DC

Portland

Denver

El Paso

Los

Angeles

Honolulu

Philadelphia

Miami

Detroit

Chicago

Baltimore

New

Orleans

Billings

Sioux

Falls

Billings

Exhibit 1.

How available is methamphetamine across the 20 Pulse Check cities 

(fall 2001)?*

According to epidemiologists/ethnographers... (N=20)

According to law enforcement sources... (N=19)*

Widely Available Somewhat Available

Not very Available Not Available

*The law enforcement source in Baltimore did not respond.

✛The following symbols appear throughout this chapter to indicate type of respondent: L

Law enforcement respondent, EEpidemiologic/ethnographic

respondent, NNon-methadone treatment respondent, and MMethadone treatment respondent.
METHAMPHETAMINE

page 48 Pulse Check: April 2002

and Seattle. Availability declined,

according to only two respondents

(the epidemiologists in El Paso and

Honolulu). Unlike reports in the last

Pulse Check, availability trends were

not based upon regional patterns:

increases occurred in all regions in

fairly equal proportions.

Locally produced and Mexican

methamphetamine are about equally

available, according to most respondents. “Ice,” nearly 100 percent pure

methamphetamine, continues to be

unavailable in most cities, except in

Honolulu (where it is considered

widely available by both the law

enforcement and epidemiologic

sources), Los Angeles and

Memphis (where it is considered

somewhat available by the law

enforcement sources), and

Washington, DC (where it

considered somewhat available

by the ethnographic source).

Similar to reports in the last Pulse

Check, most available methamphetamine is reportedly produced in “box

labs,” small, mobile, clandestine labs.

Additionally, methamphetamine labs

run by large operations in Mexico

and California produce some of the

methamphetamine available in Los

Angeles, Memphis, Philadelphia, St.

Louis, and Seattle. 

Since the last reporting period, the

number of small, local methamphetamine labs seized increased in eight

Pulse Check cities:

" Billings, MTL,E

" Boston, MAL

" Denver, COL 

" Detroit, MIL

" Los Angeles, CAL

" Portland, MEL

" Seattle, WAE

" Sioux Falls, SDL,E,N

Methamphetamine production 

methods have changed in two Pulse

Check cities:

" Memphis, TNL

: Manufacturers are

producing more amphetamines

than methamphetamine. The new

technique, referred to as “crush

and rush,” does not filter the

starch out of the ephedrine or

pseudoephedrine tablets. This

method eliminates steps and is

quick, but the methamphetamine it

produces is less pure.

" St. Louis, MOE

: The red phosphorus

method has declined because 

people began notifying the police

when customers bought more than

one box of red matchsticks. 

What are street-level methaphetamine prices and purity 

levels across the country?

(Exhibit 3) According to nearly all

law enforcement and epidemiologic/

ethnographic respondents, methamphetamine price levels, ranging from

$20–$60 per gram in Seattle to $330

per gram in Chicago, remained stable

since the last reporting period.

Exceptions include Honolulu,

where according to the epidemiologic source, prices declined at

the 1/4 gram and gram levels;

and Sioux Falls, where prices

increased for larger amounts

of the drug because it has

been more difficult to transport due to increased border

security since September 11.

Purity was reported in only five

cities and was mostly stable since the 

last reporting period, ranging from

10–70 percent in Denver to 75–95

percent in Seattle. Adulterants reported

include sugar substitutes in St. Louis

and a newly reported adulterant in

Billings: a white powder preservative

used for canning fruit that is making

some non-methadone treatment clients

sick. Moreover, the Seattle law

enforcement source states that

Mexican methamphetamine has

decreased in purity since the last

reporting period because it is being

diluted with methylsulfonomethane. 

How is methamphetamine

referred to and packaged across

the country? (Exhibit 4) Across the

country, methamphetamine continues

to be referred to as “meth,” “speed,”

Exhibit 2.

How has methamphetamine 

availability changed 

(fall 2001 vs spring 2001)?*

*The Columbia (SC) epidemiologic/

ethnographic source did not provide this

information; the Baltimore law enforcement

source did not respond.

Boston, MAL

Chicago, ILL,E

Columbia, SCL

Denver, COL

Detroit, MIE

Los Angeles, CAE

Miami, FLE

New York, NYE

Portland, MEE

Sioux Falls, SDE

Seattle, WAL,E

Baltimore, MDE

Billings, MTL,E

Boston, MAE

Denver, COE

Detroit, MIL

El Paso, TXL

Honolulu, HIL

Los Angeles, CAL

Memphis, TNL,E

Miami, FLL

New Orleans, LAL,E

New York, NYL

Philadelphia, PAL,E

Portland, MEL

St. Louis, MOL,E

Sioux Falls, SDL

Washington, DCL,E

El Paso, TXE

Honolulu, HIE
“crank,” or “crystal.” Other slang

terms continue to vary by region and

are often based on the color or consistency of the available methamphetamine. For example, the crystal form

of methamphetamine is called “blade”

in Memphis because it can cut the

nose when snorted, and another type

of methamphetamine in that city is

called “cinnamon” because it is pink.

“Christmas tree” or “holiday meth”

in the South continues to refer to

green methamphetamine produced

using Drano® crystals; “crystal glass”

in Washington, DC, refers to crystal

shards of methamphetamine; and

“hydro” in Washington, DC, refers to

high-quality methamphetamine. Since

the last reporting period, no new slang

terms have been reported in Pulse

Check cities. Similarly, no new packaging has been reported since the last

Pulse Check.

METHAMPHETAMINE: THE 

SELLERS

Who sells methamphetamine?

According to law enforcement and

epidemiologic/ethnographic respondents, nearly all street-level methamphetamine seller characteristics

remained stable since the last reporting period. Most respondents in nonWestern areas agree that street-level

methamphetamine sellers are predominantly independent. Most respondents in Western areas agree that sellers of locally produced methamphetamine are independent, but sellers of

Mexican produced methamphetamine

are organized. The Denver law

enforcement source states that, in

general, methamphetamine sellers

have become more organized since

the last reporting period. In several

Pulse Check cities (Billings, Detroit,

and El Paso), local methamphetamine

sellers are also the manufacturers. 

The age of street-level methamphetamine sellers continues to vary by

region: in the Northeast, they tend to

be adults (>30 years); in the Midwest,

they tend to be either adults or young

adults (18–30 years); and in the South

and West, they tend to be young

adults. Only the law enforcement

source in New Orleans mentioned

adolescents (13–17 years) as the predominant age group of methamphetamine sellers. As reported in the last

METHAMPHETAMINE

Pulse Check: April 2002 page 49

Exhibit 3. 

How much does methamphetamine cost in 14 Pulse Check cities?

Boston, MA $100 NR

Philadelphia, PA $100 <25

Columbia, SC $175 NR

Memphis, TN $90–$125 NR

New Orleans, LA $100 NR

Washington, DC $100–$140 NR

Chicago, IL $330 NR

St. Louis, MO $100 NR

Sioux Falls, SD $80–$100 NR

Billings, MT $100 33

Denver, CO $90–$100 10–70

Honolulu, HI $100–$300 NR

Los Angeles, CA $80–$100 15–35

Seattle, WA $20–$60 95 (Nazi)

75 (Red phosphorus)

City Gram price Purity (%)

Northeast Midwest West South

Sources: Law enforcement and epidemiologic/ethnographic respondents

NR= not reported

Exhibit 4. 

How is methamphetamine referred to in different regions of the country?

Eightballs,

elbows (1

pound), half

elbows (1/2

pound), ice,

OZs, rush

Anhydrous, bathtub meth, black, brown, chemical, california, fire,

getgo, glass, nazimeth, pink, red, spackle, speckled birds, soap, white,

white crosses, yellow J

Beanies, black beauties, blade, christmas tree meth,

cinnamon (pink in color), holiday meth, ice, sugar

Glass, girl,

window,

yellow

Sources: Law enforcement, epidemiologic/ethnographic, and treatment respondents

WEST MIDWEST

NORTHEAST

SOUTH

Batu, clear,

ice, shabu,

wash
METHAMPHETAMINE

page 50 Pulse Check: April 2002

Pulse Check, most law enforcement

and epidemiologic/ethnographic

respondents agree that methamphetamine sellers are very likely to use the

drug, and sources in two cities

(Denver and St. Louis) explain that

independent sellers are more likely to

use the drug than their organized

counterparts.

In what other crimes are streetlevel methamphetamine sellers

involved? Methamphetamine sellers

continue to be somewhat or very likely

to be involved in other crimes, most

commonly domestic violence, nonviolent crimes, and violent crimes. As

reported in the last Pulse Check (and

illustrated in exhibit 6 of the highlights section), methamphetamine 

sellers seem particularly involved in

domestic violence, accounting for 38

percent of the domestic violence

among drug sellers, compared with

only 24 percent for powder cocaine

and 19 percent for crack, according

to law enforcement and epidemiologic/

ethnographic respondents. For example, the Honolulu epidemiologist

states that methamphetamine is

involved in half of the domestic violence and sexual assault cases. Other

crimes related to methamphetamine

sales have remained relatively static

since the last reporting period, except

in Sioux Falls, where the epidemiologic source reports that domestic

violence and child abuse issues have

increased, and in Memphis, where the

epidemiologist states that reports of

violent acts and sellers involved in

gang-related activity have declined. 

What other drugs do methamphetamine sellers sell?

Methamphetamine sellers often sell

other drugs: only in four Pulse Check

cities (Boston, Columbia [SC],

Philadelphia, and St. Louis) do they

reportedly sell only methamphetamine. Other drugs sold in other Pulse

Check cities include marijuana (in

Billings, Denver, Detroit, Honolulu,

Los Angeles, Portland [ME], Seattle,

and Sioux Falls); crack (in Billings,

Denver, Honolulu, and Sioux Falls);

powder cocaine (in Denver, El Paso,

New Orleans, and Washington, DC);

heroin (in Denver, Honolulu, and

Portland); and club drugs, such as

ecstasy, GHB, and ketamine (in El

Paso, Portland, and Washington, DC).

The Memphis epidemiologic source

states that methamphetamine dealers

also sell prescription pills, a new

development during the current

reporting period; elsewhere, other

drugs sold by methamphetamine dealers have not reportedly changed.

How and where is street-level

methamphetamine sold?

According to law enforcement and

epidemiologic/ethnographic respondents in many Pulse Check cities,

dealers sell methamphetamine more

clandestinely than they do other

drugs, such as heroin, crack, and

powder cocaine. Often, as reported in

10 Pulse Check cities (Billings, Boston,

Columbia [SC], Honolulu, Memphis,

New Orleans, St. Louis, Seattle, Sioux

Falls, and Washington, DC), mutual

acquaintances introduce methamphetamine buyers to sellers, and they set up

meetings for the sale. In certain neighborhoods in Philadelphia, the drug is

sold in open-air markets located in

specific neighborhoods, as are crack,

powder cocaine, and marijuana. In

Portland (ME), methamphetamine

sales are similar to open-air market

sales, except that they take place only

at raves. In Detroit, sellers deliver the

drug directly to the buyer.

The geographic location of methamphetamine sales continues to vary

widely by region, according to law

enforcement and epidemiologic/

ethnographic respondents, with sales

occurring in all areas of cities (central, suburban, and rural) in the

Northeast and West, suburbs in most

southern cities, and rural areas in the

Midwest. Only in Memphis has the

geographic location of methamphetamine sales reportedly changed since

the last reporting period: sales in that

city are increasingly broadening to

include not only the central city, but

also suburban and rural areas. Similar

to reports in the last Pulse Check, the

most frequently mentioned specific

settings for methamphetamine sales

across Pulse Check cities are private

residences, followed by private parties

and nightclubs or bars. Respondents

also frequently mention streets, public

housing developments, cars, hotels/

motels, college campuses, and raves.

In Honolulu, dealers have been trying

to sell methamphetamine in and

around schools, but preadolescents

are not interested, according to the

epidemiologic source. The settings of

methamphetamine sales have remained

stable since the last reporting period,

with exceptions in two cities: in Sioux

Falls, the sale (and use) of methamphetamine in hotels and motels has

increased, and in Washington, DC,

the number of settings where the

drug is sold (and used) has increased. 

METHAMPHETAMINE: THE USERS

Who uses methamphetamine?

Methamphetamine users tend to be

males, according to most epidemiologic/ethnographic and treatment

sources. In the Northeast, they tend

to be adults (>30 years), but elsewhere they tend to be young adults
METHAMPHETAMINE

Pulse Check: April 2002 page 51

(18–30 years). The youngest age

group (13–17 years) was mentioned

as the predominant user group by

several sources: the non-methadone

treatment sources in Columbia (SC),

Los Angeles, and Sioux Falls and the

epidemiologic and methadone treatment sources in Billings. According to

nearly all respondents, Whites are the

predominant methamphetamine

users, and they are often overrepresented compared with the general

population. The predominant socioeconomic status of methamphetamine

users ranges from low to middle and

varies by city. Predominant user residence varies by region, with central

cities predominating in the Northeast,

central city and suburban areas predominating in the South, all areas

mentioned equally in the Midwest,

and mostly central cities and suburbs

in the West. 

Where is methamphetamine

used? Similar to the last Pulse Check,

the most frequently mentioned user

settings, according to epidemiologic/

ethnographic respondents, are private

parties and private residences. Other

common settings include cars, nightclubs and bars, college campuses,

raves, and hotels or motels. The

largest number of user settings is

reported in the West; the fewest user

settings are reported in the Northeast. Since the last reporting period,

user settings have remained relatively

stable, except in Memphis and

Washington, DC, where methamphetamine user settings have expanded, as reported above in the methamphetamine sellers section. 

How and with what other drugs do

users take methamphetamine?

Route of administration for methamphetamine varies widely, often with

several routes of administration predominating per city, according to epidemiologic/ethnographic respondents.

Smoking is more common in the West

than in non-western areas, and snorting is more common in non-western

areas than in the West. Oral ingestion

and injection are common in all

regions; in all regions, novice users

often shift from snorting or smoking

to injecting. Since the last reporting

period, according to epidemiologic/

ethnographic and treatment sources,

the route of administration for

methamphetamine use has changed in

several Pulse Check cities: smoking

and oral use have increased in Billings

and Memphis; injection has increased

in Denver and Washington, DC; and

snorting has increased in Sioux Falls.

Methamphetamine use has

increased in a number of Pulse

Check cities:

According to treatment respondents,

since the last reporting period, novice

users (those using methamphetamine for

less than 1 year before entering treatment) increased in seven cities, none of

which were in the Northeast: 

" Billings, MTN

" Columbia, SCN

" Denver, CON

" New Orleans, LAM

" Sioux Falls, SDN,M

" St. Louis, MON

" Seattle, WAM

Similarly, the numbers of methamphetamine users have increased in six Pulse

Check cities:

" Denver, COE

" Memphis, TNE

" Miami, FLE

" New Orleans, LAM

" Seattle, WAE

" Washington, DCE

By contrast, the non-methadone treatment source in Los Angeles states that the

numbers may have declined slightly

because adolescents are starting to believe

that methamphetamine is dangerous.

Methamphetamine user characteristics changed in many Pulse

Check cities across the Nation:

According to epidemiologic/ethnographic

and treatment sources...

" Females are increasingly using

methamphetamine in Memphis and

Honolulu.

" Shifts in age are reported in two

regions: the South, where adults (>30

years) have increased, and the West,

where adolescents (13–17 years) have

increased:

➤ Memphis, TNE

: Younger adults predominate, but adults are increasing.

➤ Washington, DCE

: The number of

adult users has increased: that

group and young adults (18–30

years) are the predominant users.

➤ Honolulu, HIE

: Young adults predominate, but novice adolescent

users have increased.

➤ Los Angeles, CAE

: Young adults

predominate, but adolescent users

have increased.

" Hispanics are emerging as methamphetamine users in Los Angeles and

New York.

" Emerging methamphetamine users are

from the central cities and rural areas

in Memphis and St. Louis. In Los

Angeles, where most users reside in

rural areas, suburbs are emerging as

user residences.
METHAMPHETAMINE

page 52 Pulse Check: April 2002

As reported in the last Pulse Check

by epidemiologic/ethnographic

respondents, methamphetamine users

also take a variety of other drugs.

The most common drugs used in

combination with methamphetamine

continue to be marijuana, ecstasy (as

reported in Memphis, where the

combination is new this reporting

period; Miami, where the combination is referred to as “super x” and

“hugs and kisses”; and Washington,

DC, where it is also used sequentially

with a variety of other club drugs),

and benzodiazepines (as in Memphis,

where the combination is new this

reporting period; Portland [ME]; and

Seattle, where the combination has

increased since the last reporting

period).
DIVERTED SYNTHETIC OPIOIDS

Pulse Check: April 2002 page 53

DIVERTED SYNTHETIC

OPIOIDS✛

The last issue of Pulse Check addressed

the illegal diversion and abuse of 

synthetic opioids, with most sources

specifically citing one particular 

prescription opiate, OxyContin®

(oxycodone hyrdrochloride controlledrelease). OxyContin® tablets are 

prescribed to patients suffering from

severe persistent pain—a legitimate

medical need. However, as reports of

abuse and diversion of OxyContin®

across the country continue, Pulse

Check also continues to monitor and

report on developments concerning

this drug. 

How serious is OxyContin®

abuse and diversion, and where

is OxyContin abuse emerging

across the country? (Exhibit 1)

OxyContin® is considered the most

serious illicit drug problem in three

Pulse Check cities: Miami, New

Orleans, and Portland (ME). Moreover, one source (the methadone

source in Columbia [SC]) considers it

the most widely abused drug. As

reported in the last Pulse Check, more

sources (law enforcement, epidemiologic/ethnographic, methadone treatment, and non-methadone treatment)

report OxyContin® as the emerging

drug of abuse in their communities

than any other drug this reporting

Exhibit 1. 

Where are the diversion and abuse of OxyContin® emerging across the

20 Pulse Check cities?

E,N

L,E

N,M

L

L,M

E,M

E,M

L,E,N,M

L,E,M

L,M,N

E,M

L,N

M

M

M

M

L,E

E,N

E,N

OxyContin® reported as emerging

in fall 2001

OxyContin® not reported as emerging in

fall 2001

✛The following symbols appear throughout this chapter to indicate type of respondent: L

Law enforcement respondent, EEpidemiologic/ethnographic

respondent, NNon-methadone treatment respondent, and MMethadone treatment respondent.

Comments by Pulse Check sources highlight that OxyContin® diversion and abuse are increasing in many cities

across the Nation:

" Billings, MTL,N: According to the law

enforcement source, diverted OxyContin® availability and abuse are up

dramatically. Both Billings nonmethadone treatment sources agree

that OxyContin® abuse continues to

increase, and one points out that the

emergence of an illegal market for the

drug underscores its increasing abuse.

" Columbia, SCN: Most of the younger

abusers have been using it for a few

years, but now they actively seek it,

whereas previously they were just using

it when it was available. 

" Honolulu, HIL

: “Honolulu’s drug market is slowly keeping up with national

trends with diverted OxyContin®.”

" Memphis,TNL

: Since the last reporting 

period, diverted OxyContin® sales have

increased markedly, and the drug is often

associated with the use of club drugs.

" Miami, FLL,E: OxyContin® has shifted

from limited sales in private residences

to being a “street drug,” according to

the epidemiologic source. Similarly,

according to the law enforcement

source, OxyContin® is now available

in the same neighborhoods and settings

where crack is available. 

" New Orleans, LAL

: “OxyContin® is

emerging, and we would like to get a

grip on it before it becomes a problem

like crack cocaine did in 1987.” 

" New Orleans, LAM,N: Most of the

clients in treatment for OxyContin®

abuse are there because their doctors,

who had been writing their prescriptions, have been arrested. Now that

abusers’ sources are dry they have to

come in for treatment. 

" New York, NYE

: “During this reporting

period, OxyContin® has been sighted

on the street for the first time, in two

incidents where field researchers were

approached by sellers.”

By contrast, in two cities (both in

the Northeast), OxyContin® diversion or abuse may be declining:

" Philadelphia, PAL

: Media coverage and

publicity, increased law enforcement

focus, and arrests of key violators may

have made potential diverters reconsider

selling the drug.

" Portland, MEE

: Diverted OxyContin®

availability has declined, most likely

because “tightened controls have made it

more difficult to obtain OxyContin®

than in the past.”
DIVERTED SYNTHETIC OPIOIDS

page 54 Pulse Check: April 2002

period: 29 of 75 sources in 18 of 20

Pulse Check cities report OxyContin®

as an emerging drug of abuse. Only in

Chicago (where it remains unavailable)

and Washington, DC (where it is somewhat available) was OxyContin® not

reported as emerging during this

reporting period. 

DIVERTED OXYCONTIN®: THE DRUG

How available is diverted

OxyContin®? (Exhibits 2 and 3)

Across the Nation, more than half (51

percent) of law enforcement and epidemiologic/ethnographic sources

report OxyContin® as somewhat 

or widely available. Moreover,

OxyContin® availability continues to

increase markedly: 45 percent of

respondents report increasing availability, and only one (the Portland

[ME] epidemiologic source) reports

declining availability. Sources in the

Northeast and South continue to

report wider availability than sources

elsewhere, and more southern sources

report increases in availability than do

their northeastern, midwestern, and

western counterparts. The Philadelphia

epidemiologic source adds that demand

for the drug in that city is higher than

supply, particularly because of law

enforcement crackdowns.

How much does diverted

OxyContin® cost, and how is it

referred to and packaged?

According to law enforcement and

epidemiologic/ethnographic sources,

OxyContin® continues to cost $1 per

milligram in most reporting Pulse

Check cities (Boston, Detroit, Miami,

Philadelphia, Portland [ME], and

Washington DC), with no price

changes reported since the last Pulse

Check. Pills cost $100 per 40 milligrams in New Orleans and $40 per

20 milligrams in Billings. According

to the Memphis epidemiologic source,

OxyContin® is often bartered rather

than sold, sometimes for crack, other

prescription drugs, or ecstasy.

Where available, diverted OxyContin®

continues to be referred to as “oxy”

or “OCs.” Other slang terms vary by

city: in Philadelphia it is referred to

simply as “O”; in New Orleans, it is

referred to as “ox”; and in Columbia

(SC), it is referred to as “kicker,” a

new term since the last reporting

period. In some cities, slang terms

refer to the number of milligrams in a

pill; for example, in Miami, an

OxyContin® pill is often called a

Exhibit 2. 

How available is diverted OxyContin® across the 20 Pulse Check cities

(fall 2001)?

Seattle

St. Louis

Sioux

Falls

Memphis Columbia

New York City

Boston

Washington, DC

Portland

Denver

El Paso

Los

Honolulu

Philadelphia

Miami

Detroit

Chicago

Baltimore

Seattle

St. Louis

Memphis Columbia

New York City

Boston

Washington, DC

Portland

Denver

El Paso

Honolulu

Philadelphia

Miami

Detroit

Chicago

Baltimore

New

Billings

Sioux

Falls

Billings

Orleans

New

Orleans

Angeles

Los

Angeles

*The law enforcement source in Baltimore did not respond, and the epidemiologic/ethnographic

sources in Columbia (SC), Denver, and Honolulu did not provide this information.

Widely Available

Not Very Available

Somewhat Available

Not Available

According to law enforcement sources... (N=19)*

According to epidemiologists/ethnographers sources... (N=17)*
DIVERTED SYNTHETIC OPIOIDS

Pulse Check: April 2002 page 55

“40” or an “80,” and in New

Orleans, a pill is called a “40-bar.”

As reported in the last Pulse Check,

most diverted OxyContin® is sold as

loose pills, although prescription containers are also used in Honolulu,

Memphis, and Portland. In Boston,

the diverted pills are packaged in

small, brown envelopes; and in

Billings, they continue to be packaged

in miniature coin zipper bags. Packaging has not changed since the last

Pulse Check, according to law

enforcement and epidemiologic/

ethnographic respondents.

DIVERTED OXYCONTIN®: 

THE SELLERS

How is OxyContin® diverted?

According to law enforcement

sources, OxyContin® continues to be

diverted from pharmacies in a variety

of ways within Pulse Check communities. The most frequently mentioned

diversion method is forging prescriptions, as reported in Boston, Columbia (SC), Denver, Miami, New

Orleans, New York, Philadelphia,

Portland (ME), and Washington, DC;

followed by doctor shopping in

Billings, Boston, Honolulu, New

York, Philadelphia, Portland, and

Sioux Falls; patients filling legal and

legitimate prescriptions but selling

some of the pills in Billings, Detroit,

New Orleans, New York, and

Washington, DC; doctors prescribing

it illegally for a fee or misprescribing

it in Boston, Honolulu, New York,

Philadelphia, and Seattle; and pharmaceutical robberies in Boston,

Detroit, New York, and Portland. In

some southern cities, including

Columbia and Memphis, diverted

OxyContin® may be shipped from

the Northeast. Additionally, in

Boston, some OxyContin® is being

stolen from people with legitimate

prescriptions. In Portland, pharmacists are targeting elderly people with

valid prescriptions and burglarizing

their homes. 

Most diversion methods have

remained the same since the last 

Pulse Check, except in Boston, where

robberies have increased, and people

are now paying others to rob pharmacies for them. Moreover, diversion

has increased in Billings, Boston, and

New York; however, in Portland, 

after increasing during the last year,

diversion may have leveled off. 

How is diverted OxyContin®

sold? Diverted OxyContin® is sold

in a variety of ways, depending on

the city in which it is sold. For 

example, in Billings, Memphis, and

New Orleans, private meetings

between buyers and sellers take place

via introductions, using beepers and

cell phones. In Philadelphia and

Washington, DC, most sales take

place in open-air markets outside

treatment centers or homeless shelters. According to the Columbia (SC)

law enforcement source, buyers go to

“pill houses,” residences where pills

are illicitly sold, to buy the drug.

According to the Boston law enforcement source, dealers have a small set

of customers with whom they are

familiar, customers page dealers to

place an order, and dealers and 

customers meet at customers’ houses

where the exchange takes place.

According to the Boston epidemiologist, buyers find elderly, minority

heroin or cocaine users in poor

health. These older drug users obtain

OxyContin® prescriptions from 

doctors and then sell the pills to

young Whites. 

Who sells diverted OxyContin®?

According to nearly all law enforcement and epidemiologic/ethnographic

respondents, sellers of diverted OxyContin® are mostly independent.

Exceptions are in Miami, where the

sellers are organized, and in New

Orleans, where they are loosely

organized gangs. Sellers tend to be

young adults (18–30 years) or adults

Exhibit 3.

How has diverted OxyContin®

availability changed (spring 2001

vs fall 2001)?*

*The Baltimore law enforcement source did

not respond, and the Columbia (SC),

Denver, Honolulu, and New Orleans epidemiologic/ethnographic sources did not

provide this information.

Billings, MTL

Boston, MAL,E

Columbia, SCL

Detroit, MIL

Honolulu, HIL

Memphis, TNL,E

Miami, FLL,E

New Orleans, LAL

New York, NYE

Portland, MEL

Sioux Falls, SDL

Washington, DCE

Portland, MEE

Baltimore, MDE

Billings, MTE

Chicago, ILL,E

Detroit, MIE

Denver, COL

El Paso, TXL,E

Los Angeles, CAL,E

New York, NYL

Philadelphia, PAL,E

St. Louis, MOL,E

Seattle, WAL,E

Sioux Falls, SDE

Washington, DCL
DIVERTED SYNTHETIC OPIOIDS

page 56 Pulse Check: April 2002

(>30 years), according to all respondents, with both age groups mentioned

an equal number of times. Sellers are

often chronic drug users in many Pulse

Check cities, including Honolulu and

Washington, DC (where they use 

heroin) and Memphis (where emerging sellers tend to abuse pharmaceutical depressants and opiates). Similarly,

according to 11 of 16 law enforcement

and epidemiologic/ethnographic

respondents, diverted OxyContin®

sellers are somewhat or very likely to

use the drug themselves. 

The only reported change in diverted

OxyContin® sellers’ characteristics is

that they are increasingly younger, as

reported by two sources: the law

enforcement source in Boston and the

epidemiologic source in Memphis.

In what other crimes are diverted OxyContin® sellers involved?

Besides the ones mentioned above,

diverted OxyContin® sellers continue

to be involved in a wide array of

crimes, specifically prostitution, gangrelated activities, and violent crimes

in Baltimore; theft, burglaries, and

prostitution in Billings; burglary,

theft, purse snatching, and drugassisted rape in New Orleans; domestic violence in Portland (ME); and

theft in Washington, DC.

What other drugs do diverted

OxyContin® sellers sell? Diverted

OxyContin® sellers often sell additional drugs, according to all law

enforcement and epidemiologic/ethnographic respondents. As reported in the

last Pulse Check, other prescription

opiates and heroin are the most common other drugs sold, as reported in

eight cities: Boston, Columbia (SC),

Honolulu, Memphis, Miami,

Philadelphia, Portland (ME), and

Washington, DC. Other drugs sold

include marijuana and methamphetamine in Billings; cocaine in Boston;

crack, powder cocaine, and marijuana

in Detroit; crack in Miami; and club

drugs (ecstasy and GHB) in New

Orleans, where OxyContin® is typically associated with the club drug scene. 

Where is diverted OxyContin®

sold? The geographical location 

of OxyContin® sales varies by city:

central city areas predominate in five

cities, suburbs predominate in four

cities, and all areas are equally 

dominant in three cities. Diverted

OxyContin® continues to be sold

most often in private residences, 

followed by streets and around treatment clinics. Sales are also common

around public housing developments,

inside cars, and in nightclubs and

bars. The reported number of 

diverted OxyContin® sales settings

is highest in Memphis and Miami.

The settings for OxyContin® sales

have remained relatively stable since

the last reporting period, with one

notable exception: according to the

epidemiologic source in Miami,

OxyContin® has shifted from limited

sales in private residences to being a

“street drug.” Furthermore, according

to the law enforcement source in

Miami, OxyContin® is available in

the same neighborhoods and settings

(mostly the street) where crack is

available. 

OXYCONTIN®: THE ABUSERS

Where has OxyContin® abuse

increased? (Exhibit 4) Continuing

an upward trend, according to nearly

all (16 of 18) methadone and nonmethadone treatment respondents,

the number of novice abusers of

OxyContin® in treatment (defined as

any drug treatment client who has

recently begun abusing OxyContin®)

has increased since the last reporting

period. However, unlike the last

reporting period, when most increases

were reported in the South, during fall

2001, increases occurred in all U.S.

regions and most often in the West. 

Epidemiologic/ethnographic respondents also report increases in

OxyContin® abuse:

" Boston, MA: OxyContin® abuse

has become more prevalent, especially among young, working class

polydrug users of low socioeconomic backgrounds.

" Memphis, TN: The drug is

increasingly abused, especially

among young adult polydrug users. 

" Philadelphia, PA: The numbers of

abusers and adverse reactions have

increased. 

Exhibit 4.

How has the number of novice

OxyContin® treatment clients

changed (spring 2001 vs fall

2001)?

*Billings has two non-methadone treatment

sources.

Billings, MTNN,N*

Boston, MAN

Columbia, SCN,M

Denver, COM

Honolulu, HIM

Los Angeles, CAM

New Orleans, LAN,M

Philadephia, PAN

Portland, MEM

St. Louis, MON,M

Seattle, WAN

Sioux Falls, SDN

Memphis, TNM

Portland, MEN
DIVERTED SYNTHETIC OPIOIDS

Pulse Check: April 2002 page 57

" Seattle, WA: Indicators point to

increasing abuse, and the number

of rural treatment clients has

increased. 

" Sioux Falls, SD: The number of

emerging abusers has increased. 

Who abuses OxyContin®?

According to most epidemiologic/

ethnographic and treatment respondents, the young adult (18–30 years)

and adult (>30 years) age groups 

predominate among OxyContin®

abusers, especially among novice

abusers in the West. Adolescents 

(13–17) predominate, especially

among emerging or novice abusers,

according to three sources in three

cities: Columbia (SC), New Orleans,

and Sioux Falls. Males predominate

in most areas, but females predominate and are emerging in Columbia,

St. Louis, and Seattle. Whites predominate in most cities, and socioeconomic status varies by city and

ranges from low in Honolulu and

Washington, DC, to upper-middle

(especially among novice abusers) in

El Paso, New Orleans, and Seattle. 

The geographic residence of

OxyContin® abusers also varies by

city. Central city residences predomnate in seven cities across the Nation.

Suburbs predominate in several western cities and in New Orleans, St.

Louis, and Sioux Falls. Both rural

areas and suburbs predominate in

four cities across the Nation. And

rural areas predominate in Columbia

and Portland (ME). According to the

non-methadone treatment source in

Philadelphia, OxyContin® spread

from Montgomery County into the

city this reporting period, and according to the methadone treatment source

in Columbia, rural areas have overtaken the suburbs as predominant abuser 

residences this reporting period.

Where is OxyContin® taken?

Similar to reports in the last Pulse

Check, epidemiologic/ethnographic

and treatment respondents state that

OxyContin® abuse in private is more

common than its abuse in public, and

the drug is more often abused alone

than in groups or among friends. Also

similar to the last Pulse Check, OxyContin® is reportedly most often

abused in private residences, followed

by private parties and around public

housing developments. According to

epidemiologists/ethnographers and

treatment providers, emerging 

settings include shopping malls in

Billings and Seattle, cars in Portland

(ME), raves in New Orleans, and

nightclubs and parties in Memphis.

The Sioux Falls epidemiologic source

reports that increased abuse in

hotel/motel and private party settings

might be related to methamphetamine

labs: during lab busts, sometimes

OxyContin® is also found.

How is OxyContin® taken?

According to most epidemiologic/

ethnographic sources, OxyContin®

is ingested orally. Exceptions include

Baltimore, where injecting predominates followed by snorting; Detroit,

where snorting predominates; and

Washington, DC, where injecting predominates. According to the epidemiologic source in Boston, where oral

use predominates, some users wash or

peel off the coating, fold it in a piece

of paper, crush it, and snort the powder. Similar to their epidemiologic

counterparts, most treatment

providers report oral ingestion as the

predominant route of OxyContin®

administration. Exceptions include

snorting in Boston, Columbia (SC),

Denver, and Portland (ME); snorting

and injecting in Miami and New

York; injection in New Orleans; and

injecting and oral use in St. Louis. 

How are heroin and OxyContin®

abuse related? Heroin is reported

as a common OxyContin® substitute

in 10 Pulse Check cities: Baltimore,

Boston, Detroit, Miami, New Orleans,

New York, Philadelphia, Portland

(ME), St. Louis, and Washington, DC.

The use of heroin as a substitute for

OxyContin® is a new phenomenon in

New Orleans and St. Louis. 

By contrast, OxyContin® is used as a

heroin substitute in many cities:

" Baltimore, MDE

: OxyContin®

abuse has increased, and diverted

OxyContin® is more available,

especially because heroin is less

available. 

" New Orleans, LAN: OxyContin®

addicts tend to already be “pill

poppers,” but some heroin addicts

are trying the drug or switching to

it, which has caused several overdoses. Heroin is less pure, so when

Changes in abuser characteristics

include increasing numbers of

younger abusers and increasing

numbers of females.

" OxyContin® abusers are increasingly

younger in three cities: 

➤ Boston, MAN: Although young

adults predominate, the emerging

age is 13–17 years.

➤ Memphis, TNE

: Young adults have

overtaken adults as the predominant group.

➤ New Orleans, LAN: OxyContin®

abuse dramatically increased, especially among young adults in their

twenties.

" Females are increasing in two cities:

➤ Memphis, TNE

➤ Philadelphia, PAN
DIVERTED SYNTHETIC OPIOIDS

page 58 Pulse Check: April 2002

they inject OxyContin®, they

often overdose.

" Philadelphia, PAE

: OxyContin® is

in great demand by heroin users

because it eliminates the need for

needles and it comes in a controlled measured amount, so 

users don’t have to worry about

adulterants.

" Philadelphia, PAN: OxyContin®

abusers have characteristics similar

to those of heroin users and tend

to be heroin or crack users.

" Portland, MEE

: OxyContin®

abusers in northern rural Maine

are shifting to heroin because it is

more cheap and available. In

Portland, by contrast, some heroin

users are shifting to OxyContin®.

" Portland, MEM: OxyContin®

abusers aren’t necessarily switching

to heroin, but some heroin users

are switching to OxyContin®.

How are OxyContin® and other

drug abuse related? OxyContin®

is used in combination with marijuana

in Billings, Columbia (SC), Detroit,

and Memphis. It is combined with

methamphetamine or powder cocaine

in Memphis, a new phenomenon in

that city this reporting period.

Other prescription drugs, particularly

benzodiazepines, are often used in

combination with OxyContin®, as

reported in four Pulse Check cities:

Boston, where the trend is increasing;

Miami; New Orleans; and Philadelphia.

Moreover, other prescription drug

abuse may be related to OxyContin®

abuse in other ways:

" Billings, MTN: OxyContin®

abusers tend to be former users of

pills such as benzodiazepines or

other prescription drugs for pain. 

" Boston, MAE

: “Young working and

lower working-class polydrug users

are adding it to their repertoire of

pills. These users have been taking

other prescription opiates for many

years.”

" Denver, COM: Novice abusers in

treatment tend to be people who

start using OxyContin® for chronic

pain, are not typically heroin users,

but may have used other prescription opiates for several years.

" Los Angeles, CAM: “‘Pill poppers’

are switching from whatever prescription opiate they typically take

to OxyContin®.”

" Sioux Falls, SDN: OxyContin®

abusers are not heroin users, but

they tend to be abusers of other

prescription drugs.
ECSTASY AND CLUB DRUGS

Pulse Check: April 2002 page 59

ECSTASY AND CLUB

DRUGS✛

The club or rave experience typically

involves music, dancing, and socializing and usually lasts through the

night. Drugs commonly used in these

settings include ecstasy (methylenedioxymethamphetamine or MDMA);

GHB (gamma hydroxybutyrate) and

its chemical precursors, GBL (gamma

butyrolactone) and BDL (1,4 butanediol); ketamine; Rohypnol® (flunitrazepam, a benzodiazepine no longer

marketed in the United States);

nitrous oxide (laughing gas); LSD

(lysergic acid diethylamide, “acid”);

psilocybin mushrooms (“shrooms”);

and DXM (dextromethorphan, a mild

hallucinogen in some over-the-counter cough medications). Club drugs 

are commonly combined with one

another and with other illicit drugs 

or alcohol. 

As reported in the last two Pulse

Checks, treatment sources have less

first-hand knowledge of club drug

activity than their law enforcement

and epidemiologic/ethnographic

counterparts, indicating that club

drug users have not entered treatment

in large numbers. The amount of

information received from Pulse

Check sources remains much greater

for ecstasy than for other club drugs.

Although these drugs are categorized

as club drugs, the settings and contexts of their use continue to expand

to settings other than nightclubs,

raves, and college campuses, to

include streets and in or around high

schools. Moreover, Pulse Check

sources continue to suggest that

White non-Hispanics are no longer

the exclusive sellers and users of the

drugs, and reports that ecstasy is sold

with heroin, crack, and powder

cocaine continue. Finally, in this

reporting period, adolescents have

increased markedly as ecstasy sellers

and users, according to sources in

many Pulse Check cities. 

What club drugs are emerging in

Pulse Check communities?

(Exhibit 1) Nearly identical to the last

Pulse Check, ecstasy is reported as an

emerging drug of abuse by 21 sources

in 16 cities across the Nation, with

no regional patterns evident. Other

club drugs mentioned as emerging

this reporting period include GHB in

Los Angeles, DXM (sold as ecstasy) in

Memphis, and ketamine in New

Orleans. In only four cities (Columbia,

[SC], Miami, St. Louis, and Seattle)

are club drugs not reported as emerging, but in all of those cities, they

were reported as emerging last

reporting period, suggesting they are

now established drugs of abuse in

those communities.

How available are club drugs in

Pulse Check communities?

(Exhibits 2 and 3) Nearly identical to

reports in the last two issues of Pulse

Check, ecstasy (typically in pill form)

is considered widely or somewhat

available by nearly 90 percent of law

enforcement and epidemiologic/

ethnographic sources. Only three

sources continue to report it as not

very available: the law enforcement

source in El Paso and the epidemiologic sources in Billings and New

Orleans. Moreover, ecstasy availability

has increased according to more than

half of sources, with no regional patterns evident. Only the New Orleans

epidemiologic source reports declines

in availability. 

GHB, typically in liquid form, is not

nearly as available as ecstasy, with only

38 percent of sources reporting it as

somewhat or widely available and 55

percent reporting it as not very or not

available. As reported in the last two

issues of Pulse Check, cities where

Exhibit 1. 

Where is ecstasy emerging across the 20 Pulse Check cities?

L

E

E,N

E

L

L,E

E,N

E

L

E

L,E

N

N

L L

L,E

Ecstasy reported as emerging in fall 2001

Ecstasy was not reported as emerging in fall 2001

✛The following symbols appear throughout this chapter to indicate type of respondent: L

Law enforcement respondent, EEpidemiologic/ethnographic

respondent, NNon-methadone treatment respondent, and MMethadone treatment respondent.
ECSTASY AND CLUB DRUGS

page 60 Pulse Check: April 2002

Exhibit 3.

Has ecstasy or GHB availability

changed across the 20 Pulse

Check cities (spring 2001 vs fall

2001)?

Exhibit 2.

How available are ecstasy and

GHB across the 20 Pulse Check

cities?

70

60

50

40

30

20

10

0

Ecstasy

Not Available or

Not Very Available

Widely Available

Percent

Somewhat Available

GHB

No Response

70

60

50

40

30

20

10

0

Percent

(N=40)

Sources: Law enforcement and epidemiologic/

ethnographic respondents

Sources: Law enforcement and epidemiologic/

ethnographic respondents

Up Stable

Down No response

Ecstasy GHB

(N=40)

wide availability is reported are predominantly in the West or South:

Denver, Los Angeles, Miami, New

Orleans, and (in the Northeast) New

York. In contrast with ecstasy availability trends, GHB availability remained

stable, according to most (68 percent)

sources. Increases are noted in Boston

(probably due to increased law

enforcement awareness of the drug),

Los Angeles, Memphis, New Orleans,

and Sioux Falls, and declines are

reported mostly in midwestern cities

(Chicago, Detroit, and St. Louis) and

(in the South) Washington, DC. 

Ketamine availability is increasing at

low levels in Chicago and Columbia

(SC) and at higher levels in Honolulu

and New Orleans. It is declining in

Philadelphia. Other club drugs available in Pulse Check cities include

LSD, typically as a liquid or sprayed

on blotter paper, which is somewhat

available and increasing in Denver

and Portland (ME). Rohypnol® is

widely available in El Paso and Los

Angeles at stable levels.

How are club drugs and their

combinations referred to across

the country? (Exhibit 4) Slang terms

for ecstasy are similar across the

Nation. It continues to be referred to

as “X,” “XTC,” and “Adam,” but “E”

and “roll” are also used. The practice

of taking ecstasy is often referred to as

“rolling.” Ecstasy continues to be

referred to by its logo or the shape of

the pill in many Pulse Check cities: for

example, it is called “shamrock” in 

St. Louis and “four-leaf clover” in

Columbia, SC, because pills may 

be clover shaped. New slang terms

continue to be coined, indicating the

continuing popularity of ecstasy.

GHB continues to be referred to 

as “G” and ketamine as “K” or 

“special K.” Other terms for these

drugs vary by locality, with no particular regional patterns. Use of particular

combinations of club drugs varies by

city, highlighting that multisubstance

use or “cafeteria-style use” remains

common among club drug users.

ECSTASY: THE DRUG

What form is ecstasy in, and how

is it labeled and packaged?

(Exhibit 5) According to law enforcement and epidemiologic/ethnographic

sources, the tablet form of ecstasy

remains, by far, the most available, 

followed by powder and liquid forms.

As reported in the last Pulse Check,

ecstasy tablets are white or colored,

round or sometimes shaped like 

diamonds or clovers, and many are

pressed with designs and logos that

change periodically. Designs on ecstasy tablets common across the country

are similar to those reported in the

last Pulse Check and include “E,”

“mitubishi,” “nike,” and various 

cartoon characters. Other designs 

and logos vary by city.

Overwhelmingly, law enforcement

and epidemiologic/ethnographic

respondents continue to agree that

ecstasy tablets are sold as loose (or

“naked”) pills. Additionally, pills are

often packaged in small plastic bags

and in plastic prescription bottles.

Packaging remains similar to that

reported during the last reporting

period, except in Seattle, where sellers do not sell individual, loose pills

as often as before. Now, in that city,

rather than buyers being in charge of

how many tablets they want, the

dealers increase their profits by only

selling increments of 5 or 10 tablets

per transaction. The Denver law

enforcement source reports a similar

new phenomenon.
What are street-level ecstasy

prices across the country?

(Exhibit 6) The most commonly

reported unit of ecstasy sold is one

tablet (approximately 100–150 milligrams in Miami, 150–250 milligrams

in Seattle, and 30 milligrams in

Chicago), selling at $12–$38 in the

Northeast, $5–$35 in the South,

$20–$50 in the Midwest, and $10–$40

in the West. Since the last reporting

period, prices have remained relatively

stable. In several cities, including

Honolulu and New York, ecstasy

prices depend on where it is sold. For

example, in Honolulu, it is $2–$3

cheaper per pill in high schools than

on the street, and in New York, prices

are higher in clubs than on the street.

Moreover, in that city, clubgoers in

Greenwich Village claim that because

ecstasy costs are so high, people are

reverting to using LSD.

What adulterants are added to

ecstasy? Ecstasy may be adulterated

with a variety of other substances,

most commonly hallucinogens, such as

mescaline in Memphis and Sioux Falls,

LSD in Denver, peyote in Columbia

(SC), and PCP in Detroit. Stimulants,

such as amphetamines in Sioux Falls,

methamphetamine in Memphis, and

paramethoxyamphetamine (PMA) in

Detroit, are also reported as common

adulterants. Additionally, heroin,

crack, and powder cocaine are reportedly used as ecstasy adulterants in

Memphis, and a variety of stimulants

and hallucinogens are reportedly used

in Seattle, where there are anecdotal

reports of increases in the use of these

adulterants. 

ECSTASY: THE SELLERS

Who sells ecstasy? Street-level

ecstasy sellers continue to be independent, according to most (21 of 28)

law enforcement and epidemiologic/

ECSTASY AND CLUB DRUGS

Pulse Check: April 2002 page 61

Exhibit 4. How are club drugs and club drug combinations referred to

across Pulse Check cities?

Drug or drug combination Slang term City

Ecstasy The bean, beans Denver, Memphis, and Miami

Tabs Memphis, New Orleans,

and St. Louis

Beads, ills, illy, pills Denver

Dice, four-leaf clover, Columbia, SC

smurfs

Candy, shamrock St. Louis

Charity, double stacks, 

lovers' special Memphis

Hype Washington, DC

Love pill, sky Portland, ME

Sex drug Billings

Tachas El Paso

The practice of taking ecstasy Flipping Boston

The use of more than one Piggybacking St. Louis

ecstasy tablet sequentially

The use of three or more Stacking St. Louis

ecstasy tablets in combination

Ecstasy (adulterated with Speedies Sioux Falls

amphetamine)

Ecstasy (adulterated with Snackies Sioux Falls

mescaline)

Ecstasy (adulterated with Stacks Memphis

heroin or crack)

Ecstasy + heroin (dealer Moonstone, on the ball New York

shaves a slice of ecstasy 

into a bag of heroin)

Ecstasy + LSD Candy flip Chicago, Los Angeles, 

and Philadelphia

Trolling Boston, Miami

Ecstasy + GHB, ketamine, E sitting, Sitting E St. Louis

or nitrous oxide

Ecstasy, then GHB Parachute down Miami

Ecstasy + ketamine Kitty flipping Los Angeles

Ecstasy + methamphetamine Hugs and kisses, super X Miami

Ecstasy + powder cocaine Bumping up Miami

GHB Caps, liquid G Chicago

Date rape drug Billings

Easy lay Philadelphia

Funk, holy water Denver

G juice St. Louis

Gamma New Orleans

Scoop Miami

Sleep Portland, ME

Water Sioux Falls

Ketamine Cat, thunder Columbia, SC

Kitty, in the K-hole Denver

Rohypnol Roche, roche2, roaches, El Paso

cruzettas

DXM Triple C, CCC Denver, Los Angeles

Drex, dex Washington, DC 

Skittles Denver

Sources: Law enforcement, epidemiologic/ethnographic, and treatment provider respondents

Note: A term in bold face indicates that it is reported as new to the respondent's community since

the last reporting period.
ECSTASY AND CLUB DRUGS

page 62 Pulse Check: April 2002

ethnographic respondents. Young

adults (18–30 years) continue to be the

predominant street-level ecstasy sellers,

according to most (19 of 28) respondents. However, adolescents are the

predominant sellers in El Paso, New

Orleans, and Seattle, and young adults

and adolescents are evenly split in

Detroit, Memphis, St. Louis, and

Sioux Falls. According to the law

enforcement source in Denver, adolescents are selling single pills and often

use the drug, but adults sell larger

quantities of the drug and do not 

typically use it. (A summary of ecstasy

sales characteristics appears in exhibit

9 at the end of this section.)

Are ecstasy sellers involved in

other crimes? Most law enforcement

and epidemiologic/ethnographic

respondents report that street-level

ecstasy sellers are not typically involved

in other crimes or violence. However,

the most common crime associated

with ecstasy dealers is drug-assisted

rape, as reported in eight Pulse Check

cities: Columbia (SC), Denver, El Paso,

Honolulu, Los Angeles, Memphis,

New Orleans, and New York.

According to the Memphis epidemiologist, crimes associated with ecstasy

have become less violent and less gang

related since the last reporting period. 

Where is ecstasy sold? The 

geographic locations of ecstasy sales

are mostly suburbs, followed by 

central city areas, according to law

enforcement and epidemiologic/

ethnographic respondents. Ecstasy is

mostly sold indoors, typically in raves

and nightclubs or bars. Other frequently mentioned settings include

college campuses, followed by in or

around high schools, private residences, and private parties. Streets

are mentioned as sales settings in 10

Pulse Check cities: Billings, Denver, El

Paso, Honolulu, Los Angeles, Memphis,

Miami, New York, Sioux Falls, and

Exhibit 6.

How much does a pill (one dose)

of ecstasy cost in 18 Pulse Check

cities?*

City Price

Boston, MA $20–$25 

New York, NY $12–$25 (in street)

$25–$38 (in clubs) 

Philadelphia, PA $20–$35 

Portland, ME $25

Columbia, SC $20–$35

El Paso, TX $5–$8

Memphis, TN $5–$30

Miami, FL $20–$35

Washington, DC $18–$35

Chicago, IL $20–$30 

Detroit, MI $20–$40

St. Louis, MO $30 

Sioux Falls, SD $30–$50

Billings, MT $25

Denver, CO $10–$30

Honolulu, HI $20–$45

Los Angeles, CA $20–$40

Seattle, WA $20–$30 

Sources: Law enforcement and 

epidemiologic/ethnographic respondents

*Sources in Baltimore and New Orleans did

not provide this information. Northeast South Midwest West

Since the last Pulse Check, reports

of other drugs of abuse, including

heroin and cocaine, sold by ecstasy

dealers have continued:

" Columbia, SCL

: Powder cocaine is sold

with ecstasy. 

" Memphis, TNE

: Ecstasy dealers sell 

virtually any drug because “you can 

get anything if you can get ecstasy.” 

" Miami, FLE

: Now people who sell

marijuana, cocaine, and heroin on the

street also sell ecstasy.

" New York, NYL

: The trend toward

polydrug sales (crack, powder cocaine,

heroin, and ecstasy) continues, and

“everyone wants to be involved in

ecstasy sales” because they are lucrative.

" Washington, DCL

: Crack cocaine 

dealers continue to be increasingly

involved in ecstasy sales.

Exhibit 5.

How are ecstasy pills labeled in reporting Pulse Check cities?

City Label

Boston, MA Bulldogs, calvin klein, hearts, lightning bolts, mcdonald’s, nike,

playboy, tulips, yin and yang signs

Philadelphia, PA Michelin, mitsubishi

Portland, ME E

Baltimore, MD XXX

Columbia, SC Diamonds, elephants, mercedes, mickey mouse 

El Paso, TX E (red tablets)

Memphis, TN Arrowheads, mercedes, motorola, teletubbies 

New Orleans, LA Cartoon characters, knight heads, nike, stars

Washington, DC Animals, E, igloos, mercedes, pikachu

Chicago, IL Cartoon characters, CK (calvin klein) mitsubishi, motorola

Detroit, MI Butterflies, fish, mitsubishi

St. Louis, MO Mitsubishi, playboy, clovers

Sioux Falls, SD Elephants, mitsubishi, nike, sun faces

Denver, CO Cartoon characters, clovers, stars

Honolulu, HI Happy faces, sunshines

Los Angeles, CA Blue dolphins, doves, ferrari, green apples, smiley faces

Sources: Law enforcement and epidemiologic/ethnographic respondents

Note: A logo in bold face indicates that it is newly reported this reporting period. Northeast South Midwest West
ECSTASY AND CLUB DRUGS

Pulse Check: April 2002 page 63

Washington, DC. According to the

New York ethnographer, some dealers

sell ecstasy from their houses because

the drug sells so well “that they don’t

need to sell it in clubs.”

What other drugs do ecstasy

dealers sell? The most common

other drugs sold are club drugs,

including GHB, ketamine, and LSD.

Marijuana is sold by ecstasy dealers in

six cities (Billings, El Paso, Los

Angeles, Miami, Philadelphia, and

Sioux Falls), methamphetamine in

three cities (Billings, Philadelphia,

and Washington, DC), and other pills,

typically benzodiazepines or opiates,

in Memphis and Philadelphia. 

ECSTASY: THE USERS

How has the number of novice

ecstasy users in treatment

changed? (Exhibit 7) According to

10 treatment respondents in 8 Pulse

Check cities, the number of novice

ecstasy users in treatment (defined as

any drug treatment client who has

recently begun using ecstasy) has

increased since the last reporting 

period. However, the number

declined according to the methadone

treatment source in New Orleans. It

is important to note that treatment

clients who report using ecstasy tend to

report it as their secondary substance

of abuse, with marijuana or alcohol

typically reported as the primary 

substance of abuse.

Who uses ecstasy? According to

epidemiologic/ethnographic sources,

ecstasy users tend to be young adults

(18–30 years). However, according to

non-methadone treatment sources,

ecstasy users are often adolescents, as

reported in Columbia (SC), Detroit,

Los Angeles, and Miami. They are

often evenly split between young

adults and adolescents, as reported in

Philadelphia and Sioux Falls. Ecstasy

users tend to be evenly split between

the genders, more so than with any

other drug (see exhibit 6 of the crack

cocaine section). Whites predominate

as ecstasy users in nearly all cities.

The socioeconomic status of ecstasy

users ranges from low in Baltimore to

middle-high in Detroit, Denver,

Honolulu, Memphis, St. Louis, and

Sioux Falls. User residences are predominantly in the suburbs, followed

by central city areas. 

Where do users take ecstasy? 

As reported in the last Pulse Check,

nearly all epidemiologic and treatment sources report that ecstasy is

used predominantly in groups or

among friends typically at raves,

nightclubs or bars, and private parties. Other common use settings are

similar to sales settings, including 

private residences, college campuses,

and in or around high schools. Streets

are reported as user settings in

Denver, Memphis, Sioux Falls, and

Washington, DC.

How have street-level ecstasy sales changed between spring and fall 2001? 

Ecstasy seller populations continue to expand to include more high school age sellers:

➤ Billings, MTL

: The drug is more commonly sold and used by high school and college

students than before.

➤ Los Angeles, CAL

: More adolescents are selling and using than before, and these 

sellers tend to be independent.

➤ Miami, FLL

: Young adults are increasingly involved, especially via connections

through high schools.

➤ St. Louis, MOE

: As reported in the last Pulse Check, adolescents continue to be

increasingly involved in sales, with an expansion from college age to high school 

age sellers. That expansion, however, may be starting to level off.

New seller groups continue to include various races and ethnicities:

➤ Memphis, TNL

: More Blacks are selling the drug.

➤ Miami, FLL

: Various ethnic groups are now involved in club drug (typically ecstasy)

sales. Contacts at schools, nightclubs, and raves are making it possible for a wider

variety of groups to become involved.

➤ Washington, DCL

: Some ecstasy is being sold and bought in the Black community.

Sellers there are Black and are often street (open-air market) dealers of crack cocaine.

Ecstasy sales settings have also continued to expand, especially to the streets:

➤ Memphis, TNL,E: The epidemiologic source states that ecstasy sales are moving out of

the city: they are now equally likely to take place in central city and suburban areas.

The law enforcement source agrees that sales are expanding to other areas of the city.

➤ Miami, FLE

: Ecstasy sales used to be limited to raves, clubs, and private residences,

but now people who sell marijuana, cocaine, and heroin also sell ecstasy, and this is

occurring in the street.

➤ New York, NYE

: Ecstasy sales on the street are emerging.

➤ St. Louis, MOE

: Sales continue to expand, as reported in the last Pulse Check, from

raves to schools and from the central city to the suburbs—but this reporting period

the expansion is occurring at a slower rate.

➤ Washington, DCL

: More ecstasy sales occur on the street since the last reporting 

period, most likely because crack cocaine dealers are now involved in ecstasy sales.
ECSTASY AND CLUB DRUGS

page 64 Pulse Check: April 2002

How and with what other drugs is

ecstasy taken? Oral ingestion of

an ecstasy tablet continues to be, by

far, the most common route of

administration. Alternate routes of

administration include injecting

tablets dissolved in water in Boston,

Miami (where the practice is increasing), and St. Louis; anal insertion in

Billings and Memphis; and crushing

tablets and snorting them in El Paso

and Sioux Falls.

Ecstasy is taken either in combination

with or sequentially with a wide variety of other drugs, most commonly

marijuana and other club drugs,

including GHB, ketamine, LSD,

DXM, and nitrous oxide. It is taken

with powder cocaine or prescription

pills in Miami; with heroin in St.

Louis; and with methamphetamine in

Denver. Additionally, since the last

Pulse Check, other combinations have

become more consistently reported,

Exhibit 7.

Has the number of novice ecstasy

users in treatment changed

(spring 2001 vs fall 2001)?*

*Sources in Boston, Chicago, Columbia

(SC), Denver, El Paso, Honolulu, Memphis,

Miami, and New York did not provide this

information. Billings has two non-methadone

treatment sources.

Baltimore, MDM

Billings, MTN,N

Detroit, MIN

Portland, MEN

St. Louis, MON

Seattle, WAN

Sioux Falls, SDN,M

Washington, DCN

Los Angeles, CAN

Philadelphia, PAN

New Orleans, LAM

How have ecstasy users and use patterns changed between between spring

and fall 2001?

Similar to the expansion of adolescents (13–17 years) among seller groups, ecstasy use continues to be increasingly reported among adolescents, as reported in eight Pulse Check cities:

➤ In six cities where young adults (18–30 years) predominate, emerging users are 

adolescents: Baltimore, Billings, Boston, El Paso, Miami, and St. Louis.

➤ Memphis, TNE

: Although the predominant user age is split between young adults and

adolescents, emerging users are predominantly adolescents. Furthermore, those with

high SES are increasingly using the drug.

➤ Sioux Falls, SDN: Ecstasy use increased, especially among adolescents. Typically, it is the

secondary substance to alcohol, but that may be changing for younger users. Young

novice users may start with ecstasy instead, and it is increasingly reported as their 

primary drug of abuse.

Similar to expanding seller groups, ecstasy use continues to expand to non-White and

Hispanic populations, as reported in six Pulse Check cities:

➤ Boston, MAE

: Although Whites continue to predominate, use is increasing among Black

youth.

➤ Los Angeles, CAE

: While Whites remain the predominant users, use is increasing among

Blacks (especially those involved in the “hip-hop crowd”) and among Asian/Pacific

Islanders.

➤ Miami, FLE

: Hispanics are the predominant user group, but Blacks are emerging users.

➤ New York, NYE

: While young adult, middle socioeconomic Whites continue to be the

predominant users, lower socioeconomic Black and Hispanic young adults continue to

emerge as ecstasy users.

➤ St. Louis, MON: While Whites predominate, Blacks are emerging as ecstasy users.

➤ Washington, DCE

: The club scene has started moving into the Black community, but the

numbers are still small.

Ecstasy use continues to expand to new settings (typically high schools and streets) in 

several cities:

➤ Boston, MAE

: Ecstasy use is becoming more common as a drug of abuse in high schools.

➤ Detroit, MIN: Emerging user settings include high schools and public housing 

developments.

➤ St. Louis, MOE

: Ecstasy activity in high schools is emerging.

➤ Baltimore, MDE

: During the last reporting period ecstasy was used primarily in club 

settings, now adolescents access it in school and on the street.

➤ Memphis, TNE

: Ecstasy is increasingly used in private. Additionally, street use, which

was not mentioned during the last reporting period, has become more common during

the current period.

Interestingly, as ecstasy use settings expand to include settings other than raves, in some

cities, the number and popularity of raves may be declining:

➤ Denver, CON: Raves may be phasing out, and club drug use is down, most likely because

of high-profile deaths involving ecstasy. 

➤ Los Angeles, CAE

: Use and sales are spreading from raves to other places, such as private

residences, college campuses, and nightclubs and bars. The most notable shift is from the

rave culture into the “hip-hop” culture.

➤ New Orleans, LAE

: Raves no longer take place in this city. 
including ecstasy plus powder cocaine,

crack, heroin, methamphetamine, PCP,

prescription pills, or over-the-counter

inhalers, according to the Memphis

epidemiologic source. In Boston and

Columbia, the sequential use of marijuana with ecstasy is increasing.

OTHER CLUB DRUGS: THE DRUGS

(Exhibit 8)

GHB continues to be available most

often as a liquid (typically clear), followed by a powder, as reported by law

enforcement and epidemiologic/

ethnographic sources. The drug continues to be packaged mostly in plastic

bottles (mostly water or sports drink

bottles) and distributed by the capful

for $5–$20 per dose. Other packaging

includes eyedropper bottles in Chicago

and Los Angeles; glass vials in Boston,

Philadelphia, and Washington, DC;

and mouthwash bottles in Chicago, a

new, very common packaging. 

GBL and BDL (GHB precursors) are

no longer available in many Pulse

Check cities. However, as products

containing these precursors become

more controlled and removed from

the shelves of health food stores and

gyms, two new and related precursors

are emerging: GHV (gamma hydroxyvalerate) and GVL (gamma valerolactone), as reported by the Los Angeles

and Miami epidemiologic sources. The

Los Angeles epidemiologic source

states that these precursors have joined

GBL and BDL as new GHB analogue

products sold mostly over the Internet,

at health food stores, at raves, and in

nightclubs and bars. The products are

known as “sublimiss,” “midnight

blue,” and “tranquil G.” Other than

the emergence of GHV and GVL,

GHB packaging and prices have

remained stable since the last reporting

period, as have packaging and prices

for other club drugs.

CLUB DRUGS: THE SELLERS

(Exhibit 9)

According to most law enforcement

and epidemiologic/ethnographic

sources, GHB, ketamine, and other

club drugs seller and sales characteristics remain similar to those of ecstasy

sellers with a few differences, as

shown in exhibit 9. No changes 

in other club drug sales or seller 

characteristics are reported since the

last Pulse Check.

CLUB DRUGS: THE USERS

(Exhibit 10)

Regardless of the specific drug, club

drug user characteristics are similar,

with a few key differences noted in

exhibit 10. 

ECSTASY AND CLUB DRUGS

Pulse Check: April 2002 page 65

Exhibit 8.

What are club drug prices?

City Most Common Unit Sold Price

GHB

Boston, MA Capful (GBL) (one dose) $5

Chicago, IL Shot or capful (one dose) $5–$10

Denver, CO Capful (one dose) $5–$10

Los Angeles, CA Shot or capful (one dose) $5–$20

16-ounce bottle $65–$100

Memphis, TN Capful (one dose) $40

Miami, FL Pill (one dose) $10

New Orleans, LA Shot (one dose) $5–$20

New York, NY 1 gram (one dose) $30

Philadelphia, PA Vial (one dose) $10–$20

Ketamine

Boston, MA Capful (one dose) $5

Bottle (1 ounce) $50

Columbia, SC Vial (1/2 ounce) $125

Philadelphia, PA Vial (one dose) $10–$20

Washington, DC Bag (1/8 gram) $20 

Bag (150 milligrams) $25

Bag (3/8 gram) $50

Rohypnol®

El Paso, TX Pill (one dose) $10

Los Angeles, CA Pill (one dose) $6–$10

Philadelphia, PA Pill (one dose) $10

LSD

Chicago, IL Strip (one dose) $5

Honolulu, HI Hit (one dose) $4–$6

Philadelphia, PA Tab (one dose) $3–$5

Seattle, WA One dose $5

Nitrous Oxide

Philadelphia, PA Balloon (one dose) $5

Sources: Law enforcement and epidemiologic/ethnographic sources
ECSTASY AND CLUB DRUGS

page 66 Pulse Check: April 2002

Exhibit 9.

What are the predominant characteristics of club drug sellers and sales?

Characteristics Ecstasy GHB and its precursors Ketamine 

Age 18–30 years 18–30 years 18–30 years

Organization Independent Independent Independent

Likeliness to be involved with Not very likely, with the exception Somewhat likely, especially non- Somewhat likely

other crimes or violence of drug-assisted rape violent crimes and drug-assisted rape

Likeliness to use the drug Somewhat or very likely Somewhat likely Somewhat likely

Indoors or outdoors Indoors and outdoors Indoors Indoors

Most common settings Raves, nightclubs/bars, college campuses, Nightclubs/bars, raves, the Internet, Nightclubs/bars, raves, 

in or around high schools, private college campuses, health food stores and private parties

residences and parties, but vary widely

Most common other drugs Other club drugs (GHB, ketamine, Ecstasy, LSD NR

sold with the drug LSD), marijuana

Major changes since the last Expanding to include more high school No major changes reported No major changes

reporting period in seller age sellers and other races/ethnicities reported

group characteristics

Major changes since Expanding to include the streets Health food stores are selling No major changes

the last reporting period and in or around high schools products containing new GHB reported

in sales settings precursors: GVL and GHV

Sources: Law enforcement and epidemiologic/ethnographic respondents

Exhibit 10.

What are the predominant characteristics of club drug users and use?

Characteristics Ecstasy GHB and its precursors Ketamine 

Age 18–30 years, followed closely by 18–30 years 18–30 years

13–17 years

Gender Both Males, sometimes bodybuilders Males

Race/ethnicity Whites Whites Whites

Socioeconomic status Middle, but varies widely Middle Middle

Residence Suburbs Suburbs Suburbs

Indoors or outdoors Indoors Indoors Indoors

Most common settings Raves, nightclubs/bars, private parties Private residences and parties, Private residences and parties,

and residences, college campuses, nightclubs/bars, and raves nightclubs/bars, and 

and high schools, but vary widely college campuses

Most common other Marijuana, other club drugs (GHB, Ecstasy Marijuana

drugs used with the drug ketamine, DXM, LSD) but vary widely

Major changes since the Expanding to include adolescents No major changes reported No major changes reported

last reporting period in and other races/ethnicities

user characteristics

Major changes since the Expanding to include the streets; No major changes reported No major changes reported

last reporting period in rave popularity may be declining in

use settings several cities.

Sources: Epidemiologic/ethnographic and treatment provider respondents
ECSTASY AND CLUB DRUGS

Pulse Check: April 2002 page 67

Since the last reporting period, club

drug users and use patterns have

changed in several Pulse Check

cities:

" Los Angeles, CAE

: While GHB

users are predominantly young

adults, emerging users include

both young adults and older

adults. Morever, because of

Internet access, use is expanding

to include not only use by those 

in the suburbs but also among

those who reside in central city

and rural areas.

" Portland, MEN: GHB use has

increased, but the increase is not

yet noted among treatment clients. 

" St. Louis, MOE

: Following a

recent law enforcement crackdown on precursors and Internet

sales, reports of GHB sales have

declined. Sellers who had previously not realized the seriousness

of their offense are now being

more discreet.

" Washington, DCE

: GHB use is

declining because of its unsafe

reputation.

" Denver, COE

: The proportion of

treatment clients for DXM, particularly in over-the-counter cough

medications, is now higher than

that for GHB.

" Seattle, WAE

: DXM in cough syrup

form is sometimes swallowed by

ecstasy users, as suggested by its

recent detection in three decedents

and by anecdotal information that

it is a popular club drug.
page 68 Pulse Check: April 2002

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APPENDIX 1: METHODOLOGY

Pulse Check: April 2002 page 69

APPENDIX 1: METHODOLOGY

How were the sites selected?

(See map in the Introduction) A total

of 20 sites were studied for this issue

of Pulse Check. During 2000, we

selected sites using Census Bureau

regions and divisions with a goal of

achieving geographic and demographic

diversity. In addition, we made an

effort to select sites in areas with 

special drug abuse problems of national concern. More specifically, we

applied the following methodology in

selecting sites.

We purposely selected the most populous States in the four census regions:

New York in Region I (Northeast

Region); Texas in Region II (South

Region); Illinois in Region III

(Midwest Region); and California in

Region IV (West Region). In three of

these States, we selected the most

populous metropolitan areas: New

York City, Chicago, and Los Angeles.

In Texas, however, we selected El

Paso—a known high trafficking area

with particularly high levels of unemployment, population growth, and

poverty—because of its proximity to

the United States border with Mexico.

We included four rural States, one 

per census region. (Rural States are

defined by the Census Bureau as

those in which 50 percent or more of

the State’s population reside in census-designated rural areas.) The four

rural sites selected are as follows:

! Region I (Northeast): Portland,

ME—Of the three rural States in

the Northeast Region (including

New Hampshire and Vermont),

Maine has the only Atlantic coastline and shares the longest border

with Canada. It also includes an

ONDCP-designated High Intensity

Drug Trafficking Area (HIDTA).

Portland is Maine’s most populous

metropolitan area.

! Region II (South): Columbia, SC—

The three other rural States in the

South census region are Kentucky,

Mississippi, and West Virginia.

However, South Carolina's location along a major drug trafficking

corridor makes that State a strategic choice. Recent cocaine seizures

in Columbia further highlight its

strategic importance.

! Region III (Midwest): Sioux Falls,

SD—Sioux Falls is the most populous metropolitan area within the

Midwest Region’s two rural States

(North Dakota and South Dakota).

! Region IV (West): Billings, MT—

Montana is the only census-designated rural State in the West

Region, and Billings is its most

populous metropolitan area.

The remaining 12 sites were selected

to ensure that the entire list included

at least 2 sites from each of the 9

Census Bureau divisions (East North

Central, Mountain, Middle Atlantic,

New England, Pacific, South Atlantic,

South East Central, South West

Central, and West North Central).

Additional selection criteria included

population density, representation of

racial/ethnic minorities, and emphasis

on high drug trafficking areas. 

Applying these criteria resulted in the

final selection of the following 20

Pulse Check sites:

Baltimore, MD*

Billings, MT

Boston, MA

Chicago, IL

Columbia, SC

Denver, CO

Detroit, MI

El Paso, TX

Honolulu, HI

Los Angeles, CA

Miami, FL

Memphis, TN

New Orleans, LA

New York City, NY

Philadelphia, PA

Portland, ME

St. Louis, MO

Seattle, WA

Sioux Falls, SD

Washington, DC

How do the 20 sites vary demographically? Appendix 2 highlights

the demographic diversity of these 20

sites. For example, their population

density per square kilometer ranges

from a sparse 18.6 in Billings, MT, to

a crowded 2,931.6 in New York City.

Their unemployment rates range from

a 1.7 low in Sioux Falls, SD, to a 9.4

high in El Paso, TX. The racial/ethnic

breakdowns in the 20 sites further

exemplify their diversity: White representation ranges from 30.9 percent in

Honolulu, HI, to 97.8 percent in

Portland, ME; Black representation

ranges from 0.5 percent in Billings,

MT, to 42.4 percent in Memphis, TN;

and Hispanic representation ranges

from less than 1 percent in Portland,

ME, to 75.4 percent in El Paso, TX.

*Because of concerns about its unique problems involving heroin and cocaine, Baltimore, MD, was added as a Pulse Check site for the report covering

the January–June 2001 period; Birmingham, AL, was dropped for the current (July–December 2001) issue in order to maintain balanced geographic

representation.
APPENDIX 1: METHODOLOGY

page 70 Pulse Check: April 2002

What other data are available at

the 20 selected sites? Information from other national-level data

sources will be useful for framing,

comparing, corroborating, enhancing,

or explaining the information obtained

for Pulse Check. The following data

sources are available in nearly every

site: ONDCP’s past Pulse Check

reports; the National Institute on Drug

Abuse (NIDA) Community Epidemiology Work Group (CEWG); the

Substance Abuse and Mental Health

Services Administration (SAMHSA)

Drug Abuse Warning Network

(DAWN); and the National Institute of

Justice (NIJ) Arrestee Drug Abuse

Monitoring (ADAM) program.

Who are the Pulse Check

sources, and how were they

selected? Consistent with previous

issues, the information sources for

Pulse Check were telephone discussions with 4 knowledgeable individuals

in each of the 20 sites: 1 ethnographer

or epidemiologist, 1 law enforcement

official, and 2 treatment providers.

Ethnographers and epidemiologists

were recruited based on several possible criteria: past participation in the

Pulse Check program; membership in

NIDA’s CEWG; research activities in

local universities; or service in local

community programs. We recruited

law enforcement officials by contacting

local police department narcotic units,

Drug Enforcement Administration

(DEA) local offices, and HIDTA 

directors. The vast majority of the 

40 epidemiologists, ethnographers,

and law enforcement sources who

reported for this issue of Pulse Check

were the same, or associated with the

same agencies, as those who reported

for the previous issue.

To identify treatment sources for the

Mid-Year 2000 issue of Pulse Check,

we randomly selected providers from

the 1998 Uniform Facility Data Set

(UFDS), a listing of Federal, State,

local, and private facilities that offer

drug abuse and alcoholism treatment

services. For this purpose, we excluded facilities that reported more than

50 percent of their clientele as having

a primary alcohol abuse problem,

served a caseload of fewer than 100

clients, or provided only prevention

or detox services. We then divided

the remaining facilities into two

groups—methadone and nonmethadone treatment facilities—in

order to capture two client populations whose demographic characteristics and use patterns often differ

widely. We selected one from each of

these two categories of programs for

each of the 20 selected sites. Because

Billings, MT, and Sioux Falls, SD, have

no UFDS-listed methadone treatment

facilities, we selected two nonmethadone facilities in those sites.

Since the Mid-Year 2000 issue of

Pulse Check, in order to preserve 

continuity, all actively available treatment sources have been retained.

Additionally, to ensure regular reporting, any treatment provider who

becomes unavailable to participate is

being replaced via purposeful, rather

than random, selection based on 

consultation with experts in the field.

Altogether, we recruited 40 treatment

sources: 18 methadone providers 

(1 from each Pulse Check site except

for Billings and Sioux Falls, where

methadone treatment is unavailable),

and 22 non-methadone providers (1

from each Pulse Check site plus extra

sources from Billings and Sioux Falls).

Thus, a total of 80 sources have been

identified and recruited, and for this

Pulse Check issue we successfully

obtained information from 75 of

them: a response rate of 94 percent.

Five participants were unavailable:

the law enforcement source from

Baltimore; the non-methadone 

treatment providers from Baltimore,

Honolulu, and Memphis; and the

methadone treatment provider 

from Memphis.

What kind of data were collected,

and how? For each of the 75

responding sources, we conducted a

single telephone discussion lasting

about 1 hour. We asked sources to

explore with us their perceptions of

the change in the drug abuse situation

between spring and fall 2001. We 

discussed a broad range topic areas

with these individuals, as delineated

in Appendix 5. Not surprisingly,

ethnographic and epidemiologic

sources seemed to be very knowledgeable about users and patterns of

use; they were somewhat knowledgeable about drug availability; and they

were less informed about sellers, distribution, and trafficking patterns.

Treatment providers had a similar

range of knowledge, but they generally focused on the specific populations

targeted by their programs. Some

providers, however, were able to provide a broader perspective about the

communities extending beyond their

individual programs. Among the three

Pulse Check source types, law

enforcement officials appeared to 

be most knowledgeable about drug

availability, trafficking patterns, seller

characteristics, sales practices, and

other associated activities; they were

not asked to discuss user groups and

characteristics.
APPENDICES 2 AND 3: SITE DEMOGRAPHICS AND OTHER DATA SOURCES

Pulse Check: April 2002 page 71

*Small = <300,000

persons; Medium =

300,000–1 million

persons; Large = 1

million–5 million persons; Extra Large =

>5 million persons

1

Includes Worcester,

Lawrence, Lowell,

Brockton MA-NH

2

Includes

Washington, DCMD-VA-WVA

3

Includes Los

Angeles-Long

Beach

4

Includes Seattle,

Bellevue-Everett, WA

a

1999

b

1998

c

1997

d

1990–1999

Note: Shaded boxes

indicate that selected

city is in a rural State.

SOURCE: 2001

County and City

Extra: Annual Metro,

City, and County

Data Book, Tenth

Edition. Eds: Gaquin,

D.A., and Littman,

M.S. Washington,

DC: Bernan Press

APPENDIX 2: POPULATION DEMOGRAPHICS IN THE 20 PULSE CHECK SITES

Race Percenta Violent Percent PopulaMSA American Asian Crime/ Persons Unem- tion Percent

Size* Indian and 100,000 Under18 ploy- Density/ PopuPulse Check (S, M, Eskimo Pacific Percent Popu- Below Pov- ment Square lation

Site L, X) White Black Aleut. Islander Hispanica lationb erty Levelc Rate KMa Changed

Boston, MA1 X 89.9 6.0 .2 3.9 5.7 505 15.2 3.1 353.3 3.8

New York City, NY X 61.3 28.9 .4 9.3 25.6 1,037 32.9 6.2 2,931.6 1.9

Philadelphia, PA-NJ L 76.5 20.1 .2 3.2 4.7 667 17.1 4.1 495.7 .6

Portland, ME S 97.8 .8 .3 2.6 2.0 730 16.6 4.0 368.7 4.6

Baltimore, MD L 69.1 28.0 .3 .6 .8 581 19.4 3.1 110.9 8.9

Columbia, SC M 68.7 29.6 .2 1.5 2.1 868 19.2 2.5 136.8 13.8

El Paso, TX M 94.5 3.4 .5 1.5 75.4 668 38.6 9.4 267.5 18.6

Memphis, TN L 56.3 42.4 .2 1.2 1.3 1,081 21.4 3.6 141.9 9.7

Miami, FL L 77.6 20.4 .3 1.8 57.4 1,532 29.6 5.8 432.0 12.3

New Orleans, LA L 62.6 34.9 .3 2.2 5.2 918 26.4 4.4 148.2 1.6

Washington, DC2 L 67.7 25.3 .3 6.7 7.6 537 12.8 2.6 281.1 12.2

Chicago, IL X 75.8 19.3 .2 4.6 14.8 NA 17.2 4.1 610.5 8.1

Detroit, MI L 74.9 22.6 .4 2.0 2.5 870 19.1 3.5 433.3 4.9

Sioux Falls, SD S 96.9 0.8 1.5 0.8 0.9 252 11.4 1.7 45.8 18.1

St. Louis, MO-IL L 80.8 17.6 .2 1.3 1.5 NA 16.4 3.7 155.2 3.1

Billings, MT S 95.5 .5 3.3 .6 3.3 187 16.8 4.0 18.6 12.2

Denver, CO L 89.8 6.2 .8 3.1 14.9 385 13.4 2.4 203.2 21.9

Honolulu, HI M 30.9 3.6 .5 65.0 7.4 268 14.8 4.9 556.4 3.4

Los Angeles, CA3 X 74.8 11.2 .6 13.4 44.4 1,027 30.5 5.9 887.3 5.3

Seattle, WA4 L 84.7 4.7 1.3 9.3 4.3 419 11.7 3.4 203.7 14.8

West Midwest South Northeast

APPENDIX 3: NATIONAL-LEVEL DATA SOURCES AVAILABLE IN THE 20

PULSE CHECK SITES

1

High Intensity Drug Trafficking Area of the

Drug Enforcement Administration (DEA)

2

Community Epidemiology Work Group of

the National Institute on Drug Abuse (NIDA)

3

Drug Abuse Warning Network of the

Substance Abuse and Mental Health

Services Administration (SAMHSA)

4

Arrestee Drug Abuse Monitoring program 

of the National Institute of Justice (NIJ)

Note: Shaded boxes indicate that selected

citiy is in a rural State.

Pulse Check Site HIDTA1 State CEWG2 DAWN3 ADAM4

Boston, MA ! !!

New York, NY ! ! !!

Philadelphia, PA ! !!

Portland, ME !

Baltimore, MD ! !!

Columbia, SC

El Paso, TX ! !

Memphis, TN !

Miami, FL ! ! !!

New Orleans, LA ! ! !!

Washington, DC ! ! !!

Chicago, IL ! ! !!

Detroit, MI ! ! !!

Sioux Falls, SD !

St. Louis, MO ! !!

Billings, MT

Denver, CO ! ! !!

Los Angeles, CA ! ! !!

Honolulu, HI !! !

Seattle, WA ! ! !!

West Midwest South Northeast
APPENDIX 4: PULSE CHECK SOURCES

page 72 Pulse Check: April 2002

Pulse Check Site Epidemiology/Ethnography Law Enforcement 

Baltimore, MD James Peterson Nonrespondent

Johns Hopkins University

School of Public Health 

Billings, MT Ernesto Randolfi, Ph.D. Scott Forshee

Montana State University at Billings City/County Special Investigations Unit

Department of Health and Physical Education 

Birmingham, AL Foster Cook Sergeant T.E. Thrash

University of Alabama Birmingham Police Department Vice and Narcotics Division

Boston, MA George Arlos Lieutenant Francis W. Armstrong, Jr.

Substance Abuse Treatment Boston Police Department

and Prevention Services Drug Control Division

Chicago, IL Larry Ouellet, Ph.D. Chicago Police Department

University of Illinois at Chicago Organized Crime Division, Narcotic

School of Public Health and Gang Investigations Section

Columbia, SC Department of Alcohol and C.O. Clark

Other Drug Abuse Services Columbia Police Department

Organized Crime and Narcotics Unit 

Denver, CO Bruce D. Mendelson, M.P.A. Curt Williams, B.S.

State Treatment Needs Assessment Contract Denver Police Department

Colorado Department of Human Services Fugitive Location and Apprehension Group

Alcohol and Drug Abuse Division 

Detroit, MI Richard F. Calkins Southeast Michigan HIDTA

Michigan Department of Community Health

Division of Substance Abuse Quality and Planning

El Paso, TX Tessa Hill, M.A. Jeff Cole

Aliviane, Inc. El Paso Police Department, Narcotics Unit 

Honolulu, HI D. William Wood, Ph.D., M.P.H. Lieutenant Mike Moses

University of Hawaii Narcotics, Vice Division

Department of Sociology Honolulu Police Department 

Los Angeles, CA Richard Rawson, Ph.D. Criminal Intelligence Group

University of California, Los Angeles Los Angeles Police Department

Integrated Substance Abuse Programs (ISAP) 

Memphis, TN Randolph Dupont, Ph.D. Fred Romero

Department of Psychiatry Memphis Police Department

University of Tennessee Vice Narcotics Unit 

Miami, FL James N. Hall Prefers anonymity 

Up Front Drug Information Center 

New Orleans, LA Gail Thornton-Collins Lieutenant Reginald Jacque

New Orleans Health Department 

New York, NY John A. Galea, M.A. Drug Enforcement Administration

New York State Office of Alcoholism New York Division 

and Substance Abuse Services Unified Intelligence (S-13)

Street Studies Unit

Philadelphia, PA Samuel J. Cutler Ken Bergmann

Philadelphia Behavioral Health System Drug Enforcement Administration

Coordinating Office for Drug Philadelphia Field Division

and Alcohol Abuse Programs Divisional Intelligence Group 

Portland, ME Nate Nickerson, R.N., M.S.N. George Connick

Public Health Division, Maine Drug Enforcement Agency 

Department of Health and Human Services

City of Portland 

Seattle, WA Thomas R. Jackson, M.S.W. Steve Freng

Evergreen Treatment Services High Intensity Drug Trafficking Area 

Sioux Falls, SD Darcy Jensen Jerry Mundt 

Prairie View Prevention Services Sioux Falls Police Department

Narcotics Division 

St. Louis, MO James M. Topolski, Ph.D. Detective Leo Rice

Missouri Institute of Mental Health St. Louis Police Department

Narcotics Division 

Washington, DC Alfred Pach, Ph.D., M.P.H. Sergeant John Brennan

Washington, D.C. Police Department

Major Narcotics
APPENDIX 4: PULSE CHECK SOURCES

Pulse Check: April 2002 page 73

Pulse Check Site Non-Methadone Treatment Methadone Treatment 

Baltimore, MD Nonrespondent Cindy Shaw

IBR Reach

Billings , MT Mona Sumner Illegal in the State of Montana

Rimrock Foundation 

Kathy Woodward

South Central Mental Health Center

Journey Recovery Program

Birmingham, AL Eleanor D. Powers Bill Garrett, M.P.H.

Program prefers anonymity University of Alabama 

Birmingham Substance Abuse Program 

Boston, MA Jim Sweeney Joanne Swindell

Gavin House CAB Health and Recovery Services

Patrick Griswold

NCIA 

Chicago, IL Del Larkin Cornell Interventions

Association House of Chicago 

Columbia, SD Bryan Fox Jim Van Frank

Palmetta Baptist Medical Center Columbia Metro Treatment Center 

Outpatient Behavioral Health Services

Denver, CO Tim McCarthy Pamela J. Manuele, RN, BSN, ANPC, CCJS

Arapahoe House Comprehensive Addiction Treatment Services

Detroit, MI Renaissance West Community Health Services Octavius Sapp, C.A.C.

City of Detroit, Department of Human Services

Drug Treatment Program

El Paso, TX Armando Salas Julie Renteria, L.V.N.

Aliviane Men’s Residential Facility El Paso Methadone Maintenance

and Detox Treatment Center 

Honolulu, HI Nonrespondent Lisa Cook

Drug Addiction Services of Hawaii 

Los Angeles, CA Mari Radzik, Ph.D. Wynnell Dominguez

Substance Abuse Treatment Program West Los Angeles Treatment Program 

Division of Adolescent Medicine 

Children’s Hospital of Los Angeles 

Memphis, TN Nonrespondent Nonrespondent

Miami, FL Michael Miller, Ph.D. Prefers anonymity

The Village South, Inc. 

Addiction Treatment Center 

New Orleans, LA Eleanor Glapion Prefers anonymity

New Orleans Substance Abuse Clinic 

New York, NY Jean Scott Lower Eastside Service Center

Pheonix House

Philadelphia, PA C. Joseph Schultz, M.Ed. Peter A. Demaria, Jr., M.D., FASAM

Northeast Treatment Department of Psychiatry and Human Behavior

Jefferson Medical College 

Portland, ME Stephen Leary Douglas Smith

Milestone Foundation, Inc. Discovery House Maine

Seattle, WA Ramona Graham Victoria Evans

Therapeutic Health Services 

Sioux Falls, SD Robin Erz, CCDCIII Illegal in the State on South Dakota 

Turning Point Alcohol and Drug Center

Keystone Treatment Center 

St. Louis, Missouri Mike Morrison Cheryl Gardine

Bridgeway Counseling DART 

Washington, D.C. James Shepard Umoja Treatment Center

Cataada House/Aftercare Program

Greater Mt. Calvary
APPENDIX 5: DISCUSSION AREAS

page 74 Pulse Check: April 2002

APPENDIX 5: DISCUSSION AREAS BY SOURCE TYPE*

Topic L E M N

SPECIAL SECTION: THE IMPACT OF THE SEPTEMBER 11 TERRORIST 

ATTACTS ON DRUG MARKETS AND USE

Since the terrorist attacks on September 11, what has been the reaction or change within your local !!!!

drug markets and among chronic drug users?

THE SNAPSHOT

How serious is the current illegal drug problem in your community? !!!!

How has the illegal drug problem changed in your community? !!!!

THE PERCEPTION

What is the most commonly abused drug in your community during the current reporting period? 

Second most commonly abused drug? What drug is related to the most serious consequences? !!!!

Second most serious consequences? Is any new problem drug appearing in your community?

What was the most commonly abused drug in you community during the last reporting period? 

Second most commonly abused drug in your community? What drug was related to the most serious !!!!

consequences last reporting period? Second most serious consequences?

THE DRUG**

How available is the drug in your community (for each drug, asks about various forms)? ! !

How has availability changed? ! !

What are the most common and second most common units of sale and corresponding standard units of the drug? ! !

What is the purity range for the drug during the current reporting period? During the last reporting period? ! !

What is the price range during the current reporting period? During the last reporting period? ! !

Are there any adulterants? If yes, please list and indicate if any are new this reporting period. !!!!

Why have price, purity, or adulterants changed or why have they remained stable? ! !

What is the source for your price, purity, and adulterant information? ! !

What are the street names, and are any of these new this reporting period? !!!!

What types of packaging are used, and are any of these new this reporting period? ! !

Are labels or brand names used? If yes, please list and indicate if any are new this reporting period. ! !

Have street names, packaging, or label/brand names changed since the last reporting period? ! !

How is the drug locally manufactured, processed, or grown? ! !

Have there been any changes in the local manufacturing process since the last reporting period? 

If yes, please describe. ! !

THE SALE**

What is the predominant affiliation of local, street-level sellers? ! !

What is the predominant age range of local, street-level sellers? ! !

How likely are sellers to use their own drugs? ! !

In what types of other crimes are sellers involved? ! !

Have there been any changes in seller characteristics since the last reporting period? If yes, please describe. ! !

Are there any new sellers groups this reporting period? If yes, please describe. ! !

What is the geographical area where most street-level sales of the drug occur? ! !

Is the drug sold mostly indoors, outdoors, or evenly split between both? ! !

In what settings is the drug sold? ! !

How is the drug sold? ! !

Are other drugs sold by this type of dealer? If yes, please list the drugs. ! !

Have any of the drugs sold with this drug changed since the last reporting period? If yes, please describe. ! !

Have any of the drug scene characteristics changed since the last reporting period? If yes, please describe. ! !
APPENDIX 5: DISCUSSION AREAS

Pulse Check: April 2002 page 75

Topic L E M N

THE USERS: Predominant characteristics**

What is the predominant age range of the drug users, and has it changed since the last reporting period? !!!

What is the predominant gender, and has it changed since the last reporting period? !!!

What is the predominant racial/ethnic group, and has it changed since the last reporting period? 

Is this group underrepresented, overrepresented, or about equal compared with the general population in your area? !!!

What is the predominant socioeconomic position, and has it changed since the last reporting period? !!!

What is the most common geographical residence, and has it changed since the last reporting period? !!!

What is the predominant route of administration? !!!

What are the drugs commonly taken with this drug? Are they taken sequentially, in combination with, 

or as a substitute for the drug? What are the street names for this combination or practice? !!!

Is the drug used mostly in public or in private? !!!

Is the drug used mostly alone or in groups/among friends? !!!

What are the common settings for the use of this drug? !!!

What is the most common referral source, and has it changed since the last reporting period? ! !

What is the predominant education level, and has it changed since the last reporting period? ! !

What is the most common frequency of use, and has it changed since the last reporting period? ! !

What is the predominant employment status, and has it changed since the last reporting period? ! !

THE USERS: New/emerging or novice users**

How did the number of new or emerging users change since the last reporting period? 

If increased, repeat the first 10 questions under “the users: predominant characteristics” !

for the new/emerging user group. 

How did the number of novice users in your program change since the last reporting period? 

If increased, repeat all questions under “the users: predominant characteristics” for the novice user group. ! !

METHADONE DIVERSION/TREATMENT

What is the availability of methadone treatment in your community? !

How has treatment availability changed since the last reporting period? !

What is the capacity of public methadone treatment? Private methadone treatment? !

How has the capacity of public methadone treatment changed since the last reporting period? 

Private methadone treatment? !

COMMUNITY CONTEXTS

Have drug-related consequences (HIV/AIDS, hepatitis C, liver cirrhosis, drug-related automobile 

accidents, high-risk pregnancy, drug overdoses, alcohol DTs, tuberculosis, other) increased, decreased, ! !

or remained stable since the last reporting period? If changed, explain. 

Do any potential barriers (limited slot capacity, lack of trained staff to treat comorbid clients, violent 

behavior among presenting clients, age restrictions, other) prevent your program from serving all individuals ! !

who seek treatment? If yes, explain. 

TREATMENT BACKGROUND

What is your program’s maximum capacity? ! !

What is your current enrollment? ! !

Does your program’s clientele reflect the population of your local community? If no, please describe. ! !

L

Law enforcement

E

Epidemiologic/ethnographic

MMethadone treatment

NNon-methadone treatment 

*Please note that for the methadone and non-methadone treatment interviews, “community” was replaced with “program.”

**Respondents were asked about heroin, crack, powder cocaine, methamphetamine, marijuana, ecstasy, GHB, 

OxyContin®, and any other drugs (specify) for each of the discussion areas.
page 76 Pulse Check: April 2002

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