PULSE CHECK

Trends in Drug Abuse

January 2004

Executive Office of the President

Office of National Drug Control Policy

Washington, DC 20503

NCJ 201398
ACKNOWLEDGEMENTS

page ii Pulse Check: January 2004

ACKNOWLEDGEMENTS

The Office of National Drug Control Policy (ONDCP) acknowledges the contributions made by the 97 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 11. 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: January 2004 page iii

CONTENTS

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

National Snapshot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Exhibits 

1. How serious is the perceived drug problem in the 25 Pulse Check communities? (Fall 2002) . . . . . . . . . . . . . .4

2. How has the perceived drug problem changed? (Spring vs fall 2002) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

3. How difficult is it for undercover police and users to buy drugs? (Fall 2002) . . . . . . . . . . . . . . . . . . . . . . . . . .5

4. How difficult is it for undercover police and users to buy drugs (0–10 scale, 0=not difficult at all,

10=extremely difficult)? (Fall 2002) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

5. What are the most serious drug problems in the 25 Pulse Check cities, by type of source? . . . . . . . . . . . . . . . .8

6. What are the most serious drug problem in the 25 Pulse Check cities, by number of sources and sites? . . . . . . .8

7. What new problems have emerged or intensified during fall 2002? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

8. Where is diverted methadone emerging as a problem? (Fall 2002) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

9. Where is PCP emerging as a problem? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

10a. What are the prices and purity levels of different types of heroin in Pulse Check cities? (Fall 2002) . . . . . . .17

10b. How much does one rock of crack cocaine cost in Pulse Check cities? (Fall 2002) . . . . . . . . . . . . . . . . . . .18

10c. How pure is powder cocaine, and how much does it cost? (Fall 2002) . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

10d. How much does marijuana cost? (Fall 2002) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

10e. How much does methamphetamine cost? (Fall 2002) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

10f. How much does a pill (one dose) of ecstasy cost? (Fall 2002) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

Special Topic: Local Drug Market: A Decade of Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Exhibits 

Beyond Cash: What else is accepted in exchange for drugs? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25

To what degree have the following illicit marketing innovations or tools complicated 

efforts to detect or disrupt drug activity over the past 10 years? (Mean of 0–5 ratings) . . . . . . . . . . . . . . . . . . . .30

Dealers using band names: To what extent has it complicated detection and 

disruption efforts? (0–5 ratings) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31

Markets relocating within the community: To what extent has it complicated detection 

and disruption efforts? (0–5 ratings) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31

Throwaway cell phones: To what extent have they complicated detection and

disruption efforts? (0–5 ratings) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32

Changes in the nature of users and the market: To what degree have they made the drug abuse problem 

more complex over the past 10 years? (Mean of 0–5 ratings) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37

Marijuana: To what extent have the following changes contributed to its widespread availability and use

over the past 10 years? (Mean of 0–5 ratings) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40

To what extent have changes in the following problems complicated the treatment of marijuana-using

clients, particularly youth, over the past 10 years? (Mean of 0–5 ratings) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43
CONTENTS

page iv Pulse Check: January 2004

City Snapshots

Atlanta, Georgia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50

Baltimore, Maryland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .60

Boston, Massachusetts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .70

Chicago, Illinois . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .82

Cincinnati, Ohio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .92

Cleveland, Ohio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .98

Dallas, Texas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .108

Denver, Colorado . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .122

Detroit, Michigan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .132

Houston, Texas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .142

Los Angeles, California . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .154

Miami, Florida . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164

Minneapolis/St. Paul, Minnesota . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .174

New York, New York . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .188

Philadelphia, Pennsylvania . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .198

Phoenix, Arizona . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .208

Pittsburgh, Pennsylvania . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .218

Portland, Oregon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .228

Sacramento, California . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .236

St. Louis, Missouri . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .246

San Diego, California . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .258

San Francisco, California . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .270

Seattle, Washington . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .280

Tampa/St. Petersburg, Florida . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .288

Washington, DC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .298

Appendix 1: Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 308

Appendix 2: Population Demographics in the 25 Pulse Check Sites. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309

Appendix 3: Pulse Check Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 310

Appendix 4: Discussion areas by source type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 312
INTRODUCTION

Pulse Check: January 2004 page 1

INTRODUCTION

The President has stated goals of

reducing drug use among all

Americans by 10 percent in 2 years

and 25 percent in 5 years. As part of

the strategy to accomplish this, the

Office of National Drug Control

Policy (ONDCP) has developed this

special edition of Pulse Check to

complement its current 25-Cities

Initiative, which engages local officials and concerned citizens in 25 of

American’s largest cities. Though

drug use has

harmed all cities,

America’s largest

cities have been

particularly hard

hit. Local leaders

and teams of

local citizens and

officials in those

cities will be

aided in identifying problems they

can address by

referring to this

expanded Pulse

Check, with its

new “city snapshot” format. 

ONDCP has been publishing Pulse

Check since 1992, with the goal of

providing 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: marijuana, heroin,

crack cocaine/powder cocaine, and

methamphetamine. Additionally, 

Pulse Check continues to monitor the

problems of “ecstasy” (methylenedioxymethamphetamine or MDMA),

the diversion and abuse of OxyContin®

(a controlled-release formulation of

the pharmaceutical opiate oxycodone), and other drugs of concern.

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 Survey

on Drug Use and Health 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

interpretations or

conclusions 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 25 specific sites throughout the Nation. Though these sites

cross a broad range of geographic

areas, including Census regions and

divisions, 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.

The 25 Pulse Check Sites
INTRODUCTION

page 2 Pulse Check: January 2004

Of the 100 sources across the three

disciplines, 97 provided information

for this Pulse Check issue. The information presented in this report is

based solely on the observations and

perceptions of those 97 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 97. 

Due to rounding of percentages, 

values on pie charts may not add 

up to 100.

Any contradictory reports within an

individual site are not necessarily a

Pulse Check limitation. Quite the contary, recruiting four sources per site

was incorporated into the project

design to reflect diversity within each

site. 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 25 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 in two waves, during

December 2002 through January

2003 and March through May 2003,

from telephone conversations with 97

sources, representing 25 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

2002 and in comparison to a period 

6 months earlier, during spring of

that year.

The law enforcement sources who

provided information include 24 

narcotics officers from local police

departments, field office agents of the

Drug Enforcement Administration

(DEA), and representatives of High

Intensity Drug Trafficking Areas

(HIDTAs). One law enforcement

source (from Cincinnati) did not

respond.

The epidemiologists and ethnographers are 25 researchers associated

either with local health departments,

university-based research groups, or

other community health organizations. Some of those 25 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 providers

from 24 non-methadone programs and

24 methadone programs across the 25

sites. Two treatment sources did not

respond (Miami, methadone; and

Portland, OR, non-methadone).

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 policymakers 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. 
NATIONAL SNAPSHOT

Pulse Check: January 2004 page 3

NATIONAL SNAPSHOT

PULSE CHECK
NATIONAL SNAPSHOT

page 4 Pulse Check: January 2004

KEY FINDINGS: 

LOCAL DRUG MARKETS—A

DECADE OF CHANGE

Over the past decade, various 

communities have used a range of

anti-drug strategies with varying

degrees of success. The following 

are just a few examples:

! Food stamps: Innovative technologies in lieu of paper, such as debit

cards, vouchers, or electronic

transfer, have disrupted food

stamps-for-drugs trading in several

cities, including Atlanta, Denver,

Detroit, Houston, Philadelphia,

and Pittsburgh.

! Task forces: Task forces of varying

composition and focus have been

used effectively over the past

decade in all 25 Pulse Check cities.

! Drug courts: The majority of Pulse

Check sites have some sort of drug

court program, and sources in

those areas generally consider

them highly effective.

Illicit drug dealers have employed

different marketing tactics over the

past decade, such as the examples

below, posing varying degrees of

challenge to detection and disruption

efforts:

! Detection and disruption efforts

have not been hampered much by

dealers’ use of unique packaging

or brand names.

! Throwaway cell phones and other

developments in digital communications technology have posed the

greatest challenge to law enforcement efforts. Some sources believe

that phone companies are offering

new technologies to the public

before offering counter-technologies to law enforcement.

Several changes have contributed to

the widespread availability, use, and

consequences of marijuana over the

past decade:

! The decline in social disapproval of

marijuana (by peers, parents, etc.)

and the decline in users’ perception

of its harmfulness have had an

impact on its widespread use and

availability over the past 10 years.

! In order to obtain marijuana,

youth are increasingly engaging in

risky or criminal activities, such as

trading sex, guns, or shoplifted

merchandise for the drug.

! Law enforcement sources consider

the promotion of marijuana as

“medicine” as a more significant

problem than do their epidemiologic/ethnographic counterparts.

! Many Pulse Check sources believe

the media have reported marijuanarelated issues responsibly. However

one source (MiamiL

) believes that

some local media “are quick to

report on legalization efforts and

medicinal uses” of marijuana but

not on its harmful effects.

! Because marijuana prices have

remained generally stable over the

past 10 years, sources do not attribute increased use to price declines. 

HIGHLIGHTS: 

CURRENT DRUG MARKETS

AND CHRONIC USERS

The illicit drug situation is characterized by several key features:

! Overall, law enforcement and epidemiologic/ethnographic respondents are remarkably similar in

their perceptions of how difficult

it is to buy various drugs across

the country.L,E (Exhibit 3)

*The following symbols appear throughout this chapter to indicate type of respondent: LLaw enforcement, E

Epidemiologic/ethnographic, NNon-methadone treatment, and MMethadone treatment.

Exhibit 1. How serious is the perceived

drug problem in the 25 Pulse Check

communities? (Fall 2002)

Somewhat

serious Very

serious

100

90

80

70

60

50

40

30

20

10

0

Percent (N=95)

77%

23%

Sources: Law enforcement, epidemiologic/

ethnographic, and treatment respondents

Exhibit 2. How has the perceived drug

problem changed? (Spring vs fall 2002)

Sources: Law enforcement, epidemiologic/

ethnographic, and treatment respondents

Somewhat

worse

Much

worse

Percent (N=95)

Same

66%

29%

4%

PULSE CHECK

NATIONAL SNAPSHOT*

This report is based on discussions

with 97 epidemiologists, ethnographers, law enforcement officials, and

methadone and non-methadone treatment providers from 25 Pulse Check

sites. Telephone discussions with these

individuals, conducted in two waves,

during December 2002 through

January 2003 and March through May

2003, reveal that overall, when comparing fall 2002 with the previous

spring period, the majority of Pulse

Check sources believe their communities’ drug abuse problem to be very

serious but stable. (Exhibits 1 and 2)

100

90

80

70

60

50

40

30

20

10

0
NATIONAL SNAPSHOT

Pulse Check: January 2004 page 5

! Marijuana and crack are the illicit drugs most easily purchased by

users and undercover police across

the country. They are followed, in

descending order, by heroin, ecstasy,

powder cocaine, methamphetamine,

and diverted OxyContin® (oxycodone hydrochloride controlledrelease).L,E (Exhibits 3 and 4)

! Marijuana remains the country’s

most widely abused illicit drug, as

reported by 37 sources in 22

cities. (Exhibits 5 and 6)

! Crack remains a serious problem

in 18 cities, according to 28

sources primarily in the Northeast,

South, and Midwest. It is considered the most commonly used

drug by 16 sources in 12 cities.

(Exhibits 5 and 6)

! Methamphetamine is reported as

an emerging or intensifying problem in 15 cities. (Exhibit 7)

Furthermore, sources in eight cities,

particularly in the West, consider it

to be the drug contributing to the

most serious consequences. And

sources in five western cities consider it the most commonly abused

drug. (Exhibits 5 and 6)

! Sources in 18 Pulse Check cities

believe their communities do not

have any emerging drug problems.

(Exhibit 7)

! Methylenedioxymethamphetamine

(MDMA or ecstasy) continues to

emerge or intensify as a problem

in 16 cities. (Exhibit 7)

! Increased law enforcement efforts

and media attention have somewhat reduced the supply of diverted OxyContin® in some cities.

Nevertheless, it continues to

emerge or intensify as a problem in

15 cities. (Exhibit 7) In some cases,

people who have become addicted

to it are switching to either heroin

or diverted methadone.

! Diverted methadone and phencyclidine (PCP) are reported as

emerging problems in several

cities. (Exhibits 7, 8, and 9)

! Heroin is the drug associated with

the most serious consequences—

such as overdose deaths and involvement in emergency department

episodes—as perceived by nearly

half (44) of the Pulse Check sources

in 22 cities. (Exhibits 5 and 6)

! Illicit drug prices generally

remained stable between spring

and fall 2002, with a few exceptions, such as declines in heroin

and methamphetamine prices in

some western cities. (Exhibits

10a–10f )

Exhibit 3. How difficult is it for undercover police and users to buy

drugs? (Fall 2002)

Not

difficult

at all

Undercover policeL UsersE

Marijuana (in general, Mexican

commercial, and local commercial); crack 

Hydroponic marijuana; powder

cocaine; methamphetamine (in

general and local)

Heroin (in general); ecstasy; 

sinsemilla marijuana 

Mexican black tar and SA;

Mexican methamphetamine 

SEA and SWA 

Ice; diverted OxyContin®

Mexican black tar and SA 

Mexican brown heroin; ice 

Heroin (in general); powder

cocaine; ecstasy 

Marijuana (in general); crack

4

3

2

1

0

5

6

7

8

9

Local commercial marijuana;

methamphetamine (in general)

BC bud 

Local and Mexican methamphetamine; sinsemilla and hydroponic

marijuana; diverted OxyContin®

Extremely

difficult

10

Mexican brown heroin; BC bud 

SEA and SWA 

Note: SA=South American

(Colombian) heroin;

SWA=Southwest Asian heroin;

SEA=Southeast Asian heroin;

ice=highly pure methamphetamine

in smokable form; and BC

bud=British Columbian marijuana

Sources: L

Law enforcement respondents’

mean ratings; EEpidemiologic/ethnographic

respondents’ mean ratings 
NATIONAL SNAPSHOT

page 6 Pulse Check: January 2004

The discussions with epidemiologic/

ethnographic and treatment respondents yielded insights into treatment

issues in the 25 Pulse Check sites.

These issues included methadone

maintenance treatment availability and

capacity, drug treatment referrals,

treatment of marijuana users over the

past decade, and the impact of

California’s Proposition 36 on specific

treatment programs.

As reported in past Pulse Check

issues, about half of epidemiologic/

ethnographic respondents consider

methadone maintenance to be available in selected areas only, while the

others consider it available throughout their areas. 

Between spring and fall 2002, public

treatment has become more available

in seven Pulse Check cities: Baltimore,

Minneapolis/St. Paul, Philadelphia,

Pittsburgh, Seattle, Tampa/St.

Petersburg, and Washington, DC.

Conversely, it has become less available due to State budget cuts in

Portland (OR), San Francisco, and St.

Louis. Private methadone maintenance

availability declined in three cities

(Cleveland, Minneapolis/St. Paul, and

Exhibit 4. How difficult is it for undercover police and users to buy drugs 

(0–10 scale, 0=not difficult at all, 10=extremely difficult)? (Fall 2002)

City Heroin Crack HCI MJ Meth X Oxy

Boston, MA 1.5 0.5 0.5 0.5 8.5 0.5 1.5

New York, NY 0 0 0 0 3.5 2 3.5

Philadelphia, PA 1.5 1 4.75 1.75 8.75 3.75 5.75

Pittsburgh, PA 1.75 2 2 1.5 2.25 4 2.25

Atlanta, GA 2.5 0 3 0 2 2 a

10

Baltimore, MD 0 0 1.5 0 a

7 3 6.5

Dallas, TX 0 0 0 0 0 0 0.5

Houston, TX 2.5 1 2 0.5 5 1.5 9

Miami, FL 5 0.5 0 0.5 4.5 0 4

Tampa/St.Petersburg, FL 2 0 1.5 0.5 5 1 3

Washington, DC 0 0 7.5 0 a7 3 6.5

Chicago, IL 1.5 1.5 4 1.5 8.5 4.5 10

Cleveland, OH 3 0.5 2 0.5 a

6 2 4.5

Detroit, MI 3 1 3 0 2.5 3.5 7.5 

Minneapolis/St. Paul, MN 3 0.5 1 0.5 1.5 3 b

3

St. Louis, MO 2 1 1.5 1.5 3.5 1 6.5

Denver, CO 3.5 2 4 0 1.25 4.5 9

Los Angeles, CA 4.5 1 1 0.5 1.25 1.25 5.75

Phoenix, AZ 0 a

0 a0 0 0 2.5 a3

Portland, OR 1 a

0 2 0.5 1 a3 a3

Sacramento, CA a

0 a0 a0 a0 a0 a0 a4

San Diego, CA 0.75 0.75 3.75 0.75 0.25 3.25 6.5

San Francisco, CA 0.5 0.5 4 0.5 1 1.5 4.25

Seattle, WA 2.5 3 a5 0.5 2 2.5 5 

Averages 1.75 0.7 2.25 0.5 3.4 2.2 5.2

a

Only the law enforcement rating is used because the epidemiologic/ethnographic respondent did

not provide this information.

b

Only the epidemiologic/ethnographic rating is used because the law enforcement respondent did

not provide this information.

Notes: Cincinnati is excluded from this analysis because the law enforcement source was a nonrespondent, and the epidemiologic/ethnographic source did not provide this information; HCl=

powder cocaine, MJ=marijuana, Meth=methamphetamine, X=ecstasy, Oxy=diverted OxyContin®

Sources: Mean ratings given by law enforcement and epidemiologic/ethnographic respondents

Northeast South West Midwest

METHADONE TREATMENT

AVAILABILITY

! More than 60 percent of respondents believe that the September 11

attacks have had no continuing

effects on the drug abuse situation.

! The most commonly mentioned

post-September 11 effects include

the following: supplies of some

drugs have declined in some cities;

some trafficking routes have shifted away from the East Coast;

vehicular and other means of

transport have sometimes replaced

air shipment; many sources perceive a shift in law enforcement

priorities from drugs to homeland

security; and some drug users in

treatment continue to experience

elevated levels of mental health

disorders.

! One source in Detroit notes that

because of increased security

measures, users believe that they

may have increased difficulty

obtaining drugs or maintaining

their personal drug supply. They

are therefore more willing to use a

variety of drugs or to make their

own drugs.N

SEPTEMBER 11 

FOLLOWUP

HIGHLIGHTS OF TREATMENT ISSUES
NATIONAL SNAPSHOT

Pulse Check: January 2004 page 7

San Francisco) and increased in four

(Baltimore, Detroit, Tampa/St.

Petersburg, and Washington, DC). 

Nine respondents report adequate

capacity of public methadone maintenance, while 10 (in Baltimore,

Boston, Chicago, Cincinnati, Detroit,

Pittsburgh, St. Louis, San Francisco,

Seattle, and Washington, DC) report

waiting lists of 1–24 months. Between

spring and fall 2002, public methadone

maintenance capacity has remained

relatively stable in most Pulse Check

cities, with increases reported in

Pittsburgh and declines in Portland

(OR) and St. Louis. 

! According to Pulse Check treatment

sources, most heroin users in

methadone programs are individually referred. By contrast, in the nonmethadone programs, about half of

the heroin clients are individual

referrals, and approximately half are

court or criminal justice referrals. 

! Crack and methamphetamine

clients in non-methadone programs are slightly more likely to be

court and criminal justice referrals

than to be individually referred. 

! Marijuana clients in 18 of the nonmethadone programs are predominantly court and criminal justice

referrals. Some sources specify that

marijuana court referrals are for

possession only (as in Baltimore,

Cincinnati, Houston, Los Angeles,

St. Louis, San Francisco, and

Seattle). Others specify that they

include referrals for both possession and sales (as in Atlanta,

Sacramento, and Washington, DC).

! Only powder cocaine clients are

more likely to be individually

referred than court referred to 

non-methadone treatment. 

! Several sources in the Northeast

(in Baltimore, New York, and

Philadelphia) report increased

criminal justice referrals for all

drugs. For marijuana in particular,

drug court referrals have increased

in San Francisco, and referrals

from mental health centers (mostly

for generalized anxiety) have

increased in Chicago.

! Challenges involved in treating

marijuana-using clients over the

past 10 years have increased and

include earlier initiation of marijuana use, increased marijuana

potency, and a decline in users’ 

perception of harm.

! Some treatment sources believe that

increased court referrals involving

marijuana have had the positive

effect of getting people into treatment earlier (PhiladelphiaN and San

DiegoN

). Another source believes

that this increase has made treatment more difficult because of the

emphasis on sellers, rather than

users. “Drug distributors are harder

to treat: they don’t accept they

have a problem and often resist

treatment” (AtlantaN

).

Since its implementation in July 2001,

California’s Substance Abuse and Crime

Prevention Act, known as Proposition

36, has diverted more than 37,000

people, usually those arrested for petty

crimes or drug possession, into treatment. Respondents view this initiative

as having a major impact on treatment

programs in several Pulse Check cities:

! A Sacramento treatment respondent states that these new clients

include many older drug users

with mental health problems 

(especially schizophrenia) who are

new to treatment. These new client

characteristics have made treatment

in Sacramento more complex.M

! The Sacramento methadone 

treatment source also reports 

general increases in treatment 

caseloads and court referrals due

to Proposition 36. That program

saw “100 new cases that they

would not have without ‘Prop. 36’.”

! In Sacramento, males have

increased as a proportion of treatment admissions. Before

Proposition 36, females dominated

because they were referred to treatment through child welfare cases.E

! Younger users, more females, and

more users new to treatment are

presenting for drug treatment,

especially heroin abuse, as reported in Los Angeles.E

! Also in Los Angeles, more

methamphetamine users are presenting to treatment due to the

changes in funding established by

Proposition 36.E

! Some sources are wary of

Proposition 36 because they aren’t

sure whether treatment centers

have enough capacity or whether

they “are staffed properly” (Los

AngelesL

). One respondent suggests

replacing Proposition 36 with drug

courts (San FranciscoL

). By contrast, the epidemiologic respondent

in Sacramento believes Proposition

36 has been successful.

HIGHLIGHTS BY SPECIFIC

ILLICIT DRUG

The 97 discussions yielded key findings about marijuana, crack, powder

cocaine, heroin, methamphetamine,

diverted methadone, other diverted

synthetic opioids, ecstasy, PCP, and

other drugs.

TREATMENT FOR MARIJUANA

USERS: THE PAST 10 YEARS

REFERRALS TO DRUG ABUSE

TREATMENT

IMPACT OF PROPOSITION 36
NATIONAL SNAPSHOT

page 8 Pulse Check: January 2004

! Big picture: Marijuana remains the

country’s most widely abused illicit drug, as reported by 37 sources

in 22 cities. (Exhibits 5 and 6)

Sources in non-methadone programs report stable percentages of

marijuana-using clients in treatment, with only three exceptions:

a slight decline in Atlanta and

slight increases in Chicago and

Sacramento. In the methadone

programs, declines are reported in

Boston and Cleveland, while a

slight increase is reported in

Chicago.

! Ease of purchase: Marijuana is the

most easily purchased drug across

the country (0.5 average rating).L,E

Its availability remains relatively

stable since the previous reporting

period, except in Portland (OR),L

San Francisco,L and Seattle,L where

purchasing the drug has become

less difficult.

! The different varieties: Mexican

commercial grade marijuana is the

most common variety. It can be 

purchased with little or no difficulty

(0–1 rating) in 14 Pulse Check

cities: Baltimore,E Boston,L,E

Chicago,L,E Dallas,E Denver,E

Detroit,E Houston,E Los Angeles,E

Minneapolis/St. Paul,E Phoenix,E

Pittsburgh,L San Diego,E Seattle,E

and Washington, DC.L No changes

in availability are reported.

Local commercial grade marijuana

is the next most common variety

(2.42 average ratings by law

enforcement and epidemiologic/

ethnographic respondents across

all sites). It can be purchased with

little or no difficulty (0–1 average

ratings) in all but four Pulse Check

cities: Boston, Chicago, Philadelphia, and St. Louis. (This information was not available for

Cincinnati.) Its availability remains

relatively stable, with one exception:

purchasing it has become less 

difficult in Portland (OR) as outdoor “grows” have increased 

dramatically.L

Sinsemilla (seedless marijuana) can

be purchased with little or no difficulty in 13 Pulse Check cities:

Atlanta,L Baltimore,L Dallas,L,E Los

Angeles,E Miami,L Minneapolis/St.

Paul,E New York,L,E Phoenix,E

Portland (OR),L St. Louis,L San

Exhibit 5. What are the most serious drug problems in the 25 Pulse Check

cities, by type of source?

Drug Most commonly abused?a Most serious consequences?

L E N L E NM

Boston, MA MJ MJ H HCl Crack H H

New York, NY Cocaineb MJ Crack Crack Crack Crack Crack

Philadelphia, PA MJ MJ Crack H H Crack H

Pittsburgh, PA H H H H H H H

Atlanta, GA Crack MJ Crack Crack Crack Crack H

Baltimore, MD MJ H H H H Crack Benzos

Dallas, TX MJ MJ H H Crack H H

Houston, TX MJ Crack Crack H Crack Crack H

Miami, FL MJ MJ Crack Crack Opiates Crack NR

Tampa/St. Petersburg, FL Crack H MJ Cocaineb Crack H Oxy

Washington, DC MJ MJ Crack Crack H H H

Chicago, IL Crack MJ Crack Crack H Crack H

Cincinnati, OH NR MJ MJ NR Crack H H

Cleveland, OH Crack Crack H Crack Crack Crack H

Detroit, MI MJ MJ Crack H H Crack H

Minneapolis/St. Paul, MN Crack MJ MJ Crack H MJ H

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

Denver, CO MJ MJ Meth Meth HCl Meth H

Los Angeles, CA Crack MJ MJ Crack H Meth H

Phoenix, AZ MJ Meth Meth Meth Meth Meth H

Portland, OR MJ Meth NR H H NR H

Sacramento, CA Meth Meth Meth Meth Meth Meth Meth

San Diego, CA Meth MJ Meth Meth Meth Meth H

San Francisco, CA MJ MJ H Meth H Meth H

Seattle, WA MJ MJ MJ Meth H MJ H

a

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

methadone treatment sources are excluded from this question.

b

Unspecified form

Sources: LLaw enforcement respondents, EEpidemiologic/ethnographic respondents, NNon-methadone

treatment respondents, and MMethadone treatment respondents

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

Benzos=Benzodiazepines; Oxy=OxyContin®; NR=Not reported Northeast South West Midwest

Exhibit 6. What are the most serious drug problems in the 25 Pulse Check

cities, by number of sources and sites?

Most commonly abused?* Most serious consequences?

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

Heroin 10 7 44 22

Crack 16 12 28 17

Powder cocaine 0 0 2 1

Marijuana 37 22 2 2

Methamphetamine 9 5 17 8

Diverted OxyContin® 00 1 1

Benzodiazepines 0 0 1 1

Cocaine (Unspecified) 1 1 1 1

*Methadone treatment sources are excluded from this count. 

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

treatment respondents

MARIJUANA
NATIONAL SNAPSHOT

Pulse Check: January 2004 page 9

Francisco,L Seattle,E and

Washington, DC.E Since the last

reporting period, purchasing sinsemilla has become less difficult in

Chicago,L New York,L and

Portland,L and more difficult in

ClevelandL and Philadelphia.E

Hydroponically grown marijuana

can be purchased with little or no

difficulty in 10 Pulse Check cities:

Dallas,E Los Angeles,E Miami,L

Minneapolis/St. Paul,E New York,L,E

Portland (OR),L Sacramento,L San

Francisco,L Phoenix,E and Seattle.E

Purchasing it has become more difficult in Los AngelesL and less difficult in Chicago,L New York,L San

Francisco,L and Washington, DC.L

British Columbian marijuana (“BC

bud”) can be purchased with little

or no difficulty in 6 Pulse Check

cities, mostly in the West: Dallas,E

Los Angeles,E Minneapolis/St.

Paul,L,E Portland (OR),L

Sacramento,L and Seattle.E

Purchasing it has become less difficult in Minneapolis/St. Paul,L

Portland (OR),L and St. Louis;E conversely, it has become more difficult

in ClevelandL and San FranciscoL

.

! User changes: The age of marijuana users appears stable since the

last reporting period, with only a

few exceptions: younger people

are initiating marijuana use in New

York,E Phoenix,E and San Diego.N

In some cities, such as Philadelphia,E marijuana is increasingly

involved in emergency department

episodes.

! Local market changes: Market

changes reported in three Pulse

Check cities are associated with sales

of BC bud: Canadian-based

Southeast Asian gangs are increasingly selling BC bud in Seattle and

Portland (OR). These young adults

and adolescents are associated with

violence and gang activity, and some

also import and sell ice.L Similarly,

recent gang activity in relation to

sales of BC bud from Seattle is

reported in Minneapolis/St. Paul.L 

! Purity and price (Exhibit 10d):

Reported THC levels range from

1–10 percent for commercial grade

marijuana to as much as 30 percent for BC bud (as reported in

San Diego).E Between spring and

fall 2002, THC levels increased in

PittsburghE and St. Louis.L

Most ounce prices for commercial

grade marijuana are about $100.

Between spring and fall 2002,

marijuana prices remained relatively stable with a few exceptions:

they increased in three Pulse Check

cities (Boston,L Miami,E and St.

LouisL

—at the pound level), and

declined in ChicagoE (at lower

quantity levels) and DenverE (at

the pound level).

! Big picture: Two sources (in

PhoenixN and Washington, DCL

)

believe crack is no longer the most

commonly abused drug in their

communities. Another two (in

BaltimoreL and Washington, DCN

)

believe it is no longer the drug with

the most serious consequences.

Elsewhere, crack is named as the

drug with the most serious consequences in 17 cities, according to 28

sources primarily in the Northeast, South, and Midwest. (Exhibits

5 and 6) In the West, only one

source (Los AngelesL

) considers it as

such. Treatment sources generally

report stable treatment percentages

for crack. However, non-methadone

sources report some slight increases

in Atlanta, Dallas, Minneapolis/St.

Paul, Philadelphia, Seattle, and

Washington, DC. In the methadone

programs, slight decreases are

reported in Chicago and Cincinnati,

while slight increases are reported in

Cleveland and St. Louis.

! Ease of purchase: Since the previous reporting period, purchasing

crack has become slightly more

difficult in Philadelphia,E again due

to Operation Safe Streets, and it

has become less difficult in San

Francisco.L Its availability remains

relatively stable elsewhere. Across

the country, crack follows marijuana

as the most easily purchased drug

(0.7 average rating).L,E (Exhibits 3

and 4)

! User changes: The crack-using

population continues to age, as

reported in many cities. Only two

new user populations are reported.

In Cleveland, users are getting

younger.E And in St. Louis, younger

people are entering treatment at the

methadone source’s clinic.M

! Local market changes: In AtlantaL

,

cell phone involvement in crack

sales is relatively new, and sales

have increased on college campuses. In Minneapolis/St. Paul,L

Mexican nationals are newly

involved in processing powder

cocaine into crack. These “cooks”

then sell the product to street dealers. In Boston, older sellers tend to

“mellow out,” while younger dealers are more involved in crime.E

! Purity and price (Exhibit 10b):

Purity ranges from 30 to 85 percent, with most purity levels in the

middle of that range. 

The most common unit of crack

sold in most Pulse Check cities is

one rock, approximately 0.1–0.2

grams. Prices depend mostly on

the size of the rock sold and range

from $2 to $40, with the standard

rock priced around $10. 

In two Western cities (Denver and

Los Angeles), street-level crack

prices have declined due to

decreased purity. Additionally, in

San Francisco, the cost of larger

purchases (10 rocks) has declined.L

CRACK COCAINE
NATIONAL SNAPSHOT

page 10 Pulse Check: January 2004

Rock prices have increased in New

York, where the ethnographic

source suspects that dealers are

trying to sell larger quantities at

higher prices to reduce the number

of transactions and thereby lower

the risk of being arrested.

In Baltimore, crack sales have

changed from requiring buyers to

purchase rocks of certain sizes and

prices (such as one rock for $10) to

allowing buyers to specify the exact

size and price (for example, breaking a piece off a rock and selling it

for $7).E

! Big picture: Powder cocaine use

has declined somewhat in reporting non-methadone treatment programs in Denver and Sacramento,

both among the overall treatment

population and among first-time

clients. In the methadone programs, the number of users has

declined in Phoenix and increased

in Chicago and Pittsburgh.

Elsewhere, treatment figures

appear stable. Powder cocaine is

often used as part of a polydrug

use pattern. For example, in

Miami, club drug users now take

powder cocaine to bolster ecstasy.E

! Ease of purchase: Since the previous reporting period, purchasing

powder cocaine has become more

difficult in AtlantaL and PhiladelphiaE and less difficult in Chicago,E

Cleveland,E and San Francisco.L Its

availability remains relatively stable

elsewhere. While not as easily purchased as crack, powder cocaine is

still relatively easy to purchase

across the country (2.25 average

rating).L,E (Exhibits 3 and 4)

! User changes: Characteristics of

cocaine users remained stable.

! Local market changes: Powder

cocaine markets have remained relatively stable in Pulse Check cities,

although one source in Atlanta

reports the emerging use of e-mail

and Internet communication for

powder cocaine sales.L

! Purity and price (Exhibit 10c):

Powder cocaine purity ranges from

30–60 percent in Washington, DC,

to as much as 95 percent in

Philadelphia. Between spring and

fall 2002, purity remained relatively

stable with three exceptions in the

West: it increased in Denver and

San Francisco at ounce levelsE and

in San Diego at the kilogram level.L

Powder cocaine prices range from

$25–$35 per gram in New York to

$75–$150 in Detroit. In most

cities, 1 gram costs about $100.

Between spring and fall 2002,

prices were stable except in

Houston and San Francisco where

they declined, and in Sacramento,

where gram prices declined, while

kilogram prices increased.L

! Big picture: Heroin has overtaken

crack as the drug related to the

most serious consequences—such as

its impact on users’ health, lifestyle,

and families—in BaltimoreL and

Washington, DCN

. It has overtaken

diverted OxyContin® as the most

commonly abused drug in

Pittsburgh.N Pulse Check sources in

non-methadone treatment programs report declines in Dallas,

Denver, and Sacramento; sources

report increases in primary heroin

abusers in Houston, New York,

Philadelphia, Pittsburgh, and

Washington, DCN

. The percentage

of primary heroin abusers in the

methadone programs is generally

stable, except for slight increases in

Baltimore, Cleveland, Detroit, and

Pittsburgh.

! Ease of purchase: Since the previous reporting period, purchasing

heroin has become more difficult

in Los AngelesL and PhiladelphiaE

and less difficult in PittsburghE and

Portland, ORL

. The availability

decline in Philadelphia is attributed to the Operation Safe Streets

law enforcement effort.E

Elsewhere, heroin availability

remains relatively stable. Heroin

follows marijuana and crack as one

of the most easily purchased drugs

across the country: on a 0–10

scale, with 0 being “not difficult 

at all,” law enforcement and epidemiologic/ethnographic sources

rate it at an overall average of

1.75. (Exhibits 3 and 4)

! The different varieties: High purity

snortable white South American

(Colombian) heroin still predominates throughout the Northeast and

in many cities in the South (Atlanta,

Baltimore, Miami, and Washington,

DC) and the Midwest (Chicago,

Cleveland, and Detroit). Lower purity Mexican black tar heroin predominates throughout the West and

in some cities in the Midwest

(Minneapolis/St. Paul and St. Louis)

and South (Dallas and Houston).

Southeast Asian heroin is rarer, but

it is moderately obtainable in

Boston, Cleveland, and New York.

Southwest Asian heroin, also rarer, is

moderately obtainable in Baltimore,

Cleveland, Dallas, and New York.L

Some cities have split availability:

in Cleveland, for example, white

heroin is available on the East Side

(in the Black community), and

brown heroin is available on the

West Side (in the Hispanic and

White communities).E

! User changes: Some new heroin

users are switching from or alternating use with diverted

OxyContin®, as reported in

BostonE and Cincinnati.E

POWDER COCAINE

HEROIN
NATIONAL SNAPSHOT

Pulse Check: January 2004 page 11

New and younger heroin users are

reported in many cities, including

Boston,N Chicago,N Cleveland,E,M

Dallas,E Houston,N,M Los Angeles,E

Pittsburgh,E Portland (OR),E

Sacramento,E and San Diego.E,N In

San Diego’s North County, about

15 percent of drug court clients are

first-time young injecting drug users

from upper-middle socioeconomic

families.N However, that group may

be declining, possibly due to the

increased focus of a recent special

task force.E In Cleveland, many

well-educated upper-socioeconomic

adolescents use heroin.N

In Pittsburgh, where adolescent

opiate enrollment in treatment has

increased 45 percent over the past

5 years, overdose deaths and violent murders among adolescents

high on heroin have been increasing. Schools are trying to control

the situation by holding grieving

sessions and awareness nights.E

! Local market changes: The heroin

market in Boston continues to

decentralize, with dealers becoming more independent. Many users

support their habit by selling.E

Furthermore, sales for all available

drugs (including heroin) continue to

move “underground,” with

increased beeper and cell phone use

to facilitate sales.L

In New York, polydrug sales

(including heroin, crack, and powder cocaine sales) continue to

increase, and the use of Internet

and other communications technology has risen for all drug sales.L

In Washington, DC, five new

open-air markets for heroin have

emerged. These markets are operated by sellers 16–18 years old.E

In BaltimoreE and Washington,

DC,L more younger adults are 

selling heroin (in addition to the

older adult sellers), and they are

increasingly involved in violence.L

In Baltimore, the increased violence has been specifically linked

to heroin-selling street gangs.E

! Purity and price (Exhibit 10a):

Similar to reports in the last Pulse

Check, South American heroin

ranges from 40 to 95 percent

(excluding heroin in Washington,

DC, which is highly adulterated),

with both extremes reported in

Philadelphia. Mexican black tar

heroin ranges from 5 to 64 percent pure. Purity remained relatively stable between spring and

fall 2002, except for increases in

purity levels of Mexican black tar

heroin in HoustonL (and most of

Texas) and SacramentoL and

declines in Chicago.E

Sources continue to report a wide

range of heroin adulterants (especially lactose-based additives and

baby laxatives), but no new adulterants are noted. 

One dose (about 0.1 gram) of 

heroin sells for as little as $4–$6 in

Boston and as much as $30 in

Atlanta. Between spring and fall

2002, heroin prices declined in

many Pulse Check cities: Mexican

black tar heroin prices declined in

four western cities (Dallas,L Denver,E

San Diego,L,E and San FranciscoL),

and South American white heroin

prices declined in AtlantaL and

Boston.E By contrast, heroin prices

increased in Los AngelesE (at the

ounce level) and Minneapolis/St.

PaulL (at the gram level).

! Big picture: Methamphetamine is

reported as an emerging or intensifying problem in 15 cities. (Exhibit

7) Furthermore, sources in eight

cities, particularly in the West,

consider it the drug contributing

to the most serious consequences. 

And sources in five cities consider

it the most commonly abused

drug. (Exhibits 5 and 6) Treatment

sources generally report stable percentages of methamphetamineusing clients, except for declines in

SacramentoN and San DiegoM and

slight increases in Chicago,N

Cleveland,M Philadelphia,N

Minneapolis/St. Paul,M San

Francisco,M and Seattle.N

! Ease of purchase: With a 3.4 

average rating, methamphetamine

is not very difficult to purchase

overall.L,E (Exhibits 3 and 4) It is

most easily purchased in the West.

Elsewhere, it can also be purchased with little or no difficulty

in Dallas,L,E Detroit,L Minneapolis/

St. Paul,L and Pittsburgh.E

Since the last reporting period,

purchasing methamphetamine has

become easier in 10 cities in all

four regions: Atlanta,L,E Chicago,E

Detroit,L Miami,L,E New York,L

Pittsburgh,E Portland (OR),L San

FranciscoL

, Tampa/St. Petersburg,L

and Washington, DC.L Several

respondents elaborate on the 

supply increase in their cities:

! Atlanta: “The methamphetamine

supply might have increased

because the cocaine supply

(crack and powder) has declined.

It also might be related to the

increased Hispanic community in

Atlanta.”L “Availability fluctuates

rapidly.”E

! Miami: The law enforcement

source reports methamphetamine use has increased among a

small gay user group.

! New YorkL: A growing number of

meth labs and seizures are

reported, and the drug is increasingly involved in emergency

department episodes. But all

numbers are still low compared

with other drugs.

METHAMPHETAMINE
NATIONAL SNAPSHOT

page 12 Pulse Check: January 2004

! The different varieties: Locally

produced methamphetamine 

has become easier to purchase in

six cities: Atlanta,L,E Detroit,E

Pittsburgh,E Portland (OR),L San

Francisco,L and Tampa/St.

Petersburg.L

Mexican methamphetamine has

become easier to purchase in

Miami,L Portland (OR),L San

Francisco,L and Washington, DC.L

It has become more difficult to

purchase in Cleveland.L

The ease of purchasing ice, highly

pure smokable methamphetamine,

has increased in 11 Pulse Check

cities: Atlanta,L,E Dallas,L Houston,L

Miami,E Minneapolis/St. Paul,L

Pittsburgh,E Portland (OR),L St.

Louis,E San Francisco,L Seattle,L,E

and Washington, DC.L Conversely,

it has become more difficult to

purchase ice in ClevelandL and

New York.E

! User changes: At an adolescent

facility in Los Angeles, females

coming into treatment are nearly

all primary methamphetamine

users.E In Minneapolis/St. Paul,

high school counselors are reporting use by younger age groups.E In

Sacramento, the percentage of

young adults among methamphetamine users has increased, while the

percentage of older adults has

declined.E Some Hispanic adolescents in New York are snorting

methamphetamine (“bling bling”)

purchased from one young man

selling it in $20 packets, but those

reports are limited to one neighborhood.E

Hispanics have continued to

emerge as a user population in San

Diego since about 1995, when

they began producing and marketing methamphetamine. In addition

to the mainstream use in the West,

methamphetamine use is reported

in some gay communities in cities

Exhibit 7. What new problems have emerged or intensified during fall 2002?

Atlanta, GAE

Chicago, ILL,E,N

Dallas, TXE (substance 

misnamed “ice”)

Denver, COE

Detroit, MIE

Houston, TXL (ice)

Miami, FLL,E (ice)

New York, NYL

Pittsburgh, PAL

Sacramento, CAE (“yaba”)

San Francisco, CAL (ice)

Seattle, WAL,N (ice)

Tampa/St. Petersburg, FLL

Washington, DCL

Atlanta, GAL

Baltimore, MDL

Boston, MAL

Chicago, ILE,M

Cleveland, OHL

Dallas, TXL

Denver, COL,E

Los Angeles, CAL,E

Miami, FLN

Minneapolis/St. Paul, MNN

New York, NYM

Philadelphia, PAE,M

Pittsburgh, PAN

Phoenix, AZL

San Diego, CAE,N

Washington, DCE

Atlanta, GAM

Boston, MAL,N

Chicago, ILN

Cincinnati, OHN

Cleveland, OHM

Denver, COM

Houston, TXN

Miami, FLN

Philadelphia, PAE,M

Phoenix, AZM

Pittsburgh, PAE

Portland, ORL

San Diego, CAE

Seattle, WAE,M

Tampa/St. Petersburg, FLE

Chicago, ILN

Cincinnati, OHM

Detroit, MIE

Houston, TXN

Miami, FLE

Minneapolis/St. Paul,

MNM

Pittsburgh, PAE 

Portland, ORL (ODs) 

Tampa/St. Petersburg,

FLM

HoustonE (+ embalming

fluid)

Minneapolis/St. Paul,

MNM (+ embalming fluid)

Philadelphia, PAL,E

Phoenix, AZN

St. Louis, MOE

San Diego, CAN

Washington, DCL,E,M

Methamphetamine Ecstasy/Club Drugs Diverted OxyContin® Diverted methadone PCP 

Other Emerging Drug Problems None

Baltimore, MDM

Boston, MAM

Cincinnati, OHE,M

Dallas, TXN,M

Denver, CON

Detroit, MIL,N,M

Houston, TXM

Los Angeles, CAN,M

New York, NYN

Philadelphia, PAN

Pittsburgh, PAM

Phoenix, AZE

Portland, ORE,M

St. Louis, MOL,N,M 

Sacramento, CAL,N,M

San Diego, CAL,M

San Francisco, CAE,M

Washington, DCN

Alprazolam (Xanax®): Tampa/St. Petersburg, FLE

Carisoprodol (Soma®): San Diego, CAN

Codeine: Houston, TXE

Dextromethorphan products (“triple C”): Denver, COE;Houston, TXE;

Portland, ORL and Tampa/St. Petersburg, FLN,M

Hash: Houston, TXE

Heroin: Cleveland, OHM and Pittsburgh, PAL,E

Khat*: Minneapolis/St. Paul, MNL and St. Louis, MOL

Marijuana: Chicago, ILM and Washington, DCL

Narcotic analgesics: St. Louis, MOE

Prescription pills: Minneapolis/St. PaulE and New York, NYE

Sildenafil (Viagra®): Miami, FLE (+ methamphetamine) 

*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 substances chemically similar to d-amphetamine.

Sources: LLaw enforcement respondents; EEpidemiologic/ethnographic respondents; NNon-methadone treatment respondents; MMethadone treatment

respondents
NATIONAL SNAPSHOT

Pulse Check: January 2004 page 13

such as Boston,E Chicago,E Dallas,E

Miami,E and New York.E In Miami,

use is spreading from the gay and

“techno dance” scenes to females

and heterosexual males who use it

with ecstasy to enhance endurance,

resulting in a dramatic increase in

risky sexual behavior.E

! Local market changes: In Atlanta,

more methamphetamine is sold in

central city areas than previously.E

In St. Louis, production continues

to move from rural into central

city areas, and sellers and producers see the central city as an

“untapped market.”

Outside the central city areas of

Portland (OR), methamphetamine

has replaced cocaine in sales and

use, and between spring and fall

2002, the number of “superlabs”

increased.L

While Atlanta’s methamphetamine

market is controlled primarily by

Mexican nationals, the number of

independent sellers is increasing.E

! Purity and price (Exhibit 10e):

Purity ranges from 8–12 percent in

DenverE to 95 percent in Seattle,L

with most purity hovering around

30–40 percent in reporting Pulse

Check cities. Purity declined in

three western cities (Sacramento,L

San Diego,L and DenverE), increased

in Los Angeles,E and remained relatively stable elsewhere.

As in the last Pulse Check, methamphetamine gram prices are most

commonly reported at about $100,

but they range from $20–$60 in

Seattle to $330 in Chicago. Prices

are typically lower in the West than

in other U.S. regions.

Prices remained relatively stable

since spring 2002, except in the

West, where they declined in three

cities: Los Angeles,L,E Phoenix,L

and Sacramento.L In Atlanta, the

price of ice declined.

Diverted methadone is emerging as a

problem in nine cities, many in the

South and Midwest. (Exhibits 7 and

8) Some respondents elaborate:

! Methadone-induced deaths have

increased in Miami (first-half-2002

data), where an emerging group of

addicts abuse tablets believed to be

diverted from pain management

prescriptions—not the liquid that

is dispensed at methadone clinics.

These addicts are predominantly

White middle-socioeconomic

males, older than 35 years.E

! Methadone diverted from pain

management clinics is also an issue

in Tampa/St. Petersburg.M In the

methadone clinic with which the

Pulse Check source is affiliated,

methadone-positive intake drug

screens used to be very rare, but

they jumped to 26 percent positive

in the last quarter of 2002—in

keeping with the dramatic increase

in emergency department episodes

and deaths involving methadone.

Drugs have become widely available on the street since pain management clinics have been “opening right and left” because it is

such a profitable business.

Typically, someone with chronic

pain goes to a pain management

clinic, gets addicted, gets expelled

from the program, goes to a

methadone clinic where the addiction becomes fairly controlled, but

then goes to a different pain management clinic to get additional

drugs to “start a business.”M

! In Pittsburgh, diverted methadone

has become an increasing problem

over the past 5 years.E,M One

source rates the drug as “not at

all” difficult to purchase.E Forprofit methadone treatment centers have proliferated, but the

State has not established dosage

guidelines. Some of the methadone

is diverted by patients who do not

swallow their entire dose, and

then sell the rest. Others sell their

take-home medication. Heroin

addicts often buy diverted

methadone in order to detox themselves. OxyContin® addicts use

methadone to “control their fix”—

another reason for the growing

demand for diverted methadone.E,M

! Methadone diversion has

increased in Cincinnati, and now

methadone is readily available on

the street.M A for-profit methadone

Exhibit 8. Where is diverted methadone emerging as a problem? (Fall 2002)

DIVERTED METHADONE

Sources: LLaw enforcement respondents; EEpidemiologic/ethnographic respondents; NNon-methadone

treatment respondents; MMethadone treatment respondents

PittsburghE

CincinnatiM

ChicagoN

DetroitE

MiamiE

HoustonL,M,N

PortlandL

Tampa/St.

PetersburgM

Minneapolis/ St. PaulM
NATIONAL SNAPSHOT

page 14 Pulse Check: January 2004

clinic recently opened in nearby

Indiana, which has a less regulated

methadone take-home policy than

most States. Methadone-related

deaths have recently increased,

especially among younger users

(18–20 years old) who may not

understand the potency of the

methadone bought on the street.M

! In Dallas, methadone continues to

be diverted by people who are

“cheeking and selling it.”E While

this practice has not increased, an

increase is reported of people

dying after combining methadone

with alprazolam (Xanax®).

! Big picture: After increasing during

the previous reporting period,

diverted OxyContin® use and activity has declined in Washington, DC,

because of major law enforcement

action.E The diversion problem has

not reached some cities, such as San

Francisco.E However, the diverted

product continues to emerge or

intensify as a problem in 15 Pulse

Check cities. (Exhibit 7) Treatment

sources report slight increases in 14

cities: Baltimore,M Boston,N

Chicago,N Cincinnati,N Cleveland,M

Denver,M Detroit,N Houston,N,M New 

York,M Philadelphia,N Phoenix,M

Pittsburgh,N San Francisco,M and

Seattle.N,M

! Ease of purchase: Diverted

OxyContin® is moderately difficult

to purchase across the country (5.2

average rating).L,E Purchasing it is

particularly easy in Boston,L

Dallas,L New York,L Pittsburgh,E

San Francisco,L and Tampa/St.

Petersburg.L

Since the previous reporting period,

purchasing diverted OxyContin®

has become more difficult in several cities, such as the following:

! Baltimore:L It has become less

available because of increased

awareness of the problem by law

enforcement, the manufacturer,

the medical community, and

pharmacists. Many pharmacies

no longer carry it, and they post

notices to that effect. 

! Boston:

E The cost of the drug

increased, causing demand to

decline, causing supply to

decline.

! Cleveland:E Doctors and pharmacists have become more stringent with prescriptions, so less is

available on the street, and price

has increased.

! Miami:E With the recent crackdown, more people are aware of

the problem, and fewer doctors

are prescribing the drug. 

! Philadelphia:L Enforcement

action has made a difference,

with many large diversion cases.

! San Diego:L Increased focus by

law enforcement has made a difference. For example, a main

supplier in Tijuana was arrested.

! Washington, DC:E Following

major law enforcement activity,

availability has declined, especially around methadone clinics

where it used to be sold.

By contrast, respondents in several

cities believe it has become easier

to purchase diverted OxyContin®:

Cleveland,L New York,L Pittsburgh,E

Portland (OR),L St. Louis,L San

Francisco,L and Seattle.L

! User changes: One source in

Cincinnati believes that OxyContin® abuse has peaked in the

area and is either leveling off or

declining.M Another source in that

city adds that users have switched

to heroin because diverted

OxyContin® is becoming more

expensive and more difficult to

purchase, but they would prefer

OxyContin®.

E Similarly, in Miami,

as diverted OxyContin® declines in

availability, addicts are shifting to

other narcotics, such as diverted

methadone.E A substitution effect

is also noted in Boston: while

pharmacy robberies have declined,

users are switching to other oxycodone products (such as Percocet®), clonazepam (Klonopin®), or

heroin. An emerging group of

OxyContin® abusers is still reported in Boston, often including the

younger siblings of older addicts.E

More older adults in rural areas

surrounding Dallas are starting to

abuse the drug.E

Oxycodone is increasingly mentioned in emergency department

episodes in several cities, such as

St. Louis,E PhiladelphiaE (where it

also is involved in increased mortality), and Minneapolis/St. PaulE

(where it is also increasingly mentioned in mortality, poison control,

and law enforcement data).

! Price: Diverted OxyContin® is 

typically sold by the 20- or 

40-milligram tablet, with most

prices remaining at $1 per milligram. However, prices are as low

as $0.50 per milligram, as reported

in six Pulse Check cities (BostonE

,

Los Angeles,L Philadelphia,L

Phoenix,L Tampa/St. Petersburg,L

and Washington, DCE), and as 

high as $2 per milligram in two

cities (PhiladelphiaE and

Washington, DCL

).

Between spring and fall 2002,

diverted OxyContin® prices

remained relatively stable, except

in Washington, DC, where prices

declined.E

OTHER DIVERTED

SYNTHETIC OPIOIDS
NATIONAL SNAPSHOT

Pulse Check: January 2004 page 15

! Big picture: Ecstasy continues to

emerge or intensify as a problem in

16 cities. (Exhibit 7) Nonmethadone treatment sources

report some declines in ecstasy use

in Seattle and Washington, DC, but

numbers have increased slightly in

Chicago and Houston and more

sharply in Minneapolis/St. Paul. In

Washington, DC, after increasing

for the past few reporting periods,

ecstasy use and activity have leveled

off as the rave scene there has quieted down.E In some cities, such as

San Diego,E the number of ecstasy

users is still low, but the drug gets a

lot of media attention.

! Ease of purchase: Since the last

reporting period, purchasing ecstasy

has become more difficult in

Chicago,L where seizure activity has

declined compared to 1 year earlier,

and in Pittsburgh,L where law

enforcement recently broke up a

trafficking organization. By contrast, purchasing ecstasy has

become less difficult in 10 Pulse

Check cities: Atlanta,L,E Baltimore,L

Cleveland,L Minneapolis/St. Paul,L

New York,E Pittsburgh,E San Diego,L

San Francisco,L Seattle,L and

Washington, DC.L On average

across the country, ecstasy can be

purchased with about the same ease

as powder cocaine (2.2 average rating).L,E (Exhibits 3 and 4) 

! User changes: The age of ecstasy

users appears stable, with a few

exceptions. In Boston, the number

of users in private schools continues

to increase.E In the Houston nonmethadone program, ecstasy use is

starting at a younger age.N It is also

becoming common among a subculture of young gay adolescents in

that city.E In Tampa/St. Petersburg,

more younger users are reported

over the past 5 years.E But the

methadone source in that city

believes that people are outgrowing

the drug as they mature.M

! Local market changes: The ecstasy

market continues to expand beyond

the club scene. For example, in St.

Louis and Seattle, it is reported as

more mainstream and in the suburbs.L In Washington, DC,L open-air

markets and street sales of ecstasy

have emerged. In Atlanta, ecstasy

sales have emerged in the city proper.L And in Portland (OR),L the

number of raves has declined.

Ecstasy seller characteristics

remain relatively stable, with

changes in a few cities. Sellers in

Miami are becoming less open

than they were in the past, “learning how to avoid law enforcement.”L Sales have increased in the

Black community in Washington,

DC.L Asian gangs new to Los

Angeles are rapidly taking over the

ecstasy market.E While Atlanta’s

ecstasy market is generally controlled by overseas groups, the

number of local independent sellers is increasing.E

! Price (Exhibit 10f): One tablet of

ecstasy is the most common unit

sold, and prices range from

$7.50–$15 in Dallas to $25–$40 in

Chicago. A New York respondent

reports lower prices for ecstasy sold

on streets rather than in nightclubs,

and several sources report much

lower prices for large-quantity purchases (1,000 pills, “boats,” are the

wholesale unit sold in many Pulse

Check cities).

Prices remained relatively stable

between spring and fall 2002, with

two sources in the Northeast

reporting price increases, possibly

due to decreased supply, and one

source (in Atlanta) reporting price

drops. In most Pulse Check cities,

prices have declined over the past

several years.

Although respondents do not

report ecstasy purity, several

describe increased adulterants, such

as methamphetamine (in Atlanta,E

Phoenix,E and San DiegoL), heroin

(in PhoenixE

), caffeine (in San

DiegoL

), and ketamine, gamma

hydroxybutyrate (GHB), and dextromethorphan (in Atlanta). Sources

report a wide variety of drugs sold

as ecstasy and a decline in the

amount of ecstasy found in tablets

in two Midwest cities (Detroit and

Minneapolis/St. Paul).

! PCP is emerging or reemerging as

a problem in seven Pulse Check

cities (Exhibit 9): Houston,E

Minneapolis/St. Paul,M Phoenix,E,N

Philadelphia,L St. Louis,E San

Diego,N and Washington, DC.E,M

! In Philadelphia, emergency department episodes involving PCP have

increased, particularly for individuals in their late teens.E

! In St. Louis, it is used by an

emerging group of young Black

users, particularly females.E

! PCP is sometimes sold as a liquid

in vials. Often, cigarettes or marijuana blunts are dipped in PCP

and then sold. And sometimes, as

in Houston and Minneapolis/St.

Paul, it is combined with embalming fluid and/or marijuana.

! Law enforcement personnel in

Washington, DC, are concerned

about PCP’s reemergence. Arrests

have increased.E

! Gamma hydroxybutyrate (GHB):

GHB has declined in availability in

Detroit,E Miami,E and St. Louis.L In

Dallas, adolescents are increasingly

using it, instead of flunitrazepam

(Rohypnol), for drug-assisted

ECSTASY

PCP

OTHER DRUGS
NATIONAL SNAPSHOT

page 16 Pulse Check: January 2004

rape.E It is involved in some deaths

and drug-assisted rape incidents in

San Diego, but use appears stable

because word has gotten out about

its volatility and lethal potential.E

! Ketamine (“special K”): Ketamine

availability has declined in San

Diego since the arrest of a main

supplier in Mexico (80 percent of

the ketamine in the United States

comes from Mexico via San

Diego).L The drug is well known,

but not pervasive, among youth in

Baltimore.L

! Over-the-counter dextromethorphan products: Adolescents in

many Pulse Check cities are

increasingly abusing cold medications containing dextromethorphan (often found in Coricidin®

products, commonly referred to as

“triple C”). Taken in large quantities, dextromethorphan can produce effects similar to those of

ecstasy. It is sometimes combined

with alcohol or other drugs. In

Tampa/St. Petersburg, incidents are

reported of adolescents taking 20

to 43 tablets at a time, sometimes

in combination with another overthe-counter medication, dimenhydrinate (Dramamine®). Overdoses

and thefts from groceries and

pharmacies are increasingly reported in that city.N,M Similarly, in

Portland (OR), the product has

been involved in overdoses among

youth (12–17 years old) who are

consuming it in large quantities.L

In Houston, where adolescents use

the product with alcohol, enhancing its effect, “it’s easy to get, not

controlled, and relatively cheap.”E

Dextromethorphan abuse is also

increasing in Denver, where it is

called “DXM” and is used as a

club drug. Abuse of the product is

also reported in Detroit.E

! Alprazolam (Xanax®): Sources in

two Florida cities (Miami and

Tampa/St. Petersburg) report

increasing abuse of the drug.

Additionally, the practice of using

the drug in combination with prescription opiates or ecstasy has

increased in Miami.E

! Abused sildenafil (Viagra®): In

some cities, such as MiamiE and

Pittsburgh,E ecstasy and sildenafil

are often combined. This combination is associated with high-risk

sexual activity. In Miami, sildenafil

is also increasingly used in combination with marijuana and

methamphetamine. The increase in

new abusers is particularly marked

among adolescent males.E

! Hashish: The drug is reemerging

in Houston, where the same people who used it 10 years ago now

take it as “dessert” after marijuana

to “kick it up a notch.” The

increase coincides with increased

availability since the Taliban (who

had suppressed hashish production

and export) were ousted from

Afghanistan.E

! Khat: Khat is an emerging drug

among Minneapolis/St. Paul’s

Somalian community, which is the

largest in the country.L This natural

stimulant, which loses potency in

48 hours, has leaves that contain

psychoactive ingredients structurally and chemically similar to damphetamine. It is overnightmailed or shipped in luggage on

airplanes from Kenya.E The drug

has also increasingly appeared on

the St. Louis drug market, with

three seizures by law enforcement

during fall 2002. It is being transported via overnight mail services,

a method that city’s law enforcement has not seen before.L

Exhibit 9. Where is PCP emerging as a problem? (Fall 2002)

Sources: LLaw enforcement respondents; EEpidemiologic/ethnographic respondents; NNon-methadone

treatment respondents; MMethadone treatment respondents

Washington, DCL,E,M

PhiladelphiaL,E

St. LouisE

PhoenixN,E

HoustonE,N

San

DiegoN

Minneapolis/St. PaulM
NATIONAL SNAPSHOT

Pulse Check: January 2004 page 17

Exhibit 10a. What are the prices and purity levels of different types of heroin in Pulse Check cities? (Fall 2002)

Most common Street Unit 1 Gram 

City/Source Unit Price Purity Price

Dallas, TXL 1 oz $800–$2,000 5–6% $150–$250

Denver, COL One balloon (0.1 g) $20 NR $100

Denver, COE 1 oz $1,500–$3,000 8–64% $100–$150

Houston, TXL 1 oz $1,000–$2,500 13–58% $100–$150 

Los Angeles, CAL One balloon (0.1 g) $20 NR NR

Los Angeles, CAE 1 oz (“pedazo”) $700–$800 NR NR

Minneapolis/St. Paul, MNL NR NR NR $300–$400

Phoenix, AZL One twenty (100–200 mg) $20 NR $100–$200

Sacramento, CAL 0.25 oz $20–$40 16–18% NR

1 oz $500–$800 

San Diego, CAL,E One ten (0.1 g) $10 14–70% $50–$100

One forty (0.4 g) $40

1 oz $600–$1,200

San Francisco, CAE One bag (0.25 g) $10–$20 NR NR

San Francisco, CAL One balloon, one bag (0.1–0.25 g) $10 17% $60

Seattle, WAL 0.1 g $90–$120 14–58% NR

1 oz $600–$300 

Atlanta, GAL One hit $30 NR $300

Atlanta, GAE 20-bag (2–3 g) $20 >50% NR

Boston, MAL One bundle (0.1 g) $4–$6 >80% NR

Boston, MAE 0.5 g $50–$75 NR $80–$150

Chicago, ILL One hit (0.2 g) $20 NR $150

Cleveland, OHL One bag (bindle) $20 NR NR

Cleveland, OHE Dime bag (0.1 g) $10–$20 NR NR

Miami, FLL 1 oz $2,100 NR NR

New York, NYL One bag $10–$14 NR $60–$80

New York, NYE One packet (0.1 g) $10 >60% NR

Philadelphia, PAE One hit $10 NR $20–$100 (bundle)

Philadelphia, PAL One bag (<1 g) $10–$20 40–95% $67–$300

10 bags (one bundle) $70–$200

Pittsburgh, PAL One bundle (10 bags) $180–$200 60–90% $300–$600

Washington, DCE Bags (of “scrambled,” adulterated) $8, $10, $12 23% $120–$150

Washington, DCL Dime bag (50–75 mg) $10 10–15% NR

Chicago, ILE (white powder with 

unknown source) Dime bag $10 NR $50–$300 

Cleveland, OHE Dime bag (0.1 g) $10–$20 NR NR 

Baltimore, MDL,E 10-bag, one capsule $10 NR NR 

Detroit, MIE One hit $10–$12 NR NR 

One bundle (10 hits) $100–$200 NR NR 

Detroit, MIL Dime bag (0.1 g) $10 NR $100–$150 

Los Angeles, CAE NR NR NR 100–$150 

Minneapolis/St. Paul, MNE One bindle $10–$50 NR $300–$400L

New York, NYE One packet (0.1 g) $10 NR NR 

Philadelphia, PAE One hit $10 NR NR 

San Francisco, CAL One bag (0.01–0.25 g) $10 17% $60 

St. Louis, MOL NR NR NR $100 

St. Louis, MOE NR NR NR $250–$600

Tampa/St. Petersburg, FLL 0.25 g $20 NR $80 

Sources: LLaw enforcement respondents; EEpidemiologic/ethnographic respondents

Mexican black tar or brown South American (Colombian) white Unspecified Type
NATIONAL SNAPSHOT

page 18 Pulse Check: January 2004

Exhibit 10b. How much does one rock of crack cocaine cost in Pulse Check cities? (Fall 2002)

City/Source Unit (slang term) Price

Boston, MAL One jum (0.1 g) $10

Boston, MAE One jum (approximately four hits) $20–$40

New York, NYL,E One vial, one bag $10–$20

Philadelphia, PAL,E One vial, one rock (0.5–0.1 g) $3–$10

Pittsburgh, PAL,E One rock $5, $10, $20

Atlanta, GAL One rock $10, $20

Atlanta, GAE One rock $5

Baltimore, MDL,E One rock, one vial $10

Dallas, TXL One rock $10–$40

Miami, FLL One rock $10–$20

Tampa/St Petersburg, FLL One rock (0.1–0.2 g) $20

Washington, DCL,E Dime bag (75 mg), one rock $10

Chicago, ILL One rock (0.2 g) $20–$25

Chicago, ILE One rock $5–$20

Cleveland, OHL One rock $20

Cleveland, OHE One rock $10

Detroit, MIL One rock (0.1 g) $10

Detroit, MIE One rock $5–$25

Minneapolis/St. Paul, MNL,E One rock $20

St. Louis, MOL,E One rock $20

Denver, COL One rock $20

Los Angeles, CAL,E One rock (0.2 g) $10–$20

Phoenix, AZL 200–300 mg ("twenty") $20

Sacramento, CAL One rock (0.2 g) $20

San Diego, CAL,E 0.1 g ("tens") $10

San Francisco, CAL One rock (0.1 g) $6–$10

San Francisco, CAE One rock $2–$20

Seattle, WAL 1 g $100

Sources: LLaw enforcement respondents; EEpidemiologic/ethnographic respondents

Exhibit 10c. How pure is powder cocaine, and how much does it cost? (Fall 2002)

City/Source Purity Gram Price Ounce Price

Boston, MAL NR $50–$60 NR

New York, NYL NR 25–$35 $600–$1,000

Philadelphia, PAL 40–95% $100–$125 $800–$1,300

Pittsburgh, PAL 50–70% $75–$100 NR

Baltimore, MDL NR $90–$100 NR

Dallas, TXL NR $50–$100 NR

Houston, TXL NR $60–$100 $400–$650

Miami, FLL NR NR $650

Tampa/St. Petersburg, FLL NR $50 $700–$850

Washington, DCL,E 30–60% $50–$100 NR

Chicago, ILL NR $125 NR

Chicago, ILE NR $50–$150 NR

Detroit, MIL,E NR $75–$150 NR

Minneapolis/St. Paul, MNE NR $100 NR

St. Louis, MOL,E 77% $100–$125 NR

Denver, COL NR $100 NR

Denver, COE 30–90% (g); 65-85% (oz) $100–$125 $500–$900

Los Angeles, CAL 80% $100 NR

Sacramento, CAL 78% $80 $500–$600

San Diego, CAL,E 54–90%L

; 68–72%E $40–$80 $300

San Francisco, CAL 64% $100 $400–$600

Seattle, WAL 57–68% $80–$100 $45–$700 

Sources: LLaw enforcement respondents; EEpidemiologic/ethnographic respondents

Northeast South West Midwest

Northeast South West Midwest
NATIONAL SNAPSHOT

Pulse Check: January 2004 page 19

Exhibit 10d. How much does marijuana cost? (Fall 2002)

City/Source Type Price/Unit Ounce price

Boston, MAL NR NR $325 

Boston, MAE NR $20/0.125-oz bag NR 

New York, NYL,E Commercial $5/bag $100–$200

$1,000–$2,000/lb 

Hydroponic $20/bag $300–$1,200 

$3,000–$5,000/lb 

Philadelphia, PAL Commercial NR $150–$200 

Philadelphia, PAE NR $5/bag NR 

Pittsburgh, PAL NR NR $90–$150 

Atlanta, GAL Sinsemilla $10/bag NR 

Atlanta, GAE Commercial $10/dime bag (2–3 g) $120 

Baltimore, MDL NR $1–$3/joint $100

$10–$12/blunt 

Dallas, TXL Mexican commercial $2/joint NR 

Houston, TXL Mexican commercial $5/g NR 

$300–$500/lb 

Sinsemilla $600/lb NR 

Tampa/St. PetersburgL NR $40/0.25 oz $1,100–$1,200 

Washington, DCL NR $20/bag (750 mg) NR

Washington, DCE Commercial $5–$10/bag (a few joints) $100

$10–$20/blunt 

Hydroponic NR $480 

Chicago, ILE NR $5–$10/bag $80–$200 

Cleveland, OHL NR NR $200 (about 10–12 blunts) 

Cleveland, OHE NR $5–$10/blunt $100 

Detroit, MIL NR $10/bag (1 g) NR 

Detroit, MIE NR $50–$200/0.25 oz NR 

Minneapolis/St. Paul, MNL Commercial $700/lb NR 

BC bud $7,000–$12,000/lb NR 

Minneapolis/St. Paul, MNE NR $5/joint NR 

St. Louis, MOL NR $1,000–$1,100/lb $100 

Denver, COL NR NR $100–$200 

Denver, COE Mexican and local commercial NR $200–$300 

Los Angeles, CAL Commercial $10/dime bag (1 g) NR 

Phoenix, AZL Commercial $20/dime bag (6–7 g) $60–$80 

Sacramento, CAL Commercial $25/g $200–$250 

San Diego, CAL Mexican commercial $5/nickel bag (0.5–1 g) $600–$1,000 

Sinsemilla $150/0.25 oz $450

$300/0.5 oz 

San Diego, CAE Commercial NR $60–$100 

BC bud $3,000–$5,000/lb NR 

Seattle, WAL Mexican commercial $500–$700/lb NR 

BC bud $2,800–$4,000/lb NR 

Sources: LLaw enforcement respondents; EEpidemiologic/ethnographic respondents

Northeast South West Midwest
NATIONAL SNAPSHOT

page 20 Pulse Check: January 2004

Exhibit 10f. How much does a pill

(one dose) of ecstasy cost? (Fall

2002)

City/Source Price per pill

Boston, MAL,E $20–$25

New York, NYL $20–$28

New York, NYE $12–$25 (street)

$25–$35 (clubs)

Philadelphia, PAL,E $15–$30

Pittsburgh, PAL $15–$30

Atlanta, GAE $15–$20

Baltimore, MDL $18–$20

Dallas, TXL $7.50–$15

Houston, TXL $20–$30

Miami, FLL $11–$18

Tampa/

St. Petersburg, FLL $12–$15

Washington, DCL,E $18–$35

Chicago, ILL,E $25–$40

Cleveland, OHL,E $8–$20

Detroit, MIL,E $20–$40

Minneapolis/

St. Paul, MNL,E $20

St. Louis, MO $20–$30

Denver, COL,E $15–$25

Los Angeles, CAL $20–$40

Phoenix, AZL $20–$30

Sacramento, CAL $20

San Diego, CAL,E $15–$25

San Francisco, CA" $10–$20

Seattle, WAL $10–$20

Sources: LLaw enforcement respondents; E

Epidemiologic/ethnographic respondents

Northeast South West Midwest

Northeast South West Midwest

Exhibit 10e. How much does methamphetamine cost?

(Fall 2002)

City/Source Gram Price Price/Unit

Boston, MAL $100 NR

New York, NYL $100–$300 $10–$20/pill

$1,600–$6,000/oz

Philadelphia, PAL $100 NR

Pittsburgh, PAL $100–$200 $45/0.25 g

Atlanta, GAL NR $10, $20/hit

Dallas, TXL $70–$100 NR

Houston, TXL NR $500–$800/oz

$6,000–$11,000/lb

$18,000–$20,000/kg

Washington, DCL $140 NR

Chicago, ILL $330 NR

Cleveland, OHL $75 NR

Minneapolis/St. Paul, MNL,E $100 $1,000/oz

St. Louis, MOL $100 NR

St. Louis, MOE NR $700–$1,300/oz

Denver, COL,E $80–$110 $700–$1,000/oz

Los Angeles, CAL NR $125/1

/16 oz

Los Angeles, CAE NR $450–$550/oz

Phoenix, AZL NR $80–$110/1

/16 oz (“teener”)

$120–$180/1

/8 oz

Sacramento, CAL $80 $300–$600/oz

San Diego, CAL $50–$75 $20/0.25 g

$500/oz

San Diego, CAE $40–$100 $3,500–$5,500/lb

San Francisco, CAL $130 $170/1

/16 oz

$300/1

/8 oz

Seattle, WAL $20–$60 $350–$650/oz

Sources: LLaw enforcement respondents; EEpidemiologic/ethnographic respondents
LOCAL DRUG MARKETS: A DECADE OF CHANGE

Pulse Check: January 2004 page 21

LOCAL DRUG MARKETS: A DECADE OF CHANGE

SPECIAL TOPIC
page 22 Pulse Check: January 2004

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LOCAL DRUG MARKETS: A DECADE OF CHANGE

Pulse Check: January 2004 page 23

The last issue of Pulse Check examined local drug markets which, like

any economic markets, are subject to

a wide variety of influences. The current issue expands upon that topic

by exploring other aspects of the

current markets and comparing them

with the markets of 10 years ago.

As key informants and opinion leaders in their communities, Pulse

Check sources are well positioned to

describe past and present drug markets, pinpoint their vulnerabilities,

and comment on tactics that have or

have not disrupted them. Therefore,

during our two waves of telephone

discussions, conducted December

2002 through January 2003 and

March through May 2003, we

asked these individuals to discuss a

series of market-related topics relevant to their specific areas of

expertise.

All 97 respondents were asked to

discuss the degree to which streetlevel drug transactions involve cash

versus the exchange of specific goods

and services. They were also asked to

discuss any changes in such transactions over the past 10 years.

The law enforcement and epidemiologic/ethnographic respondents were

also asked to discuss and rate the

following: 

! Various illicit marketing tactics

used by dealers, and to what

degree they have complicated

efforts to detect or disrupt drug

activity over the past 10 years

! Community strategies used to

address the increased complexities

of drug markets, and their success

in doing so

! Additional community measures

being planned for the future and

any recommendations

LOCAL DRUG MARKETS: A DECADE OF CHANGE

! The extent to which various items

have contributed to the widespread availability and use of marijuana over the past 10 years

Non-methadone and methadone

treatment sources, similarly, were

asked to discuss and rate the 

following:

! Changes in local drug markets

and in the nature of drug users

over the past 10 years, and the

impact of those changes on the

drug abuse problem

! Problems that have complicated

the treatment of marijuana-using

clients, particularly youth

Finally, as a followup to the last two

Pulse Check issues, all 97 respondents

discussed any continuing effects of

the September 11 attacks and their

aftermath on their communities’

drug abuse problem.

Highlights from these discussions

include the following:

In exchange for drugs...

! Cash, by far, is the most common

currency exchanged for drugs, 

followed by sex and shoplifted

merchandise.

! The exchange of drugs for food

stamps has declined in several

cities over the past decade

because of the use of innovative

technologies—such as debit

cards, vouchers, or electronic

transfers—aimed at preventing

abuse and diversion.

! In order to obtain marijuana,

youth are increasingly engaging in

risky or criminal activities, such as

trading sex, guns, or shoplifted

merchandise.

Illicit marketing strategies

! Detection and disruption efforts

have not been hampered much by

dealers using unique packaging or

by their increased or decreased

use of brand names.

! Sources are divided in their views

about relocation of drug markets

within communities: many believe

it poses a challenge to detection

and disruption efforts, many

believe it has no effect, and many

even view it as a positive outcome

of disruption efforts.

! Throwaway cell phones and other

developments in digital communications technology, by far, have

posed the greatest challenge to

market detection and disruption

efforts. Some sources believe that

phone companies are offering

new technologies to the public

before offering counter-technologies to law enforcement.

Fighting back: Community tactics

! Task forces of varying composition and focus have been used

effectively over the past decade in

all 25 Pulse Check cities.

! The majority of Pulse Check sites

have some sort of drug court program, and sources in those areas

generally consider them highly

effective.

! Precursor laws are rated as moderately successful in cities where

they are enacted.

! Efforts to monitor prescription

drug diversion have met with great

to moderate success in many cities.

! Overall, drug-free zone laws are

considered moderately effective,

but opinions vary widely.
LOCAL DRUG MARKETS: A DECADE OF CHANGE

page 24 Pulse Check: January 2004

! About half of the Pulse Check sites

have provided law enforcement

personnel with drug user recognition education (DRE), and those

programs have proven generally

effective.

The nature of drug users:

Complicating changes

! Drug abuse problems over the past

decade have been particularly

complicated by the lack of housing

opportunities for recovering treatment clients.

! Other frequently mentioned 

complications to disrupting 

illegal drug markets include a

lack of jobs and job training

opportunities for recovering

clients and an increasing availability of new and substitute

drugs.

Continued widespread marijuana

availability and use: Contributing

changes

! The decline in social disapproval

of marijuana (by peers, parents,

etc.) has had an impact on its

widespread use and availability

over the past 10 years.

! The decline in users’ perception of

marijuana’s harmfulness is viewed

as exacerbating the marijuana

problem.

! Law enforcement sources consider

the promotion of marijuana as

“medicine” as a more significant

problem than do their epidemiologic/ethnographic counterparts.

! Because marijuana prices have

remained generally stable over the

past 10 years, sources do not attribute increased use to price declines.

Treatment for marijuana users: The

past 10 years

! Challenges involved in treating

marijuana-using clients over the

past 10 years have increased and

include earlier initiation of marijuana use, increased marijuana

potency, and a decline in users’

perception of harm.

! The news media and increased

court referrals appear to have had

little complicating effect on marijuana users in treatment.

September 11 followup

! More than 60 percent of respondents believe that the September

11 attacks have had no continuing

effects on the drug abuse situation.

! The most commonly mentioned

post-September 11 effects include

the following: supplies of some

drugs have declined in some cities;

some trafficking routes have shifted away from the East Coast;

vehicular and other means of transport have sometimes replaced air

shipment; many sources perceive a

shift in law enforcement priorities

from drugs to homeland security;

and some drug users in treatment

continue to experience elevated

levels of mental health disorders.

The remainder of this chapter elaborates on these highlights.
LOCAL DRUG MARKETS: A DECADE OF CHANGE

Pulse Check: January 2004 page 25

Beyond cash: What else is accepted in exchange for drugs?

Heroin

67%

10%

7%

7%

74 respondents 68 respondents

62 respondents 67 respondents

48 respondents

5%

6%

2%

4%

12%

5%

6%

4%

3%

8%

6%

2%

2%

4%

4%

2%

8%

6%

3%

4%

4%

2%

3%

2%

2%

2%

5%

Based on their knowledgeable

sense of the street scene, all

sources were asked to

“guesstimate” what percentage of their communities’

street-level transactions

involves cash and what percentage involves exchanging other

specific goods or services.

About three-quarters of the

sources (74 of 97) responded

to this question. 

Their combined estimates

yield several overall findings

for drugs in general:

! The majority of drug transactions are “cash only,” 

particularly in the case of

marijuana.

! Sex is commonly exchanged

for drugs, particularly crack

(an estimated 12 percent of

transactions), powder

cocaine (nearly 8 percent),

and methamphetamine

(more than 6 percent).

! Shoplifted merchandise is

the next most commonly

exchanged item, particularly

for heroin (nearly 7 percent

of transactions) and crack

(nearly 6 percent).

Source: Mean of estimated percentages given by law enforcement, epidemiologic/ethnographic, non-methadone treatment, and methadone treatment

respondents

* “Other” includes items accounting for 2 percent or less of transactions for all five drugs, such as guns, other drugs, drug transport, drug theft, food stamps,

injecting services, and lookout services. It also includes items specifically added by some respondents, such as pawning (Dallas), dealing (Boston, Houston),

panhandling (San Francisco), bad checks (San Francisco), trading one’s children (Cleveland), shoplifted merchandise converted to cash (Minneapolis/St.

Paul), stolen precursor chemicals (Dallas, Minneapolis/St. Paul), methamphetamine manufacture (Dallas; Portland, OR), and mail theft (Seattle).

Crack cocaine

Powder cocaine Marijuana

Methamphetamine

63%

75% 85%

74%

Cash

Shoplifted merchandise

Property/merchandise

Drug buying services

Lookout services

Other*

Sex
LOCAL DRUG MARKETS: A DECADE OF CHANGE

page 26 Pulse Check: January 2004

HEROIN sales involve the exchange of

a range of goods and services in addition to cash:

! Cash: Nearly all heroin transactions in Washington, DC, are cash

only. Other particularly high

“cash-only cities” (average estimates of 80 percent and higher)

are Atlanta, Cincinnati, Denver,

New York, and San Diego.

! Shoplifted merchandise: More

than one-fifth of heroin transactions in San Francisco involve

shoplifted merchandise, in the

combined opinions of that city’s

four Pulse Check sources. Such

transactions are also common

(estimates of 10–22 percent) in

Atlanta, Boston, Phoenix, St.

Louis, and Seattle.

! Sex: Sex-for-heroin appears to be

most common (10–13 percent of

transactions) in Cincinnati,

Houston, Phoenix, and Portland

(OR).

! Injecting services: Sometimes

addicts need help in injecting, so

they offer heroin to other addicts

in exchange for that service. Such

is the case in Houston, where

respondents estimate more than 18

percent of heroin is obtained in

that manner.

! Drug buying services: In Boston

and Seattle, users commonly go

out to buy heroin for other users,

then keep a portion of the drug

for themselves (estimates of 14

percent and 10 percent, respectively, of transactions).

! Other drugs: In Cincinnati, other

drugs are traded for heroin in an

estimated 10 percent of transactions.

! Other: One source in DallasN

believes that 50 percent of heroin

transactions involve pawning merchandise to obtain drugs or cash

for drugs.

CRACK is more likely than the other

drugs to be traded for items other

than cash:

! Cash: Cities with particularly high

estimated percentages of “cashonly” transactions (80 percent and

higher) are Denver, Los Angeles,

Portland, San Diego, and

Washington, DC. By contrast,

items other than cash are traded

for crack more than half the time

in Boston, Dallas, Houston,

Phoenix, San Francisco, and

Seattle.

! Sex: Respondents in 15 of the 

25 Pulse Check sites estimate particularly high average percentages

(10–40 percent) of crack transactions involving sex: Atlanta,

Baltimore, Boston, Cincinnati,

Dallas, Detroit, Houston, Miami,

Minneapolis/St. Paul, New York,

Phoenix, Pittsburgh, St. Louis, San

Francisco, and Seattle.

! Shoplifted merchandise:

Substantial proportions of crack

transactions involve shoplifted

merchandise (estimates of 10–17

percent) in Boston, Dallas,

Houston, St. Louis, and Seattle.

! Other stolen merchandise: More

valuable stolen merchandise, such

as electronic equipment, is commonly exchanged for crack (estimates of 10–13 percent) in New

York, Phoenix, and Seattle.

! Property or merchandise:

Respondents in Phoenix and St.

Louis estimate particularly high

percentages (13 percent and 10

percent, respectively) of crack

transactions involve these items.

! Drug buying services: As in the

case of heroin, drug buying services

in exchange for crack are fairly

common in Boston and Seattle 

(estimates of 25 percent and 10 percent of transactions, respectively).

! Other: In Seattle, fairly large 

proportions of crack transactions

involve food stamps, drug transport services, and theft of the drug

from dealers or other users

(approximately 10 percent each).

POWDER COCAINE transactions are

more diverse than those for other

drugs: a wide range of goods and

services—such as drug transport, food

stamps, and guns, to name just a

few—account for small portions of

transactions (average estimates of

1–10 percent per item). Only the

most frequently traded items are

described below:

! Cash: Sources in nearly half (12 of

25) of the Pulse Check sites believe

that the vast majority (80 percent)

of powder cocaine transactions are

cash only. 

! Sex: One source in HoustonE

believes that as much as 80 percent of the powder cocaine in the

area is traded for sex. The practice

is also fairly common in Philadelphia, Phoenix, and Seattle (average

estimates of 10–13 percent of

transactions). 

! Property or merchandise: These

items are often traded for powder

cocaine (10–14 percent of transactions) in Dallas, Phoenix, and

Portland (OR). At the wholesale

level, vehicles are often traded for

drugs in Houston: for example, a

used car might be traded for a

kilogram of cocaine.

! Guns: In Houston,L at the wholesale level, a Drug Enforcement

Administration (DEA)/Federal

Bureau of Investigation (FBI) gunsfor-cocaine investigation in fall

2002 yielded $25 million of military-grade weapons and many

arrests of right-wing Colombian

paramilitaries.
LOCAL DRUG MARKETS: A DECADE OF CHANGE

Pulse Check: January 2004 page 27

! Other (estimates of 10 percent of

transactions): Other commodities

sometimes exchanged for powder

cocaine include shoplifted merchandise in Atlanta and Boston,

other stolen merchandise in

Phoenix, and other drugs in

Cincinnati.

MARIJUANA, compared with other

drugs, is less likely to be traded for

items other than cash: 

! Cash: Sources believe that cash is

the only commodity accepted for

marijuana in Boston, Cincinnati,

Denver, and Seattle; and nearly all

marijuana transactions (an estimated 95–99 percent of transactions)

involve cash in Detroit, Portland,

and Washington, DC. Cash transactions for marijuana are least

common in Phoenix. Nevertheless,

cash still accounts for an estimated

65 percent of marijuana transactions in that city.

! Gifts: One source in Seattle

believes that half of the youth who

use marijuana pay for it in cash,

while the other half get it as a

“gift” to get them hooked on it.

! Other: Throughout the 25 Pulse

Check sites, only three items are

reported as traded for marijuana

to any substantial degree (10 percent estimates for each): property

or merchandise in Cleveland,

other drugs in Sacramento, and

food stamps in Chicago.

METHAMPHETAMINE transactions

sometimes involve more unusual

items:

! Cash: All methamphetamine transactions in Chicago involve cash, as

do nearly all in Detroit and

Washington, DC.

! Sex: One source in Houston

believes that 50 percent of that

city’s methamphetamine is sold for

cash, and the other 50 percent is

traded for sex. In Miami, nearly

13 percent of methamphetamine

transactions are believed to involve

sex. The drug is fairly new to that

area, so it is often introduced into

sexual situations, like parties. The

epidemiologic source there expects

that practice to decline.

! Methamphetamine manufacture:

Unlike most other illicit drugs,

methamphetamine can be manufactured by the user, which is 

common in Dallas and Portland

(OR).

! Stolen precursor chemicals: These

items are frequently traded for

methamphetamine in Dallas.

! Gifts: Since methamphetamine is

often used in a group setting in

San Francisco, it is frequently

given away in clubs by friends and

acquaintances.

! Other: Property or merchandise is

frequently traded for methamphetamine in Phoenix, Sacramento,

and Seattle. Shoplifted merchandise is commonly traded in San

Francisco and Seattle.

BEYOND CASH: WHAT HAS CHANGED OVER THE PAST 10 YEARS?

Sources were also asked whether any

of these specific types of transactions

have changed over the past 10 years.

Their responses yield a few recurring

themes:

! Cash: Cash-only transactions have

increased in some cities, such as

Chicago and New York; conversely, they have declined in Boston.

! Sex: The practice of exchanging

sex for drugs has increased in

Atlanta, Detroit (heroin),

Minneapolis/St. Paul (marijuana,

heroin), Phoenix, Portland (OR)

(heroin), and St. Louis (crack or

methamphetamine). It has declined

in Houston (crack), Philadelphia

(crack), Sacramento, and San

Francisco (crack).

! Food stamps: The use of innovative technologies in lieu of paper,

such as debit cards, vouchers, or

electronic transfers, has disrupted

food stamps-for-drugs trading in

several cities, including Atlanta,

Denver, Detroit, Houston,

Philadelphia, and Pittsburgh.

! Marijuana-youth issues: In order

to obtain marijuana, youth are

increasingly engaging in risky or

criminal activities, such as trading

sex or shoplifted merchandise in

Minneapolis/St. Paul and trading

guns in Dallas. 

These changes, as well as others that

are more site specific, are described in

the narrative surrounding the map on

the next page.
LOCAL DRUG MARKETS: A DECADE OF CHANGE

page 28 Pulse Check: January 2004

BEYOND CASH: WHAT HAS CHANGED

SEATTLE

No changes are reported over the

years.N

PORTLAND, OR

Female addicts are using less cash,

less property, and more sex in

exchange for heroin. The number of

portable meth labs has greatly

increased.E

SACRAMENTO

Sex for drugs has declined due to

fear of human immunodeficiency

virus (HIV)/acquired immunodeficiency syndrome (AIDS) and hepatitis C. The exchange of shoplifted

merchandise for drugs has declined

because retail store exchange policies

have made it harder to “return”

shoplifted items for cash.N

SAN FRANCISCO

Sex for crack has declined slightly.E

LOS ANGELES

Little has changed over the past 10

years. “Cash is still king.”E

SAN DIEGO

Methamphetamine manufacturing

has declined because task force 

activities have reduced the size and

number of labs, pushing them into

neighboring areas.N

PHOENIX

Phoenix’s high auto theft rate is

probably due to the increase in

methamphetamine users who need

the money.E Sex for drugs is no

longer limited to female users only:

males are now just as likely to resort

to it.M Cash exchanges have declined,

while increases are noted in transactions involving home robberies, identity theft, fraudulent documents, and

chemicals for manufacturing.N

MINNEAPOLIS/ST. PAUL

Young people are increasingly shoplifting in order to trade merchandise,

such as CDs, for marijuana.E Sex for

marijuana is a new phenomenon.

Drug theft (“ripping off dealers or

friends”) has increased.N Trading

stolen precursors for methamphetamine is a relatively new phenomenon.E

Sex for heroin has increased. Opium

users in the Hmong community

increasingly use welfare checks to

support their $250-per-month

habits.M At higher levels, suppliers

increasingly “front” kilos of drugs to

dealers, allowing them to pay after

selling the drugs.

DENVER

Trading of food stamps has declined

since the use of debit cards has been 

instituted.M

DALLAS

Youth are increasingly trading guns

for marijuana. Many purchase these

guns at a large annual gun show.E

Distribution of free drugs has

increased—a practice aimed at gaining and maintaining market share.N

Middleman involvement in transactions also has increased: “You gotta

know somebody who knows somebody.”N Methamphetamine users have

become increasingly involved in the

manufacturing process.N

HOUSTON

As dealers have become more aware

of HIV risks, they have allowed

fewer “rock stars” (women or men)

to hang out in crack houses in order

to trade sex for crack.N Texas’ new

food stamp system, which uses debit

cards instead of paper, has disrupted

the ability to trade food stamps for

drugs.N

SEATTLE

PORTLAND

SACRAMENTO

SAN

FRANCISCO

SAN DIEGO

LOS ANGELES

PHOENIX

DALLAS

DENVER ST.

LOUIS

CHICAGO

HOUSTON

MINNEAPOLIS/

ST. PAUL
LOCAL DRUG MARKETS: A DECADE OF CHANGE

Pulse Check: January 2004 page 29

OVER THE PAST 10 YEARS? (continued)

BALTIMORE

In some cases, trading guns for drugs

has become more widespread. Use of

middlemen to buy drugs has also

become more common.L

ATLANTA

Food stamps have declined as a 

tradable commodity: electronic

transfer has made it more difficult 

to manipulate the system. Shoplifting

also has declined due to increased

law enforcement. Sex for drugs, 

however, has increased.N

WASHINGTON, DC

Guns and violence have increased

greatly.E

TAMPA/ST. PETERSBURG 

Diverted prescription drugs (such as

alprazolam and OxyContin®) have

become increasingly traded for 

other drugs, especially for methamphetamine.E

MIAMI

The provision of lookout services in

exchange of drugs has declined over

the past decade because of the

decline in street sales.E With the

advent of ecstasy, sexual exchange

between male sellers and female 

buyers has increased.L

CLEVELAND

Sex for crack remains common: nearly all prostitutes are crack addicts.E

CHICAGO

Injecting services for heroin have

declined over the past 10 years

because needle exchange programs

have made shooting galleries irrelevant.E Dealers don’t want merchandise any more: they just want cash.N

DETROIT

Guns and food stamps have declined

as commodities exchanged for drugs;

the provision of lookout services in

exchange for drugs has increased

slightly.E Michigan’s switch to vouchers for food stamps has made it more

difficult to trade them for drugs.N Sex

for heroin has increased, largely due

to the increase in female substance

abusers. “Prostitution used to be for

money; now it’s for drugs.”M

CINCINNATI

No changes are reported over the years.

ST. LOUIS

Sex for crack or methamphetamine

has increased. Common settings

include truck stops, libraries, and

book stores.E “Crack used to be cash

only; now the use of sex and

exchange of merchandise have

become more common.”L

BOSTON

“As police activity has disrupted sales

and driven markets underground,

criminal activity has escalated while

straight cash transactions have

declined. For example, users are more

likely to fence shoplifted merchandise

and use the proceeds to buy drugs.”E

NEW YORK

Drug transactions have become

increasingly “cash only.” The larger

organizations of the past sometimes

sold drugs on consignment. But

today’s smaller, more independent

street-level dealers can’t recoup any

outlay quickly enough to do so.E

PITTSBURGH

Food stamps are traded less commonly

than in the past.E Users are increasingly stealing property and merchandise

(shoplifting of meat has become especially common), pawning it, and using

the cash proceeds to buy drugs.L,E,M

PHILADELPHIA

Sex for crack has declined, while the

exchange of property for crack has

increased—more electronic equipment,

particularly CD players and CDs, are

being traded.E Food stamps are not as

widely traded as in the past because

many people are no longer eligible for

them.M Injecting services have declined

because snorting has increased.M

ATLANTA

TAMPA/ST. PETERSBURG

MIAMI

PHILADELPHIA

NEW YORK CITY

BOSTON

BALTIMORE

WASHINGTON, DC

CLEVELAND

CINCINNATI

PITTSBURGH

DETROIT
LOCAL DRUG MARKETS: A DECADE OF CHANGE

page 30 Pulse Check: January 2004

! Law enforcement and epidemiologic/ethnographic

sources generally agree that detection and disruption

efforts have not been hampered much by dealers using

unique packaging or by their increased or decreased use

of brand names.

! Epidemiologic/ethnographic sources tend to view relocation of drug markets within communities as a challenge

to detection and disruption efforts. Law enforcement

sources are more divided in their opinions. Many believe

that this type of movement has no effect, and many even

view it as a positive outcome of disruption efforts.

! According to law enforcement sources, throwaway cell

phones and other developments in digital communications technology, by far, have posed the greatest challenge to market detection and disruption efforts.

To what degree have the following illicit marketing innovations or tools complicated efforts to detect or disrupt

drug activity over the past 10 years? (Mean of 0–5 ratings)

0 1 23 45

How much complicated: Mean ratings

Not at all A lot

Fewer brand names

More or changing brand names

Unique packaging

Less organized networks 

Polydrug dealers

Relocation of sales settings within the community

Expansion of drug sales beyond the central city

Increased communications via Internet

More organized networks 

Throwaway cell phones

! Law enforcement respondent

# Epidemiologic/ethnographic respondent 

Change

(n=24)

(n=13) 

(n=24)

(n=12) 

(n=24)

(n=14) 

(n=25)

(n=14) 

(n=23)

(n=11) 

(n=24)

(n=12) 

(n=24)

(n=13) 

(n=23)

(n=13) 

(n=24)

(n=13) 

(n=23)

(n=12) 

Source: Mean of ratings given by law enforcement and epidemiologic/ethnographic respondents

In an attempt to market illicit drugs

and at the same time stay one step

ahead of law enforcement, dealers

have introduced a variety of marketing innovations, strategies, and tools

over the past 10 years. Pulse Check

law enforcement and epidemiologic/ 

ethnographic sources discussed the

specific strategies listed below and

rated the extent to which they have

complicated detection and disruption

efforts in their communities.

ILLICIT DRUG MARKETING STRATEGIES: CHANGES OVER THE PAST 10 YEARS
LOCAL DRUG MARKETS: A DECADE OF CHANGE

Pulse Check: January 2004 page 31

Sources: LLaw enforcement respondents; EEpidemiologic/ethnographic respondents

Note: The law enforcement sources from Miami and Pittsburgh did not provide a rating, nor did the epidemiologic/ethnographic sources from Atlanta,

Chicago, Cleveland, Denver, Minneapolis/St. Paul, Phoenix, Portland (OR), Sacramento, San Diego, Seattle, Tampa/St. Petersburg, and Washington, DC.

Markets relocating within the community: To what extent has it complicated detection and disruption efforts?

(0–5 ratings)

Relocation of sales settings within the 

community: What they have to say...

Shifting markets can be viewed in several ways:

as a positive outcome of disruption efforts (as

in Philadelphia), as having little effect (Dallas),

or as a challenge to those efforts (Boston). 

! Philadelphia:E Markets have relocated as

a result of Operation Safe Streets, ongoing

since May 2002. Residents were given a

phone number to call if markets moved to

new corners. Dealing has moved indoors

and into cars, with more home deliveries,

cell phone use, and other indoor dealings.

This change has had an impact on users:

people are more reluctant to go to indoor

locations, knock on strangers’ doors, or get

home deliveries, because of the possibility

of getting “ripped off.” 

! Dallas:E Sales locations are moving

fast, but police are keeping up.

! Detroit:L Markets do “pop over,” but

they are easily identified.

! Boston:E Sales locations keep changing. The more police activity there is,

the more they change. And the more

they change, the harder they are to find.

! Chicago:E Some parts of the city are 

stable; other parts are less so.

! Denver:E Dealers move from known

areas to selling in cars or to new areas.

! New York:L The effects of relocation

depend on where the markets are moving: if they move indoors, disruption

becomes harder.

Dealers using brand names: To what extent has it complicated detection and disruption efforts? (0–5 ratings)

Fewer brand names More brand names

PhiladelphiaE

Baltimore,E Boston,EDetroit,E

Los Angeles,E New York,E

Pittsburgh,E Portland (OR)L

Atlanta,L Baltimore,L Houston,E

Los Angeles,L Minneapolis/

St.Paul,L New York,L

Philadelphia,E San FranciscoE

Denver,L Houston,L Miami,E

PhiladelphiaL

Dallas,L,E St. Louis,L,E

Tampa/St. PetersburgL 

San FranciscoL

New YorkE

Detroit,L New YorkL

Denver,L Houston,L Los

Angeles,L Minneapolis/St.

Paul,L St. LouisE

Atlanta,L Baltimore,L Boston,L

Chicago,L Cleveland,L Dallas,L,E

Detroit,E Houston,E Los

Angeles,E Miami,E

Philadelphia,L Phoenix,L

Portland (OR),L Sacramento,L

San Diego,L San Francisco,L,E

Seattle,L St. Louis,L Tampa/St.

Petersburg,L,E Washington, DCL

BostonE

4

3

2

1

0

5

Extremely 

BostonL

Los Angeles,L New York,L

PittsburghL

Denver,L Los Angeles,L New

York,L Pittsburgh,L Houston,L

Minneapolis/St. Paul,L

Philadelphia,L San Francisco,L

St. LouisE

Atlanta,L Baltimore,L Boston,E

Chicago,L,E Cleveland,L Dallas,L,E

Detroit,L,E Los Angeles,E Miami,E

Philadelphia,E Phoenix,L

Portland (OR),L Sacramento,L

San Diego,L San Francisco,E

Seattle,L St. Louis,L Tampa/St.

Petersburg,L,E Washington, DCL

None

Houston,E New YorkE

Sources: LLaw enforcement respondents; E

Epidemiologic/ethnographic respondents

Note: The law enforcement sources from

Miami and Pittsburgh did not provide a rating,

nor did the epidemiologic/ethnographic

sources from Atlanta, Baltimore, Chicago,

Cleveland, Denver, Minneapolis/St. Paul,

Phoenix, Pittsburgh, Portland, Sacramento,

San Diego, Seattle, and Washington, DC.

Not

at all

4

3

2

1

0

5

Extremely 

Not

at all

Brand names: What they have to say...

! Boston:E Over the past 10 years, it has

become less easy to attach specific brands

to specific people.

! Chicago:E Brand names have increased

over the past 10 years, but they have not

affected disruption efforts.

! New York:L Depending on what an organization is doing, the number of brand

names can increase or decline. Either way,

disruption efforts are not complicated.

Boston,L Chicago,L Cleveland,L

Detroit,L Phoenix,L

Sacramento,L San Diego,L

Seattle,L Washington, DCL
LOCAL DRUG MARKETS: A DECADE OF CHANGE

page 32 Pulse Check: January 2004

Other marketing strategy changes

over the past 10 years. Sources

attribute little to moderate success to

dealers in complicating law enforcement efforts by using the strategies

listed below. 

! Increased communications via

Internet: The Internet’s impact is

hard to measure because it is hard

to track, as noted by one source

(Portland, ORL

). Another source

(DetroitL

) believes that law

enforcement is way behind dealers

and users technologically, especially at the local and State levels, and

especially regarding club drugs.

Another (New YorkL

) agrees that

traffickers are “one-up” over law

enforcement personnel, who are

just starting to get Internet training. That source, however, expects

the problem to lessen as the

knowledge gap closes.

The Internet is mentioned specifically in conjunction with club

drugs and designer drugs (Boston,E

Chicago,L and Minneapolis/St.

PaulL

), and even more specifically

with regard to GHB among younger

users (Tampa/St. PetersburgE

). One

source mentions the Internet in relation to paraphernalia (PittsburghL

),

and another reports its use among

smugglers (MiamiL

).

! Expansion of drug sales beyond

the central city: Over the past 10

years, markets have stayed within

the city confines of San Francisco.E

The reverse is true in Dallas,E

where markets have moved into

the city from the outside. The situation is somewhat more complex

in Pittsburgh,L which is a series of

townships that have conglomerated over the years, and where “nice

neighborhoods” have turned into

“drug neighborhoods” as the economic situation has declined.

Sources have little to say about

whether such changes have affected

detection and disruption efforts.

! Less organized or more organized

networks: Tampa/St. Petersburg’s

“meth squad” has disrupted that

city’s methamphetamine network.E

Elsewhere, the degree of network

organization has remained stable

in many areas, including DallasE

(except for methamphetamine in

rural areas), New YorkL (where the

market remains highly organized),

and San Francisco.E In Boston,E

networks have become more fragmented, so fewer people know

one another, making it more difficult to find informants. Similarly,

in Chicago, the law enforcement

source believes it has become more

difficult to identify who is doing

what. By contrast, Chicago’s epidemiologic source believes that

drug activity has become more

organized over the years, although

this change has not necessarily

complicated law enforcement

efforts.

Sources: LLaw enforcement respondents; E

Epidemiologic/ethnographic respondents

Note: The Miami law enforcement source did not provide a 

rating, nor did the epidemiologic/ethnographic sources from

Atlanta, Baltimore, Chicago, Cincinnati, Cleveland, Denver,

Minneapolis/St. Paul, Phoenix, Portland (OR), Sacramento, San

Diego, Seattle, Tampa/St. Petersburg, and Washington, DC.

Throwaway cell phones: To what extent have they complicated detection and disruption efforts?

(0–5 ratings)

Throwaway cell phones:

What they have to say...

! Baltimore:L Digital communications (cell phones)

have caused more complications than anything else

over the past 10 years:

they have provided sellers

a degree of protection, and

they have completely

changed the nature of law

enforcement interception. 

! St. Louis:L People are

becoming more cautious

about using cell phones,

especially since recent

movies and the media

have revealed law enforcement techniques (such as

cloning phones and

cloning pagers) to the public. Therefore, more are

using disposable phones,

cell phones with two-way

radio communication features, and calling cards

with prepaid minutes.

These new technologies

make it hard to write an

affidavit on wiretaps.

Phone companies are supposed to supply the government with technology to

combat each new technology, but they are offering it

to the public first.

4

3

2

1

0

5

Extremely 

Not

at all

Boston,L Cleveland,L Dallas,L Detroit,L,E Houston,L

Los Angeles,L,E Minneapolis/St.Paul,L Portland (OR)L, Sacramento,L St. Louis,L San Diego,L Tampa/St.

Petersburg,L New York,E PhiladelphiaE

Chicago,L Houston,E Miami,E New York,L

Philadelphia,L St. LouisE, SeattleL

Atlanta,L Baltimore,L Denver,L Phoenix,L PittsburghL

Boston,E Dallas,E Pittsburgh,E San FranciscoE

San Francisco,L Washington, DCL

None
LOCAL DRUG MARKETS: A DECADE OF CHANGE

Pulse Check: January 2004 page 33

! Polydrug dealing: Polydrug dealing

has increased over the past 10

years in several cities, including

Boston,E Chicago,E and Pittsburgh.L

Sources, however, do not believe

this change has complicated disruption activities.

! Unique packaging: In the many

cities where drugs are packaged in

a variety of unique ways, law

enforcement and epidemiologic/

ethnographic sources generally

believe that such packaging does

little to hamper disruption efforts.

Rather, the reverse is often true.

For example, the law enforcement

source in New York believes that

the many types of unique packaging in that city make it easier to

identify sources.

! Additional strategies: In addition

to the above strategies, some law

enforcement and epidemiologic/

ethnographic sources report the

following innovations: use of

mobile delivery and prearranged

meetings (DetroitE

); false floors

and other compartments in vehicles, such as cavities beneath car

windshields (HoustonL

); and use of

women and children in cars to

transport drugs (PhoenixE). 

FIGHTING BACK: HOW SUCCESSFUL HAVE DIFFERENT COMMUNITY TACTICS BEEN OVER THE PAST 10 YEARS? 

Over the past 10 years, communities

have employed a range of tactics to

address the increased complexities of

drug markets. Law enforcement and

epidemiologic/ethnographic sources

were asked whether their communities have tried any of the tactics listed

below and, if so, to describe them

and rate their success.

Onsite lab tests. Onsite lab tests can

be administered in many ways, in

many settings and contexts, and on

both substances and humans. In cities

where such tests are administered,

law enforcement and epidemiologic/

ethnographic sources generally rate

them as highly successful:

! Chicago:L After an undercover buy,

street tests can verify whether a

substance is illegal—helping the

evidence hold up for convictions.

! Los Angeles:E Onsite crime labs

are highly successful.

! Minneapolis/St. Paul:L Field testing helps in prosecution.

! Tampa/St. Petersburg:E When a

needle is found, it can be tested

immediately for methamphetamine, enabling quick identification

and rapid response.

! San DiegoL and Washington, DC:L

Field testing has been highly successful for more than 18 and 30

years, respectively.

! Houston:L Field kits used for

seizures are only moderately successful because they sometimes test

positive for the wrong drug. 

! Miami:E At DUI stops, when a 

driver’s alcohol level is low, the

driver is then tested for illegal

drugs onsite. Such testing aids in

convictions because it combines

experts’ observations with actual

urine testing.

! Pittsburgh:E Parents now use storebought drug tests for their children.

! Sacramento: Within the past year,

the children’s protective services

program, in conjunction with drug

courts, have started administering

onsite breathalizers and urine

screens to parents when their children are removed from their care.E

Presumptive field tests help identify the drugs present.L

Not all cities use onsite drug testing

kits. In New York,L for example, such

kits don’t hold up in court, so samples are always sent to outside laboratories. Similarly, drug samples in

Pittsburgh are sent to regional labs.

Task forces. Task forces of varying

compositions and focuses are reported as a key innovation in all 25 Pulse

Check sites. Law enforcement and

epidemiologic/ethnographic sources

generally give them high success ratings. Below are just a few examples:

! Dallas:L Because of budgetary

restraints, the DEA relies heavily

on task forces with State and local

counterparts.

! Denver:L The formation of larger

task forces has increased the ability to investigate large criminal

drug operations.

! Los Angeles:E The many small

departments have small budgets,

so getting involved in a task force

stretches each dollar.

! Miami:E The High Intensity Drug

Trafficking Area (HIDTA) has 

created task forces for heroin and

other drugs, and the State has task

forces on club drugs and on prescription abuse. All have been

highly successful.

! Minneapolis/St. Paul:

Multidisciplinary law enforcement

task forces enable pooling of

resources and funding, so even

small towns can go after bigger

dealers. Such task forces are 

essential as drug sales move out of

central city areas.E The county

sheriff’s office and the

Minneapolis Police Department

work together, so they double

their human resources for large

cases, such as wiretaps.L
LOCAL DRUG MARKETS: A DECADE OF CHANGE

page 34 Pulse Check: January 2004

! New York:L The city has an

unprecedented level of task force

cooperation compared with the

rest of the country, with at least 15

task forces between the police and

the DEA or HIDTA. Also, Mobile

Enforcement Teams (MET) of special agents go to communities for a

few months at a time to address

specific problems as needed.

! Philadelphia:L The DEA task force

program has included different

groups whose combined expertise

has made a difference.

! St. Louis:E Several methamphetamine

task forces have been established

statewide, mostly through law

enforcement agencies, to address

clandestine labs, precursor chemicals, and policy regarding ephedrine

and cough medicine sales.

! San Diego: The Meth Strike Force,

ongoing since March 1996, has led

to additional efforts, such as the

Meth Hotline (for reporting suspected cooks, turning in dealers,

and obtaining help for users) and

the Drug Endangered Children 

program (for dealing with children

of methamphetamine dealers and

manufacturers).E The San Diego

Narcotics Task Force, one of the

first in the Nation, includes representatives from every police agency

in the county, under the DEA

umbrella, plus occasional participation by various other agencies such

as the border patrol. The Violent

Gang Task Force draws representatives from Federal, State, and local

entities toward a common goal. 

! Tampa/St. Petersburg:E A Meth

Squad has been introduced and has

successfully seized many labs in a

nearby rural county that serves as

the source for Tampa’s methamphetamine supply.

! Washington, DC:L A newly formed

homicide-narcotics task force has

already shown signs of success.

Drug courts. The majority of Pulse

Check sites have some sort of drug

court program, and sources in those

areas generally consider them highly

effective. Below are several examples.

! Chicago: Nonviolent offenders are

given the alternative of drug school

or drug counseling instead of incarceration. Data show a drop in

recidivism over a year for program

completers.E State’s attorneys and

judges are becoming more attuned

to the concept and are beginning to

understand it a little better.L

! Miami:E The judicial monitoring

program’s first phase was for 

nonviolent offenders without a previous record. Now it includes people with prior records as well as a

juvenile drug court, so it also captures the chronic, more acute addictive population and the newer users.

! Boston:E Drug courts are effective

for middle-class people with low

levels of dependency, more solid

support systems, education, and

chances of employment. But this

source believes they don’t work

for hard-core central city addicts,

who have a different relationship

with legal authorities.

! Sacramento:E The program

includes an adult court, a dependency drug court, and a Proposition

36 drug court. It is also planning a

juvenile drug court, with a team in

place while awaiting funding.

! San Diego:E Six courts are in 

operation: one juvenile, one

dependency, and four adult courts.

Additional funds are sought to 

further expand.

! San Francisco:E With increased

availability of treatment, drug

court is now obligatory, rather

than voluntary as in the past.

! St. Louis:E Missouri is third in the

country in the number of drug

courts.

! Seattle:L Drug courts are proliferating. They are reducing drug-related

incarceration and recidivism.

Crack house (nuisance abatement)

laws. Law enforcement and 

epidemiologic/ethnographic sources

range widely in their assessment of

such laws’ efficacy—from very poor

to fairly high ratings, with the majority somewhere in between. Some

examples follow:

! Miami:E Since the Miami Coalition

Crack House Demolition program

began in 1989, more than 600

crack houses have been knocked

down. More demolitions occurred

during the early phases; later,

more landlords began correcting

the problem.

! San Francisco:L Large crack

sweeps have been conducted 

with combined local, State, and

Federal efforts, including HIDTA

funding, the National Guard, and

equipment such as radios and pole

cameras.

! Dallas:E When crack houses are

bought and then bulldozed, people

just move to other locations.

! Detroit:L In some cases, these laws

have been used on rave sites.

! Minneapolis/St. Paul:E These laws

have not been effective because

crack houses are mobile and 

transitory.

! Philadelphia:E The Clean and Seal

Operation more than 10 years ago

boarded up many crack houses.

But many have since been broken

into and reverted to places of drug

use (“abandominiums”).

Precursor laws. These laws are 

generally rated as moderately successful in cities where they are enacted.

! Seattle:E Declines in meth labs may

be due to precursor laws and

enforcement.
LOCAL DRUG MARKETS: A DECADE OF CHANGE

Pulse Check: January 2004 page 35

! Sacramento:L Supplies of iodine,

red phosphorous, and hydriotic acid

are now controlled. Also, an

HIDTA officer is assigned to go to

supply houses, feed stores, and

home improvement stores to educate workers, provide threshold limits on volume sales, and give them a

phone number for calling in tips on

who is buying and what is bought.

! Los Angeles:E New legislation

includes a civil fine for companies

who break laws (as opposed to

criminal fines), increased penalties

for small clandestine labs, and

laws addressing child abuse and

neglect by methamphetamine

manufacturers.

! San Diego: City and county ordinances have led to training for

retail workers in limiting

ephedrine sales to six retail-sized

packages.E The precursor laws of

the early 1990s made it difficult to

acquire ephedrine, red phosphorous, and hydriotic acid, with several results: local “cookers” who

used to buy chemicals from chemical companies started extracting

themselves, thus labs became

smaller; many labs spread out into

rural areas across the country; and

Mexican manufacturers started

coming into the area.L

! St. Louis:E Ephedrine sales and

availability of ephedrine-based

products have declined because

retail workers are learning to flag

people who buy excessive amounts. 

! Minneapolis/St. Paul:E Minnesota

was one of the first States with laws

concerning anhydrous ammonia.

! Dallas:L Texas recently enacted

some laws making it harder to

obtain some of the chemicals

essential to making methamphetamine. Traffickers, however, are

finding other types of chemicals. 

For example, they steal anhydrous

ammonia from rural farms.

! Detroit:L,E Michigan changed its

laws a few years ago to control

ephedrine and pseudoephedrine

above certain quantities. However,

enforcement has been difficult.

Pseudoephedrine flows from

Canada by the truckload, making

Detroit a transshipment point for

the superlabs in the West.

Prescription drug monitoring. Efforts

to monitor prescription drug diversion have met with moderate to great

success in many cities, according to

law enforcement and epidemiologic/

ethnographic sources:

! Boston:E Following a barrage of

pharmacy robberies a few years

ago, mostly involving OxyContin®,

pharmacists have become more

vigilant. It is harder to fill prescriptions for Schedule II and III

drugs than it was 2 or 3 years ago.

! Chicago:E Illinois has been a triplicate prescription State for more

than 10 years.

! Detroit: Michigan’s switch to triplicate prescription pads a few years

ago has increased accountability.

Diversion occurs less frequently

than in many other States.L The

triplicate program is about to be

replaced with a high-tech electronic

system that will expand to all drug

schedules. Resources will be needed

to implement the system.E

! Houston:L Diversion investigators

inspect pharmacies, check forged

prescriptions, and perform many

other monitoring activities. An

example is a recent cutting-edge

investigation involving an Internet

pharmacy case in San Antonio.

! Los Angeles:E While there is no

triplicate prescription program,

pharmacists can call a hotline

monitored by a DEA tactical 

diversion team.

! New York:L A diversion unit targets

diversion of prescription drugs

from hospitals. 

! Pittsburgh:E The Department of

Welfare is monitoring diverted

OxyContinE for medical plans and

has made doctors reexamine their

prescribing practices.

! St. Louis:E The “Scam of the

Month” newsletter, no longer in

publication, was highly effective.

! Seattle:E OxyContin® diversion

has leveled off since its sales have

been monitored by the State.

Sentencing changes. Sources in

PhiladelphiaE and ChicagoL believe

sentencing reductions involving 

diversion to treatment have been 

particularly effective in their communities. Sources vary more in assessing

the impact of increased sentences.

! Philadelphia:E The Forensic

Intensive Recovery (FIR) program,

started 8 or 9 years ago in an effort

to reduce prison overcrowding, has

led the way for forced treatment

programs across the country. 

Low-level criminals are evaluated

after serving half of their sentence,

and then they are conditionally

released to treatment (sometimes

under electronic monitoring).

! Seattle:L,E A new State initiative will

reduce sentences for some minor

drug offenses (except those involving methamphetamine) to allow

diversion into treatment courts.

! Chicago: Penalties have become

more severe: thresholds for possession are lower, and sentences are

longer. One source believes this

measure has been highly successfulL

,

while the other believes it has not.E

! St. Louis:E Stiffer penalties for 

possession of precursors and for

methamphetamine manufacture

and distribution have been 

moderately successful. 
LOCAL DRUG MARKETS: A DECADE OF CHANGE

page 36 Pulse Check: January 2004

Drug-free zone laws. The majority of

the Pulse Check sites have protected

zones, often around schools and

recreational facilities, where anyone

arrested for drug possession or sales is

sentenced more severely. Overall, law

enforcement and epidemiologic/ethnographic sources consider this type of

measure to be moderately effective,

but their opinions range widely, as in

the following examples:

! Sacramento:L The Safe Schools

program, together with the School

Resources Officers program, hires

off-duty uniformed police to post

signs, educate in schools, and help

enforce the drug-free zone laws.

! Chicago:E Dealers do observe the

drug-free zone laws.

! Houston: Neighborhoods are 

taking back their areas through

vigils, neighborhood watch groups,

evening marches, media attention,

and exposing crack houses to

media. But they are just pushing

drug activity back and forth

between neighboring areas. When

they ease their efforts, the problem

returns.E Drug-free zone laws are

more useful as a tool for prosecutors than as a deterrent.L

! Dallas:E Youth are still getting

caught selling drugs in schools.

! Washington, DC:L It is not unusual

to see someone selling drugs while

standing beneath a drug-free-zone

sign.

Drug user recognition education

(DRE) for law enforcement. About

half of the Pulse Check sites, including the following, train some law

enforcement personnel to recognize

drug users, with effective outcomes.

! Denver:L State DRE traffic enforcement has allowed law enforcement

to identify and prosecute those

driving under the influence of 

illegal drugs.

! Sacramento:L The Safe Schools

program and the School Resources

Officers program (described

above) include a DRE component.

All in-house narcotic teams are

DRE certified. All patrol 

officers are offered voluntary

training, but it is not mandated.

! Detroit:E DRE training is particularly effective for State police patrol

officers who work at road stops.

! San Diego:E DRE training for law

enforcement has become an outgrowth of the Meth Strike Force

and its partners. Training is also

available for educators, parents,

and other interested parties.

Additional tactics. In addition to the

above measures, some law enforcement and epidemiologic/ethnographic

sources describe some unique tactics

tried by their communities over the

past 10 years, as in the following

examples:

! Criminal drug conspiracy operations for street corner cases

(ChicagoL

): This 3-month tactic

uses covert investigative tools,

such as wiretapping and videotaping, to identify every person

involved in a street corner operation. Each person is subsequently

charged with the total weight of

all the drugs recovered, so each

person gets the same charge. 

! Crack house tours (Minneapolis/

St. PaulE

): These walking tours of

neighborhoods are intended to

humiliate people seen at crack

houses.

! Local summit activities (San

DiegoE

): Annual substance abuse

summits, involving schools, the

sports community, the media, and

adolescents, have evolved from 

1-or 2-day conferences to yearround outreach and prevention

activities, including monthly meetings. This year’s focus has been on

substance abuse and sports, with

local sports figures talking to the

adolescents. Involving youth in

planning activities has been a particularly effective strategy.

Suggested innovations. Several

sources recommend a variety of tactics that would enhance their specific

communities’ efforts in meeting

unique challenges.

! Atlanta:L Enhance communication

between local, Federal, and regional task forces.

! Detroit:E Develop a monitoring program to address the proliferation of

diverted or misprescribed

methadone from pain clinics.

! Houston:E Develop a system for

tracking and monitoring gang

activity, and implement a graffiti

abatement program. These suggestions are in response to recent

gang activity, presumably drug

related, which has included a rash

of car break-ins, car thefts, and

graffiti incidents.

! Miami:E Expand and enhance the

drug testing program at DUI 

(driving under the influence)

stops, both for research purposes

and to get convictions, to test for

other drugs even when alcohol

levels are high.

! Miami:E Rather than tear down

crack houses, confiscate them from

owners and then rent them cheaply to treatment programs that

would rebuild them. 

! Miami:E Schedule sildenafil citrate

(Viagra®).

! Miami:L Expand scheduling of

checkpoints and roadblocks to

meet the challenge posed by clubs

that are open 24 hours a day.

! MiamiL and Minneapolis/St. PaulL

:

Send only users—not dealers—to

drug court.
LOCAL DRUG MARKETS: A DECADE OF CHANGE

Pulse Check: January 2004 page 37

! Minneapolis/St. Paul:E Develop

enhanced cross-pharmacy, crossState tracking systems.

! Minneapolis/St. Paul:E Encourage

retail sellers to voluntarily limit

sales of pseudoephedrine and

other ephedrine products.

! Minneapolis/St. Paul:L Add

resources to follow up after the 

forgery unit forwards cases of prescription fraud.

! Los Angeles:

E Get out the message

about the neurotoxicity of ecstasy.

! St. Louis:E Add training to pharmacy school curricula on subjects

such as prescription abuse, scams,

and different diversion techniques.

! Sacramento:L Develop more community outreach programs.

! San Diego:E Expand the Meth

Strike Force to address other drugs.

! Tampa/St. Petersburg:E Form an

epidemiologic network, similar to

those in other areas, to collect 

specific data, disseminate it, alert

the community to emerging problems, and allow for rapid response.

! Overall, non-methadone and methadone treatment

sources agree that their communities’ drug abuse

problems over the past 10 years have been particularly

complicated by the lack of housing opportunities for

recovering clients. 

! Other complications frequently mentioned by both

types of treatment sources include a lack of jobs and

job training opportunities for recovering clients and an

increasing availability of new and substitute drugs. 

! Methadone treatment sources also believe that the

declining cost of drugs has contributed to the drug

problems in their communities.

Changes in the nature of users and the market: To what degree have they made the drug abuse problem more 

complex over the past 10 years? (Mean of 0–5 ratings)

0 1 2 3 45

Degree of complication: Mean ratings

Not at all A lot

!$$Non-methadone treatment source

#$$Methadone treatment source

Change

Source: Mean of ratings given by non-methadone and methadone treatment respondents

Spread of use among all age groups

Increased court referrals

Declining cost of drugs

More polydrug use 

Normalization of drug use

Increased treatment case loads

Earlier first use of more dangerous drugs

Increasing availability of new 

and substitute drugs

Lack of jobs and job training 

opportunities for recovering clients

Lack of housing opportunities 

for recovering clients 

(n=18)

(n=22)

(n=18)

(n=20)

(n=19)

(n=22)

(n=19)

(n=18)

(n=19)

(n=20)

(n=19)

(n=22)

(n=19)

(n=20)

(n=19)

(n=23)

(n=18)

(n=21)

(n=18)

(n=23)

THE NATURE OF DRUG USERS: CHANGES OVER THE PAST 10 YEARS
LOCAL DRUG MARKETS: A DECADE OF CHANGE

page 38 Pulse Check: January 2004

The comments below describe some

of the specific changes that have 

complicated—or, in some cases, simplified—the problem over the past 10

years. 

Increased court referrals. Many

treatment sources agree that court

referrals have increased, but most of

them also agree that this increase has

not complicated the treatment situation. Several believe this change has

helped in their efforts to treat people,

as in the following examples. 

! Houston:N Many adolescents, 

pregnant women, and other special

needs populations are court

referred.

! Minneapolis/St. Paul:M Clients in

a focus group convened for Pulse

Check stated that court referral to

treatment helped get them on

track and gave them a push to “get

cleaned up.”

Declining cost of drugs. Drug prices

in St. Louis have not declined over

the past 10 years, and in Atlanta,

heroin price and purity have actually

increased. Declines, however, are

reported by treatment sources in 

several cities. Methadone treatment

sources, in particular, believe that the

declining cost of drugs has played a

major role in their communities’ drug

abuse problem. 

! Baltimore:N,M Crack and heroin

have become cheaper than ever.

! Boston:M Heroin cost has declined

from $20 per bag 10 years ago to

$1 per bag now—less expensive

than opiate pills.

! Chicago: Cocaine prices have

dropped to $2 per rock.N Heroin

prices have declined, so more people are using it, and they are using

more of it.M

! Cincinnati:M Heroin has become

cheaper and more available.

! Detroit:M The more a dealer can

buy and cut, the lower the cost,

and the more he or she can sell—

and the more a user can buy.

! Houston: A “starter rock” of crack

has declined from $10 a few years

ago to $2.N With cheaper and

purer heroin coming from South

America, the cost of supporting a

habit has declined from $100 per

day to $20 per day.M

! Minneapolis/St. Paul:M Heroin

prices have declined from $5 to $1

per milligram.

! New York:M It has become more

cost effective to snort, rather than

inject, heroin because of the

increased purity per unit.

! Philadelphia:N,M Heroin prices have

declined steadily over the past 10

years, while purity has increased.

! Pittsburgh:N Heroin costs have

declined.

! Sacramento:M Heroin, crack, and

methamphetamine prices have

dropped dramatically.

! San Francisco: Heroin has

declined both in cost and purity.M

Designer drug prices have become

low.N

More polydrug use. Treatment sources

generally believe that polydrug use

has only moderately complicated the

drug abuse problem. In several cities,

such as Boston,M Pittsburgh,N and San

Francisco,N such use is a significant

problem and has been stable over the

past decade. It has, however,

increased in some cities.

! Atlanta: Heroin users are increasingly mixing their heroin with

marijuana, cocaine, and benzodiazepines.M Cocaine, marijuana, and

crack are more commonly used in

combination (by about one-third

of clients) than in the past.N

! Chicago:N Heroin and cocaine

combinations have increased.

! Cleveland:M Heroin is increasingly

combined with crack or powder

cocaine.

! Houston:M Alprazolam (Xanax®) is

increasingly used by methadone

clients.

! Minneapolis/St. Paul: Polydrug use

has increased, but it hasn’t changed

anything. According to focus group

members, “you can’t ‘blow’ (inject

heroin) without a ‘mo’ (powder

cocaine),” and a high dose of

methadone is frequently taken with

crack “on the side.”M Polydrug use

makes it hard to determine what

clients are using.N

! San Francisco:M Older clients (in

their fifties) are more likely to be

heroin-only users, but younger

clients are more likely to use

“speed,” opiates, and benzodiazepines.

Earlier first use of more dangerous

drugs. Age of first use has gone up in

San DiegoN (from 11 to 13). The

reverse seems to be occurring, 

however, in several other sites:

! Baltimore,N PhiladelphiaM: These

treatment programs are seeing

increasing numbers of younger

users.

! Boston:M A growing number of

people under 18 are seeking

methadone services and being

turned away from programs, which

are not supposed to serve them.

! Chicago:M None of the clients in

an adolescent treatment program

were heroin users 10 years ago.

Now 30 percent of the adolescent

clients are heroin users.

! Cincinnati:

M The program has

been seeing younger heroin

abusers over the past 5 years.
LOCAL DRUG MARKETS: A DECADE OF CHANGE

Pulse Check: January 2004 page 39

! Dallas:N Age of onset is dropping

annually. Marijuana use is now

starting at age 10–12.

! Houston: Because purity has

increased, youth snort heroin or

squirt it up their noses (“shebanging”).M One program is getting 

12-year-old referrals who have

started with cocaine—something

not seen 10 years ago.N

! New York:M Younger people are

using heroin and inhalants.

! Pittsburgh:N Heroin use is beginning at younger ages.

Increasing availability of new and

substitute drugs. The drugs listed

below have become newly or increasingly available in the various cities

over the past 10 years, sometimes

replacing other drugs. Treatment

providers generally believe these new

drugs have moderately complicated

the drug abuse situation.

! Atlanta:M Diverted OxyContin®

! Baltimore:N Crack and diverted

OxyContin®

! Boston:M Diverted OxyContin®

! Chicago:N Methamphetamine and

ecstasy

! CincinnatiM and Tampa/St.

Petersburg:M Diverted OxyContin®

and, several years ago, MS Contin®

(morphine sulfate)

! Cleveland: Heroin, crack, ice, and

crystal methamphetamine

! Dallas:N Designer drugs

! Denver:M Club drugs and

methamphetamineN

; some fentanyl

! Houston: Prescription drugs, especially oxycodone and hydrocodone

(Vicodin®)

! Los Angeles: Diverted OxyContin®

and clonazepam (Klonopin®)

! Minneapolis/St. Paul: Smokable

heroin among young adults;N,M

methamphetamine, ecstasy and

gamma hydroxybutyrate (GHB)N

! New York:M Designer drugs—but

localized in neighborhoods and

subcultures, not citywide

! Philadelphia: Diverted OxyContin®;

N,M alprazolam, ecstasyM

! Phoenix:M Diverted OxyContin®

! Pittsburgh:N Ecstasy and diverted

OxyContin®

! St. Louis:N Rise in crack, heroin,

and more recently, the rise in

methamphetamine

! Sacramento:N Ecstasy and GHB

! San Francisco: Ecstasy and GHB;N

diverted OxyContin® and other

prescription drugsM

Lack of jobs and job training opportunities for recovering clients. Job

opportunities have actually increased

in New YorkM, particularly since 1996

legislation increased the focus on

work as part of recovery. In some

other cities, however, treatment

sources paint a different picture.

! Cleveland:M Potential employers

can’t legally discriminate because

of past drug abuse, but they still

do not hire recovering clients.

! Philadelphia:M Methadone patients

are not allowed in job training

programs.

! St. Louis:N It is easy to find lowskill, low-paying jobs, but it is difficult for clients to pull themselves

up after years of drug addiction and

find high-skill sustainable jobs.

! Sacramento: Prospective employers are increasingly using drug 

testing. One-third of recovering

clients are unemployed.N Training

programs are in place, but the job

market in general is crumbling.M

Lack of housing opportunities for

recovering clients. Recovery houses

in Philadelphia provide sufficient

housing opportunities. Elsewhere,

treatment sources view this growing

need as one of the more serious complications in the drug abuse situation

over the past 10 years.

! Chicago: Most clients are unable

to find housing, so they often

move in with dealers or users.N

They have no safe place to live

after treatment, so they go back to

the same neighborhoods, with the

same family members, and the

same friends—all of whom use

drugs.M

! Cleveland:M Opiate addicts have

few to no housing opportunities

because people don’t trust them.

! Dallas:N Homelessness “has created

terrible problems.”

! Houston:N Users are becoming

homeless more quickly than in the

past—often within 6 months of

the onset of their cocaine or 

heroin use. Increasing their length

of stay in treatment would help

because they have no stable environment to return to. 

! New York:M Lack of housing has

been an ongoing “rock-bottom”

problem, so it has not worsened

over the past 10 years.

! St. Louis: Treatment staff say it is

increasingly difficult to find places

for clients to go because more 

people are in need of housing but

fewer places are available.

! Sacramento:M The problem of

homeless clients is severe and

worsening.

! San Diego:N Most clients don’t

qualify for HUD funds, so they

lack sober living environments.
LOCAL DRUG MARKETS: A DECADE OF CHANGE

page 40 Pulse Check: January 2004

! San Francisco: Clients tend to live

in single residency hotel rooms in

the worst parts of town where drug

use is high.N The number of recovery home slots is limited, especially

for those on methadone.M

Additional changes. In discussing 

10-year changes in the drug market

and the nature of drug users, some

treatment sources mentioned additional changes unique to their cities. 

! Multigenerational users: In

Baltimore,M clients frequently

come from families with long histories of drug use. The Pulse

Check source is personally treating

children of former patients.

! Drug use during pregnancy: In

Cleveland,M women have increasingly used heroin, crack, and powder cocaine during pregnancy.

! Co-occurring disorders: Increases

in psychiatric disorders have complicated treatment in many cities,

such as Atlanta,M Dallas,N,M and St.

Louis.N Similarly, the increase in

hepatitis C among clients has complicated treatment, as mentioned

in Denver and New York.M

Increasing medical and dental

problems, sometimes associated

with an aging addicted population,

are mentioned in several cities,

including Baltimore, San Diego,

and San Francisco.N

! Funding declines: Public funds in

PittsburghN have declined for treating those with no insurance,

reducing treatment opportunities

for many. In Dallas,N treatment

resources have declined following

a 10-percent cut in public funding.

WIDESPREAD MARIJUANA AVAILABILITY AND USE: CONTRIBUTING CHANGES OVER THE PAST 10 YEARS

Marijuana: To what extent have the following changes contributed to its 

widespread availability and use over the past 10 years? (Mean of 0–5 ratings)

01 23 4 5

Degree of complication: Mean ratings Extremely

!$$Law enforcement source

#$$Epidemiologic/ethnographic source

Change

Source: Mean of ratings given by law enforcement and epidemiologic/ethnographic respondents

Decline in social disapproval (e.g., peers, parents, etc.) 

Promotion of marijuana 

as “medicine” 

Decline in users’ 

perception of harm 

Glamorization by 

entertainment industry

Less emphasis by 

law enforcement and courts 

Increased THC potency 

Increase in indoor farms 

More local production 

Glamorization by news media 

Decline in price 

(n=24)

(n=17)

(n=22)

(n=18)

(n=24)

(n=17)

(n=22)

(n=15)

(n=22)

(n=16)

(n=21)

(n=19)

(n=24)

(n=16)

(n=24)

(n=16)

(n=21)

(n=14)

(n=16)

(n=22)

Not at all

! Law enforcement and epidemiologic/ethnographic sources tend to agree that the decline in social disapproval of 

marijuana (by peers, parents, etc.) has had an impact on its widespread use and availability over the past 10 years. 

! Both types of sources also 

generally believe that the

decline in users’ perception of

marijuana’s harmfulness has

contributed to its increased

use. 

! Law enforcement sources

attribute more importance to

the promotion of marijuana as

“medicine” in contributing to

increased marijuana use than

do their epidemiologic/

ethnographic counterparts.

! Prices have remained generally

stable over the past 10 years,

according to both types of

sources, so increasing use 

cannot be attributed to price

declines.
LOCAL DRUG MARKETS: A DECADE OF CHANGE

Pulse Check: January 2004 page 41

The comments below reflect the

beliefs of some Pulse Check law

enforcement and epidemiologic/

ethnographic sources:

Decline in social disapproval. Law

enforcement and epidemiologic/

ethnographic sources tend to agree

that the decline in social disapproval

of marijuana (by peers, parents, etc.)

has had an impact on its widespread

use and availability over the past 10

years:

! Baltimore:

L Peer pressure among

juveniles has played an important

role.

! Houston:E People who smoke 

marijuana think of it as an herb

that doesn’t affect their driving.

They use it recreationally and

believe it is safer than alcohol.

! New York:L We have not been

effective in changing people’s 

perceptions.

! Philadelphia:E According to a

recent youth survey, social

approval of marijuana use continues to increase. Many users are

children of users from the sixties

and seventies generation, who

have a more tolerant attitude

toward the drug.

! San Francisco:L The public is still

largely unaware of the negative

consequences of marijuana use.

Promotion of marijuana as “medicine.” Only a few sources have specific comments regarding this issue: 

! New York:E The debate about “medical” marijuana has contributed to

the notion that it is harmless.

! Sacramento: One source believes

Proposition 215 is ambiguous about

laying down thresholds for “compassionate use” and that it contains

many loopholes.L The other source

adds that since no prescription is

needed, just a recommendation

from a doctor, the proposition 

creates havoc in some situations.

For example, in dependency drug

courts, some people are reprimanded severely, and then someone

comes in with a doctor recommendation. Similarly, providers have

problems using a zero tolerance

model when someone in the room

is “smelling of pot.”E

Decline in users’ perception of harm.

One source in St. LouisL believes 

people are becoming more aware of

marijuana’s harmfulness. Others,

however, do not share that opinion:

! Dallas:L People feel marijuana is

“no big deal.” They do not think

of it as a gateway drug.

! Minneapolis/St. Paul:E In the past,

the perception of harm was declining. But for the past 3 years it has

been in a holding pattern.

! New York:L People don’t realize

marijuana’s potency. They still

view it as the same drug of 10

years ago.

! San Diego:E The misperception

that marijuana is not harmful is

not new—it has always been a 

problem. Youth need continued

pressure to say no to marijuana.

! San Francisco:E Harm perception

has declined since 20 years ago,

but it has remained relatively

unchanged over the past 10 years.

Glamorization by entertainment

industry. Only low to moderate

importance is attached to this 

phenomenon, with a few exceptions

as listed below.

! Houston:E Not only are more 

people in the music business using

marijuana, they also are including

it in their songs, which sends a bad

message to youth. Also, more 

athletes are using marijuana.

! Pittsburgh:E The rap, “hip hop,”

and MTV cultures have many 

references to marijuana.

! San Francisco:L The entertainment

industry in California has become

desensitized to marijuana use.

Less emphasis by law enforcement

and courts. Sources in some cities,

including New York,L Seattle,E and

Tampa/St. Petersburg,L believe that

emphasis on marijuana has not

declined. In Chicago,E many offenders

are being sent to treatment for 

marijuana use. Other sources have

different opinions:

! Cleveland: One sourceE believes

that law enforcement officials feel

“marijuana is not really worth the

paperwork.” The otherL agrees

that penalties are light.

! Dallas:L Marijuana is given low

priority over other types of drugs.

! Houston:L Local prosecutors don’t

take Federal cases anymore

because they were not getting

reimbursed. 

! Phoenix:L Prosecutors don’t seem

to care about marijuana.

! Sacramento:L Because of

Proposition 215, the “medical

marijuana law,” the district 

attorney opts not to prosecute

many marijuana cases. Federal

prosecutors sometimes come in

instead.

! San Diego:E In a recent focus

group, users agreed that “everyone

turns a blind eye, even though it’s

everywhere.”

Increased potency. In discussing 

marijuana’s increased use and 

availability over the past 10 years,

law enforcement and epidemiologic/ethnographic sources attribute

only a moderate amount of importance to the drug’s increased potency. 
LOCAL DRUG MARKETS: A DECADE OF CHANGE

page 42 Pulse Check: January 2004

Increase in indoor farms. Several

sources report increases in indoor

farms. Nevertheless, many find this

increase only moderately associated

with the widespread marijuana use

and availability over the past 10

years.

! Dallas: Marijuana is grown in 

closets, bedrooms, and bathtubs:

“Anywhere you can put a grow

light.”E Indoor growth yields

increased THC content and is 

easier to conceal. It is becoming

easier to obtain growing equipment from catalogues, head shops,

and other sources.L

! Houston:L Indoor grows are rare

along the border because of the

prevalence of Mexican marijuana.

But they increase as one goes

northward.

! Los Angeles:E Indoor production

has made marijuana stronger and

more difficult to detect. It allows

large quantities to be grown in

small spaces.

! Minneapolis/St. Paul:E The short

growing season does not allow for

much outside growth.

! New York:L Interdiction is more

difficult when marijuana is grown

indoors. Over the last 3 years,

high-quality hydroponic marijuana—much of it indoor

grown—has increased.

! Sacramento:L Grow houses are

increasing in number, and bigger

businesses are catering to them

with retail merchandise that 

supports inside growth.

! San Diego:E Some increase in

indoor farming has led to higher

grade, less detectable marijuana.

! Tampa/St. Petersburg:L Most 

marijuana is grown inside.

More local production. The amount

of locally produced marijuana has

remained stable in some cities, such

as Minneapolis/St. PaulL and

Tampa/St.Petersburg.L,E In Detroit,

greater amounts do not necessarily

reflect an increase, but rather more

detection.

! Miami:L Competition has lowered

the price of local hydroponic 

marijuana.

! Dallas:E With the economy down,

many people grow marijuana for

income.

Glamorization by news media. Only a

few sources have comments on this

subject, including the following:

! Los Angeles:L Some media are

quick to report stories about 

legalization efforts and use of 

marijuana for “medicinal” purposes, but they are not as quick in 

reporting “the other side.”

! Minneapolis/St. Paul:E The 

mainstream media perpetuate the

public debate regarding the harmfulness of marijuana. For example,

articles in teen magazines present

the subject as a matter of debate,

rather than fact.

! San Francisco:L This source

believes the media are slanted in

reporting marijuana as “medicine.”

Decline in price. Price declines do not

seem to be a factor in the increased

use and availability of marijuana over

the past 10 years. Price has remained

unchanged in several cities, including

Minneapolis/St. Paul,E New York,L

Philadelphia,E St. Louis,L San Diego,L

San Francisco,L and Seattle. In New

York,E similarly, prices have not

declined, but they vary more in

range, so prices at the lower levels

allow more youth to get involved.

Prices have actually increased in some

cities, such as St. Louis (because of a

recent shortage) and Chicago.

Additional changes. Some sources

mention additional changes that have

contributed to the widespread use

and availability of marijuana over the

past 10 years:

! Increased movement of marijuana

from Mexico to San DiegoE and

HoustonL

! Deteriorating family and social

relationships (St. LouisE

)

! Easier access to information on

marijuana over the Internet, especially among teens (BaltimoreL

)

! Promotion of hemp products to

youth (Minneapolis/St. PaulE

)
LOCAL DRUG MARKETS: A DECADE OF CHANGE

Pulse Check: January 2004 page 43

TREATMENT FOR MARIJUANA USERS: THE PAST 10 YEARS

! In discussing changes that have complicated the treatment of marijuana-using clients over the past 10

years, non-methadone and methadone treatment

providers alike tend to place a fairly high degree of

importance on earlier initiation of marijuana use, on

increased tetrahydrocannabinol (THC) potency,

and—like their law enforcement and epidemiologic/

ethnographic counterparts—on a decline in users’ 

perception of harm.

! Methadone treatment sources also believe that

increased polydrug use has played a fairly important

role in making treatment more complex.

! The news media and increased court referrals appear

to have had little complicating effect. Some sources

even believe they have had a positive effect. 

To what extent have changes in the following problems complicated the treatment of marijuana-using clients, 

particularly youth, over the past 10 years? (Mean of 0–5 ratings)

01 2 3 4 5

Degree of complication: Mean ratings

Not at all A lot !$$Non-methadone treatment source

#$$Methadone treatment source

Change

Source: Mean of ratings given by non-methadone and methadone treatment respondents

Earlier initiation of marijuana use

Increased THC potency of marijuana 

Decline in users’ perception of harm

Decline in social disapproval (e.g., peers, parents, etc.)

Glamorization by entertainment industry

Increased polydrug use

Increased progression to use of other drugs 

Increased severity of addiction among clients 

Increased overall difficulty in treating the addiction

Increased court referrals involving marijuana possession 

Increased court referrals involving marijuana sales

Glamorization by news media

(n=17)

(n=12)

(n=17)

(n=12)

(n=18)

(n=14)

(n=18)

(n=14)

(n=18)

(n=13)

(n=17)

(n=14)

(n=18)

(n=11)

(n=17)

(n=14)

(n=14)

(n=17)

(n=14)

(n=18)

(n=12)

(n=18)

(n=12)

(n=18)
LOCAL DRUG MARKETS: A DECADE OF CHANGE

page 44 Pulse Check: January 2004

Earlier initiation of marijuana use.

One source, in St. Louis,M believes

that though many people initiate 

marijuana use earlier, treatment has

not been complicated. Other sources,

however, believe earlier initiation to

be more problematic. Non-methadone

sources, in particular, assign a higher

overall rating to this change than to

any other change that has complicated

treatment over the past decade.

! Boston:M Alcohol, cigarettes, and

marijuana are among the first 

substances used by children as

young as 9.

! Cleveland:

M Elementary school

children are using marijuana.

! DenverN and St. Louis:N Clients are

getting younger and younger.

! Sacramento:N Initiation age ranges

from 9 to 13 years.

Increased THC potency. Higher marijuana potency has posed several challenges to treatment.

! Minneapolis/St. Paul:

N THC 

content is much higher compared

with what it was 20—rather than

10—years ago.

! Philadelphia: Marijuana is two to

three times stronger than it was in

the 1970s.N Clients don’t recognize

THC withdrawal symptoms, 

mistakenly believing their

methadone is not effective.

! Pittsburgh:N Higher THC content

has caused an increase in withdrawal symptoms.

! San Francisco:N More clients are

coming in because it is increasingly

difficult to stop using marijuana

and because it has more intense

side effects.

Decline in users’ perception of harm.

Many Pulse Check treatment sources,

like their law enforcement and 

epidemiologic/ethnographic counterparts, believe this misperception to be

a fairly serious problem.

! Chicago:N Clients generally believe

that marijuana causes no harm and

that it may actually have social

benefits.

! Cleveland,M Minneapolis/St.

Paul,M and PittsburghN: Society

still isn’t convinced about marijuana’s harmful effects.

! New YorkN and PhiladelphiaM: The

perception of harm has not

declined because clients never

thought it was harmful.

! San Francisco:M Perception of harm

is especially low at this clinic.

Decline in social disapproval. Parent

and peer attitudes toward marijuana

use appear to present a challenge in

treating marijuana-using youth.

! Chicago:N Peers and parents smoke

it, so it’s not just a decline in 

disapproval, but actually an

increase in approval.

! Cleveland:

M Parents of many

clients smoke marijuana.

! Pittsburgh:N Many parents also

used marijuana when they were

young, so they don’t treat it 

seriously.

! St. Louis:N An inconsistency exists

between parental acceptance and

institutional disapproval of 

marijuana use.

! Tampa/St. Petersburg:N Parents

are not as concerned as they

should be.

! Sacramento:N In some social

scenes, people are looked down

upon if they don’t use marijuana.

Glamorization by entertainment

industry. One particularly recurring

theme throughout the treatment

sources’ comments concerns the

harmful effects of rap music.

! Atlanta:N The glamorization of

marijuana use is more apparent in

the music culture and rap subculture than in films and TV.

! Boston:M Some TV programs

show teenagers in situations where

they are obviously (though not

explicitly) smoking marijuana.

! Cleveland:

M The music culture has

glamorized marijuana more than

the movie industry.

! Chicago:N Marijuana has become

more fashionable in the community mostly because of the rap 

culture.

! Houston:N Rappers are always 

rapping about “tokin’” and

“smokin.’” Furthermore, stars who

use drugs get a lot of publicity.

! Minneapolis/St. Paul:N Rap

videos, in particular, glamorize

marijuana use. For example, one

video shows someone smoking a

blunt and drinking a Hennessy.

! Philadelphia:N Gangster rap videos

are a big problem. They glorify a

lifestyle involving marijuana. In

these videos, “it’s in your face,”

and youth don’t have the discernment to evaluate these messages

like adults.

! Pittsburgh:N Rather than deterring

youth from marijuana use, the rap

and entertainment industry

encourages it.

! St. Louis:N The rap and hip-hop

genre has contributed to the use,

normalization, and glamorization

of marijuana.

Increased polydrug use. A few

sources name specific combinations:

! AtlantaN and ChicagoN

: Marijuana

is increasingly used with crack.

! Baltimore:M The majority of

patients come in cocaine-positive.
LOCAL DRUG MARKETS: A DECADE OF CHANGE

Pulse Check: January 2004 page 45

! Cleveland:M Clients show

decreased allegiance to any one

drug.

! Pittsburgh:N Clients use marijuana

simultaneously with heroin, diverted OxyContin®, and ecstasy.

Increased progression to use of

other drugs. Treatment sources,

overall, attribute a moderate degree

of significance to this aspect of the

problem.

! Chicago:M According to this clinic’s

biopsychosocial screening, 

marijuana is now a gateway drug

to alcohol, rather than the other

way around as in the past. 

! New YorkM and PhiladelphiaM: By

the time methadone programs see

marijuana users, they have already

progressed to other drugs. 

! Pittsburgh:N Many clients progress

from marijuana to heroin, diverted

OxyContin®, or ecstasy use.

! St. Louis:N The earlier people start

with one drug, the earlier they

usually start with others.

! San Francisco:N Newer patterns

include more dangerous combinations, including methamphetamine

or ecstasy.

! Seattle:N Marijuana clients are

branching off into use of prescription drugs, such as diverted

OxyContin®, and use of methamphetamine. All clients who use

crack, methamphetamine, and

heroin used marijuana before.

Increased severity of addiction

among clients. One source

(ClevelandM) believes that marijuana

use seems to be leveling off. Another

(St. LouisM) believes that increased

severity of addiction applies mostly to

drugs other than marijuana. Other

treatment sources, however, perceive

increases in amount consumed, availability, and potency—all of which

lead to increased addiction severity.

! Baltimore:N Users gradually

increase their intake by progressing from joints to blunts.

! Boston:M Continued use of 

marijuana interferes with the success of methadone treatment.

! ChicagoN and PittsburghN

:

Addiction severity has increased

because of increased marijuana

availability.

! Houston,N Philadelphia,N and

PittsburghN

: Addiction severity has

increased because THC potency

has increased.

! St. Louis:N The increase in 

adolescents using marijuana on a

daily basis and at a younger age

contributes to the addiction severity.

Increased court referrals involving

marijuana possession. Comments on

this subject are mixed:

! Boston:M Drug courts don’t generally refer to methadone programs.

! Dallas:N Court referrals have

increased, but that hasn’t complicated treatment.

! DenverN and Detroit:N Court 

referrals have remained stable.

! St. Louis:N If anything, court 

referrals may have declined. Laws

haven’t changed, but more and

more youth tell how police stop

them, take their marijuana away,

and just give them a warning.

! PhiladelphiaM and San Diego:N

Increased court referrals have had

the positive effect of getting 

people into treatment earlier.

Increased court referrals involving

marijuana sales. Only a few 

treatment sources have comments on

this subject.

! Atlanta:N Drug distributors are

harder to treat because they don’t

accept that they have a problem

and are therefore more resistant to

treatment.

! Cleveland:M More “heat” is placed

on users than on dealers. More

pressure on dealers is needed.

Glamorization by news media. Some

sources believe the news media have

played a positive role, while others

disagree.

! Atlanta:N The news media give

pretty accurate information.

! Boston:M The news media appear

to support medicalization and

decriminalization of marijuana.

! Cleveland:M Overall, the media

has been more responsible in

exposing the consequences of

marijuana.

! Seattle:N ONDCP’s anti-drug ads

are having an impact on youth and

adults.
LOCAL DRUG MARKETS: A DECADE OF CHANGE

page 46 Pulse Check: January 2004

SACRAMENTO

The law enforcement technical support system has shifted priorities. For

example, wiretaps are used more for

detecting terrorism activities than for

drug activities.L When people with a

drug problem get frightened, they use

more drugs—as was the case before

the Iraq war.M Referrals through the

dual diagnosis program (mental

health) have increased.N

SAN FRANCISCO

Self-treatment of anxiety with 

benzodiazepines has increased.N

LOS ANGELES

Law enforcement resources, reallocated

to security/terrorist duty, are beginning

to come back to narcotics duty. But

some still have not returned. And those

who are returning are finding more

drugs than ever because dealers have

been acting without fear of arrest.L

SAN DIEGO

Trafficking at airports has been downscaled because of increased security

measures.L

MINNEAPOLIS/ST. PAUL

Some of the best narcotics officers

have been reassigned to homeland

security.E Before the war in Iraq,

methadone patients hoarded

methadone because they were scared,

worried about the war, depressed, or

felt that “I’m going to die anyway, I

might as well have a good time.”M

DENVER

Fewer clients are entering treatment.M

PHOENIX

Anxiety and depression might have

become more severe among drug

users.

DALLAS

Some trafficking organizations may be

transiting through Dallas to the East

Coast because security measures are

tighter on the East Coast.L Treatment

enrollment is slightly elevated.M

SEATTLE

Border seizures of marijuana from

Canada have increased.E

PORTLAND, OR

On the West Coast, the outflow of

drug proceeds (cash and goods) to

Mexico has increased because law

enforcement is concentrating more on

what is coming into the United States.L

SEATTLE

PORTLAND

SACRAMENTO

SAN

FRANCISCO

SAN DIEGO

LOS ANGELES

PHOENIX

DALLAS

DENVER ST. LOUIS

CHICAGO

HOUSTON

MINNEAPOLIS/

ST. PAUL

SEPTEMBER 11 FOLLOWUP: 

HAVE THE ATTACKS AND THEIR AFTERMATH HAD ON THE More than 60 percent (46 of 75) of

the Pulse Check sources who responded to this question believe that the

attacks have had no continuing

effects on the drug abuse situation.

The remaining responses deal with

several recurring themes:

! Supplies of some drugs have

declined in some cities—for 

example, cocaine in Atlanta and

Houston and unadulterated ecstasy

in Miami; supplies of other drugs

have increased—for example,

methamphetamine in Atlanta and

“wets” (marijuana plus embalming

fluid) and hashish in Houston.

! Some trafficking routes have 

shifted, usually to avoid flying 

directly to the East Coast.

! Vehicular and other means of 

transport have replaced air 

shipment in some cities.

! Many sources perceive a shift in law

enforcement priorities from drugs to

homeland security.

! Many drug users in treatment, 

especially those with existing mental

issues, continue to experience elevated levels of anxiety, depression,

and post-traumatic stress disorder

(PTSD). Some related prescription

drug abuse is reported.
LOCAL DRUG MARKETS: A DECADE OF CHANGE

Pulse Check: January 2004 page 47

CHICAGO

Depression and anxiety have

increased among clients and have

stayed at that elevated level.N

ST. LOUIS

Traffickers are using motor vehicles

rather than carrying drugs on planes

via body strapping, body packing, or

in luggage.L

HOUSTON

Since September 11, crack availability

has declined, “wets” availability has

increased, and marijuana price has

increased. Hashish, whose production and export had been suppressed

by the Taliban in Afghanistan, has

now increased in the United States.

More alcohol and marijuana use

among the middle class is attributed

to anxiety, an impending feeling of

doom, and escapism.E

DETROIT

Pseudoephedrine trafficking is linked

to terrorist groups who use it to fund

their activities. The law enforcement

focus on the area has increased

because of its large Middle Eastern

population.L Border security has

increased, with more awareness of

traffic volume.E,N Users know their

supplies can get disrupted, so they

are more willing to use multiple

drugs, switch to whatever drugs are

available, or make their own drugs.E

CLEVELAND

Increases among clients are noted in

opiate addiction, alcohol abuse, and

antidepressant use.M

CINCINNATI

No continuing effects are reported.

ATLANTA

The powder and crack cocaine supplies

have declined; the methamphetamine

supply has increased.L Mental health

symptoms increased somewhat, as

they did again after the war in Iraq.N

TAMPA/ST. PETERSBURG

Treatment staff perceive a decrease in

funding.N

MIAMI

Increasing prescription drug abuse,

while not entirely linked to

September 11, has coincided with

trafficking crackdowns. More adulterated products are being sold as

ecstasy since the Benelux supply

route was cut off.E

BOSTON

No continuing effects are reported.

NEW YORK

Southwest Asian heroin prices have

been dropping, purity has been 

rising, and more groups have been

getting involved in trafficking the

drug. Traffickers afraid to fly directly

to New York have been going to other

cities and using rail, bus, car, and

other transportation means. Some

traffickers have broken shipments

down, making them smaller, so interdiction doesn’t stop all traffic.L

PHILADELPHIA

With increasing unemployment, a

sense of hopelessness and depression

has been increasing. Before the war

in Iraq, many adopted a “why bother”

attitude, saying “we’re going to war

anyhow.”M

BALTIMORE

Suppliers’ ability to use airports has

been curtailed substantially, but they

use other means of transportation.

Switching law enforcement efforts to

antiterrorism has limited resources

for drug abuse efforts.L

WASHINGTON, DC

Traffickers still do not ship by plane,

but they find other means of transport. Whenever the terror alert is

high, law enforcement officers come

across more drugs, but as soon as an

alert goes down everything goes back

to normal.L

PITTSBURGH

Many people with PTSD in the 

recovering population have been 

vulnerable and have not had a 

support system available. Economic

strain is an added stressor.E

ATLANTA

TAMPA/ST. PETERSBURG

MIAMI

PHILADELPHIA

NEW YORK CITY

BOSTON

BALTIMORE

WASHINGTON, DC

CLEVELAND

CINCINNATI

PITTSBURGH

DETROIT

WHAT CONTINUING EFFECTS, IF ANY, 

DRUG ABUSE PROBLEM (EITHER FOR BETTER OR WORSE)?
page 48 Pulse Check: January 2004

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CITY SNAPSHOTS

Pulse Check: January 2004 page 49

CITY SNAPSHOTS

PULSE CHECK
SNAPSHOT: ATLANTA, GEORGIA

page 50 Pulse Check: January 2004

ThreeL,N,M of four Pulse Check respondents believe the city’s overall drug

problem is very serious and stable,

and one believes it is somewhat serious but somewhat worse.E

Respondents report several changes in

Atlanta’s drug abuse scene:

! South American heroin, the most

common form available, became

more difficult for undercover officers to buy.E

! Tuberculosis cases among methadone

clients, although somewhat high in

Atlanta compared with other cities,

decreased due to increased surveillance and treatment.N,M

! Shoplifting in order to obtain

goods or cash to be exchanged for

cocaine declined over the past 10

years due to increased law

enforcement.N

! Although hepatitis C diagnoses are

increasing, they may be due to

increased awareness and testing

for the disease.N

! In general, heroin use increased;

however, the number of new heroin users declined.E

! Opiate-related overdoses increased,

perhaps because OxyContin® (oxycodone controlled-release) abusers

often switch to heroin and then

overdose.M

! Heroin is often cut with diverted

OxyContin® or powder cocaine—

both new phenomena.M

! OxyContin® abuse among

methadone treatment admissions

increased slightly, and 50 percent of

all methadone admissions now

abuse the drug.M

! Marijuana use in general increased

slightly;E however, marijuana use

among non-methadone treatment

admissions declined.N

! All forms of methamphetamine

(including ice) are less difficult to

buy.L,E The increased supply and

availability of methamphetamine

may be related to the decreased

supply of cocaine.L

! As reported in several other Pulse

Check cities, methamphetamine use

increased dramatically. Its use

increased at nightclubs and raves.E

! Locally based sellers of methamphetamine manufactured in small,

local labs increased.E

! Methylenedioxymethamphetamine (MDMA or ecstasy) has

been less difficult to buy as the

supply increased.L,E

! Ecstasy use increased dramatically,

as did the variety of use settings.E

! Independent dealers who sell

locally pressed ecstasy tablets

increased, and prices declined.E

Three sources agree that crack is

the drug related to the most serious

consequences.L,E,N The sources differ

in their perception of which drug is

most commonly abused.

What are the primary drugs of abuse

among clients in a non-methadone

treatment program? (Fall 2002)

Heroin

Crack cocaine

Powder cocaine

Marijuana

! Since spring 2002, crack has increased slightly as a primary drug among nonmethadone treatment admissions while marijuana has declined slightly.N

! OxyContin® abuse among methadone treatment clients increased between spring

and fall 2002.M One-fifth of the clients report it as a primary problem, and half of the

clients report any use.M

Source: Non-methadone treatment respondent

66%

25%

7%ATLANTA METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Total population:. . . 4,112,198

! Median age: . . . . . . 32.9 years 

! Race (alone):

! White . . . . . . . . . . . . . . 64.2%

! Black . . . . . . . . . . . . . . 29.6%

! American Indian/

Alaska Native . . . . . . . . 0.7%

! Asian/Pacific Islander 3.8%

! Other race . . . . . . . . . . . 3.6% 

! Two or more races . . . . 1.7% 

! Hispanic (of any race): . . . 6.5%

! Unemployment rate: . . . . 3.5% 

! Median household 

income: . . . . . . . . . . . $51,948

! Families below poverty level 

with children <18 years: 11.8%

Source: U.S. Census 2000* 

*The census data in this table are provided as a frame of reference for the information given by Pulse Check sources. Whenever possible, the data given by

the law enforcement and epidemiologic/ethnographic sources reflect the metropolitan area. 

What drugs do clients in a methadone

program abuse+? (Fall 2002)

(N=252)

(N=145)

+

Includes any use, whether as a primary, secondary, or tertiary drug; responses for methamphetamine and ecstasy were “very small.”

Source: Methadone treatment respondent

Heroin

Abused OxyContin®

Powder cocaine

Crack 

Marijuana

Prescription opiates other than OxyContin®

Percent 

0 20 40 60 80 100

40

20

85

15

5

50

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

2%
SNAPSHOT: ATLANTA, GEORGIA

Pulse Check: January 2004 page 51

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Sources: LLaw enforcement respondent; E

Epidemiologic/ ethnographic respondent Note: SA = South American (Colombian)

heroin; SWA = Southwest Asian heroin;

SEA = Southeast Asian heroin; ice = highly

pure methamphetamine in smokable form;

and BC bud= British Columbian marijuana

Not

difficult

at all

Undercover policeL UsersE

Heroin (in general and SA);

crack; marijuana (in general,

sinsemilla )

Powder cocaine

4

3

2

1

0

5

6

7

8

9

Methamphetamine 

(in general, ice, and imported) 

Most widely abused drug:

CrackL,N

MarijuanaE

HeroinM

No reported changes between spring

and fall 2002L,E,N,M

Second most widely abused drug:

CrackE,M

Ecstasy and methamphetamineL

MarijuanaN

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the most serious

consequences:

CrackL,E,N

HeroinM

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the second most

serious consequences:

MethamphetamineL

HeroinE

MarijuanaN

CrackM

No reported changes between spring

and fall 2002L,E,N,M

New or emerging problems:

EcstasyL

MethamphetamineE

OxyContin® abuse continues to increaseM

Sources: LLaw enforcement, EEpidemiologic/ 

ethnographic, NNon-methadone treatment,

and MMethadone treatment respondents 

Note: These symbols appear throughout this

city profile to indicate type of respondent.

Extremely

difficult

10

Crack; marijuana (in general

and local commercial grade);

ecstasy

Mexican commercial grade

marijuana; methamphetamine

(in general, locally produced,

and Mexican) 

Heroin (in general and SA);

powder cocaine

Ice

Mexican brown heroin

SEA, SWA, and Mexican black

tar heroin

BC bud and hydroponic 

marijuana

Locally produced 

methamphetamine 

Hydroponic marijuana 

SEA, SWA, and Mexican heroin;

local commercial grade marijuana and BC bud; diverted

OxyContin®

Ecstasy

Some drugs were more difficult to

buy between spring and fall 2002: 

! South American heroinL

! Crack and powder cocaine (“The

supply has dwindled substantially

since September 11, 2001.”L

)

Two drugs were less difficult to buy

since spring 2002:

! MethamphetamineL,E (as reported by

10 other Pulse Check respondents in

8 other cities)

! EcstasyL,E (as reported in New York

and Pittsburgh)

The law enforcement source believes

that the increased methamphetamine

supply may be due to the decreased

cocaine supply, and the epidemiologic source notes that within a 6-month

period, methamphetamine availability

fluctuates rapidly.E

Heroin availability declined, but use

increased:

! South American heroin, the most

common form available in Atlanta,

has become more difficult for

undercover officers to buy

between spring and fall 2002.E

! In general, heroin use increased;

however, new heroin users declined.E

COCAINE

Three sources report crack as the drug

relating to the most serious consequences, but most indicators show

cocaine use and activity have declined:

! Crack and powder cocaine have

become more difficult for undercover officers to buy between

spring and fall 2002.L

! Crack cocaine use in general 

has declined since spring 2002;E

however, crack cocaine nonmethadone treatment admissions

increased slightly.N

! Crack cocaine sales on college

campuses increased between 

spring and fall 2002.L

HEROIN
SNAPSHOT: ATLANTA, GEORGIA

page 52 Pulse Check: January 2004

METHAMPHETAMINE

MDMA (ECSTASY)

THE USE PERSPECTIVE

WHAT’S HAPPENING IN TREATMENT?

Treatment capacity

! The Pulse Check non-methadone

treatment source is with a program

that is nearly at full capacity (145

of 160 treatment slots filled).

Crack remains the most common

drug used, followed by marijuana.

(See pie chart on the first page of

this chapter.)

! The non-methadone treatment

source notes that outpatient slots

are available, but residential slots

often are not, and capacity has

declined due to funding cuts.N

! The methadone treatment source is

with a private methadone center

that is 84-percent full (252 of 300

treatment slots filled).M Although

heroin remains the most common

primary drug of abuse (at 75 percent), primary OxyContin® abusers

constitute 20 percent of clients.

M

Furthermore, 50 percent of the

clients in that program report

either primary, secondary, or 

tertiary abuse of OxyContin.

® (See

pie chart on the first page of this

chapter.)

! The methadone treatment source

notes an increase in treatment

demand not matched by increased

treatment capacity.M

Negative health consequences of

drug abuse

! HIV/AIDS, hepatitis C, and drugrelated overdoses are the most

common negative health consequences among methadone treatment admissions, and all three

have increased since spring 2002.M

HIV/AIDS may be rising due to

increased injecting drug use; the

apparent rise in hepatitis C is due

to increases in injecting drug use

and testing for the disease.

! Tuberculosis among methadone

clients, although somewhat high in

Atlanta compared with other cities,

decreased between spring and fall

2002 due to increased surveillance

and treatment.N,M

! HIV/AIDS among non-methadone

treatment clients increased slightly

due to more common heterosexual

transmission among young adults.N

! Cardiovascular problems related to

cocaine use are increasing because

people are taking higher doses of

cocaine.N

! High-risk pregnancies among 

non-methadone treatment clients

(especially wealthier clients) are relatively common and detected more

often because of increased testing.N

! The methadone source reports that

the number of dually diagnosed

clients increased in the past 10

years. These clients are difficult to

refer to mental health centers

because many do not take clients

who are on methadone.M

! Mood disorders among treatment

clients, which are the most common

comorbid disorders, increased due to

improved diagnostic techniques.N,M

! Antisocial or conduct disorders

increased among methadone treatment clients and may be related to

increased methamphetamine or

OxyContin® abuse.M

Barriers to treatment

! Among non-methadone treatment

clients, the most common barrier

to treatment is inadequate housing

during and after treatment. This

problem has increased since spring

MARIJUANA

Nearly all reports point to increasing

use and activity of the drug:

! All forms of methamphetamine

(including ice) are less difficult to

buy.L,E The increased supply and

availability of methamphetamine

may be related to the decreased

supply of cocaine.L

! Ecstasy became less difficult to

buy between spring and fall 2002

as the supply increased.L,E

! Ecstasy use increased dramatically,

the variety of use settings

! Among methadone treatment

admissions, primary OxyContin®

abuse increased.M

! Opiate-related overdoses increased,

perhaps because OxyContin®

abusers often switch to heroin use

and then overdose on heroin.M 

Marijuana use in general increased

slightly.E However, marijuana use

among non-methadone treatment

admissions declined.N

ABUSED OXYCONTIN®

! Methamphetamine use increased

dramatically. Its use is more common at nightclubs and raves than it

was in spring 2002.E

! New methamphetamine users

increased. Theyoften use the drug

by heating it and, using a plastic

tube, inhaling the vapor through

the nose—a practice referred to as

“hotrailing.”E

increased, and the drug is now

used by Whites and Blacks equally.E

! Recent adulterants include ketamine, gamma hydroxybutyrate 

(GHB), methamphetamine,

amphetamine, and dextromethorphan.E
SNAPSHOT: ATLANTA, GEORGIA

Pulse Check: January 2004 page 53

2002. “Atlanta is a homeless 

magnet, and many people emigrate

here from other places.”N

! Adolescent programs in Atlanta

have been recently discontinued.N

! Medicaid has stopped providing

transportation; thus, the nonmethadone program offers less

money for it now.N

! Violent behavior among presenting

clients and lack of trained staff to

treat comorbidity are uncommon

problems and have further declined

since spring 2002. The source

reports more and better trained staff

to treat comorbid illnesses.N

! The methadone treatment source

claims that treatment cost is their

number-one barrier and has increased

as a problem since spring 2002.M

! Other common barriers to methadone treatment include limited slot

capacity (an increasing problem due 

to higher demand for treatment),

lack of transportation or money for

transportation, cultural barriers

among Hispanics (a problem that

has grown as the Hispanic population has increased in Atlanta), and

the social stigma of treatment (especially among OxyContin® abusers,

who are typically new to treatment

for any drug).M

Increased complications for drug

treatment over the past 10 years

! Increasing availability of new drugs:

The emergence of OxyContin® as a

drug of abuse has made it much

more difficult to treat clients.M

! More polydrug use: Both treatment

respondents report polydrug use

(crack and powder cocaine and

marijuana among non-methadone

clients; and heroin, cocaine, marijuana, and benzodiazepines among

methadone clients) as increasing

steadily in the past 10 years.N,M

! Lack of housing, jobs, and job

training opportunities for recovering clients: Treatment respondents agree that resources for

recovering clients have declined

in the past 10 years and especially

in the past 2 years.N,M

WHO USES ILLICIT DRUGS?

The Pulse Check epidemiologic, nonmethadone treatment, and methadone

treatment sources were asked to

describe the populations most likely to

use heroin, cocaine, marijuana,

methamphetamine, and ecstasy. They

were also asked to describe any emerging user groups and to report on how

the drugs are used. As shown on the

following pages, user characteristics

vary by drug. Further, because of the

different perspective each brings, the

three sources sometimes describe quite

different populations and use patterns

for each drug. For example, all methadone clients are primary opiate users

who may use drugs other than opiates

in a secondary or tertiary manner. 

Who’s most likely to use cocaine?

Crack Powder cocaine

Characteristic E N M E N M

Age group (years) >30 >18 >30 >30 >30 >30 

Mean age (years) 32 30 NR 30 NR NR 

Gender Split evenly 60% male Split evenly 60% male Split evenly 60% male

Race/ethnicity Black White Black White and Black Black Black

Socioeconomic status Low Low Low Low and middle Low Low

Residence Central city Central city Central city Central city Central city Central city 

and suburbs 

Referral source N/A Criminal justice Individual N/A Individual Individual 

Level of education completed N/A High school High school N/A High school High school 

Employment at intake N/A Unemployed Unemployed N/A Part time Part time 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Crack cocaine (“pop” or “rock”) use declined between

spring and fall 2002E

; however, crack cocaine nonmethadone treatment admissions increased somewhat

over the same time period. 

! Smoking crack in combination with marijuana is a common practice.E,N

! Among new powder cocaine users, use increased somewhat since spring 2002.E These new users are more likely

than the general powder cocaine-using population to be

Black young adults of low-middle socioeconomic status

who live in the central city. The new users often smoke

powder cocaine in combination with marijuana.E
SNAPSHOT: ATLANTA, GEORGIA

page 54 Pulse Check: January 2004

Who’s most likely to use marijuana?

Characteristic E N M

Age group (years) 13–30 18–30 >18 

Mean age (years) 18 NR NR 

Gender 60% male 60% male 70% male 

Race/ethnicity White and Black Black White 

Socioeconomic status All Low Middle 

Residence All Central city Central city 

Referral source N/A Criminal justice Individual 

Level of education completed N/A High school High school 

Employment at intake N/A Unemployed Full time 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone

treatment respondent 

! Marijuana use in general

increased slightly since spring

2002;E however, marijuana

use among non-methadone

treatment admissions

declined.N

! Marijuana is often smoked in

joints, blunts, and pipes.E,N,M

! Respondents report no

changes in marijuana user

and use characteristics

between spring and fall 2002.

How do users take heroin?

Characteristic E N M

Primary route of Injecting Injecting Injecting 

administration 

Other drugs taken Powder cocaine Powder or crack Crack cocaine or 

(speedball) cocaine (speedball) benzodiazepines 

(in combination)

Publicly or privately? Privately Publicly Privately 

Alone or in groups? Both Alone Alone 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; Methadone

treatment respondent

! Sources agree that injecting is

the most common route of heroin

administration in Atlanta.E,N,M

! Cocaine is often injected with

heroin as a speedball.E,N,M

! Sources report no changes in use

characteristics.

Who’s most likely to use heroin?

Characteristic E N M

Age group (years) >30 >30 >30 

Mean age (years) 32 NR NR 

Gender 80% male Male 62% male 

Race/ethnicity Black Black White 

Socioeconomic status Low Low Low 

Residence Central city Central city Central city 

Referral source N/A Individual Individual 

Level of education completed N/A High school High school 

Employment at intake N/A Unemployed Full and part time 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! In general, heroin use increased

between spring and fall 2002.E

! Sources agree that most heroin (“boy,”

“little boy,” and “mac”) users are males

older than 30 of low socioeconomic

status who live in the central city.E,N,M

! New heroin users, who declined in

number since spring 2002, are more

likely than the general heroin-using

population to be White young adults

of middle socioeconomic status who

snort the drug.E
SNAPSHOT: ATLANTA, GEORGIA

Pulse Check: January 2004 page 55

Increased THC potency of marijuana 

Glamorization by entertainment industry 

Decline in users’ perception of harm 

Decline in social disapproval (e.g., peers, parents, etc.) 

Increased polydrug use

Earlier initiation of marijuana use 

Increased progression to use of other drugs

Increased overall difficulty in treating the addiction 

Increased court referrals involving marijuana sales 

Increased severity of addiction among clients 

Glamorization by news media 

Increased court referrals involving marijuana possession

0 12 345

Extent complicated treatment

Not at all Extremely complicated

Marijuana-using clients: To what extent have changes in the following problems

complicated their treatment over the past 10 years?

What they have to say... 

! Increased THC potency of marijuana: Rated as somewhat of

a problem in treating marijuana

clients, the increased potency

of the drug has caused “greater

dependence on marijuana”

than it has in the past.N,M

! Increased court referrals

involving marijuana sales: One

source states that “drug distributors are harder to treat

because they don’t accept that

they have a problem and often

resist treatment.” N

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

Marijuana, used either alone or with

other drugs, is associated with the

following consequences, which

remained stable between spring and

fall 2002:

! Drug-related arrestsN

! Dropping out of schoolN

! Unemployment ratesN

! Short-term memory lossM

! Poor workplace performanceM

Problem Change

!$Non-methadone treatment respondent

#$Methadone treatment respondent

0

0

0

0

Less emphasis by law 

enforcement and courts 

Decline in price

Increased THC potency 

Decline in social disapproval (e.g., peers, parents, etc.)

Decline in users’ perception of harm

012 3 45

Extent contributed

Not at all Extremely

Widespread marijuana availability and use over the past 10 years:

To what extent have the following contributed? What they have to say... 

! Less emphasis by law enforcement and

courts and decline in the price of marijuana contribute most to increased

marijuana activity.L

! THC potency has increased 7 percent

over the past 10 years, which is seen

as somewhat responsible for increased

marijuana use.L

! The law enforcement source believes

that indoor marijuana farms, promotion

of marijuana as “medicine,” and glamorization by the entertainment industry

and news media are not related to

increased marijuana activity.

Source: Law enforcement respondent

Reason
SNAPSHOT: ATLANTA, GEORGIA

page 56 Pulse Check: January 2004

Who’s most likely to abuse OxyContin®?

Characteristic E M

Age group (years) >30 >30 

Gender NR 55% male 

Race/ethnicity White White 

Socioeconomic status NR Middle 

Residence Suburbs Suburbs 

Sources: EEpidemiologic/ethnographic respondent; MMethadone treatment respondent.

! OxyContin® abuse among methadone treatment

admissions increased somewhat since spring

2002. Half of all methadone admissions now

abuse the drug.M

! OxyContin® abusers tend to be White adults older

than 30 who live in the suburbs.E,M

! Oral administration is most common, and combining hydrocodone (Vicodin®) with OxyContin® is

a common practice.M

Characteristic E

Age group (years) 13–30 

Gender Split evenly 

Race/ethnicity White 

Socioeconomic status Middle 

Residence Suburbs and rural areas 

Primary route of administration Snorting 

Other drugs taken Ecstasy (in combination and

sequentially to “kick it up”) 

Publicly or privately? Both 

Alone or in groups? Both 

Source: EEpidemiologic/ethnographic respondent

! Methamphetamine use in general increased dramatically since spring 2002.E

! Methamphetamine users tend to be White, 13–30

years old, and split equally between genders.E

! New methamphetamine users are younger than the

general methamphetamine-using population (adolescents versus adolescents and young adults ) and are

more likely to use the drug publicly and in groups.E

! New methamphetamine users often heat the drug and,

using a plastic tube, inhale the vapor through the

nose—a practice referred to as “hotrailing.”E

! The use of methamphetamine with ecstasy has

increased, especially at nightclubs and raves.E

Who’s most likely to use methamphetamine, and how do

they take the drug?

Who’s most likely to use ecstasy?

Characteristic E

Age group (years) 13–30 

Gender 60% male 

Race/ethnicity White and Black 

Socioeconomic status Middle 

Residence Suburbs 

Source: EEpidemiologic/ethnographic respondent

! Ecstasy use increased dramatically between spring and fall 2002.E

! Most ecstasy users are male adolescents and young adults who are

equally likely to be White or Black.E

! Although ecstasy is most often used in public places, the epidemiologic

source reports an increase in use in private residences and increased

diversity in the places where people use the drug.E
SNAPSHOT: ATLANTA, GEORGIA

Pulse Check: January 2004 page 57

WHERE ARE DRUGS USED AND

SOLD?

Heroin and crack cocaine are most

often sold in central city areas, and

powder cocaine, methamphetamine,

and ecstasy are most often sold in

central city and suburban areas.L Since

spring 2002, methamphetamine and

ecstasy sales increased in central city

areas.E

Drug sales in Atlanta, excluding

methamphetamine sales, often take

place on streets and in open-air markets. Three known open-air drug markets exist in Atlanta neighborhoods:

Pittsburgh, Mechanicsville Community,

and Vine City (“The Bluff”). The number of buyers who go to the two former markets declined, but the open-air

market in Vine City has become busier. 

Along with open-air market sales,

heroin sales occur in a variety of

mostly public settings:

! Crack houses and shooting galleriesL,E

! Public housing developmentsL,E

! Hotels/motelsL,E

! Around shopping mallsL

! Private residencesE

! Around drug or alcohol treatment

clinicsE

Crack and marijuana are sold at all

heroin sales locations plus the following: 

! In or around schoolsL,E

! College campusesL,E

! Nightclubs and barsL,E

! Playgrounds and parksL

! Private partiesL,E

! RavesL,E

! ConcertsL,E

! Around supermarketsL

! Inside carsL

! Around drug or alcohol treatment

clinics (excluding marijuana)E

Crack cocaine sales on college campuses increased between spring and

fall 2002.L

Methamphetamine and ecstasy sales

occur in more private settings than do

heroin sales:

! Private residencesL,E

! Nightclubs and barsL,E

! Private partiesL,E

! RavesE

! ConcertsL,E

! Hotels/motelsL

! The Internet (excluding ecstasy)E

Additionally, ecstasy is sold around

shopping malls, in or around

schools,L,E and on college campuses.E

Use settings for the various drugs

tend to mirror their sales settings.

Between spring and fall 2002, one

source notes two changes in use settings: methamphetamine use is now

more common at nightclubs and

raves, and ecstasy is used in a wider

variety of settings.

HOW DO DRUGS GET FROM SELLER

TO BUYER?

To purchase heroin, crack and powder cocaine, or marijuana, a buyer

must know in what neighborhoods

(open-air markets), public housing

developments, or shopping malls

drugs are available. The buyer goes to

a known location and approaches a

dealer openly for a hand-to-hand

exchange of the drug.L,E

Along with out-in-the-open sales,

powder cocaine and marijuana are

often purchased via delivery: sellers

may be involved with the same buyers

for several years, and buyers contact

dealers (via cell phones and e-mail) to

set up a delivery to their private residences.L,E

In addition to street sales, marijuana

is sold in some settings (college campuses and schools) via acquaintance

networks. At certain venues (raves

and concerts), buyers can “ask

around” about where to purchase

marijuana, and someone will direct

them to a dealer for a hand-to-hand

exchange of the drug.L

Methamphetamine sales are more private than other drug sales in Atlanta:

a mutual acquaintance must introduce

buyers to sellers to facilitate a sale, or

a buyer must know a nightclub or bar

where methamphetamine is sold.L

Ecstasy is sold in a variety of ways,

including at open-air markets similar

to heroin sales, and the following: 

1. A buyer goes to a particular nightclub, bar, concert, or rave and

“asks around” for the drug.L,E

2. Ecstasy dealers have private parties

at private residences where the

drug is sold and used.L

3. Buyers call their “regular” dealer

to have the drug delivered.E

WHO SELLS HEROIN, CRACK AND

POWDER COCAINE, AND MARIJUANA?

Most heroin, crack cocaine, and marijuana dealers (who often sell all three

drugs) are young adults organized into

loose-knit gangs whose members tend

to live in the same neighborhoods and

obtain drugs from the same supplier.L

Many sales also involve “runners,”

adolescents who act as liaisons

between sellers and buyers.E

Most powder cocaine dealers are

adults older than 30 who are organized and connected to the trafficking

organizations.L

THE MARKET PERSPECTIVE
SNAPSHOT: ATLANTA, GEORGIA

page 58 Pulse Check: January 2004

Which drug sellers are associated with which crimes?

Heroin Powder Crack Marijuana Metham- Ecstasy

Crime cocaine cocaine phetamine

Prostitution % %

Gang-related activity %% % %

Violent criminal acts: %% % % %

robberies and burglaries

Nonviolent criminal acts: %% % % % %

shoplifting 

No other crimes associated % %

Sources: Law enforcement respondent; Epidemiologic/ethnographic respondent

Drug dealers are associated with a wide variety

of crimes in Atlanta,

including robberies, 

burglaries, gang-related

crimes, shoplifting, and

prostitution.L,E

WHO SELLS METHAMPHETAMINE

AND ECSTASY?

Methamphetamine sellers are 

divided into two groups based on the

type of methamphetamine sold:E (1)

methamphetamine manufactured in

large Mexican labs is sold by adults

older than 30 whose organization is

controlled by Mexican trafficking

groups; (2) methamphetamine 

manufactured in small, local labs is

sold by independent young adults, a

group that increased since spring

2002.

Ecstasy dealers may be organized and

affiliated with ecstasy traffickers, or

else independents who sell locally

pressed pills.L,E Independent dealers

increased between spring and fall

2002.E

How pure are heroin, cocaine, and marijuana, and how much do they cost?

Drug Unit Purity Price 

South American heroin “20 bag” >50% $20E

One hit NR $30L

1 g $300L 

Crack One rock NR $5, $10, $20L,E

Powder cocaine One bag 60% $5E 

Marijuana (commercial Dime bag (2–3 g) NR $10L,E

grade or sinsemilla) 1 oz NR $120E

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic respondent

Most prices and purity levels

remained stable between spring

and fall 2002 with a few exceptions:

! Heroin prices declined at all unit

levels.L

! Heroin is often cut with

OxyContin® or powder cocaine—

both new phenomena since

spring 2002.M

! Crack cocaine dealers often “run

specials” such as two rocks for

one on Sundays.E

How much do methamphetamine and ecstasy cost?

Drug Unit Price

Methamphetamine (powder) One hit $10, $20L

Ecstasy One pill $15–$20E

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic

respondent

! Methamphetamine purity is about 34 percent at most unit

levels. Price and purity have remained relatively stable

between spring and fall 2002.E

! Ecstasy prices have declined from $20–$25 to $15–$20

per pill. Recent adulterants include ketamine, GHB,

methamphetamine, amphetamine, and dextromethorphan.E
SNAPSHOT: ATLANTA, GEORGIA

Pulse Check: January 2004 page 59

Cash

Shoplifted merchandise

Property/

Merchandise

Sex

Other stolen merchandise

(e.g., electronic equipment)

Heroin

Crack cocaine

83% 68% 65%

10%

4%

5%

8%

8%

15%

85% 80%

5%

10%

5%

5%

13%

9%

6%

5%

Beyond cash: What else is accepted in exchange for drugs?

Powder cocaine

Source: Mean of response ratings given by non-methadone and methadone treatment respondents. The non-methadone respondent did not provide

information on methamphetamine exchanges.

What they have to say...

! Like in nearly all Pulse Check cities, cash

remains the number-one means of exchange

for drugs.N,M

! One source reports that sex in exchange for

crack and powder cocaine increased over the

past 10 years.N

! Although still accounting for nearly 10 percent

of all cocaine exchanges, shoplifting as a mode

of exchange declined over the past 10 years

due to increased law enforcement.N

! As reported in several Pulse Check cities, food

stamps are no longer used in exchange for

drugs because people are not able to manipulate the new electronic version of food stamps.N

Marijuana Methamphetamine 

10%

3%

1%

COMMUNITY INNOVATIONS AND TOOLS

OVER THE PAST 10 YEARS: HOW

SUCCESSFUL HAVE THEY BEEN?

! Task forces: Like in many Pulse

Check cities, task forces rate as the

most successful law enforcement

innovation for combating drug

activity. The law enforcement 

source suggests even more communication between local law enforcement and regional and Federal task

forces. 

! Drug courts: Over the past 10 years,

the number of drug courts has

increased, and Atlanta now has countyand municipal-level drug courts.N

Drug marketing innovations and tools over the past 10 years: To what degree

have they complicated efforts to detect or disrupt drug activity in Atlanta?

More organized networks 

Relocation of sales settings

within the community 

Throwaway cell phones

Less organized networks

Expansion of drug sales beyond

the central city 

01 2 3 4 5

Degree of complication

Not at all Extremely complicated

Source: Law enforcement respondent

What they have to say...

! Drug marketing innovations

that have posed the greatest

challenges for narcotics

enforcement include more

organized sales networks,

relocations of sales settings

within the community, and

throwaway cell phones.L

SEPTEMBER 11 FOLLOWUP

The law enforcement source reports

a large decline in the supply of

crack and powder cocaine since

September 11, 2001. The methamphetamine supply, which has

increased recently, may be substituting for the lack of cocaine. The

non-methadone treatment source

reports a general increase in mental

health disorders and comorbidity

among treatment clients.N

Illicit marketing innovation/tool
SNAPSHOT: BALTIMORE, MARYLAND

page 60 Pulse Check: January 2004 BALTIMORE PRIMARY METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Total population: . . . 2,552,994

! Median age: . . . . . . 36.6 years

! Race (alone):

! White: . . . . . . . . . . . . . 67.3%

! Black: . . . . . . . . . . . . . 27.4%

! American Indian/

Alaska Native: . . . . . . . 0.3%

! Asian/Pacific Islander: 2.7%

! Other race: . . . . . . . . . . 0.7%

! Two or more races: . . . 1.5%

! Hispanic (of any race): 2.0%

! Unemployment rate: . . . . 3.3%

! Median household 

income: . . . . . . . . . . . . $49,938

! Families below poverty level

with children <18 years: 10.3%

Source: U.S. Census 2000* 

Notes: These numbers may include client

reports of two primary drugs of abuse. No

clients report marijuana, methamphetamine, or

ecstasy as a primary drug of abuse.N

Source: Non-methadone treatment respondent

(N=210)

Heroin

Crack cocaine

Powder cocaine

What are the primary drugs of abuse

among clients in a non-methadone

treatment program? (Fall 2002)

0 20 40 60 80 100

80

35

5

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

Two of the Pulse Check respondents believe that Baltimore’s drug problem

is stable,L,E while the two treatment respondents report a worsening situation.N,M All four agree, however, that the city’s overall drug problem is

either somewhatL,E or veryN,M serious. Some changes are reported since

spring 2002:

! Abuse of OxyContin® (oxycodone hydrochloride controlled-release)

appears to have decreased somewhat since the springE,N The drug is no

longer considered a new or emerging drug, but rather part of the drug

culture.E

! OxyContin® is now most commonly

diverted through prescription

fraud, as opposed to pharmacy

burglaries as was the case in past

reporting periods.L

! The percentage of primary heroin

users in treatment increased.M

! Methylenedioxymethamphetamine

(MDMA or ecstasy) remains 

easily accessible to adolescents in

school settings.L,E

! Ecstasy has penetrated the traditional drug market, especially

suburban and rural youth.L

! Marijuana dealers have recently

begun selling joints dipped in

phencyclidine (PCP).L

! Juveniles are involved in distributing marijuana, often through

“underground networks.”L

*The census data in this table are provided as a frame of reference for the information given by

Pulse Check sources. Whenever possible, the data given by the law enforcement and epidemiologic/ethnographic sources reflect the metropolitan area. 

Most widely abused drug:

HeroinE,N,M

MarijuanaL

No reported changes between spring

and fall 2002L,E,N,M

Second most widely abused drug:

Crack cocaineL,E,N,M

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the most serious

consequences:

HeroinL,E

Crack cocaineN

BenzodiazepinesM

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the most serious

consequences:

Crack cocaineL,E,M

HeroinN

No reported changes between spring

and fall 2002L,E,N,M

New or emerging problems:

Ecstasy is penetrating the traditional

drug market.L

Diverted OxyContin® has grown from

a new/emerging drug to a part of the

traditional drug culture.E

Sources: LLaw enforcement, E

Epidemiologic/ethnographic, 

N

Non-methadone treatment, and

MMethadone treatment respondents

Note: These symbols appear throughout this

city profile to indicate type of respondent.

Three of the four respondents indicate that heroin is the city’s most widely

abused drug, and all concur that crack cocaine is the second most widely

abused drug in Baltimore. The methadone treatment source reports benzodiazepines as the drugs related to the most serious consequences—unlike nearly

all other Pulse Check methadone sources, who consider heroin as such.

Percentage 
SNAPSHOT: BALTIMORE, MARYLAND

Pulse Check: January 2004 page 61

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic respondent

Note: SA=South American (Colombian) heroin; SWA=Southwest Asian heroin; SEA=Southeast Asian heroin

Undercover policeL UsersE

Heroin (in general and SA); crack

and powder cocaine; marijuana (in

general, local grade, and Mexican

commercial grade) 

SEA and SWA heroin, sinsemilla;

diverted OxyContin®

Ecstasy

SEA, ketamine

Hydroponic marijuana;

methamphetamine

Heroin (Mexican black tar and

Mexican brown); local commercial grade marijuana

SWA heroin

Powder cocaine

Heroin (in general and SA),

crack cocaine, marijuana (in

general and sinsemilla)

Heroin (Mexican black tar and

Mexican brown)

! Baltimore is one of eight 

Pulse Check cities where 

users can purchase heroin with

no difficulty at all.E

! SWA heroin availability increased

since spring 2002.L

! Ecstasy is more available on the

street as a traditional drug than in

the past.L,E

! Users continue to have virtually no

difficulty obtaining heroin, cocaine, or

marijuana.L,E 

COCAINE

MARIJUANA

METHAMPHETAMINE

0

1

2

3

4

5

6

7

8

9

10

Not

difficult

at all

Extremely

difficult

HEROIN

OTHER DRUGS

Three sources consider heroin to be

Baltimore’s most widely abused

drug,E,N,M and two associate the most

serious drug-related consequences

with the drug.L,E

! The percentage of primary heroin

users in treatment increased, with

70 percent representing return

clients within the methadone 

program.M

! Demand for heroin is increasing.L

! New street names for heroin

appeared in Baltimore since the

spring: (1) “dope”N and (2) “the

bomb,” which refers to heroin

from Washington, DC, that has an

estimated purity of 20 percent.L

All four respondents consider crack

cocaine to be Baltimore’s second

most widely abused drug, and three

associate it with the second most serious drug-related consequences. The

crack problem has, however, remained

stable since spring 2002, and abuse of

powder cocaine remains stable at very

low levels.N,M Methamphetamine use remains stable

at very low levels among treatment

clients,N,M and is fairly difficult to purchase on the street.L,E

! The methamphetamine that does

appear on the drug market generally comes from west of

Baltimore.

! There is some evidence of a few

small labs within the city.

! Diverted OxyContin®: After a large

increase in primary OxyContin®

abusers in the non-methadone

program last spring, the numbers

have declined to nearly zero. This

is partly attributable to the nonmethadone clinic’s move into a

“heavy heroin neighborhood” during the reporting period. The ethnographic/epidemiologic respondent

similarly notes a slight decrease in

abusers of OxyContin®.

! Ketamine: While ketamine abuse

is not pervasive in Baltimore, the

drug is well known among youth.L

The marijuana problem in Baltimore

appears stable, although use remains

at high levels.E,N

! Marijuana is the primary drug of

abuse among preadolescents and

adolescents.E

! Marijuana dealers recently began

selling joints dipped in PCP.L

Ecstasy use remains stable at low 

levels,N,M but is increasingly available

on the street.L,E

MDMA (ECSTASY)
SNAPSHOT: BALTIMORE, MARYLAND

page 62 Pulse Check: January 2004

WHAT’S HAPPENING IN TREATMENT?

Treatment capacity and availability

! The Pulse Check non-methadone

treatment facility has the capacity

to serve 160 clients; however, its

current enrollment exceeds capacity at 210. Among these clients, the

primary drug of abuse is heroin,

with crack cocaine the distant second (see bar chart on the first page

of this chapter). This clinic relocated during the reporting period,

accounting for some of the

changes seen among treatment

clients (see the Other Drugs arrow

on the previous page).

! The methadone treatment facility

can serve up to 620 clients, with a

current enrollment of 597. Seventy

percent of the program’s treatment

population are return clients for

primary heroin abuse.M

! While treatment is somewhat

more available through both 

public and private clinics in

Baltimore, methadone programs

continue to have waiting lists 

several months long.E,M

Consequences of drug use

! The number of clients with hepatitis C increased significantly in the

non-methadone program, largely

attributable to the clinic’s new

location: a significant number of

clients come to treatment directly

from jail, where hepatitis C prevalence is great.N In the methadone

program, hepatitis C diagnoses

remain stable at high levels.M

! An increase in drug-related automobile accidents is noted among

methadone treatment clients.M

Co-occurring disorders

! A lack of trained staff to treat 

comorbid clients increased as a

major barrier to treatment within

the methadone program, due to

insufficient funding for staff and

the increased severity of patient

problems.M

! The rate of clients with dual diagnoses in the methadone program

remains high, at 80 percent. Mood

disorders account for the majority

of the mental health issues.M

! Comorbidity (psychosis, mood 

disorders, post-traumatic stress 

disorder [PTSD], and physical 

and sexual abuse) increased among

clients in the non-methadone treatment program. This is due to more

effective identification of dual

diagnoses by new staff trained to

treat comorbid disorders.N

WHO USES ILLICIT DRUGS?

The Pulse Check epidemiologic, 

non-methadone treatment, and

methadone treatment sources were

asked to describe the populations

most likely to use heroin, cocaine,

marijuana, methamphetamine, and

ecstasy. They were also asked to

describe any emerging user groups

and to report on how the drugs are

used. As shown on the following

pages, user characteristics vary by

drug. Further, because of the different perspective each brings, the three

sources sometimes describe quite 

different populations and use patterns for each drug. For example, 

all methadone clients are primary

opiate users who may use drugs

other than opiates in a secondary 

or tertiary manner. 

Who’s most likely to use heroin?

Characteristic E N M

Age group (years) >30 >30 >30 

Mean age (years) 35 37 40 

Gender Male 70% male 65% male 

Race/ethnicity Black Black White and Black

Socioeconomic status Low Low Low 

Residence Central city Central city Central city 

Referral source N/A Criminal justice Criminal justice 

Level of education N/A Did not complete school Did not complete

completed school

Employment at intake N/A Unemployed Unemployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! The education level of heroin users

declined, with more clients in the

methadone program achieving less than a

GED (general equivalency diploma).M

! While the majority of heroin users in

treatment are male (65 percent), new

treatment clients are more evenly distributed between males and females.M

! The primary referral source for heroin

users in the methadone program is now

the criminal justice system. Previously,

most clients were self-referred or came

from the health care system. This change

is attributable to a recent anticrime push

by the Baltimore Health Department that

involves many heroin users.M Similar shifts

are reported in other Pulse Check cities.

THE USE PERSPECTIVE
SNAPSHOT: BALTIMORE, MARYLAND

Pulse Check: January 2004 page 63

Who’s most likely to use marijuana?

Characteristic E N M

Age group (years) 13–17 18–30 >30

Gender Male 95% male 70% male

Race/ethnicity Black Black Black 

Socioeconomic status Low Low Low 

Residence Central city Central city Central city 

Referral source N/A Criminal justice Criminal justice 

Level of education completed N/A Did not complete school Junior High 

Employment at intake N/A Unemployed Unemployed

S Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

Who’s most likely to use cocaine?

Crack cocaine Powder cocaine 

Characteristic E N M N

Age group (years) 18–30 >30 >30 >30

Mean age (years) NR 35 35 35

Gender Male 60% female Female 60% female

Race/ethnicity Black Black Black Black

Socioeconomic status Low Low Low Low

Residence Central Central Central Central

city city city city

Referral source N/A Criminal Criminal Criminal

justice justice justice

Level of education N/A Did not complete Did not complete Did not complete

completed school school school

Employment at intake N/A Unemployed Unemployed Unemployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

How do users take heroin?

Characteristic E N M 

Primary route of 

administration Injecting Snorting Snorting and injecting

Other drugs taken Powder cocaine Powder cocaine Crack cocaine

Publicly or privately? Both Privately Privately 

Alone or in groups? In groups Alone Alone

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! While the typical heroin user takes the

drug alone, most new treatment clients

use heroin in groups and with friends.N,M

Also, these new clients tend to snort the

drug, while the overall treatment population snorts and injects heroin equally.M

! Common adulterants to heroin include

baking soda, quinine, rat poison, Ajax®

cleanser, arsenic, and benzodiazepines.N

! An emerging practice of injecting crack cocaine is noted.E

! Crack cocaine users often take

the drug along with heroin.N

! Common adulterants to 

both forms of cocaine include

baking soda, quinine, rat poison, Ajax® cleanser, arsenic,

and benzodiazepines.N

! Primary marijuana users are

younger than users of other drugs:

they are typically adolescents and

young adults. Marijuana is the

most widely abused drug for these

age groups.E,N

! Primary marijuana users who 

are referred to treatment by the

criminal justice system are generally arrested for possession of

marijuana as opposed to selling

the drug.N

! As in most Pulse Check cities,

marijuana use occurs across 

age groups. 
SNAPSHOT: BALTIMORE, MARYLAND

page 64 Pulse Check: January 2004

Marijuana-using clients: To what extent have changes in the following problems complicated their treatment

over the past 10 years?

Problem change

01 23 4 5

Extent complicated treatment 

Not at all Extremely

Decline in social disapproval (e.g. peers, parents, etc.)

Decline in users’ perception of harm

Increased overall difficulty in treating the addiction

Increased court referrals involving marijuana possession

Increased severity of addiction among clients

Glamorization by entertainment industry

Increased THC potency of marijuana

Earlier initiation of marijuana use

Increased polydrug use

Increased progression to use of other drugs

Glamorization by news media

Increased court referrals involving marijuana sales

What they have to say...

! Perception of harm/social disapproval: Two factors that particularly complicate

treatment of marijuana-using clients are the declines in users’ perception of

harmN and in social disapproval of marijuana use—perceptions shared by treatment sources in many Pulse Check cities.N,M 

! Treatment difficulty: Because marijuana abusers in treatment now are younger

than the rest of the treatment population, they have few life experiences without

drug use, making it more difficult to treat their addiction.N

! Polydrug use: Polydrug use among marijuana users is far more common than it

was a decade ago, increasing the severity of their addiction and making it more

difficult to treat them.M

! Entertainment industry: Glamorization of marijuana use is cited as a major contributor to the increased difficulty in treating marijuana addiction. This includes

primarily the music industry (including music videos) and movies.N,M

!""Non-methadone treatment respondent

#""Methadone treatment respondent

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

Respondents associate marijuana,

used either alone or with other drugs,

with the following consequences,

which remained stable between

spring and fall 2002:

! Drug-related arrestsN,M

! Short-term memory lossN,M

! Deteriorating family and social

relationshipsN

! Poor academic performanceM

! Poor workplace performanceM

! Unemployment ratesN
SNAPSHOT: BALTIMORE, MARYLAND

Pulse Check: January 2004 page 65

WHERE ARE DRUGS USED AND

SOLD?

Heroin, cocaine, and marijuana are

sold throughout the city in all of

these settings:L,E

! Streets/open-air markets

! Crack houses/shooting galleries

! Private residences

! Public housing developments

! College campuses

! Nightclubs/bars

! Shopping malls

! Playgrounds/parks

! Private parties

! Raves

! Concerts

! Hotels/motels

! Around drug treatment clinics

! Inside cars

Cocaine is also used in these settings,

with the exception of college campuses, shopping malls, raves, and around

drug treatment clinics. While heroin

is sold in these varied settings, it is

generally used in the streets, in crack

houses/shooting galleries, private residences, public housing developments,

playgrounds/parks, hotels/motels, and

inside cars.

In addition to all the locations listed

above, marijuana is also sold in

school settings.L Users smoke the drug

in all of the sale settings except for

schools, shopping malls, and around

drug treatment clinics.E

Ecstasy sales have moved into many

of these traditional drug markets,

including the streets, private residences, schools and colleges, nightclubs/bars, shopping malls, playgrounds/parks, private parties, at

raves and concerts, and inside cars.

The drug is also used in all of these

settings, except for playgrounds/parks

and concerts.L,E

Widespread marijuana availability and use over the past 10 years: To what

extent have the following contributed?

THE MARKET PERSPECTIVE

Reason

Extremely

Less emphasis by law enforcement and courts 

Decline in users’ perception of harm

Other: Internet communications

Decline in social disapproval

Increased THC potency

Decline in price

Promotion of marijuana as “medicine”

Not at all

What they have to say...

! Law enforcement/courts: Compared with many other Pulse

Check cities, the Baltimore law enforcement and court system seems to place less emphasis on marijuana (according

to average ratings by Pulse Check law enforcement sources).

! Perception of harm: Widespread availability and use of marijuana among youth has been substantially affected by a

decline in users’ perception of harm. Further, not only has

there been a notable decline in social disapproval of marijuana use, but there is now significant peer pressure to smoke

marijuana.L

! Internet: Communications over the Internet make information about marijuana easily accessible and has increased

pressure to use the drug.L

WHO’S MOST LIKELY TO USE ECSTASY?

! Ecstasy users in Baltimore are 

primarily young adults using privately in groups or among

friends;E,M males and females are

equally likely to use the drug.E

! Blacks residing in the central city

are growing as an ecstasy-using

population,E,M shifting from primarily White users living in more 

suburban and rural areas.E

! Primary ecstasy users are generally

more educated than primary users

of other drugs.M

012 3 4 5

Source: Law enforcement respondent Extent contributed
SNAPSHOT: BALTIMORE, MARYLAND

page 66 Pulse Check: January 2004

HOW DO DRUGS GET FROM SELLER

TO BUYER?

! Transactions involving heroin and

cocaine generally take place in the

central city,E although cocaine sales

also occur in large numbers in the

suburbs.L

! Heroin and cocaine users often

have one dealer, who will get

whatever they request through

either open-air markets or telephone communications.E Users

often go to a known market area

to find such a dealer.L The dealer

sometimes takes the money for the

drugs and then directs the user

where to pick them up.L

! Some dealers distribute free drugs

to “testers” early in the morning,

and then count on word-of-mouth

to bring them more buyers

throughout the day based on the

quality or purity of the drug.E

! Marijuana and ecstasy sales take

place in all areas of Baltimore.

Dealers often sell these two 

drugs only.L,E

! While ecstasy users formerly needed to know a dealer personally, the

drug is becoming more common

on the street.L

! Diverted OxyContin® is typically

acquired through prescription

fraud, with one person giving

addicts fraudulent prescriptions to

fill; the user then returns the filled

prescription to the dealer, who

gives some back to the user and

sells the rest.L

Beyond cash: What else is accepted in exchange for drugs?

Heroin

Cash

73%

8%

8%

1%

1%

4% 5%

Powder cocaine

76%

9%

8%

Crack cocaine

64%

9%

18%

Marijuana

84%

Shoplifted merchandise

Property/Merchandise

Drug buying services

Lookout services

Other: Includes items accounting for less than 3 percent of

transactions for all four drugs, such as other drugs, transporting the drugs, food stamps, and injecting services.

Sex

Note: The epidemiologic/ethnographic source provided information about heroin only.

Source: Mean of response ratings given by law enforcement, epidemiologic/ethnographic, non-methadone treatment, and methadone treatment respondents

What they have to say...

! As in all Pulse Check cities, cash remains the primary

currency for drug transactions in Baltimore.L,E,N,M

! While the exchange of sex for drugs is a common 

practice for drugs like heroin and cocaine, it is virtually

unheard of among marijuana users.L,E,N,M

! Receiving marijuana as payment for providing drug

buying services is more common for marijuana transactions than for those involving other drugs.M

3%

2% 2% 2% 4%

4%

2%

5% 3%2%

4%
SNAPSHOT: BALTIMORE, MARYLAND

Pulse Check: January 2004 page 67

WHO’S SELLING HEROIN?

! Heroin sellers in Baltimore range

from adolescents and young adults

operating independentlyE to adults

working within organized structures.L

! An increasing level of violence is

associated with heroin dealers, due

to gangs seeking new “territories”

within the city.E

! Heroin dealers sometimes sell

heroin and powder cocaine in one

bag for speedballing.E

WHO’S SELLING COCAINE?

! Dealers of both crack and powder

cocaine work within structured

organizations and are often involved in prostitution, gang-related

activity, and violent criminal acts.L,E

! Crack dealers are younger than

powder cocaine dealers.L,E

! Powder cocaine dealers often pack

the drug in pills and lace it with

heroin.E

WHO’S SELLING MARIJUANA?

! Persons of all ages, from preadolescents to adults, sell marijuana.L,E

! Marijuana dealers are likely to use

the drug as well,L,E and are often

involved in both violent and nonviolent criminal acts.L

WHO’S SELLING METHAMPHETAMINE?

! Sales of methamphetamine are 

very low throughout Baltimore, 

but there are some indications of

lab activity in the city.L

! Those who do sell the drug are young

adults working independently.L

WHO’S SELLING ECSTASY?

! Adolescents continue to represent

the vast majority of ecstasy

dealers,E although young adults

also commonly deal the drug.L

! Most ecstasy dealers work independently.L

How much does marijuana cost?

Unit Price

Joint $1–$3

Blunt $10–$12

Ounce $100

Pound of sinsemilla $3,700–$4,700

Source: Law enforcement respondent

How much does heroin cost? 

Unit Price

Vial $5–$10E

Bag $10L

Capsule $10L

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

How much does cocaine cost?

Form Unit Price 

Crack Rock $5–$10L,E

Powder Vial/“baggie” $5–$10E

1 g $90–$100L

3–5 g $270–$500L

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

Which drug sellers are associated with which crimes?

Crime Heroin Crack Powder Marijuana Diverted Ketamine

cocaine cocaine OxyContin®

Gang-related activity $$ $

Violent criminal acts $$ $ $

Nonviolent criminal acts $$ $ $ $ $

Prostitution $$ $ $

Sources: Law enforcement and epidemiologic/ethnographic respondents

All reported prices are stable

between spring and fall 2002. 

All reported prices are stable

between spring and fall 2002. 

! All reported prices are stable

between spring and fall 2002.

! Dealers will break off a particular

size of rock depending on how

much money the user can pay.E 

Who’s selling other drugs, and

how much do they cost?

Drug Unit Price

Diverted 1 mg $1L

OxyContin® 1 pill $30E

Ecstasy 1 pill $18–$20L

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

! All prices are stable between

spring and fall 2002.

! Unlike many other cities such

as Philadelphia and Detroit,

diverted OxyContin® dealers 

in Baltimore typically use the

drug themselves, and are also

involved in both prostitution

and property crimes.L,E

! Young adults working independently are the primary

dealers of ketamine, which

they obtain through burglaries

of veterinary clinics.L
SNAPSHOT: BALTIMORE, MARYLAND

page 68 Pulse Check: January 2004

Drug marketing innovations and tools over the past 10 years: To what degree have they complicated efforts

to detect or disrupt illicit drug activity in Baltimore?

012 3 4 5

Degree of complication

Not at all Extremely complicated

Other: Cell phones

Relocation of sales settings within the community

Expansion of drug sales beyond the central city

Polydrug dealers

Less organized networks

More organized networks

Throwaway cell phones

Increased communications via Internet

Unique packaging

THE MARKET PERSPECTIVE:

A 10–YEAR VIEW

!""Law enforcement respondent

#""Epidemiologic/ethnographic respondent 

What they have to say... 

! A Baltimore source articulates a

belief shared by the vast majority of

sources in other Pulse Check cities:

The proliferation of cellular phones

over the past decade has caused

more problems than anything else

in law enforcement efforts to disrupt drug activity. It has changed

the ways that law enforcement can

intercept transactions and provides

sellers with a degree of protection.L

! The relocation of sales settings

within the community represents a

substantial complication of efforts

to detect or disrupt drug activity in

Baltimore.E

NR=Not reported

0

NR

NR

NR

NR

NR

NR
SNAPSHOT: BALTIMORE, MARYLAND

Pulse Check: January 2004 page 69

SEPTEMBER 11 FOLLOWUP

Three of the four Pulse Check sources believe that the September 11 attacks and their aftermath have had no continuing

effects on the drug abuse problem in Baltimore. The law enforcement respondent, however, notes two continuing effects

also noted by Pulse Check sources in other cities. First, the switch in law enforcement focus to antiterrorist efforts has limited resources for fighting the city’s drug problem. Second, while increased scrutiny at airports has curtailed drug trafficking

in that venue, suppliers have simply increased their use of other means of transportation.

Increased use of task forces

Drug users recognition education (DRE) for law enforcement

Prescription drug monitoring

Drug courts

Onsite lab tests

!""Law enforcement respondent 

0123 45

Degree of success

Not at all Extremely successful

What they have to say... 

! Like other Pulse Check cities, Baltimore

has used task forces effectively. Regional

task forces, in particular, can readjust their

focus as needed.L

! Drug courts have been largely successful,

but resources are currently limited. Law

enforcement is seeking to expand the drug

courts into several jurisdictions.L

! While onsite lab tests located on police

premises have been beneficial, law

enforcement points to a need for availability of reliable portable kits to all officers

working in the field.L

! Law enforcement stresses that the key to

reducing drug supply and sales is to somehow reduce dealers’ profit margin.L

Community innovations and tools over the past 10 years: 

How successful have they been?
SNAPSHOT: BOSTON, MASSACHUSETTS

page 70 Pulse Check: January 2004 BOSTON PRIMARY METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Total population: . . . 3,406,829

! Median age: . . . . . . 36.3 years

! Race (alone):

! White: . . . . . . . . . . . . . 82.5%

! Black: . . . . . . . . . . . . . . 7.0%

! American Indian/

Alaska Native: . . . . . . . 0.2%

! Asian/Pacific Islander: 4.9%

! Other race: . . . . . . . . . . 3.0%

! Two or more races: . . . . 2.4%

! Hispanic (of any race): . . . 5.9%

! Unemployment rate: . . . . 2.9%

! Median household 

income: . . . . . . . . . . . . $55,183

! Families below poverty level

with children <18 years: 8.6%

Source: U.S. Census 2000* 

*The census data in this table are

provided as a frame of reference for

the information given by Pulse Check

sources. Whenever possible, the data

given by the law enforcement and

epidemiologic/ethnographic sources

reflect the metropolitan area. 

What are the primary drugs of abuse

among clients in a non-methadone

treatment program? (Fall 2002)

Source: Non-methadone treatment respondent;

responses for primary ecstasy and methamphetamine use were zero.

(N=33)

61%

10%

12%

6% Heroin

Abused OxyContin®

(oxycodone hydrochloride controlledrelease)

Crack cocaine

Powder cocaine

Marijuana

What drugs do clients in a methadone

program use+? (Fall 2002)

Percentage 

(N=904)

99

20

18

10

3

2

1

Heroin

Powder cocaine

Benzodiazepines

Marijuana

Abused prescription barbiturates

Crack cocaine

Abused prescription opiates

0 20 40 60 80 100

Heroin remains the most common primary drug of abuse among nonmethadone treatment admissions, and

OxyContin® abuse increased slightly

between spring and fall 2002.N

Among methadone treatment admissions,

marijuana use declined slightly and benzodiazepine abuse declined dramatically

since spring 2002. Among methadone

clients new to treatment, powder cocaine

use increased slightly. 

+

Includes any use, whether as a primary, secondary, or tertiary drug; responses for methamphetamine and ecstasy were “very low.”

Source: Methadone treatment respondent

10%

Three of the Pulse Check sources

believe that the area’s overall drug

abuse problem has remained stable at

high levels,L,E,N while the methadone

treatment respondent believes it has

worsened. Sources report several specific developments:

! Three drug abuse-related health

consequences have declined since

spring, including tuberculosis (due

to improved testing and treatment),N suicide (due to increased

crisis intervention among younger

clients),N and high-risk pregnancies.M

! Diverted OxyContin® availability

declined, it is more difficult to purchase, and pharmacy robberies continue to decline.L,E,N These declines

are most likely due to media coverage of its abuse and increased law

enforcement attention. However,

Boston is now witnessing the “substitution effect”: because the drug is

no longer widely available,

OxyContin® abusers are switching

to other forms of oxycodone

(Percocet®), clonazepam

(Klonopin®), fentanyl, or heroin.E

One respondent explains that

OxyContin® abusers are switching

to “whatever drug is most available.”N

! Among methadone treatment

admissions, marijuana use

declined slightly.M

! Gamma hydroxybutyrate (GHB)

has become more difficult to purchase.E

! Methylenedioxymethamphetamine (MDMA or ecstasy) use

increased slightly, but at a slower

rate than it has in the past.E

! Cocaine (crack and powder) use

increased. This resurgence may

have occurred because adolescents

and young adults who began using

heroin several years ago have

switched to cocaine use.E

Several marketing methods for heroin and cocaine sales have changed:

! Many drug sales have moved

indoors to inconspicuous or anonymous places, such as rooftops, hallways, and restaurants.E

! Sales are increasingly “underground” and are facilitated by

beepers and cell phones.L

! Heroin and powder cocaine sales

continued to become more decentralized, and the numbers of independent dealers increased.L,E

! Polydrug sellers (typically of

heroin and crack and powder

cocaine) continued to increase.E

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)
SNAPSHOT: BOSTON, MASSACHUSETTS

Pulse Check: January 2004 page 71

Most widely abused drug:

MarijuanaL,E

HeroinN,M

No reported changes between spring

and fall 2002L,E,N,M

Second most widely abused drug:

Powder cocaineL,N,M

Crack cocaineE

Powder cocaine replaced marijuana as

the second most widely abused drug.N

Drug related to the most serious

consequences:

HeroinN,M

Powder cocaineL

Crack cocaineE

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the second most

serious consequences:

HeroinL,E

Crack cocaineN

Powder cocaineM

Crack replaced powder cocaine as the

drug related to the second most serious consequences.N

New or emerging problems:

OxyContin® abuse continues to 

increase.L,N

Ecstasy use continues to increase.L

Sources: LLaw enforcement, E

Epidemiologic/ethnographic, 

N

Non-methadone treatment, and

MMethadone treatment respondents

Note: These symbols appear throughout this

city profile to indicate type of respondent.

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

Note: SA=South American (Colombian)

heroin; SWA=Southwest Asian heroin;

SEA=Southeast Asian heroin; ice=highly pure

methamphetamine in smokable form; BC

bud=British Columbian marijuana.

Undercover policeL UsersE

Heroin (in general and SA); crack

and powder cocaine; marijuana

(in general and Mexican commercial); ecstasy 

Sinsemilla and local commercial

marijuana; diverted OxyContin®

Hydroponic marijuana

SEA

Hydroponic marijuana

SWA; sinsemilla, local commercial marijuana, and BC bud

Methamphetamine (in general

and locally produced)

Mexican heroin; Mexican

methamphetamine and ice

Heroin (in general)

SA

Crack and powder cocaine;

marijuana (in general and

Mexican); ecstasy; diverted

OxyContin®, oxycodone

(Percodan® and Percocet®),

hydrocodone (Vicodin®), and

clonazepam

BC bud

GHB

SEA, SWA, and Mexican heroin;

methamphetamine

! Respondents agree that South

American heroin, crack and powder

cocaine, Mexican marijuana, ecstasy, and diverted OxyContin® are relatively easy to purchase in Boston.L,E

! As in three other Pulse Check cities

(Cleveland, Miami, and Washington, DC), users found it more difficult to purchase diverted

OxyContin® in fall 2002. Its high

price caused demand to drop,

which then caused supply to drop.

Sales of other diverted oxycodone

products, such as Percocet®, have

taken the place of OxyContin®

sales.E

! Since spring 2002, users have

found GHB harder to purchase.E

HEROIN

0

1

2

3

4

5

6

7

8

9

10

Not

difficult

at all

Extremely

difficult

COCAINE

THE BIG PICTURE 

(continued) 

! Heroin use remained stable at relatively high levels, with increases

among young adult users.E,N

! OxyContin® and other prescription opiate abusers are increasingly switching to heroin use.E

! Cocaine (crack and powder) use

increased between spring and fall

2002. This resurgence may have

occurred because adolescents and

young adults who began using

heroin several years ago have

switched to cocaine use.E

! Among methadone admissions

new to treatment, powder cocaine

use increased between spring and

fall 2002—a consistent finding

across Massachusetts.M

The most widely abused drugs in

Boston are marijuana (as in 21

other Pulse Check cities) and

heroin (as in only 6 other Pulse

Check cities). The drugs related

to the most serious consequences include heroin, powder

cocaine, and crack. OxyContin®L,N

and ecstasyL abuse and activity

continue to emerge.
SNAPSHOT: BOSTON, MASSACHUSETTS

page 72 Pulse Check: January 2004

THE USE PERSPECTIVE

METHAMPHETAMINE

MDMA (ECSTASY)

OTHER DRUGS

MARIJUANA

DIVERTED OXYCONTIN®

Marijuana remains one of the most

widely used and available drugs in

Boston; however, among methadone

treatment admissions, marijuana use

declined slightly between spring and

fall 2002. Moreover, this group of

users aged slightly, and males

increased dramatically.M

Ecstasy use increased slightly since

spring 2002, but at a slower rate

than it has in the past.E Adolescent

use of the drug is increasing at a

faster rate than young adult use. 

! Benzodiazepines: Although benzodiazepine abuse among

methadone treatment clients

remains relatively high, the proportion has declined dramatically

between spring and fall 2002.M

! GHB: GHB became harder to purchase between spring and fall

2002.L

Methamphetamine use remains low,

and treatment admissions who use

methamphetamine are negligible. 

! While diverted OxyContin®

remains somewhat available,

abusers found it more difficult to

purchase in fall 2002. Its high

price caused demand to drop,

which then caused supply to drop.E

! Because of its high price and

decreased availability, abusers have

increasingly switched from

OxyContin® abuse to other prescription opiate or heroin abuse.L,E

! Non-methadone admissions to

treatment for OxyContin®

(“OCs”) abuse have increased

slightly, but among the general

population, OxyContin® abuse has

leveled off.N

WHAT’S HAPPENING IN TREATMENT?

Treatment capacity and availability

! The Pulse Check non-methadone

respondent is with an inpatient

facility that treats adult males and

is at 100 percent capacity (33 of

33 slots). Heroin remains the most

common primary drug of abuse

(see pie chart on the first page of

this chapter), and treatment percentages are stable, with the

exception of an increase in

OxyContin® abuse.N

! The methadone treatment respondent is with a facility that operates

at about 90 percent capacity (904

of 1,000 slots).M Twenty percent of

its heroin clients also use powder

cocaine, and 18 percent abuse

benzodiazepines (see bar graph on

the first page of this chapter). 

! Methadone maintenance treatment

is available throughout the Boston

area, but there are waiting lists:

1–2 months for public treatment

and 3–4 months for private treatment. Capacity and treatment

availability remained stable

between spring and fall 2002.E

Consequences of drug use

! Hepatitis C and drug overdoses

remain the most common drug

abuse-related health consequences

among non-methadone treatment

clients. Hepatitis C detection has

increased, most likely due to new

and improved testing and

increased awareness of the problem. Drug overdoses are most

often related to heroin and

OxyContin® abuse, typically

among young, inexperienced drug

users.

! Several drug abuse-related health

consequences have declined since

spring 2002, including tuberculosis (due to improved testing and

treatment) and suicide (due to

increased crisis intervention

among younger clients).N

! Among methadone treatment

clients, the most common drug

abuse-related health consequence

is hepatitis C, which continues to

increase, as do related medical

problems such as liver cancer.

Because the average age of clients

is increasing, age-related medical

problems have intensified. Highrisk pregnancies declined slightly

between spring and fall 2002.M

Barriers to treatment

! Limited slot capacity remains the

number-one barrier to nonmethadone treatment, and it has

increased as a problem since

spring 2002.N The lack of residential recovery homes for clients has

also increased as a problem.
SNAPSHOT: BOSTON, MASSACHUSETTS

Pulse Check: January 2004 page 73

Who’s most likely to use heroin?

Characteristic E N M

Age group (years) >30 18–30 >30 

Mean age (years) 37 30 42.2 

Gender Male 100% male* 58% male 

Race/ethnicity White White White

Socioeconomic status Low Middle Low 

Residence Central city Central city Central city 

Referral source N/A Alcohol/drug abuse Individual

care provider

Level of education N/A High school High school

completed 

Employment at intake N/A Unemployed Unemployed

*The non-methadone program serves only males.

Sources: E

Epidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Sources agree that most heroin users are White males who live in the central

city.E,N,M Treatment sources agree that most heroin admissions are high school

graduates and are currently unemployed.N,M

! The emerging group of heroin users are Whites who have recently switched

from OxyContin® abuse to injecting heroin.E

! New heroin users are much younger than the general heroin-using population

(mean age of 20 years versus 37 years).E

! Between spring and fall 2002, heroin treatment admissions are younger, and

more are referred by the criminal justice system.N

! Although lack of transportation,

money for transportation, and

insurance coverage has remained

relatively stable as a problem, the

methadone treatment respondent

believes that in 2003 it may

increase due to upcoming cuts in

insurance coverage for drug treatment.M

Comorbidity and recidivism

! The most common co-occurring

disorders among methadone 

treatment clients remain antisocial

or conduct disorders and mood

disorders, all of which continue to

increase.M Psychosis, although

occurring at lower levels than 

conduct and mood disorders, also

continues to increase.

! Nearly all primary heroin 

admissions in the non-methadone

treatment program have received

treatment (for heroin or any drug)

previously, and about 25 percent

of methadone clients have

received treatment previously.M

WHO USES ILLICIT DRUGS?

The Pulse Check epidemiologic, nonmethadone treatment, and

methadone treatment sources were

asked to describe the populations

most likely to use heroin, cocaine,

marijuana, methamphetamine, and

ecstasy. They were also asked to

describe any emerging user groups

and to report on how the drugs are

used. As shown on the following

pages, user characteristics vary by

drug. Further, because of the different perspective each brings, the three

sources sometimes describe quite different populations and use patterns

for each drug. For example, all

methadone clients are primary opiate

users who may use drugs other than

opiates in a secondary or tertiary

manner. 

How do users take heroin?

Characteristic E N M 

Primary route of 

administration Injecting Injecting Injecting

Other drugs taken Cocaine (speedball); Marijuana Powder cocaine

benzodiazepines, (in combination) (speedball), crack

prescription opiates, (sequentially), benzodiaand marijuana zepines (“BZs”), marijuana (in combination) 

Publicly or privately? Privately Privately Privately 

Alone or in groups? In groups Alone Alone

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Sources agree that injecting is the most common route of heroin administration in

Boston.E,N,M

! Among young heroin admissions, snorting is the most common route of administration, but these users often switch to injecting as they age.N

! Speedball injection is common, but the use of crack in speedballs has leveled since

spring 2002.E
SNAPSHOT: BOSTON, MASSACHUSETTS

page 74 Pulse Check: January 2004

Who’s most likely to use marijuana?

Characteristic E N M

Age group (years) 18–30 18–30 >30

Mean age (years) 25 NR 40

Gender 60% male 100% male* 72% male

Race/ethnicity White White White 

Socioeconomic status Middle Low, middle Low 

Residence Suburbs Central city, suburbs Central city 

Referral source N/A Criminal justice (for mari- Individual

juana sales), alcohol/drug

abuse care provider

Level of education completed N/A High school High school

Employment at intake N/A Unemployed Unemployed

*The non-methadone program serves only males.

Sources: E

Epidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

Who’s most likely to use cocaine?

Crack cocaine Powder cocaine 

Characteristic E N M E N M

Age group (years) >18 18–30 >30 >30 >30 >30

Mean age (years) 30 NR 30.1 35 NR 40.2

Gender 60% male 100% male* 55% male 70% male 100% male* 55% male

Race/ethnicity Black White White White White White

Socioeconomic status Low Low Low Middle Low, middle Low

Residence Central city Central city Central city Suburbs Central city, suburbs Central city

Referral source N/A Criminal justice, alcohol/ Individual N/A Alcohol/drug abuse Individual

drug abuse care provider care provider

Level of education N/A 2-year college High school N/A 2-year college High school 

completed

Employment at intake N/A Unemployed Unemployed N/A Unemployed Unemployed

*The non-methadone program serves only males.

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Cocaine (crack and powder) use increased between 

spring and fall 2002. This resurgence may have occurred

because adolescents and young adults who began using 

heroin several years ago have switched to cocaine use.E

! Among methadone admissions new to treatment, 

powder cocaine use increased between spring and

fall 2002—a consistent finding across Massachusetts.M

! Among methadone treatment admissions, crack and powder

cocaine users aged slightly, and females increased (from 40

to 45 percent) between spring and fall 2002.M

! Two respondents agree that crack users are younger, more

likely to live in the central city, and of lower socioeconomic

status than powder cocaine users.E,N

! Other drugs commonly used sequentially with crack or powder

cocaine include heroin,E,M marijuana,E benzodiazepines,E,N and

prescription opiates.E

! Most marijuana users in Boston

are young adult Whites who live

in the central city and suburbs.E,N

! New marijuana users are

younger than the general marijuana-using population (mean

age of 16 versus 25 years).

Marijuana use is on the rise

among this new group.E

! Among methadone treatment

admissions, marijuana use

declined slightly between spring

and fall 2002. Moreover, this

group of users aged slightly, and

males increased dramatically.M
SNAPSHOT: BOSTON, MASSACHUSETTS

Pulse Check: January 2004 page 75

Marijuana-using clients: To what extent have changes in the following problems complicated their treatment

over the past 10 years?

Problem change

01 2 3 4 5

Extent complicated treatment 

Not at all Extremely

Increased severity of addiction among clients

Increased polydrug use

Decline in users’ perception of harm

Decline in social disapproval (e.g., peers, parents, etc.)

Glamorization by entertainment industry

Increased THC potency of marijuana

Earlier initiation of marijuana use

Increased progression to use of other drugs

Glamorization by news media

Increased overall difficulty in treating the addiction

Other: News media in support of “medicalization” and

decriminalization

What they have to say...

The methadone treatment source

cites several changes as complicating treatment dramatically, including

increased severity of addiction

among clients, increased polydrug

use, decline in users’ perception of

harm, decline in social disapproval,

glamorization by the entertainment

industry, and the news media’s support of “medicalization” and decriminalization of the drug.M

!""Methadone treatment respondent

How do users take marijuana?

Characteristic E N M 

Primary delivery 

vehicle Joints Joints Joints

Other drugs taken Powder cocaine, OxyContin®, Phencyclidine (PCP) Heroin 

benzodiazepines, ecstasy, (in combination) (sequentially)

lysergic acid diethylamide (LSD)

Publicly or privately? Privately Privately Privately 

Alone or in groups? In groups In groups In groups

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone

treatment respondent

! Sources agree that joints are the

most common route of marijuana

administration in Boston.E,N,M

! New, adolescent marijuana users

are switching from joints to blunts

and bongs. Typically Whites use

bongs, and Blacks use blunts.E

! Sources agree that other drugs are

commonly used with marijuana.

The non-methadone treatment

respondent states: “By the time

marijuana users are referred to

treatment, they tend to use many

other drugs.”

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

Respondents associate marijuana,

used either alone or with other drugs,

with the following consequences,

which remained stable between

spring and fall 2002:

! Drug-related arrestsE

! Automobile accidentsE,N

! Short-term memory lossN,M

! Deteriorating family or social

relationshipsE

! Poor academic performanceM

! School absenteeism or truancyE,M

! Poor workplace performanceM

! Lack of motivationM
SNAPSHOT: BOSTON, MASSACHUSETTS

page 76 Pulse Check: January 2004

Widespread marijuana availability and use over the past 10 years: To what extent have the following

contributed?

Reason

Decline in users’ perception of harm

Decline in social disapproval (e.g., peers, parents, etc.)

More local production

Increase in indoor farms

Promotion of marijuana as “medicine”

Increased THC potency

Glamorization by entertainment industry

Glamorization by news media

Less emphasis by law enforcement and courts

Decline in price

What they have to say...

As in nearly all Pulse Check

cities, respondents in Boston

agree that declines in users’

perception of harm and in

social disapproval of marijuana

have contributed to widespread use of the drug.

!""Law enforcement respondent

#""Epidemiologic/ethnographic respondent

Who’s most likely to use ecstasy?

Characteristic E

Age group (years) 18–30

Mean age (years) 25

Gender Split evenly

Race/ethnicity White

Socioeconomic status Middle

Residence Suburbs

Source: EEpidemiologic/ethnographic 

respondent

Who’s most likely to abuse OxyContin®?

Characteristic E N M

Age group (years) >18 18–30 >30 

Mean age (years) 35 16–30 41 

Gender 70% 100% 58% 

male male* female

Race/ethnicity White White White

Socioeconomic Low Low, Low 

status middle

Residence Central city, Central Central 

rural city city

*The non-methadone program serves only males.

Sources: EEpidemiologic/ethnographic respondent; NNonmethadone treatment respondent; MMethadone treatment

respondent

! Although non-methadone admissions to treatment for OxyContin® (“OCs”)

abuse increased slightly, OxyContin® abuse has leveled off in the general

population.N

! As with non-methadone treatment admissions for heroin, OxyContin®

abusers are younger.N The ethnographic source states that most emerging

OxyContin® abusers are the younger siblings of OxyContin® abusers. 

! Diverted OxyContin® availability declined, most likely to due to media coverage

of its abuse. However, Boston is now witnessing the “substitution effect”:

because the drug is no longer widely available, OxyContin® abusers are switching to other forms of oxycodone, clonazepam, fentanyl, or heroin.E The nonmethadone treatment respondent explains that OxyContin® abusers are switching to “whatever drug is most available.”

! Oral administration is the most common route of OxyContin® administration,

followed by snorting and injecting.E The methadone treatment respondent

reports the common practices of snorting crushed tablets and injecting the

drug by crushing tablets, shaking the powder in cold water, and cooking the

solution (a process known as “cold shake”).

! Ecstasy use increased slightly between spring and fall 2002, but at a slower rate

than it has in the past.E Adolescent use of the drug is increasing at a faster rate

than young adult use. 

! Use among private high school students continues to increase.E

! Use among the treatment population is very low.N,M

! Most ecstasy is taken orally, but anecdotal reports of crushing the tablets, adding

water, and heating the solution for injection increased. Other drugs, such as heroin and ketamine, are sometimes added to the injectable solution.E

! Ecstasy is commonly used with marijuana, LSD, GHB, heroin, and ketamine.E

Not at all Extremely

01 2 3 4 5

Extent contributed

0

0

0

0
SNAPSHOT: BOSTON, MASSACHUSETTS

Pulse Check: January 2004 page 77

WHO’S MOST LIKELY TO USE OTHER

DRUGS?

! Methamphetamine: Use and treatment admissions are low in

Boston, with the exception of sporadic reports of methamphetamine

use among gay couples.E

! Benzodiazepines (Alprazolam

[Xanax®] and clonazepam

[Klonopin]®): Nearly 20 percent of

methadone treatment clients also 

abuse benzodiazepines, but that

proportion declined dramatically

between spring and fall 2002.

Benzodiazepine use among females

declined, possibly because females

are more compliant than males

with a new policy of the treatment

program: clients who use benzodiazepines without a prescription are

eventually discharged. 

! GHB: Use is relatively low, but

reported as common among 

strippers.E

! Promethazine (Phenergan®):

Methadone clients abuse this

phenthiazine, known as

“finnegan,” to potentiate their

methadone.E

! Barbiturates: Methadone clients

abuse barbiturates, such as phenobarbital and migraine medications,

by combining them with opiates.

About 3 percent of methadone

clients (a stable percentage between

spring and fall 2002) abuse them as

secondary or tertiary drugs.M

WHERE ARE DRUGS SOLD?

All drugs available in Boston—including heroin, crack, powder cocaine,

marijuana, methamphetamine (when

available), diverted OxyContin®,

ecstasy, and GHB—are sold in private

residences, at private parties, or inside

cars.L All drugs available, except for

club drugs, are sold on the streets and

around public housing developments.L,E In addition to the settings

listed above, heroin, crack, powder

cocaine, and marijuana are also sold

in crack houses and shooting 

galleries, playgrounds and parks, and

around supermarkets.L

Drug sales in high schools and on college campuses are common for powder and crack cocaine, marijuana,

ecstasy, and diverted OxyContin®.

Drug sales in nightclubs and bars,

raves, and concerts are common for

powder and crack cocaine, marijuana,

methamphetamine, ecstasy, diverted

OxyContin®, and GHB. Powder

cocaine, marijuana, and ecstasy are

sometimes sold via the Internet.L

The epidemiologic respondent claims

that many drug sales have moved

indoors to inconspicuous or anonymous places, such as rooftops, hallways, and restaurants. 

HOW DO DRUGS GET FROM SELLER

TO BUYER?

According to the law enforcement

source: 

Heroin, powder and crack cocaine,

marijuana, and diverted OxyContin®

are sold in a similar manner: a dealer

has a small customer or clientele list,

a buyer on the list contacts a dealer

via beeper or cell phone, and the

dealer delivers the drug to the buyer’s

residence. The small size of the clientele list protects dealers from law

enforcement. These sales are increasingly “underground” and are facilitated by beepers and cell phones. 

Methamphetamine and GHB are sold

hand to hand via acquaintance networks. Most ecstasy is sold around

schools via acquaintance networks,

typically before the drugs are used in

nightclubs and bars. 

According to the epidemiologic source:

Buyers collect lists of phone numbers

of active heroin and cocaine dealers.

When buyers want these drugs, they

call a dealer to arrange a meeting for

the exchange of the drug indoors. 

In the central city, heroin and powder

cocaine sales take place in open-air

markets, but these markets have

become decentralized in the past few

years. Thus, the introduction of beepers and cell phones to set up meetings

between buyers and sellers in public

places has occurred. In the suburbs,

meetings for the exchange of powder

cocaine are more “casual” and take

place almost exclusively in apartments. 

Marijuana and ecstasy sales are similar to the delivery method for heroin

and cocaine sales, but meetings for

the exchange of marijuana and ecstasy

usually take place in private residences of buyers or sellers. 

WHO SELLS DRUGS?

The law enforcement source states

that most drug sellers in Boston are

independent adults who sell only one

type of drug. 

The epidemiologic source states that

heroin and powder and crack cocaine

sellers fall into two groups: independent adults older than 30 and organized young adults, with an increase in

the numbers of independent sellers

and addicts who support their habits

via drug sales. Over the past 2 years,

polydrug sellers (typically of heroin,

crack, and powder cocaine) have

increased.

Marijuana, ecstasy, and diverted

OxyContin® sellers are independent

young adults.E

THE MARKET PERSPECTIVE
SNAPSHOT: BOSTON, MASSACHUSETTS

page 78 Pulse Check: January 2004

How much does South American

heroin* cost? 

Unit Price

One bindle (0.1 g) $4–$6L

One bag $10M

0.5 g $50–$75E

One bundle (10 bags) $80E

1 g $80–$150E

*Purity 60–96%L,E

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

! Between spring and fall

2002, the most common

unit of heroin sold

declined in quantity from

1 to 0.5 grams.E

! Smaller quantities of

heroin declined in price

(from $100–$150 to

$80–$150 per gram).

This may be a marketing

ploy for new buyers.E

! Over the last 10 years,

heroin prices declined

(from $20 to $10 per

bag—a lower price than

for prescription opiate

pills).M

How much does cocaine cost? 

Form Unit Price

Crack One “jum” (small 

rock, 0.1 g $10L

One “bump,” “jum”

(approximately four hits) $20–$40E

1 g $50–$60E

Powder 0.25 g $20E

1 g $50–$60E

Eightball (4 g) $200–$250L

Sources: LLaw enforcement respondent; EEpidemiologic/

ethnographic respondent

Crack and powder cocaine prices remained relatively

stable between spring and fall 2002.L,E

How is OxyContin® diverted and sold

illegally? 

OxyContin® is diverted in a variety of

ways:

! Unscrupulous doctors, some who

exchange OxyContin® prescriptions

for sexL,E

! “Doctor shopping”L

! Doctors who misprescribe the drugL

! Pharmacy robberiesL

! Falsified prescriptionsL

! Prescription thefts from individualsL

Additionally, OxyContin® is obtained

from local health providers who prescribe it to people with legitimate ailments. These people use part of the

drug and sell part of it illegally.N A

new way to divert OxyContin® has

emerged in fall 2002: well-dressed

people pose as prospective real estate

clients. When a real estate agent

shows a “client” a house, the client

rifles through medicine cabinets to

steal OxyContin®.

L

Fortunately, pharmacy robberies continue to decline, and many pharmacies now display signs stating that

they no longer sell OxyContin®.

L,E,N

Beyond cash: What else is accepted in exchange for drugs?

Heroin

Cash

44%

4%

4%

15%

7%

14%

4% 8%

Powder cocaine

80%

10%

Crack cocaine

43%

Marijuana

100%

Shoplifted merchandise

Property/Merchandise

Drug buying services

Distributing the drug

Other*

Other stolen merchandise

(e.g., electronic equipment)

Sex

* “Other” includes items accounting for 2 percent

or less of transactions for each of the five drugs,

such as transporting the drug, stealing the drug,

food stamps, and injecting services. 

Source: Mean of response ratings given by epidemiologic/ethnographic and methadone treatment respondents; the methadone treatment

respondent provided percentages only for heroin

exchanges. 

! As in most Pulse Check cities, cash is the most common means of exchange for

illegal drugs in Boston. However, drug buying services, shoplifted merchandise, and

sex are relatively prevalent as modes of exchange for heroin and crack cocaine. 

! The ethnographic source notes that shoplifted merchandise is usually exchanged

for cash, which is then used to buy illegal drugs.E 

10%

15%

15%

25%

2%
SNAPSHOT: BOSTON, MASSACHUSETTS

Pulse Check: January 2004 page 79

How much does marijuana cost?

Unit Price

0.125 oz $20E

0.33-oz bag $50E

1 oz $100–$125E

$325L

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

Which drug sellers are associated with which crimes?

Crime Heroin Crack Powder Marijuana Metham- Ecstasy Diverted

cocaine cocaine phetamine OxyContin®

Prostitution $$ $

Gang-related activity $$ $

Violent criminal acts (armed robbery, 

assault and battery, extortion) $$ $ $ $

Nonviolent criminal acts: (shoplifting, 

petty theft, petty embezzlingE

;

robberies, prescription theft, larceny, 

forged prescriptionsL) $ $ $$

Domestic violence $$ $ $

Drug-assisted rape $

No crimes associated $ $

Sources: Law enforcement and epidemiologic/ethnographic respondents

How much do various other drugs cost?

Drug Unit Price

Methamphetamine 1 g $100L

Ecstasy One pill 

or tablet $20–$25L,E

Diverted OxyContin® 20-mg pill $10–$20E

80-mg pill $80L

Oxycodone 

(Percocet®) 5-mg pill $5E

Special K One capful $5L

One bottle (1 oz) $50L

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic respondent

! Nearly all prices

for other drugs

remained stable. 

! Although ecstasy

prices are stable,

undercover officers “continue to

see more of it.”L

! Marijuana prices increased dramatically

since the last Pulse Check.

L

! The number of indoor grows (“hydrogrows”),

the amount of marijuana grown, and the

level of THC continues to increase.L

! Illegal drug sales in Boston are associated with a wide variety of crimes, including prostitution, gang-related activity, armed

robbery, extortion, assault, petty theft, shoplifting, larceny, and domestic violence.L,E

! Crack dealers (especially young adults) are more involved in crimes than any other drug dealers.E
SNAPSHOT: BOSTON, MASSACHUSETTS

page 80 Pulse Check: January 2004

01 2345

Degree of complication

Drug marketing innovations and tools over the past 10 years: To what degree have they complicated efforts

to detect or disrupt illicit drug activity in Boston?

THE MARKET PERSPECTIVE:

A 10–YEAR VIEW

Not at all Extremely complicated

Increased communications via Internet

Throwaway cell phones

More organized networks

Expansion of drug sales beyond the central city

Less organized networks

Polydrug dealers

Relocation of sales settings within the community

Fewer brand names

!""Law enforcement respondent

#""Epidemiologic/ethnographic respondent 

What they have to say...

! Less organized networks: Networks are more fragmented now, which has led to fewer police informants.E

! Fewer brand names: The decline in the use of brand names for illegal drugs has made it more difficult for law enforcement to

connect certain drugs to specific dealers.E

! Polydrug dealers: As reported in the “Who Sells Drugs?” section, dealers who sell both heroin and cocaine have increased

over the past 2 years.E

0

0

0

0

Illicit marketing innovation/tool
SNAPSHOT: BOSTON, MASSACHUSETTS

Pulse Check: January 2004 page 81

Onsite lab tests

Drug-free zone laws

Drug courts

Increased use of task forces

Prescription drug monitoring

012 34 5

Degree of success

Not at all Extremely successful

What they have to say...

! Task forces: Although task force use has not increased over the past 10 years, task forces include interaction between local

and State police, the Federal Bureau of Investigation (FBI), and the Drug Enforcement Administration (DEA). As in most other

Pulse Check cities, the law enforcement source rates task forces as relatively successful in combating drug abuse.

! Prescription drug monitoring: OxyContin® has become harder to obtain from pharmacies due to the increased attention paid

to the problem by pharmacists.E

! Drug courts: The epidemiologic source believes that drug courts are especially effective for middle class people with low levels

of drug dependency, solid support systems, high education levels, and high chances of employment.E

Community innovations and tools over the past 10 years: How successful have they been?

SEPTEMBER 11 FOLLOWUP

All four Boston Pulse Check sources believe that the September 11 attacks and their aftermath have had no effects on the

drug abuse problem.L,E,N,M

NR

NR

NR=Not reported

0

NR

Community innovation/tool

!""Law enforcement respondent

#""Epidemiologic/ethnographic respondent 
SNAPSHOT: CHICAGO, ILLINOIS

page 82 Pulse Check: January 2004

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

All four Pulse Check respondents agree that Chicago’s drug problem is stable.

However, they also believe it remains very serious. Despite the overall stability in

the drug problem, several developments are reported since spring 2002:

! As reported in eight other Pulse Check cities, methadone abuse (both as a substitute for and in addition to heroin) is increasing.N It accounts for 5 percent of

treatment clients in both the non-methadone and methadone programs.N,M

! While the numbers of methamphetamineL,E,N and methylendioxymethamphetamine (MDMA or ecstasy)L,N

users numbers remain low, they are

increasing.

! Marijuana use among methadone

clients is emerging as a new treatment

problem.M

! As in many other Pulse Check cities,

the incidence of hepatitis C among

treatment clients has increased to high

levels.N,M

! Treatment providers observe a dramatic

increase in high-risk sexual behaviors

and drug use.N

The drug market (especially for heroin)

has also changed in several ways:

! Overall, drugs have become more

available since spring 2002 (see diagram

on the following page).L,E

! Seizures of brown heroin, presumably

Mexican, are up 50 percent from

2001; however, white heroin still

accounts for the bulk of heroin available on the street.L

! The Drug Enforcement Administration

(DEA) recently seized a small sample of

base heroin (not hydrochloride), which

is common in Europe. When smoked,

this base form delivers the drug almost

as quickly as injected heroin.E

! DEA data indicate an increase in the

amount of methamphetamine arriving

from Mexico.E

Most widely abused drug:

CrackL,N

MarijuanaE

HeroinM

No reported changes between spring

and fall 2002L,E,N,M

Second most widely abused drug:

HeroinL,N

CrackE

Powder cocaineM

Between spring and fall 2002, powder

cocaine replaced crack as the second

most widely abused drug among

methadone clients.M

Drug related to the most serious

consequences:

CrackL,N

HeroinE,M

No reported changes between spring and

fall 2002.L,E,N,M

Drug related to the second most

serious consequences:

HeroinL,N

CrackE

Powder cocaineM

Between spring and fall 2002, powder

cocaine replaced crack as the drug

related to the second most serious consequences among methadone clients.M

New or emerging problems:

MethamphetamineL,E,N

EcstasyE,M

Diverted OxyContin® (oxycodone

hydrochloride controlled-release)N

Abused methadoneN

MarijuanaM

Sources: LLaw enforcement, EEpidemiologic/

ethnographic, NNon-methadone treatment,

and MMethadone treatment respondents 

Note: These symbols appear throughout this

city profile to indicate type of respondent.

What are the primary drugs of abuse

among clients in a non-methadone

treatment program? (Fall 2002)

Heroin

Methamphetamine

Ecstasy

Hydrocodone (Vicodin®)

Crack cocaine

Source: Non-methadone treatment respondent

68%

26%

CHICAGO PRIMARY METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Total population:. . . 8,272,768 

! Median age: . . . . . . 33.7 years 

! Race (alone):

! White . . . . . . . . . . . . . . 65.8%

! Black . . . . . . . . . . . . . . 18.9%

! American Indian/

Alaska Native . . . . . . . . 0.3%

! Asian/Pacific Islander 4.6%

! Other race . . . . . . . . . . . 8.2% 

! Two or more races . . . . 2.3% 

! Hispanic (of any race): 17.1% 

! Unemployment rate: . . . . 6.2% 

! Median household 

income: . . . . . . . . . . . $51,680 

! Families below poverty level 

with children <18 years: 11.4% 

Source: U.S. Census 2000* 

*The census data in this table are provided as a frame of reference for the information given by Pulse Check sources. Whenever possible, the data given by

the law enforcement and epidemiologic/ethnographic sources reflect the metropolitan area. 

(N=402)

What drugs do clients in a methadone

program use+? (Fall 2002)

+

Includes any use, whether as a primary,

secondary, or tertiary drug

Source: Methadone treatment respondent 

Heroin

Marijuana

Powder cocaine

Crack cocaine

Hydrocodone

Percent who abuse the drug

0 20 40 60 80 100

(N=266)

1% 5%

1%

95

70

30

10

5

! The use of methadone as a substitute

for heroin, or in addition to heroin,

emerged as a new problem among

non-methadone treatment clients.N

! The use of crack cocaine among methadone treatment clients decreased somewhat,

but the use of powder cocaine and marijuana increased slightly between spring and

fall 2002.M
SNAPSHOT: CHICAGO, ILLINOIS

Pulse Check: January 2004 page 83

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Not

difficult

at all Undercover policeL UsersE

Heroin (in general, SA); crack;

marijuana (in general)

Heroin (Mexican brown)

Heroin (Mexican black tar); 

powder cocaine; marijuana (sinsemilla and hydroponic); ecstasy

BC bud 

Marijuana (local commercial

grade), methamphetamine (in

general, Mexican, and ice)

Heroin (SEA, SWA)

4

3

2

1

0

5

6

7

8

9

10

Overall, the heroin problem is fairly

stable, but some increases are noted:

! The number of younger heroin

users entering treatment has

increased. These clients are typically referred by the mental health

system.N

! Heroin use among the overall drugusing population and among new

drug users appears to be increasing.E

COCAINE

HEROIN

Several increases are noted among

marijuana users in treatment:

! Hospital emergency department

mentions for marijuana remain

stable.E

! The number of adolescents and

young adults using marijuana is

increasing.N

! Heroin users in treatment have

increased their use of marijuana as

a secondary or tertiary drug.M

! The rate of depression and generalized anxiety disorder has increased

significantly among primary marijuana users in the non-methadone

treatment program.N

The cocaine problem is stable in

Chicago, although treatment providers

note two changes: 

! Among primary heroin users in

treatment, those also using crack

cocaine have decreased since spring

2002, while those using powder

cocaine have increased.M

! More sales of crack cocaine take

place within the community, as

opposed to traditional drug markets.N

Heroin (Mexican brown)

Powder cocaine; hydroponic

marijuana

Heroin (Mexican black tar);

ecstasy; phencyclidine (PCP)

Methamphetamine (locally

produced and Mexican forms,

downstate) 

Methamphetamine (in general)

Heroin (in general); crack

cocaine; marijuana (in general

and Mexican commercial grade)

Methamphetamine (locally produced and Mexican); diverted

OxyContin®

The methamphetamine problem in

Chicago is small, but growing:L,E,N

! The number of methamphetamine

users in treatment has increased

somewhat, although the numbers

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

Note: SA=South American (Colombian) heroin;

SWA=Southwest Asian heroin; SEA=Southeast Asian heroin;

ice=highly pure methamphetamine in smokable form; and BC

bud=British Columbian marijuana

METHAMPHETAMINE

Extremely

difficult

MARIJUANA

! While law enforcement

reports increased difficulty

in purchasing methamphetamine, users report

that it is becoming

easier..L,E

! It is more difficult for undercover agents to purchase ecstasy.L

! Undercover law enforcement found it easier to purchase Mexican brown heroin in

the fall.L Even though it is still relatively difficult to find Mexican brown heroin on the

street, users know where to find it.E

! Purchasing sinsemilla and hydroponic marijuana has become less difficult.L

! It has become easier for users to purchase powder cocaine.E

remain very low (see pie chart on

the first page of this chapter).

N

! Methamphetamine use in

Chicago’s gay male community is

increasing.E

! Law enforcement agencies seized

53 kilograms of methamphetamine in Chicago during 2002.L
SNAPSHOT: CHICAGO, ILLINOIS

page 84 Pulse Check: January 2004

WHAT’S HAPPENING IN TREATMENT?

Treatment capacity and availability

! The Pulse Check non-methadone

treatment facility can serve 498

clients and has a current enrollment of 402. For these clients, the

primary drug of abuse is crack

cocaine, with heroin the distant

second (see pie chart on the first

page of this chapter). Treatment

percentages for methamphetamine,

ecstasy, diverted OxyContin®,

hydrocodone, and methadone have

all increased between spring and

fall 2002, but they remain extremely low when compared with those

for heroin and cocaine.N

! The methadone treatment facility

has the capacity to serve 253

clients. It is currently operating over

capacity, serving 266. Ninety percent of clients in the methadone

treatment program are self-referred,

similar to the generally high selfreferral rates in methadone clinics

across other Pulse Check sites.M

! Funding cuts and the closing of

two major Chicago hospitals

(which served indigent high-risk

patients) have made already limited slot capacity an even greater

barrier to treatment in the community.N The waiting list at most

public clinics is at least a month,

while most private programs have

adequate slots available.E

Barriers to treatment

! Age restrictions became a more

significant barrier to drug treatment because of the increase in

juveniles needing such treatment.N

! The lack of child care remains a

common barrier to treatment in

the non-methadone program,

despite the fact that the facility has

an onsite licensed day care program. There are not enough slots

in the facility to meet demand.N

Post-treatment Issues

! Most clients have no safe place to

go following treatment, so they

end up living with old friends who

are users or dealers, which places

them back into their old living

patterns.N,M

! Currently, there are not enough

tailored recovery support services

for men, particularly fathers.N

! Recovering users who are also exoffenders find it difficult to secure

jobs following treatment, leading

to continued instability and stress.N

Consequences of drug use

! Hepatitis C is pervasive among

clients in treatment, having

increased since spring 2002.N,M

“Just about everyone [in the

methadone program] is positive.”M

Fortunately, testing is now more

widespread,M with the nonmethadone program offering

onsite testing.N

! The number of clients reporting

drug-related automobile accidents

increased, corresponding to an

increase in DUI (driving under the

influence) arrests in the State.N

! The number of HIV-positive

clients has increased since the

spring in the non-methadone 

program, likely due to the start 

of onsite testing and, therefore,

increased diagnoses.N

! The incidence of tuberculosis

among treatment clients is also up

since spring 2002, although it is

still not very common.M

! The methadone treatment respondent assesses clients as being more

physically ill than in the past. This

is due partly to clients with undiagnosed hepatitis C and to HIVpositive clients who are living

longer but are declining in health.

A positive effect, however, is that

through drug treatment, these

THE USE PERSPECTIVE

MDMA (ECSTASY)

While overall use of ecstasy remains

low,E,N the number of ecstasy users in

treatment is increasing.N

! Diverted OxyContin® : While the

number of clients in treatment

remains negligible (less than 1 percent of the treatment population),

the number seeking treatment for

abuse of OxyContin® has increased

slightly since spring 2002.N

! Diverted hydrocodone (Vicodin®):

A slight increase in clients seeking

treatment for hydrocodone use is

noted.N These clients generally

receive the drug for treatment of

chronic pain, but become addicted

and then seek to purchase it illegally.N Five percent of nonmethadone and methadone treatment clients use the drug—more

than those in treatment for

methamphetamine, ecstasy, or

diverted OxyContin® combined.N,M

! Diverted methadone: Treatment

providers report a high level of

illegal methadone use among

clientsN,M—representing 5 percent

of methadone treatment clients.M

! Phencyclidine (PCP): Use of PCP

is stable, and remains most common among young adult males living in the central city.E

! Diverted alprazolam (Xanax®):

Abuse of alprazolam is also stable.

The drug is abused equally among

males and females and among

Whites, Blacks, and Hispanics.

These users, who take alprazolam

along with alcohol, are typically

lower income adults living in the

central city.E

OTHER DRUGS
SNAPSHOT: CHICAGO, ILLINOIS

Pulse Check: January 2004 page 85

Who’s most likely to use heroin?

Characteristic E N M

Age group (years) 18–30, >30 >30 >30

Mean age (years) 35 31 39 

Gender 65% male 52% female Split evenly 

Race/ethnicity Black Black Black 

Socioeconomic status Low Low Low 

Residence Central city Central city Central city 

Referral source N/A Individual Individual 

Level of education N/A None High school

completed

Employment at intake N/A Unemployed Unemployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Younger heroin users have

entered treatment since

spring 2002.N

! The number of female

heroin users entering 

treatment increased at the

non-methadone program.

The respondent attributes

this to the availability of

programs for females at

their facility.N

individuals gain access to primary

health care facilities.M Poor dental

hygiene is becoming more common as well.N

Co-occurring disorders

! A lack of staff qualified to treat

dually diagnosed clients has increased as a significant barrier to

effective treatment. The increase in

comorbidity over the past year

puts more pressure on existing

staff,N and it is difficult to find

qualified mental health professionals willing to work for the 

pay available in drug treatment

settings.M

! The rate of psychiatric diagnoses

among treatment clients increased

to extremely high levels in the

non-methadone program. This

increase includes antisocial, conduct, and mood disorders, as well

as psychosis, suicidal thoughts/

attempts, post-traumatic stress disorder (PTSD), and attention deficit

hyperactivity disorder (ADHD).

The increase is due to many factors: better screening and identification of mental disorders,

decreased slots available within the

mental health system, and—with

respect to PTSD—trauma related

to a drug lifestyle.N

! The rate of dual diagnoses among

methadone treatment clients

remained stable at low levels, 

with the exception of mood disorders, which remained stable at

high levels.M

Changes over the past 10 years

! Treatment respondents note that

during the past decade, youth

began using more dangerous

drugs, particularly heroin.N,M The

methadone respondent estimates

that, among drug-using teenagers,

30 percent use heroin regularly,

compared with none 10 years ago.M

! As in several other Pulse Check

cities, the declining cost of drugs

represents a significant complication to Chicago’s drug problem.N,M

A rock of crack costs just $2,N and

heroin has become inexpensive

enough for more people to use it

in greater amounts.M

! Chicago’s drug problem is further

complicated by the increased practice of polydrug use, particularly

the combination of heroin and

cocaine.N

! Increasing caseloads are a major

obstacle to treating the community’s

drug problem, as is the case in several other Pulse Check cities.N,M

WHO USES ILLICIT DRUGS?

The Pulse Check epidemiologic, nonmethadone treatment, and methadone

treatment sources were asked to

describe the populations most likely

to use heroin, cocaine, marijuana,

methamphetamine, and ecstasy. They

were also asked to describe any

emerging user groups and to report

on how the drugs are used. As shown

in the following pages, user characteristics vary by drug. Further, because

of the different perspective each

brings, the three sources sometimes

describe quite different populations

and use patterns for each drug. For

example, all methadone clients are

primary opiate users who may use

drugs other than opiates in a secondary or tertiary manner. 
SNAPSHOT: CHICAGO, ILLINOIS

page 86 Pulse Check: January 2004

Who’s most likely to use marijuana?

Characteristic E N M

Age group (years) 18–30 18–30 18–30

Mean age (years) Twenties NR NR

Gender Split evenly 60% male Split evenly

Race/ethnicity Split evenly: White, Black Black 

Black, and Hispanic

Socioeconomic status All Low Low 

Residence All areas (city, Central city Central city

suburbs, rural, areas)

Referral source N/A Individual Individual 

Level of education completed N/A None High school 

Employment at intake N/A Unemployed Unemployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! As in nearly all Pulse Check cities, 

marijuana use occurs in all segments

of society. 

! The number of clients entering treatment for marijuana has increased

since the spring. This increase is predominantly among adolescents—the

rate of primary marijuana use among

adolescents in treatment is 6 percent,

compared with less than 1 percent for

the overall treatment population.N

! While most clients enter treatment on

their own initiative, an increasing number come from mental health centers,

particularly individuals diagnosed with

generalized anxiety disorder.N

! Marijuana users are smoking more

joints laced with PCP.E

How do users take heroin?

Characteristic E N M 

Primary route of 

administration Snorting and injecting Snorting Snorting

Other drugs taken Powder and crack None Powder cocaine 

cocaine (speedball) (speedball)

Publicly or privately? Privately Privately Privately 

Alone or in groups? Alone and in groups Alone Alone

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! The epidemiologic respondent notes that

nearly all new users begin by snorting

heroin, particularly new White users, 

but many soon shift to injecting. Young

Blacks, however, tend to continue snorting the drug.E

! Speedballing may be more prevalent

among Black than among White users.E

Who’s most likely to use cocaine?

Crack Powder cocaine 

Characteristic E N M E M 

Age group (years) >30 >30 >30 >30 >30

Mean age (years) 38 31 39 NR 39

Gender 60% male 52% female Split evenly 60% male Split evenly

Race/ethnicity Black Black Black NR Black

Socioeconomic status Low Low Low Low Low 

Residence Central Central city Central city Central Central

city city city

Referral source N/A Individual Individual N/A Individual

Level of education N/A None High school N/A High school

completed

Employment at intake N/A Unemployed Unemployed N/A Unemployed

Note: The non-methadone respondent did not provide information for powder cocaine.

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

Sources report two shifts in cocaine

use between spring and fall 2002:

! Powder cocaine users report an

increase in smoking rather than

snorting the drug.M

! More treatment clients report using

marijuana along with crack than in

spring 2002. This may be attributable to more crack being distributed in

traditional marijuana settings.N
SNAPSHOT: CHICAGO, ILLINOIS

Pulse Check: January 2004 page 87

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

Respondents associate marijuana,

used either alone or with other

drugs, with the following consequences, which remained stable

between spring and fall 2002:

! Drug-related emergency department visitsE

! High-risk pregnanciesN

! Short-term memory lossN

! Dual diagnoses, particularly

depression and anxietyN

! Deteriorating family and social

relationshipsM

! Poor workplace performanceM

! Workplace absenteeismM

! Unemployment ratesM

Widespread marijuana availability and use over the past 10 years: To what extent have the following contributed?

Reason

01 2 3 4 5

Extent contributed

Extremely

Increase in indoor farms

Glamorization by entertainment industry

Less emphasis by law enforcement and courts 

Increased THC potency

More local production

Glamorization by news media

Other: Unemployment increase

Not at all

!""Law enforcement respondent

#""Epidemiologic/ethnographic respondent

NR

0

NR

0

0

What they have to say...

! Emphasis by law enforcement and courts:

Chicago is one of four Pulse Check cities where

sources believe law enforcement emphasis on

marijuana has not declined. Rather, law enforcement has played a positive role in the situation by

sending more marijuana users to treatment over

the past 10 years.E

! Glamorization: Normalization, more than glamorization, of marijuana use by the entertainment

industry contributes to the increased availability

and use of the drug.E

0 1 2 34 5

Extent complicated treatment

Increased THC potency of marijuana

Increased severity of addiction among clients

Decline in users’ perception of harm

Decline in social disapproval 

Glamorization by entertainment industry

Earlier initiation of marijuana use

Increased progression to use of other drugs

Increased polydrug use

Glamorization by news media

Increased court referrals involving marijuana possession

Increased court referrals involving marijuana sales

Increased overall difficulty in treating the addiction

Not at all Extremely

Marijuana-using clients: To what extent have changes in the following

problems complicated their treatment over the past 10 years?

What they have to say:

! Perception of harm: As with many

other Pulse Check cities, the decline

in both users’ perception of harm

and social disapproval associated

with marijuana has significantly 

complicated the treatment of 

marijuana-using clients.N

! Progression from marijuana to other

drugs: Rather than alcohol serving

as a gateway to marijuana use, marijuana now appears to be a gateway

drug to alcohol.M

! Entertainment industry: The music

industry—rap in particular—has glamorized marijuana use, making treatment of marijuana-using clients

much more difficult.N

! Polydrug use: The increased polydrug use by marijuana users over 

the past 10 years is seen most often

in the combination of crack with 

marijuana.N

!""Non-methadone treatment respondent

#""Methadone treatment respondent 

Problem change

0

0

NR= Not Reported
SNAPSHOT: CHICAGO, ILLINOIS

page 88 Pulse Check: January 2004

Who’s most likely to use methamphetamine?

Characteristic E N

Age group (years) 18–30 18–30 

Gender Male 95% male 

Race/ethnicity White White 

Socioeconomic status Low/middle Middle 

Residence Rural areas Central city 

Referral source N/A Mental health system

Level of education completed N/A High school 

Employment at intake N/A Full time 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent

Who’s most likely to use ecstasy?

Characteristic E N

Age group (years) 18–30 18–30 

Mean age (years) 25 NR 

Gender Split evenly 95% male 

Race/ethnicity White White

Socioeconomic status Middle Middle 

Residence Suburbs Central city

Referral source N/A Mental health system 

Level of education completed N/A High school

Employment at intake N/A Full time

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent

WHO’S MOST LIKELY TO USE OTHER

DRUGS?

! Methadone: Abusers of methadone

range from young adults to older

adults, are generally Black, and are

split nearly evenly between males

and females.N

! Hydrocodone: Abusers of hydrocodone are typically young adults

and adults.N,M While abusers in

non-methadone treatment are 

predominantly male, White, and

middle class,N abusers in the

methadone program are split 

evenly between males and females,

and most are Black and of low

socioeconomic status.M

! Compared with the overall treatment population at the non-methadone treatment program, methamphetamine users are more likely to be male, White, 

middle class, better educated, and employed full time.N

! The proportion of White users in treatment for primary methamphetamine use

is higher than their proportion in the overall Chicago population.

WHERE ARE DRUGS USED AND SOLD?

While the overall heroin-using 

population purchases the drug in the

streets, private residences, public

housing developments, playgrounds

and parks, and around supermarkets,

new heroin users purchase the drug

either in street markets or private residences.E Heroin appears to be the

only drug still sold in crack houses or

shooting galleries in Chicago.L

Cocaine is sold in most of the same

settings as heroin, and also in school

settings and on college campuses.L

The majority of these sales venues

also serve as use settings.

Marijuana is generally used and sold

in the streets/open-air markets, private

residences, and public housing developments; on college campuses; and at

private parties.L,E It is also sold in nightclubs/bars and at raves and concerts.L

The majority of methamphetamine

transactions occur in private residences, but new and emerging users

are also buying and using in nightclubs

and bars.E

Ecstasy is typically sold and used in

private residences, nightclubs, and 

bars; at raves and concerts; and on

college campuses. The drug is also

sold, but not used, in open-air markets, in school settings, and through

package deliveries.L,E

HOW DO DRUGS GET FROM SELLER

TO BUYER?

! The same dealers generally sell

both heroin and cocaine, but most

transactions involving heroin and

crack take place in the central city,

while powder cocaine is sold in all

areas of the city.E Most of these

transactions occur face-to-face

through prearranged meetings. Cell

phones, beepers, and pagers are

common tools for communications

between seller and buyer.L,E

THE MARKET PERSPECTIVE

! In contrast to the overall treatment population at the non-methadone treatment

program, ecstasy users are predominantly White, middle class, better educated, and employed full time.N

! Generally, ecstasy users do not combine

ecstasy with other drugs,N but some

occasionally take it with nitrous oxide.E

! Unlike primary users of most other

drugs, ecstasy users most often take the

drug in public.N

! The proportion of White users in treatment for primary ecstasy use is higher

than their proportion in the overall

Chicago population.
SNAPSHOT: CHICAGO, ILLINOIS

Pulse Check: January 2004 page 89

What they have to say...

! The practice of exchanging

heroin for injecting services

has declined significantly over

the past 10 years because

needle exchange programs

have made shooting galleries

“irrelevant.”E

! While the practice of sex-fordrugs is nonexistent among

male crack cocaine users, this

practice accounts for up to 20

percent of crack cocaine purchases by females, similar to

reports in other Pulse Check

cities.N

! Female marijuana users use

sex as payment for the drug

up to 5 percent of the time, as

opposed to males, who do not

use this practice at all.N

! An estimated 60 percent of

female marijuana users

exchange food stamps for 

marijuana, while only 20 percent of males do so.N

! Rather than exchanging stolen

merchandise for drugs, many

users sell stolen merchandise

and use the cash to purchase

drugs.E Most dealers no longer

want merchandise for drugs;

they prefer cash payment.N

! As in most Pulse Check cities,

cash, by far, remains the most

common means of paying for

illegal drugs.

Beyond cash: What else is accepted in exchange for drugs?

a

The non-methadone treatment respondent did not provide data for powder cocaine. 

b

The methamphetamine data are provided by the non-methadone treatment respondent only.

Source: Mean of response ratings given by law enforcement, non-methadone treatment, and methadone treatment respondents; the epidemiologic/ethnographic respondent did not provide quantitative data.

Heroin and crack cocaine

Cash

Methamphetamineb Marijuana

75%

Shoplifted 

merchandise

Property/

merchandise

Other drugs

Food Stamps

Drug buying services

Other: Includes

items accounting

for 5 percent or less

of transactions for

all five drugs, such

as guns, transporting the drug, and

lookout services

Sex

70%

100%

Powder cocainea

88%

7%

5%

3% 3% 5%

5%

3%

7%

7%

Cocaine buyers also know where

they can go to purchase the drug

on the street without prior

arrangements.E

! Marijuana sales take place in all

areas of Chicago—central city,

suburbs, and rural areas. Dealers

sometimes conduct business on the

same street where heroin and

cocaine are sold, but they are generally not involved in the sale of

the other drugs.E

! For heroin, cocaine, and marijuana, several layers of people tend to

be involved in the transactions.

For example, a buyer may go to

one location to ask for the drug,

follow directions to another 

location to pay, and then meet

someone else to take possession of

the drug. These transactions take

place in either fairly open street

settings or in more discreet locations such as stairwells, particularly in public housing areas.L

! Methamphetamine sales occur

primarily in the central city, either

through meetings arranged via telephone or in social settings between

seller and buyer.E The number of

meth labs operating in Chicago is

believed to be very small; law

enforcement has not seen any new

meth production since a number of

seizures in spring 2002.L

! Dealers sell ecstasy in both the

central city and the suburbs

through prearranged meetings,

friend/acquaintance networks, on

the street, or by simply walking 

around semipublic settings such as

nightclubs or raves.L,E In the latter

case, “hawkers” walk through the

setting announcing “caps” or

“rolls” to advertise their product.E

These dealers often sell gamma

hydroxybutyrate (GHB) and lysergic acid diethylamide (LSD) along

with ecstasy. Ecstasy transactions

that do take place on the street are

usually in different locations from

heroin and crack sales.L

! Law enforcement officials occasionally identify OxyContin® being

diverted through the postal system, but they have not detected

traditional dealing of the drug.L

! Most drug seizures by the DEA

involve truckloads of multiple

drugs—mostly heroin and cocaine,

as well as methamphetamine.E

5%

5%

7%

2%

2%
SNAPSHOT: CHICAGO, ILLINOIS

page 90 Pulse Check: January 2004

Which drug sellers are associated with which crimes?

Crime Heroin Crack Powder Mari- Metham- Ecstasy GHB

cocaine cocaine juana phetamine

Gang-related activity $$ $$

Violent criminal acts $$ $

Nonviolent criminal acts $ $$

Prostitution $ $

Domestic violence $

No crimes associated $ $$

Sources: Law enforcement respondent; epidemiologic/ethnographic respondent

How much does marijuana cost?

Form Unit Price 

Commercial grade 1 oz $6L

In general Loose bag $5–$10E

1 oz $80–$200

Hydroponic 1 oz $30L

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic respondent

How much does heroin cost? 

Unit Price 

Dime bag $10E

One hit $20L

1 g $150L

$50–$300E

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic respondent

How much does cocaine cost?

Form Unit Price 

Crack One rock $2N

$5–$20E

0.2 g $20–$25L

1 g $123L

1 g $50–$150E

Powder One bag $5–$20E

0.2 g $20L

1 g $125L

$50–$150E

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic respondent; N

Non-methadone treatment respondent

The lower end of the price

range for an ounce of

marijuana has declined

since the spring.E

! According to the DEA, the purity of white

powder heroin (the most common form)

has decreased between spring and fall

2002.E

! In most cases, powder cocaine

is available in large quantities

rather than small doses.L

! All reported prices are stable

between spring and fall 2002. 

WHO’S SELLING HEROIN?

Heroin dealers are generally 

adolescents and young adults working as part of a structured organization.L,E

WHO’S SELLING COCAINE?

! Dealers of both powder and crack

cocaine range from adolescents to

older adults; they usually work as

part of an organized structure.L,E

! On the whole, cocaine dealers are

not typically users of the drug,E

although dealers identified through

law enforcement typically are.L

WHO’S SELLING MARIJUANA?

! As with heroin and cocaine, 

marijuana dealers are most often

adolescents and young adults

working both independently and

within structured organizations.L,E

! Marijuana dealers are almost

always users of the drug.L,E

WHO’S SELLING METHAMPHETAMINE, AND HOW MUCH DOES IT

COST?

! Individuals selling methamphetamine typically work independently,L,E although some work as part

of an organized structure.L They are

usually adolescents and young adults

who use the drug themselves.E

! The majority of methamphetamine

dealers identified by law enforcement are not local residents;

rather, they come from out of

town and set up shop in hotels to

sell the drug.L

! The price of methamphetamine is

stable at $330 per gram.L

WHO’S SELLING ECSTASY, AND HOW

MUCH DOES IT COST?

! Ecstasy dealers, like methamphetamine dealers, work independently and usually use the drug.

However, they are slightly older,

with adolescents not commonly

involved in selling ecstasy.L,E

! The price of ecstasy is stable, 

estimated at $25 per 30-mg pill,L

or ranging from $20 to $40.E

HOW MUCH DO VARIOUS OTHER

DRUGS COST?

! No pricing information for diverted OxyContin® is available.L,E

! A capful of liquid GHB currently

sells for $5.L
SNAPSHOT: CHICAGO, ILLINOIS

Pulse Check: January 2004 page 91

Community innovations and tools over the past 10 years: How successful have they been?

NR

0

NR

NR

NR

NR

NR=Not reported

Drug-free zones

Sentencing changes

Other: New law enforcement

street-corner tactics

Drug courts 

Increased use of task forces

Use of crack house (nuisance abatement) laws

Onsite lab tests

Drug user recognition education

(DRE) for law enforcement

Precursor laws

Prescription drug monitoring 

!""Law enforcement respondent 

#""Epidemiologic/ethnographic respondent 

01 2 3 4 5

Degree of success

Not at all Extremely successful

What they have to say... 

! Task forces have proven effective in Chicago, as in all

other Pulse Check cities. The increased use of task forces

involving Federal and State agencies has resulted in large

drug seizures and significant arrests.L,E

! Increased communication and interaction among various

law enforcement agencies have had a positive effect in

disrupting drug activity in the city.L

! As reported in most Pulse Check cities where drug courts

are available, Chicago respondents consider them successful tools for combating drug use and activity.LE As an

alternative to incarceration, drug courts have sentenced

users to drug school or counseling, resulting in reduced

recidivism for program completers.E

! The use of onsite lab tests has provided stronger evidence

for undercover operations to convict those involved in drug

sales.L

! Chicago law enforcement began criminal drug conspiracy

operations to disrupt street markets. In these 3-month operations, law enforcement works to identify all parts of the

drug chain, using covert investigative tools to tie in the

numerous people involved in a street-corner operation. Each

person identified is subsequently charged with the same

crime, based on the total weight of the drugs recovered.L

Drug marketing innovations and tools over the past 10 years: To what degree

have they complicated efforts to detect or disrupt illicit drug activity in Chicago?

012 3 4 5

Degree of complication

Not at all Extremely complicated

Throwaway cell phones

More organized networks

Less organized networks

Expansion of drug sales beyond the central city

!""Law enforcement respondent 

SEPTEMBER 11 FOLLOWUP 

Three of the four Pulse Check sources believe that the

September 11 attacks and their aftermath have had no continuing effects on the drug problem in Chicago.L,E,M The nonmethadone respondent, however, notes that after increasing just

after the attacks, the incidence of depression and anxiety has

remained at that increased level, contributing to an increased

rate of suicidal thoughts/attempts among treatment clients.N

THE MARKET PERSPECTIVE: A 10-YEAR VIEW

What they have to say...

! Advances in technology over the

past decade have impacted community efforts to crack down on

drug trafficking in Chicago. The

use of cell phones in particular—

as in all other Pulse Check cities—

has presented a significant barrier.

Also, while the Internet has not

become a barrier in disrupting traditional drug trafficking, it is used

for transactions involving newer,

designer drugs.L

! The increased organization of

some drug networks has complicated efforts to detect and disrupt

drug activity in Chicago. On the other hand, the increase in more loosely organized networks has also made it more difficult to identify who is involved in those structures.L

! Chicago is one of only a handful of Pulse Check cities where changing brand names

and an increased number of these names over the past 10 years have created some

difficulty in detecting drug transactions.E
SNAPSHOT: CINCINNATI, OHIO

page 92 Pulse Check: January 2004

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

Two of three Pulse Check sources believe the illegal drug problem in

Cincinnati is very seriousE,M, and one believes it is somewhat serious. Two of

three sources consider the problem as somewhat worseN,M, and one believes

that it is stable.E

Respondents report several changes in the drug abuse scene:

! Crack and powder cocaine use in general declined slightly between spring

and fall 2002.E

! OxyContin® “has already peaked in Cincinnati, so it’s beginning to level off.”M

! Diverted OxyContin® has received much media and law enforcement

attention recently and is harder to obtain.E

! A for-profit methadone clinic opened nearby (in Indiana) with a more liberal

methadone take-home policy. Since then, methadone diversion has increased,

the diverted drug is now widely available on the streets, and methadonerelated overdose deaths have increased

(especially among young users [18–20

years]).M

! Violent crimes relating to drug sales

and activity have increased.N

The greatest changes in drug abuse 

concern heroin:

! Historically, Cincinnati is a “pillshooting town,” but in the past few

years heroin has emerged.M

! Heroin use has increased dramatically,

especially among Whites.E The increase

is most likely due to OxyContin®

abusers switching to heroin use as

diverted OxyContin® becomes less

available.E,M

! Some OxyContin® abusers are 

switching to methadone or other 

prescription opiates when they can’t

obtain OxyContin®.

M

What are the primary drugs of abuse

among clients in a non-methadone 

treatment program? (Fall 2002) 

Heroin

Crack cocaine

Powder cocaine

Marijuana

! Between spring and fall 2002, primary drug of

abuse proportions among non-methadone treatment admissions remained relatively stable,

with the exception of abused OxyContin®, which

increased slightly.N

! Between spring and fall 2002, most drug use

remained stable among methadone treatment

admissions, with the exception of two decreases: crack use and OxyContin® abuse declined.M

Note: Methamphetamine, methylenedioxymethamphetamine (MDMA or ecstasy), and abused OxyContin® (oxycodone hydrochloride controlledrelease) percentages were less than one.

Source: Non-methadone treatment respondent

50%

4%

24%

22%

CINCINNATI PRIMARY METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Total population:. . . 1,646,395

! Median age: . . . . . . 35.1 years 

! Race (alone):

! White . . . . . . . . . . . . . . 84.1%

! Black . . . . . . . . . . . . . . 13.0%

! American Indian/

Alaska Native . . . . . . . . 0.2%

! Asian/Pacific Islander 1.2%

! Other race . . . . . . . . . . . 0.4% 

! Two or more races . . . . 1.1% 

! Hispanic (of any race): . . . 1.1% 

! Unemployment rate: . . . . 2.9% 

! Median household 

income: . . . . . . . . . . . $44,248

! Families below poverty level 

with children <18 years: 11.1% 

Source: U.S. Census 2000* 

*The census data in this table are provided

as a frame of reference for the information

given by Pulse Check sources. When possible,

the data given by the law enforcement and

epidemiologic/ethnographic sources reflect

the metropolitan area.

What drugs do clients in a methadone

program use+? (Fall 2002)

Heroin

Marijuana

Powder cocaine

Diverted OxyContin®

Crack 

+

Includes any use, whether as a primary,

secondary, or tertiary drug; methamphetamine use is reported as “very low.”

Source: Methadone treatment respondent

90

(N=112)

0 20 40 60 80 100

Percentage 

Most widely abused drug: 

MarijuanaE,N 

HeroinM 

No reported changes between spring

and fall 2002E,N,M

Second most widely abused drug:

CrackE,N

Diverted OxyContin® and other 

prescription opiatesM

No reported changes between spring

and fall 2002E,N,M

Drug related to the most serious

consequences: 

CrackE

HeroinN,M

No reported changes between spring

and fall 2002E,N,M

Drug related to the second most

serious consequences: 

Heroin and other opiatesE

CrackN

Diverted OxyContin®M

No reported changes between spring

and fall 2002E,N,M

New or emerging problems: 

Heroin use increasingE

Diverted OxyContin®N

Sources: EEpidemiologic/ethnographic, N

Non-methadone treatment, and

MMethadone treatment respondents

Note: These symbols appear throughout this

city profile to indicate type of respondent.

The law enforcement source in Cincinnati

did not respond.

70

40

30

20
SNAPSHOT: CINCINNATI, OHIO

Pulse Check: January 2004 page 93

Heroin use has increased dramatically,

especially among Whites.E The

increase is most likely due to

OxyContin® abusers switching to

heroin use as diverted OxyContin®

becomes less available.E

HEROIN

MARIJUANA

METHAMPHETAMINE

As reported in several other Pulse

Check cities, methadone diversion

and abuse have increased:

! Since a for-profit methadone clinic

opened nearby (in Indiana) with a

more liberal methadone takehome policy, methadone diversion

has increased.M

! Diverted methadone is now widely

available on the streets.M

! Methadone-related overdose deaths

have increased (especially among

young users [18–20 years]).M

COCAINE

ABUSED OXYCONTIN®

ABUSED METHADONE

MDMA (ECSTASY)

THE USE PERSPECTIVE

WHAT’S HAPPENING IN TREATMENT?

! The Pulse Check non-methadone

treatment respondent’s program,

which operates at about 85 percent capacity (89 of 104 treatment

slots filled) sees a variety of drug

clients, most of whom use marijuana, followed by cocaine (crack

or powder) (see the pie chart of

the first page of this chapter). That

source reports a slight increase in

OxyContin® abuse between spring

and fall 2002.N

! The methadone treatment respondent is with a facility that operates

at its maximum capacity of 120

methadone maintenance clients.M

Many of its clients have secondary

and tertiary drug problems (see

bar chart of the first page of this

chapter).

! Methadone maintenance is available only in selected areas of the

community; in fact, only one public methadone treatment center

exists in Cincinnati.E Methadone

treatment programs have large

waiting lists, and treatment availability remained stable between

spring and fall 2002.E

! The non-methadone treatment

source notes several drug-related

consequences as relatively high,

including drug-related auto accidents (which have increased

recently), high-risk pregnancies,

drug overdoses, and tuberculosis.N

The methadone treatment source

notes that hepatitis C is very common and that awareness of it

increased recently due to

improved testing.M That source

also notes that high-risk pregnancies have increased slightly

between spring and fall 2002. 

Marijuana use remains high, and it is

considered the most widely abused

drug by two of three sources.E,N

Ecstasy use remains relatively low. 

Methamphetamine use remains low.

! Crack and powder cocaine use in

general decreased slightly between

spring and fall 2002.E Crack use

among methadone treatment

admissions also declined.M

! Although powder cocaine use in

general declined, use among

females and Whites increased.E

After peaking in the last several years,

OxyContin® abuse is beginning to

level off:

! Abuse declined slightly among

methadone treatment admissions.M

(By contrast, among nonmethadone treatment admissions

OxyContin® abuse increased

slightly.N)

! Diverted OxyContin® has received

a lot of media and law enforcement attention recently and is

harder to obtain.E

! Most primary OxyContin® abusers

in the methadone treatment program are new to opiates and not

addicted to heroin, but once

addicted to OxyContin,® they

often switch to heroin,

methadone, or other prescription

opiates if they can’t obtain

OxyContin®.

M
SNAPSHOT: CINCINNATI, OHIO

page 94 Pulse Check: January 2004

! Although comorbid disorders are

relatively stable since spring 2002,

several are reported as common,

including antisocial or conduct disorders,N,M psychosisN

, mood disorders,N,M and suicidal thoughts/

attemptsN. The non-methadone

source notes that the dual diagnosis

program receives “more referrals

than it can handle.”N

WHO USES ILLICIT DRUGS?

The Pulse Check epidemiologic,

non-methadone treatment, and

methadone treatment sources were

asked to describe the populations

most likely to use heroin, cocaine,

marijuana, methamphetamine, and

ecstasy. They were also asked to

describe any emerging user groups

and to report on how the drugs are

used. As shown on the following

pages, user characteristics vary by

drug. Further, because of the different perspective each brings, the

three sources sometimes describe

quite different populations and use

patterns for each drug. For example,

all methadone clients are primary

opiate users who may use drugs

other than opiates in a secondary or

tertiary manner. 

Who’s most likely to use heroin?

Characteristic E N M

Age group (years) >30 >30 18–30 

Mean age (years) 38 41 28 

Gender Split evenly 60% male 60% female

Race/ethnicity White White White and Black 

Socioeconomic status Low Low Low 

Residence Central city Central city Central city 

Referral source N/A Criminal justice Individual 

Level of education completed N/A None High school 

Employment at intake N/A Part time Unemployed 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Heroin use has increased dramatically

between spring and fall 2002, especially

among Whites.E The increase is most

likely due to OxyContin® abusers switching to heroin use as diverted OxyContin®

becomes less available.E

! New heroin users are more likely than

the general heroin-using population to

be of a higher economic status (middle

versus low) and from the suburbs.E

! Many young methadone clients present

as male-female couples.M

! Users new to treatment are more likely

than the general methadone treatment

population to be male (split evenly versus 60 percent female).M

! Injecting is the most common route of

administration for heroin (known as

“smack,” “boy,” and “H”) in Cincinnati;

however, among new heroin users,

snorting predominates.E,N,M

! Sources report no other changes in

heroin user or use characteristics

between spring and fall 2002.

How do users take heroin?

Characteristic E N M

Primary route of Injecting Injecting Injecting 

administration

Other drugs taken Diverted Marijuana Powder cocaine 

OxyContin® (speedball) 

(as a substitute) marijuana 

(sequentially) 

Publicly or privately? Privately Privately Privately 

Alone or in groups? Alone Alone In groups 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent
SNAPSHOT: CINCINNATI, OHIO

Pulse Check: January 2004 page 95

Who’s most likely to use cocaine?

Crack Powder cocaine

Characteristic E N M E N M

Age group (years) >30 >30 18–30 >30 18–30 >30 

Mean age (years) 38 39 NR 34 NR NR 

Gender Split evenly 69% male Split evenly 54% female 60% male Split evenly 

Race/ethnicity Black Black White and Black White White White and Black 

Socioeconomic status Low Low Low Middle Low Low 

Residence Central city Central city Central city Central city Central city Central city 

Referral source N/A Criminal justice Criminal justice N/A Criminal justice Individual 

Level of education N/A None High school N/A High school High school 

completed 

Employment at intake N/A Unemployed Unemployed N/A Part time Unemployed 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Crack and powder cocaine use decreased slightly between spring and fall 2002.E Crack use among methadone

treatment admissions also declined.M

! Powder cocaine use among females and Whites increased.E

! Marijuana is often taken in combination with crack and powder cocaine.E,N Alprazolam (Xanax®) is often taken

sequentially after cocaine.M And crack and powder cocaine are often used interchangeably.N

! Among methadone treatment admissions, most powder cocaine is injected with heroin in a speedball.M

Who’s most likely to use marijuana?

Characteristic E N M

Age group (years) All 18–30 18–30 

Mean age (years) 23 NR NR 

Gender 60% male Split evenly 60% female 

Race/ethnicity Black White and Black White and Black 

Socioeconomic status Low Middle Low 

Residence Central Central city Central city and suburbs

Referral source N/A Criminal justice Individual 

Level of education completed N/A High school High school 

Employment at intake N/A Full time Unemployed 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! As in most Pulse Check cities,

marijuana use in Cincinnati

cuts across demographics. 

! Marijuana (known by many

slang terms, a new one of

which is “chronic”) is smoked in

blunts and joints.E,N,M

! About 80 percent of marijuanausing adolescents are male,

but there is a shift toward more

female use.E

! Sources report no other

changes in user or use characteristics between spring and 

fall 2002.

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

The epidemiologic respondent associates marijuana, used either alone or

with other drugs, with the following

consequences, which remained stable

between spring and fall 2002:

! Drug-related arrestsN

! Automobile accidentsN

! Deteriorating family and social

relationshipsN

! Poor academic performanceE,N

! School absenteeism, truancy, and

dropping out of schoolE,N
SNAPSHOT: CINCINNATI, OHIO

page 96 Pulse Check: January 2004

Who’s most likely to use methamphetamine?

Characteristic N

Age group (years) >30 

Mean age (years) 35 

Gender Split evenly 

Race/ethnicity White 

Socioeconomic status Low 

Residence Central city 

Referral source Criminal justice 

Level of education completed None 

Employment at intake Unemployed 

Sources: NNon-methadone treatment respondent

! Methamphetamine use in Cincinnati is very

low.N,E

! Most methamphetamine is smoked, and

users are adults older than 30.N

! Sources report no changes in user or use

characteristics between spring and fall 2002.

WHO’S MOST LIKELY TO USE ECSTASY? 

! Ecstasy use is relatively low and stable. Most users are

young, White adults (18–30 years old) of middle

income who live in the suburbs.E

! Ecstasy users are not showing up in public treatment.

But the drug is a common “recreational drug,” often

taken with other club drugs.E

Who’s most likely to abuse OxyContin®?

Characteristic E M

Age group (years) >30 >30 

Mean age (years) 35 32 

Gender 60% female 60% female 

Race/ethnicity White White and Black 

Socioeconomic status Low Middle 

Residence Central city Central city 

and suburbs 

Route of administration Oral and snorting Injecting and 

snorting 

Other drugs taken Heroin (as a Heroin or other

substitute) prescription

marijuana or club opiates (as 

drugs (in combination) substitutes) 

Sources: EEpidemiologic/ethnographic respondent; MMethadone 

treatment respondent

! OxyContin® abuse has received much media and law enforcement attention recently, and the diverted

drug has become harder to obtain.E

! OxyContin® abuse “has already peaked in Cincinnati, so it’s beginning to level off,” and methadone treatment admissions declined between spring and fall 2002.M

! By contrast, OxyContin® admissions to the non-methadone treatment program increased slightly between

spring and fall 2002, although these admissions are relatively low.N

! Many OxyContin® abusers users have switched to heroin because diverted OxyContin® is more expensive

and more difficult to obtain than heroin.E

! Most primary OxyContin® abusers in the methadone treatment program are new to opiates and not

addicted to heroin. But once addicted to OxyContin® they often switch to heroin, methadone, or other prescription opiates if they can’t obtain OxyContin®.

M

! OxyContin® is often abused at concerts and nightclubs.E

! Abusers are increasingly younger and White.E

! Most abusers snort or use the drug orally; some inject the drug.E

! Marijuana and other club drugs are often used in combination with the drug.E
SNAPSHOT: CINCINNATI, OHIO

Pulse Check: January 2004 page 97

SEPTEMBER 11 FOLLOWUP

None of the three Cincinnati Pulse Check

sources believes that the September 11 attacks

and their aftermath have had any effects on the

drug abuse problem.E,N,M

Beyond cash: What else is accepted in exchange for drugs?

Heroin

Cash

Crack cocaine Marijuana

80%

Other drugs

Sex

100% 60%

10%

10% 40%

Powder cocaine

90%

10%

Source: Methadone treatment respondent

! As in nearly all Pulse Check cities, cash is the most common currency exchanged for

illegal drugs in Cincinnati.M

! The practice of exchanging sex for crack cocaine is relatively high; at an estimated 40

percent of all exchanges,M it appears more common than in most other Pulse Check

cities (although this estimate is based on the response of only one source).

Illicit marketing innovation/tool

Declining cost of drugs 

Earlier first use of more dangerous drugs 

Normalization of drug use 

Increased treatment case loads 

Increasing availability of new and substitute drugs 

Increased court referrals 

Spread of use among all age groups 

Lack of housing opportunities for recovering clients 

Lack of jobs and job training opportunities for recovering clients 

01 2345

Extent complicated treatment

Not at all Extremely

Drug marketing innovations and drug users’ characteristics: To what degree have they complicated treatment

efforts in Cincinnati?

Source: Methadone treatment respondent

What they have to say...

! Increasing availability of new and substitute drugs: New opioids

(especially OxyContin®) have complicated methadone treatment.M

! Declining cost of drugs: Heroin is more available, and its price

has declined.M

! Earlier first use of more dangerous drugs: Over the past 5 years,

heroin users have become younger.M

! Normalization of drug use: The increased use of marijuana and

club drugs, especially among the younger population, may be due

to the perceived acceptance of illegal drug use.M

! Increased court referrals: New drug courts in the last 10 years

have increased the number of people in treatment and made

treatment more complex.M
SNAPSHOT: CLEVELAND, OHIO

page 98 Pulse Check: January 2004

What are the primary drugs of abuse

among clients in a non-methadone 

treatment program? (Fall 2002) 

Heroin

Crack cocaine

Powder cocaine

Marijuana

Abused OxyContin®

(oxycodone hydrochloride controlled-release)

! One program’s typical clients are polydrug users who tend to use “whatever is available, easy to obtain, and cheap as their drug of choice.”N

! Among non-methadone treatment clients, percentages for primary drugs of abuse

remained relatively stable between spring and fall 2002.N

! Marijuana use among methadone treatment admissions decreased.M By contrast, abuse

of several drugs increased, including heroin, crack, powder cocaine (among admissions

new to treatment), and three drugs that still remain at low levels of use: methamphetamine, OxyContin®, and benzodiazepines. 

Source: Non-methadone treatment respondent

50%

3%

6% 4%

38%CLEVELAND PRIMARY METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Total population:. . . 2,250,871

! Median age: . . . . . . 37.3 years 

! Race (alone):

! White . . . . . . . . . . . . . . 76.9%

! Black . . . . . . . . . . . . . . 18.5%

! American Indian/

Alaska Native . . . . . . . . 0.2%

! Asian/Pacific Islander 1.4%

! Other race . . . . . . . . . . . 1.4% 

! Two or more races . . . . 1.6% 

! Hispanic (of any race): . . . 3.3% 

! Unemployment rate: . . . . 3.4% 

! Median household 

income: . . . . . . . . . . . $42,089

! Families below poverty level 

with children <18 years: 13.1% 

Source: U.S. Census 2000* 

*The census data in this table are provided as

a frame of reference for the information given

by Pulse Check sources. When possible, the

data given by the law enforcement and epidemiologic/ethnographic sources reflect the

metropolitan area.

What drugs do clients in a methadone

program use+? (Fall 2002)

Heroin

Marijuana

Powder cocaine

Crack 

+

Includes any use, whether as a primary, 

secondary, or tertiary drug; responses for

methamphetamine, OxyContin®, and benzodiazepine abuse were less than 1 percent.

Source: Methadone treatment respondent

90

22

25

70

(N=42)

0 20 40 60 80 100

Percentage 

(N=340)

All four respondents consider

Cleveland’s illegal drug problem

very serious, and oneM considers it

somewhat worse. However, respondents do report positive trends:

! As in many Pulse Check cities,

task forces are rated as highly

successful in combating illegal

drug activity in Cleveland.L,E

! Marijuana use among methadone

treatment admissions decreased

slightly.M That source believes that

the media has become more

responsible about marijuana by

increasingly exposing the negative

consequences of its use.M

! Several drugs, including two types

of marijuana and two types of

methamphetamine, are more difficult for undercover officers to buy.L

Sources also point to other developments:

! Polydrug use, which is the norm,

increased. Drug users’ decreasing 

“allegiance” to one drug has

made treatment more difficult.M

! More cocaine (crack and powder) is

coming into the area, it is easier to

buy, prices have dropped, and the

drug may be more marketable.L,E

! Powder cocaine use in general

increased.E Among methadone

treatment clients, crack use

increased slightly, especially 

among females.M

! One respondent reports that

diverted OxyContin® availability

has declined because doctors and

pharmacists are more stringent

with prescriptions.E Other

respondents, however, report

abuse and activity as increasing.

! Heroin activity seems to be increasing: diverted OxyContin® users

often switch to heroin, which is

cheaper and easier to buy.E,M

! Among treatment admissions,

methamphetamine use is low.N,M

Declines are reported in one

treatment program,N while a

slight increase is reported in

the other.M

! Methylenedioxymethamphetamine (MDMA or ecstasy) activity increased. The drug is easier to

buy, but much that is sold is not

really ecstasy.L

! Among non-methadone treatment

admissions, tramadol (Ultram®)

abuse increased.N

! Phencyclidine (PCP) use has begun

to emerge among Blacks.M

Crack and heroin remain the most

widely abused drugs and are related

to the most serious consequences.

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)
SNAPSHOT: CLEVELAND, OHIO

Pulse Check: January 2004 page 99

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic

respondent

Not

difficult

at all

Undercover policeL UsersE

Crack, powder cocaine; marijuana (in general and local

commercial grade); ecstasy 

4

3

2

1

0

5

6

7

8

9

SA; diverted OxyContin®

Heroin (in general)

SEA, SWA; sinsemilla and

hydroponic marijuana

BC bud; PCP

! Several drugs are more difficult for undercover officers to buy since spring 2002:L sinsemilla, BC bud, Mexican

methamphetamine, and ice.

! Diverted OxyContin® has become more difficult for users to buy on the street. Doctors and pharmacists are more

stringent with prescriptions, and street prices have increased.E

! As reported in five other Pulse Check cities (New York, St. Louis, San Francisco, Seattle, and Portland, OR), diverted

OxyContin® has become less difficult for undercover officers to buy since spring 2002.L

! Sources agree that heroin, cocaine, marijuana, and ecstasy remain relatively easy to buy.L,E

! As reported in seven other Pulse Check cities (Atlanta, Baltimore, Minneapolis, San Diego, San Francisco, Seattle,

and Washington, DC), ecstasy has become easier for undercover officers to buy.L

! Powder cocaine has become less difficult for users to buy. Between spring and fall 2002, prices have dropped, and

the drug may be more marketable.E

! In a 6-month period, heroin availability fluctuates: “droughts” are typically related to large law enforcement busts.E 

Extremely

difficult

10

Crack; marijuana

Heroin; powder cocaine; ecstasy 

Diverted OxyContin®

Locally produced 

methamphetamine 

Mexican brown heroin; Mexican

methamphetamine and ice

Mexican black tar heroin

Methamphetamine (in general) 

Note: SA=South American (Colombian) heroin; SWA=Southwest Asian heroin; SEA=Southeast

Asian heroin; ice=highly pure methamphetamine in smokable form; and BC bud=British

Columbian marijuana.

Most widely abused drug:

CrackL,E

HeroinN,M

No reported changes between spring

and fall 2002L,E,N,M

Second most widely abused drug:

CrackN,M

HeroinL

MarijuanaE

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the most serious

consequences:

CrackL,E,N

HeroinM

No reported changes between spring 

and fall 2002L,E,N,M

Drug related to the second most

serious consequences:

HeroinL,E,N

Powder cocaineE

CrackM

No reported changes between spring

and fall 2002L,E,N,M

New or emerging problems:

EcstasyL

Abused OxyContin®M

Sources: LLaw enforcement, EEpidemiologic/

ethnographic, NNon-methadone treatment,

and MMethadone treatment respondents 

Note: These symbols appear throughout this

city profile to indicate type of respondents.
SNAPSHOT: CLEVELAND, OHIO

page 100 Pulse Check: January 2004

Ecstasy activity has increased:

! The drug is easier to buy (but much

that is sold is not really ecstasy).L

! However, ecstasy use and treatment

admissions remain low. 

One respondent reports that diverted

OxyContin® availability declined due

to doctors and pharmacists being

more stringent with prescriptions.E

Other respondents, however, report

diverted OxyContin® abuse and

activity as increasing:

! Diverted OxyContin® has become

less difficult for undercover officers to buy.L

! OxyContin® abuse, in general,

increased.E

! The non-methadone treatment

respondent’s program tends to see

OxyContin® abusers “in droves.” In

the program’s chronic pain division,

90 percent of clients abuse the drug.N

! One source “suspect[s] that

OxyContin® will become a rising

concern in Cleveland” and suggests that “physicians be alerted to

its consequences and specifically

trained to refer clients to opiate

addiction programs.”M

! Benzodiazepines: Abuse increased

among methadone treatment admissions, especially among females.M

! Tramadol: Abuse increased among

non-methadone treatment admissions.N People “doctor shop” for it

or buy it on the street and then

come into treatment for detox. 

! PCP: The practice of dipping cigarettes in liquid PCP has begun to

emerge among Blacks.M

THE USE PERSPECTIVE

WHAT’S HAPPENING IN TREATMENT?

Treatment capacity and availability

! The Pulse Check non-methadone

treatment respondent’s program,

which operates at about 75 percent

capacity (42 of 56 inpatient and outpatient slots filled), sees mostly heroin clients, followed closely by crack

cocaine clients (see the pie chart on

the first page of this chapter).

! The methadone treatment respondent is with a public facility that

operates over capacity, with 340 of

300 slots filled.M Beyond that specific facility, methadone maintenance treatment is available only in

selected areas of the city, and public programs are at full capacity.E

Cleveland has no private methadone clinics. 

! Treatment respondents agree that limited slot capacity is the main barrier to

treatment. One respondent explains

that “opiate addiction and use have

increased but funds have not.”M

! One source reports increases in

barriers to treatment: lack of

trained staff to treat comorbidity

among clients (due to lack of integrated training for counselors) and

lack of child care for clients.M

Consequences of drug use

! The treatment sources note that

hepatitis C and drug overdoses are

common among clients.N,M The

methadone treatment source further notes that several health consequences have increased since

spring 2002, including HIV/AIDS

(especially among males who have

sex with males and are also injecting drug users), drug-related automobile accidents (due to increased

polydrug use), high-risk pregnancies (because drug use among

females has increased), drug overdoses (due to increased polydrug

Two reports indicate that heroin

activity and use are increasing:

! Methadone treatment admissions

for heroin increased between

spring and fall 2002.M

! Diverted OxyContin® abusers are

switching to heroin because

diverted OxyContin® is more

expensive than heroin and more

difficult to buy. E,M

Several observations suggest increased

cocaine activity and use:

! The cocaine supply in Cleveland

increased, and the drug is easier to

buy.L,E

! In general, powder cocaine use

increased since spring 2002.E

! Among methadone treatment

clients, crack use increased slightly,

especially among females who start

taking heroin at an early age.M 

Marijuana use remains relatively 

stable, according to most respondents.

Among methadone treatment admissions, it decreased slightly between

spring and fall 2002.M

Methamphetamine use and activity

are low in Cleveland. 

! Among non-methadone treatment

admissions, methamphetamine use

continues to decline from its peak

several years ago.N

! Among methadone treatment

admissions use increased slightly

between spring and fall 2002.M

HEROIN

MARIJUANA

COCAINE

DIVERTED OXYCONTIN®

OTHER DRUGS METHAMPHETAMINE

MDMA (ECSTASY)
Who’s most likely to use heroin?

Characteristic E N M

Age group (years) >30 18–30 >30 

Mean age (years) 40 24 40 

Gender 70% male 60% male 70% male 

Race/ethnicity White and Black White White 

Socioeconomic status Low High Low 

Residence Central city All Central city 

Referral source N/A Other heroin addicts Individual 

Level of education N/A High school and High school

completed 2-year college 

Employment at intake N/A Unemployed Part time 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

SNAPSHOT: CLEVELAND, OHIO

Pulse Check: January 2004 page 101

use), and tuberculosis (due to

increased homelessness and poor

health care).M The non-methadone

treatment source adds that heart

attacks (related to cocaine use) and

narcotic-related withdrawal sicknesses (including deaths caused by

breathing difficulties) are relatively

common health problems within

the treatment program.N

! Several comorbid disorders are

common among treatment clients,

including mood disorders,N,M suicidal thoughts and attempts,N borderline personality disorders,N eating disorders,N and post-traumatic

stress disorder (PTSD) related to

childhood abuseN. 

Increased complications for drug

treatment over the past 10 years 

! Increasing availability of new and

substitute drugs: The increasing

availability of heroin, crack, and

ice over the past 10 years has complicated methadone treatment dramatically.M

! More polydrug use: The increased

combination of heroin and crack or

powder cocaine and the declining

price of crack cocaine over the past

10 years have made methadone

clients more difficult to treat.M

WHO USES ILLICIT DRUGS?

The Pulse Check epidemiologic, nonmethadone treatment, and methadone treatment sources were asked to

describe the populations most likely

to use heroin, cocaine, marijuana,

methamphetamine, and ecstasy. They

were also asked to describe any

emerging user groups and to report

on how the drugs are used. As shown

on the following pages, user characteristics vary by drug. Further,

because of the different perspective

each brings, the three sources sometimes describe quite different populations and use patterns for each drug.

For example, all methadone clients

are primary opiate users who may

use drugs other than opiates in a secondary or tertiary manner. 

! Heroin use, in general, increased between spring and fall 2002.E Heroin (now referred to as “dog food”

or “garbage”) use among methadone treatment admissions increased.M

! Between spring and fall 2002, heroin admissions to the methadone program are increasingly younger,

female, and Black.M

! New heroin users are much more likely than the general heroin-using population to be young adults

(early twenties versus 40 years), female (equally split between genders versus 70 percent male), and

of a higher socioeconomic status.E

! New heroin users buy the drug in the central city but use it in the suburbs.E

! Many well-educated adolescents of upper socioeconomic status use heroin.M

! Heroin users are referred to the non-methadone treatment program by other heroin addicts and by

heroin dealers whose supply “runs out.”N
SNAPSHOT: CLEVELAND, OHIO

page 102 Pulse Check: January 2004

Who’s most likely to use cocaine?

Crack Powder cocaine

Characteristic E N M E N M

Age group (years) >30 >30 18–30 18–30 >30 18–30 

Mean age (years) 35 30–50 27 NR 30–50 28 

Gender Male Split evenly 60% male Split evenly Split evenly 70% male

Race/ethnicity Black White and Black White White, Black, White

Black and Hispanic 

(any race) 

Socioeconomic status Low High Low Middle High Middle 

Residence Central city All Central city Suburbs Suburbs Suburbs 

Referral source N/A Individual Criminal justice N/A Individual Criminal justice 

Level of education N/A 4-year college None N/A 4-year college High school

completed 

Employment at intake N/A Part time Unemployed N/A Full time Part time 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

How do users take heroin?

Characteristic E N M

Primary route of administration Injecting and snorting Injecting Injecting 

Other drugs taken Powder or crack Cocaine (speedball); Crack (speedball) 

cocaine (speedball) prescription opiates 

(as substitutes) 

Publicly or privately? Privately Privately Privately 

Alone or in groups? In groups Alone In groups 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment

respondent

! Injecting is the most common route of heroin administration in

Cleveland. Speedball use is common.E,N,M

! New users tend to snort heroin. They often use other drugs.E

! Between spring and fall 2002, polydrug use increased, especially powder or crack cocaine with heroin in a speedball and

prescription opiates abused as heroin substitutes.M

! In addition to injecting heroin in speedballs, crack users often smoke “crumbs” of crack in marijuana blunts.E

! Among methadone treatment clients, crack use increased slightly, especially among females who start taking heroin

at an early age. The most common route of administration among methadone clients is injecting, especially with

heroin in a speedball.M

! In general, powder cocaine (“connie”) use increased since spring 2002.E 

! Among non-methadone treatment admissions, snorting and injecting are the most common routes of administration

for powder cocaine.N 
SNAPSHOT: CLEVELAND, OHIO

Pulse Check: January 2004 page 103

Who’s most likely to use marijuana?

Characteristic E N M

Age group (years) >13 18–30 >30 

Mean age (years) Wide age range Wide age range 42 

Gender Split evenly Split evenly 77% male 

Race/ethnicity White and Black White and Black Black 

Socioeconomic status All Middle Low 

Residence All All Central city 

Referral source N/A Other health Individual 

care provider

Level of education N/A High school High school 

completed 

Employment at intake N/A Full time Part time 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Marijuana use among methadone treatment

admissions decreased slightly between spring

and fall 2002.M New terms for marijuana

include “sticky icky” and “trees.”M

! In rural and suburban areas, most marijuana

is smoked in joints; in central city areas, most

is smoked in blunts.E

! A small percentage of non-methadone treatment clients use marijuana only, but most

other drug clients use marijuana as a secondary or tertiary drug. Furthermore, insurance

companies prefer not to pay for treatment if

marijuana is the primary drug.N

! “Wet” is a new term for a marijuana combination that users are smoking; it could refer to

marijuana joints or blunts dipped in embalming fluid or in PCP, but users are not sure. WHAT ARE THE NEGATIVE CONSE- E

QUENCES OF MARIJUANA USE?

Marijuana, used either alone or with

other drugs, is associated with the

following consequences, which

remained stable between spring and

fall 2002:

! Drug-related deathsM

! Drug-related emergency room

visitsM

! Drug-related arrests E,M

! Automobile accidentsM

! High-risk pregnanciesM

! Short-term memory lossM

! Deteriorating family and social

relationshipsM

! Poor academic performanceM

! School absenteeism, truancy, and

dropping out of schoolM

! Poor workplace performanceM

! Workplace absenteeismM

Reason

012345

Extent contributed

Not at all Extremely

0

0

0

Less emphasis by law 

enforcement and courts 

Increased THC potency 

Decline in users’ perception of harm 

Decline in social disapproval (e.g.,

peers, parents, etc.)

Widespread marijuana availability and use over the past 10 years:

To what extent have the following contributed?

!"Law enforcement respondent

#"Epidemiologic/ethnographic

respondent

! The law enforcement and epidemiologic/ethnographic sources differ widely

in their opinions.

! They do agree on one belief: law enforcement and the courts have placed

less emphasis on marijuana over the years.

! The law enforcement respondent adds that the penalties for marijuana possession or sales are too light.
SNAPSHOT: CLEVELAND, OHIO

page 104 Pulse Check: January 2004

Problem Change 

Increased overall difficulty in treating the addiction 

Increased polydrug use

Earlier initiation of marijuana use 

Decline in users’ perception of harm 

Glamorization by entertainment industry 

Other: Decreased treatment capacity

Other: Marijuana addiction masked by other drug addictions 

Increased severity of addiction among clients 

Increased THC potency of marijuana 

Increased progression to use of other drugs 

Decline in social disapproval (e.g., peers, parents, etc.) 

Glamorization by news media 

Increased court referrals involving marijuana possession

Increased court referrals involving marijuana sales 

01234 5

Extent complicated treatment

Not at all Extremely

Marijuana-using clients: To what extent have changes in the following problems complicated their treatment over

the past 10 years?

Source: Methadone treatment respondent

What they have to say...

! Increased polydrug use: The

decreasing “allegiance” of drug users

to one drug, including marijuana, has

made treatment more difficult over

the past 10 years.M

! Decreased treatment capabilities for

THC addiction: Too few programs

treat THC as a primary addiction, particularly for adult clients. Moreover,

THC addiction is often masked by

other drug addictions (such as heroin,

cocaine, or alcohol) and not treated.M

! Glamorization by news media: The

methadone treatment source

believes that the media has become

more responsible about marijuana by

increasingly exposing the negative

consequences of its use.M

Who’s most likely to use methamphetamine?

Characteristic N M

Age group (years) 18–30 18–30 

Mean age (years) 18–20 26 

Gender 80% male 80% male 

Race/ethnicity White White 

Socioeconomic status High Middle 

Residence Suburbs Suburbs 

Referral source Emergency room Individual 

and parents

Level of education completed 4-year college High school 

Employment at intake Full-time students Part time 

Sources: NNon-methadone treatment respondent; MMethadone treatment respondent

! Among treatment admissions, methamphetamine (“tina”) use is low.N,M Among methadone

treatment admissions, use increased slightly

between spring and fall 2002,M but among

non-methadone treatment admissions,

methamphetamine use continues to decline

from its peak several years ago.N

! Non-methadone clients inject methamphetamine and take many other drugs (such as

marijuana, heroin, and prescription pills) in

combination with the drug.N

! Most methadone treatment clients take the

drug orally and as a substitute for heroin.M
SNAPSHOT: CLEVELAND, OHIO

Pulse Check: January 2004 page 105

Who’s most likely to use ecstasy? 

Characteristic E N

Age group (years) 13–30 18–30 

Mean age (years) NR 18–24 

Gender Split evenly 70% female 

Race/ethnicity White and Black White 

Socioeconomic status Low and middle High 

Residence All Suburbs 

Referral source N/A Emergency rooms and parents 

Level of education completed N/A High school 

Employment at intake N/A Full-time students 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent

! The epidemiologic source claims that

ecstasy use is low in Cleveland.E

Ecstasy use among non-methadone

treatment admissions is secondary

and tertiary to other drugs, especially

benzodiazepines.N

! Most ecstasy users are adolescent or

young adult females.E,N

! Sources report no changes in use or

user characteristics between spring

and fall 2002.

Who’s most likely to abuse OxyContin®?

Characteristic E N

Age group (years) 18–30 18–30 

Gender Split evenly Split evenly 

Race/ethnicity White White 

Socioeconomic status Low and middle Middle and High 

Residence Central city and Central city and 

suburbs rural areas

Route of administration Oral Injecting 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone 

treatment respondent

! In general, OxyContin® abuse increased since spring 2002.E

! The non-methadone treatment respondent’s program tends to

see OxyContin® abusers “in droves,” causing the proportion of

clients over time to “fluctuate wildly.” That program also has a

chronic pain division in which 90 percent of clients abuse

OxyContin®. Over the past 2 years, OxyContin® abuse increased

dramatically.N

! Many abusers start out taking the drug orally, as prescribed.

They then move to snorting or injecting.E

! Most OxyContin® abusers are young adults: “once they reach 

an older age, they have already moved on to heroin.”E

! Most OxyContin® abusers switch to heroin use because

OxyContin is more expensive and more difficult to buy.E

! Opiate abusers take “whatever is available”: OxyContin® abusers

often use heroin as a substitute, and heroin users often take

OxyContin® as a substitute.N

WHERE ARE DRUGS USED AND SOLD?

Illegal drugs in Cleveland are sold mostly in the central city, with the exceptions

of methamphetamine and diverted

OxyContin® (sales are equally distributed in all geographic areas) and ecstasy

(sales occur mostly in the suburbs).L

Heroin, powder cocaine, marijuana,

ecstasy, and especially crack are sold

on streets and in open-air marketsL as

well as at the following locations:

! Crack houses and shooting galleries (excluding ecstasy)L,E

! Private residencesL,E

! Public housing developmentsL,E

! In or around schoolsL

! Nightclubs and barsL,E

! Private partiesL,E

! RavesL

! Concerts (excluding heroin)L

! Hotels/motelsL

! Around drug treatment clinics

(excluding ecstasy)L

! Inside carsL

THE MARKET PERSPECTIVE
SNAPSHOT: CLEVELAND, OHIO

page 106 Pulse Check: January 2004

Beyond cash: What else is accepted in exchange for drugs?

Heroin Cash Crack cocaine

Methamphetamine

62%

Shoplifted merchandise 

Other stolen merchandise

(e.g., electronic equipment)

Property/Merchandise

Other: Includes items accounting for 4 percent

or less of transactions for each of the five

drugs, such as guns, other drugs, transporting

the drug, stealing the drug, food stamps, drug

buying services, injecting services, and lookout services. 

Sex

81%

68%

10%

5%

Marijuana

86%

5%

3%

3%

2%

1%

10%

6%

7%

4%

7%

10%

9%

8%

5%

2%

2%

2%

Powder cocaine

79%

4%

6%

6%

Source: Mean of response ratings given by law enforcement, epidemiologic/ethnographic,

and methadone treatment respondents. The non-methadone treatment respondent did not

provide percentages for any drugs.

! As in most Pulse Check cities, cash is the most 

common means of exchange for illegal drugs in

Cleveland.L,E,M

! Nearly all female prostitutes in Cleveland use crack

and exchange sex for the drug.E

2%

2%

3%

Additionally, ecstasy is often sold on

college campuses.L,E

Methamphetamine and diverted

OxyContin® are not typically sold on

streets or in open-air markets, but

sales take place at the following locations:L

! Private residences

! Public housing developments

! Nightclubs and bars

! Raves

! Concerts

! Hotels/motels

! Around drug treatment clinics

(excluding methamphetamine)

! Inside cars

HOW DO ILLEGAL DRUGS GET FROM

BUYER TO SELLER?

To purchase heroin and crack and

powder cocaine, buyers may go to an

open-air market to exchange the drug

hand to hand on the street or contact a

dealer via cell phones, landline phones,

or two-way pagers to set up a meeting

for exchange of the drug.L,E Crack, in

particular, is available at open-air markets, and dealers will “walk up to buyers’ cars to sell it.”E 

Most ecstasy sales are venue oriented

(at raves, concerts, and nightclubs),

and buyers “ask around” at these

locations to find a dealer and make

the exchange hand to hand.L

Abusers buy most OxyContin® from

dealers on the street, who obtain the

drug either by legal prescription or by

stealing it from their families or

acquaintances.E

WHO SELLS ILLEGAL DRUGS?

Heroin, crack, and powder cocaine

dealers are organized, often into

street gangs. Most heroin and powder cocaine dealers are older than 30,

whereas most crack cocaine dealers

are 18–30 years old. 

Most crack and powder cocaine dealers sell only cocaine, but dealers who

primarily sell heroin often deal

cocaine as well.L

Heroin and powder cocaine dealers

are often involved in prostitution and

violent crimes such as robberies. In

addition, powder cocaine dealers are

involved in escort services and gangrelated activity.L

Most other dealers who sell drugs

such as marijuana, methamphetamine, ecstasy, diverted OxyContin®,

and PCP are independent young

adults (18–30 years).L
SNAPSHOT: CLEVELAND, OHIO

Pulse Check: January 2004 page 107

How much do illegal drugs cost?

Drug Unit Price

South American heroin 0.1 g (dime bag) $10–$20E

One bag (1 g) $20L

Crack cocaine One rock $10–$20L,E

Powder cocaine 0.1 g $20E

Eightball $180L

Marijuana One blunt $5–$10E

1 oz (10–12 blunts) $100–$200L,E

“Wets” (marijuana blunts dipped in One blunt $10–$20E

formaldehyde or PCP)

PCP One bottle $40–$100L

Methamphetamine 1 g $75L

Ecstasy One pill $15–$20L

$8–$10E

Diverted OxyContin® 20-, 40-mg pills $20, $40E

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic respondent

! Drug prices in Cleveland remained relatively

stable between spring and fall 2002.

! Respondents did not report drug purity, but

they identified several adulterants new in

fall 2002: baby formula is a new heroin

adulterant; fingernail polish remover is a

new crack adulterant; and twigs are now

sold in packages and blunts of marijuana.N

Drug marketing innovations and

tools over the past 10 years: To what

degree have they complicated

efforts to detect or disrupt illicit

drug activity in Cleveland?

As in many Pulse Check cities, the use

of throwaway cell phones has made it

much harder over the past 10 years

to disrupt drug activity in Cleveland.L

Community innovations and tools over the past 10 years: How successful

have they been?

01 2 3 4 5

Degree of success

Not at all Extremely successful

Increased use of task forces 

Crack house (nuisance abatement) laws 

Prescription drug monitoring 

Drug courts

Sentencing changes

Community innovation/tool 

What they have to say...

! Task forces: As in many Pulse Check cities, task

forces are rated as highly successful in combating

illegal drug activity in Cleveland.L,E

! Drug courts: Drug courts, which have existed in

Cleveland for the past 3–5 years, are described as

somewhat successful in combating drug activity by

the law enforcement respondent. The epidemiologic

source states that experts have “conflicting opinions” about the effects of drug courts.

NR

NR

NR

NR=Not reported

NR SEPTEMBER 11 FOLLOWUP

Three of the four Cleveland Pulse

Check sources believe that the

September 11 attacks and their aftermath have had no effects on the drug

abuse problem. The methadone treatment respondent believes that the

increase in opiate addiction may be

due to increased anxiety levels. That

source further states that antidepressants, prescribed or bought from the

streets, are increasingly used.

!"Law enforcement respondent

#"Epidemiologic/ethnographic respondent
SNAPSHOT: DALLAS, TEXAS

page 108 Pulse Check: January 2004

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

All four Pulse Check sources believe the city’s overall drug problem has

remained stable since the previous reporting period, particularly the situation

regarding cocaine, heroin, and marijuana. Three of the sources consider the

city’s drug problem very serious, and the law enforcement source describes it as

“somewhat serious.” Because of the different populations with whom they have

contact, the sources vary in their perception of which drugs are most commonly

abused and which have the most serious consequences:

! One source names crack as the drug with the most serious consequences

because it is associated with violence, health problems, and loss of family

support. Methamphetamine follows in consequences because the cold fusion

and “Nazi” production methods use

toxic substances such as rat poison,

liquid fertilizer, matches, lithium 

batteries, and Drano®. The resulting

effects, such as health problems,

legal issues, and violence, are intensified because recipes involving such 

substances proliferate over the

Internet.E

! Another source names heroin as the

drug with the most serious consequences because of high relapse

rates among treatment clients.

Crack follows in consequences

because of its links to criminal

activity.N

! An unidentified substance, mislabeled

“ice,” is increasingly reported at

clubs and circuit parties in the gay

community. The Drug Enforcement

Administration (DEA) will be testing

this substance, whose effects differ

from those of “speed.”E

! Compared with 5 years ago, the

most widely abused drug among

clients in one program has shifted

from crack to heroin. Short-term

trends, however, are stable.N

! Methylendioxymethamphetamine

(MDMA or ecstasy) and gamma

hydroxybutyrate (GHB) continue 

as emerging problems.L

What are the primary drugs of abuse

among clients in a non-methadone 

treatment program? (Fall 2002) 

Heroin

Methamphetamine

Crack cocaine

Powder cocaine

Marijuana

Ecstasy

Source: Non-methadone treatment respondent

12%

6%

13%

33%

35%

DALLAS PRIMARY METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Total population: . . . 3,519,176

! Median age: . . . . . . 31.8 years 

! Race (alone):

! White . . . . . . . . . . . . . . 67.2%

! Black . . . . . . . . . . . . . . 15.1%

! American Indian/

Alaska Native . . . . . . . . 0.6%

! Asian/Pacific Islander 4.1%

! Other race . . . . . . . . . . 10.7% 

! Two or more races . . . . 2.4% 

! Hispanic (of any race): 23.0% 

! Unemployment rate: . . . . 3.4% 

! Median household 

income: . . . . . . . . . . . $55,854

! Families below poverty level 

with children <18 years: 11.6% 

Source: U.S. Census 2000*

*The census data in this table are provided as a frame of reference for the information given by Pulse

Check sources. Whenever possible, the data given by the law enforcement and epidemiologic/ethnographic sources reflect the metropolitan area. 

What drugs do clients in a methadone

program use+? (Fall 2002)

Heroin

Benzodiazepines

Marijuana

Pain pills++

Crack/Powder cocaine

+

Includes any use, whether as a primary, secondary, or tertiary drug; responses for methamphetamine and ecstasy were “very small.”

++Hydrocodone products (Vicodin®, Lortab®, Lorcet®)

Source: Methadone treatment respondent

5

Most widely abused drug:

MarijuanaL,E

HeroinN,M

No reported changes between spring

and fall 2002L,E,N,M

Second most widely abused drug:

CrackE,N

MethamphetamineL

MarijuanaM

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the most serious

consequences:

HeroinL,N,M

CrackE

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the second most

serious consequences:

CrackL,N,M

MethamphetamineE

No reported changes between spring

and fall 2002L,E,N,M

New or emerging problems:

Ecstasy and GHB use continues.L

Sources: LLaw enforcement, EEpidemiologic/

ethnographic, NNon-methadone treatment,

and MMethadone treatment respondents 

Note: These symbols appear throughout this

city profile to indicate type of respondents.

(N=419)

0 20 40 60 80 100

Percentage 

(N=350) 25

75

90

95

1%
SNAPSHOT: DALLAS, TEXAS

Pulse Check: January 2004 page 109

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent;

N

Non-methadone treatment respondent

Note: SA=South American (Colombian)

heroin; SWA=Southwest Asian heroin;

SEA=Southeast Asian heroin; ice=highly

pure methamphetamine in smokable

form; and BC bud=British Columbian

marijuana.

Not

difficult

at all

Undercover policeL UsersE

Heroin (in general, Mexican

black tar, Mexican brown);

crack, powder cocaine; marijuana (in general, sinsemilla,

local commercial); methamphetamine (in general, locally

produced, Mexican); ecstasy 

4

3

2

1

0

5

6

7

8

9

Diverted OxyContin®

Extremely

difficult

10

Heroin (in general, SA, Mexican

black tar, Mexican brown);

crack, powder cocaine; marijuana (all varieties); methamphetamine (all varieties); ecstasy;

diverted OxyContin®(oxycodone

hydrochloride controlled-release)

SEA, SWA

Ice

SWA

SA; hydroponic marijuana 

SEA

BC bud

With the city’s close proximity to the

border, and with continued high

demand, Mexican black tar heroin

remains the primary threat. However,

as Colombian traffickers have been trying to expand their market (possibly

trying to avoid the tightened security

on the East Coast), South American

heroin has become increasingly available over the last year. Southwest Asian

white heroin is also more easily obtainable.L

While heroin users are predominantly

older Black injectors from central city

areas, an emerging group of young,

White, more affluent smokers from the

suburbs (mean age 17.5 years) is

increasingly experimenting with

heroin.E

COCAINE

MARIJUANA

HEROIN

Overall, the number of crack and

powder cocaine users remains stable,

and no new user groups are reported.E

The percentage of clients in treatment

for a primary crack problem declined

somewhat since the last reporting period (to 19 percent); among first-time

admissions, however, that percentage

increased slightly (to 16 percent).N The

treatment percentage for powder

cocaine remains stable.N

Overall, the number of marijuana users

remains stable, and no new or emerging groups are reported.E Marijuana

user characteristics remain stable.E,N

The exchange of guns for marijuana

has increased. “More youngsters are

trading and carrying.” Many of

these youth get their guns from a

large gun show that comes through

Dallas annually.E

! Undercover officers find it easier to purchase SA and SWA white heroin in fall 2002

than in the previous spring due to greater street availability and new trafficking groups.L

! Additionally, the non-methadone treatment source describes three recent heroin dry

spells: one after September 11, and two during the second half of 2002. Each lasted a

few weeks, causing increases in price and number of users seeking detox, and then

leveled out.N

! Ice is also more easily purchased by undercover officers than previously. It is more

available, and more organizations are moving the drug.L

! The epidemiologic source reports no change in ease of user drug purchases. One

treatment source, however, reports an increase in crack availability.N

! Both sources believe it is not difficult at all to purchase the majority

of illicit drugs.

! Dallas is one of only six Pulse

Check cities where diverted

OxyContin® (oxycodone hydrochloride controlled-release) can be

purchased with no difficulty at all.

(The other five are BostonL

, New

YorkL

, PittsburghE, San FranciscoL,

and Tampa/St. PetersburgL

).

METHAMPHETAMINE

Ice, which had not been encountered

for a while, has become more available

as more Mexican organizations have

become involved, and demand is

increasing because of lower prices.

Increases in use are reported, both

among methamphetamine users in

general and within the gay community,

which is an emerging user group.E
SNAPSHOT: DALLAS, TEXAS

page 110 Pulse Check: January 2004

! Gamma hydroxybutyrate (GHB):

Adolescents are reportedly using it

more, sometimes instead of flunitrazepam (Rohypnol®), to commit

drug assisted rape.E

! Alprazolam (Xanax®) plus

methadone: This combination is

increasingly reported in methadone

clinics and often results in fatalities.E

No increase, however, is reported

for methadone alone: users still

resort to the standard practice of

“cheeking” and selling the drug.E

! Diverted OxyContin®: While users

tend to be young adult (18–30

years), White, suburban males,

adults in rural areas are increasingly

starting to use the drug.E An increase

is also noted among club-goers.N

Tablets are usually ingested orally,

but a slight increase is noted in

crushing and injecting.E “Blue” refers

to the combination of OxyContin®

plus almost any other drug, from

crack to a depressant.N

MDMA (ECSTASY)

OTHER DRUGS

THE USE PERSPECTIVE

WHAT’S HAPPENING IN TREATMENT?

Treatment capacity and availability

! Methadone maintenance treatment

is available throughout the Dallas

area and remained stable between

spring and fall 2002. Both public

and private programs have adequate capacity, which is unchanged

since the previous reporting period.

! The Pulse Check non-methadone

treatment source directs a program

whose enrollment of 101 residential clients and 142 outpatients is

below its capacity of 120 residential clients (determined by square

footage for licensing by the Single

State Agency and the Texas

Commission on Alcohol and Drug

Abuse) and 300 outpatients (determined by program schedule and

licensing counselor-to-patient

ratio). Slightly more than one-third

of the clients in treatment from

September 1 through November

30, 2002, reported heroin as their

primary drug of abuse, and another

third reported crack cocaine as

such (see pie chart on the first page

of this chapter). 

! The methadone treatment source is

president of a program whose 350

outpatient clients at the time of the

Pulse Check discussion were below

its 400 outpatient capacity (determined by the State law’s counselorto-patient ratio). The vast majority

(90 percent) of the opiate users in

the program also use marijuana,

and three-quarters of them also use

some form of cocaine (see bar

graph on the first page of this chapter). Five percent of the methadone

patients use pain pills, such as

hydrocodone products (Vicodin®,

Lortab®, Lorcet®), as their primary

drug of abuse. These individuals

generally became addicted because

of some health condition that

required pain management—underscoring the need for educating doctors and dentists about drug addiction.M

Co-occurring disorders

! Incidence of HIV/AIDS and hepatitis

C has stabilized because of effective

intervention programs in the city.N,M

! Dual diagnoses involving antisocial

disorder or conduct disorder

declined among clients in the nonmethadone program because the program has a history of dealing with

this population and has improved its

screening process. The program has a

high but stable number of dually

diagnosed clients with psychosis

because two central screening facilities in the area refer them for detox.N

Barriers to treatment

! Cases of violent behavior among

presenting clients have declined

because the program has an

improved screening process and a

history of dealing with this population.N

! One program does not lack transportation or money for transportation because managed care covers

some of the costs.N The other program notes the transportation barrier as fairly common but stable.M

! Hispanics are underrepresented in

treatment programs throughout

the city for several reasons: a cultural distrust of engaging in official

activities; the availability of

church-based counseling; a lack of

education about resources; and a

Two sources note related increases

among sellers and users:

! Ecstasy sellers used to be primarily

White males. But an increase is

reported in the number of AsianAmerican, Black, and Mexican traffickers, and the market is now

expanding into night clubs in Black

communities.L

! While ecstasy users are predominantly White, some increase is noted in

the Black community.E

Only one source reports a decline:

Non-methadone treatment clients

report that availability and quality may

have declined because of recent police

action on labs. Nevertheless, they

report the drug as widely available and

cheaper than powder cocaine.N
SNAPSHOT: DALLAS, TEXAS

Pulse Check: January 2004 page 111

lack of professional Hispanic staff

to engage Hispanic users.N

! Lack of training and adequate reimbursement for professional staffing to

deal with comorbidity causes one

program to have a slight but stable

staffing problem.N The other program’s lack of trained staff to treat

clients with psychiatric problems has

increased: as the treatment community’s awareness of the problem is

growing, the program is struggling to

find staff to deal with it.M

! One respondent notes the lack of

education, and the misinformation about what treatment and

addiction are, within the medical

community and in the general

population.M

WHO USES ILLICIT DRUGS?

The Pulse Check epidemiologic, nonmethadone treatment, and

methadone treatment sources were

asked to describe the populations

most likely to use heroin, cocaine,

marijuana, methamphetamine, and

ecstasy. They were also asked to

describe any emerging user groups

and to report on how the drugs are

used. As shown on the following

pages, user characteristics vary from

drug to drug. Further, because of the

different perspective each brings, the

three sources sometimes describe

quite different populations and use

patterns for each drug. For example,

all methadone clients are primary

opiate users who may use drugs other

than opiates in a secondary or tertiary manner. 

Who’s most likely to use heroin?

Characteristic E N M

Age group (years) >30 >30 >30 

Mean age (years) 35 39 47 (median) 

Gender 60% male 76% male 56% male 

Race/ethnicity Black White White 

Socioeconomic status Low Low Low 

Residence Central city Central city Central city 

Referral source N/A Individual; Individual 

Council on AOD

Level of education completed N/A High school Junior high 

Employment at intake N/A Unemployed 50% employed, 

50% unemployed 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone

treatment respondent

! Two user groups are reported: the older, poorer, Black injectors from central city areas; and an emerging group of

young, White, more affluent smokers from the suburbs

(mean age 17.5 years). The latter group has increased

somewhat.E

! A slight decline in the percentage of clients in treatment for

primary heroin abuse does not reflect the street situation.

Rather, it is related to changes in the managed care system’s

definition of treatment priorities.N

! Whites and Blacks constitute 48 percent and 40 percent,

respectively, of the heroin users.

! North of Dallas, in the Plano area, the younger, more affluent, suburban heroin-using population is stabilizing. Fewer

deaths are reported than in the past because of increasing

awareness about heroin.M

! Most clients have been addicted to heroin for more than 20

years, since their twenties.
SNAPSHOT: DALLAS, TEXAS

page 112 Pulse Check: January 2004

How do users take heroin?

Characteristic E N M

Primary route of administration Injecting Injecting Injecting 

Other drugs taken Alprazolam, powder cocaine, Powder cocaine Marijuana, crack, 

crack, methamphetamine, benzodiazepines, pain pills

over-the-counter medications 

Publicly or privately? Privately Publicly and privately Privately 

Alone or in groups? Alone Alone Alone and in groups/

among friends 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! The older injectors combine heroin with powder or crack cocaine (speedballs, “he-she,” or “boy-girl”) or alprazolam. The

younger smokers mix their “chiva” with “speed” or over-the-counter medications.E A variety of other combinations are

reported (see box below).

N

! The younger emerging group tends to use heroin more publicly than the older injectors, who prefer more private settings,

such as shooting galleries (though some use heroin in parks).E

! White and Black heroin users tend to inject. Mexican users, however, tend to snort or smoke.M

! One-quarter of the methadone patients use diazepam or alprazolam as well as heroin. These individuals usually start out

with a co-occurring medical condition for which they obtain a benzodiazepine prescription—underscoring the need for educating doctors and dentists about drug addiction.M

“Beast”: Heroin plus lysergic acid diethylamide (LSD)

“China white” or “TNT”: Heroin plus fentanyl

“Cotton brothers”: Heroin plus cocaine plus morphine

“The five way”: Heroin plus snorted cocaine plus methamphetamine 

plus flunitrazepam plus alcohol

“LBJ”: Heroin plus LSD plus phencyclidine (PCP)

“Mud”: Heroin plus opium

“Sleeper and red devil”: Heroin plus a depressant

“Blanco”: Heroin plus cocaine

“Bombita”: Heroin plus amphetamine

“El diablito”: Heroin plus cocaine plus marijuana plus PCP smoked

“Poro”: Heroin plus PCP

“Goma”: Black tar heroin plus opium

“Homicide”: Heroin cut with strychnine

“Hot heroin”: Heroin poison to give a police informant

“Red rock” or “red rum”: Heroin plus barbitol plus strychnine plus caffeine

“Scramble”: Low purity heroin plus crack

“Spike”: Heroin cut with strychnine for injecting use

A “lexicon” of heroin combinations

Clients at the program directed by the Pulse Check non-methadone treatment source provided the following list of slang names for various drug combinations that include heroin:

Source: Non-methadone treatment respondent
SNAPSHOT: DALLAS, TEXAS

Pulse Check: January 2004 page 113

Who’s most likely to use cocaine?

Crack cocaine Powder cocaine Cocaine (unspecified)

Characteristic E N E N M

Age group (years) 18–30 >30 18–30 >30 >30 

Mean age (years) 25 37 28 34 47 (median) 

Gender 60% male 72% male 70% male 62% male 56% male

Race/ethnicity Black Black White White White 

Socioeconomic status Low Low Middle Low Low 

Residence Central city Central city Suburbs Central city Central city 

Referral source N/A Individual; N/A Individual Individual

Council on AOD 

Level of education completed N/A High school N/A High school Junior high 

Employment at intake N/A Unemployed N/A Unemployed 50% employed, 

50% unemployed 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! The percentage of clients in treatment for a primary crack problem declined somewhat since spring 2002 (to 19

percent); among first-time admissions, however, that percentage increased slightly (to 16 percent).N

! The treatment percentage for powder cocaine remained stable.N

! The percentage of males admitted for primary crack abuse increased—“probably a random blip.”N

! User characteristics remained stable between spring and fall 2002.E

! Some users are beginning to inject crack, using lemon juice or vinegar to liquefy it. As a result, an increase is

reported in skin infections around injection sites.E

! Some methadone patients mix cocaine with heroin or marijuana.M

! The combination of crack plus marijuana, according to clients at the program directed by the Pulse Check nonmethadone treatment source, has several slang names, including “bazooka,” “cocktail,” “crack bash,” “juice joint,”

“primo turbo,” “woolie,” and “woolie blunt.” “Cigamos” refers to crack plus tobacco.N

! The non-methadone clients also report several slang names for combinations that include powder cocaine plus

various other drugs: speedball (plus methamphetamine or plus heroin); “beam me up scottie” (plus PCP); “shabu”

(plus ice or methamphetamine); “spaceball” (plus PCP); and “wicky” (plus PCP plus marijuana).N

Who’s most likely to use marijuana?

Characteristic E N M

Age group (years) 18–30 18–30 >30 

Mean age (years) 19.5 24 47 (median) 

Gender 55% male 91% male 56% male

Race/ethnicity White White White 

Socioeconomic status Middle Low Low 

Residence Suburbs Central city Central city 

Referral source N/A Individual Individual 

Level of education N/A High school Junior high 

completed 

Employment at intake N/A Unemployed 50% employed, 50% unemployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Marijuana use cuts across all age

and racial groups.E

! User characteristics remained stable

between spring and fall 2002.E,N

! The methadone clinic no longer

imposes consequences (such as loss

of privileges) on clients for using

marijuana: otherwise, the majority of

its clients would drop out of the program.M
SNAPSHOT: DALLAS, TEXAS

page 114 Pulse Check: January 2004

How do users take marijuana?

Characteristic E N M

Primary delivery Joints Joints NR 

vehicle

Other drugs taken Embalming fluid, Cocaine, Heroin, pain

crack cocaine methamphetamine pills, cocaine

(sometimes 

powder cocaine) 

Publicly or privately? Publicly Publicly NR 

and privately

Alone or in groups? In groups/ In groups/ NR

among friends among friends

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! While marijuana is most often smoked in joints,

blunts are also common.E

! Marijuana combined with embalming fluid is

known as “water.”E

! Marijuana combined with crack is known as a

“primo.”E

! A variety of other drug combinations including 

marijuana are listed below. 

“Wet”: Marijuana plus embalming fluid

“Syrup”: Marijuana plus cough syrup

“Bad seed”: Marijuana plus peyote

“Chronic” or “kryptonite”: Marijuana plus crack

“Herb and al”: Marijuana plus alcohol

“Hydro”: Marijuana plus amphetamine or ecstasy

“Killer,” “parsley,” ”frios,” 

“yerba mala,” or “zoom” Marijuana plus PCP

A “lexicon” of marijuana combinations

Clients at the program directed by the Pulse Check non-methadone treatment source provided

the following list of slang names for various drug combinations that include marijuana:

Source: Non-methadone treatment respondent

Respondents associate marijuana, used

either alone or with other drugs, with

the following consequences, which

remained stable between spring and fall

2002:

! Drug-related deathsM

! Drug-related emergency room

visitsM

! Drug-related arrestsM

! Automobile accidentsE

!" High-risk pregnanciesE

! Poor academic performanceE

! Dropping out of schoolE

! Poor workplace performanceE,N

! Deteriorating family and social

relationshipsN

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?
SNAPSHOT: DALLAS, TEXAS

Pulse Check: January 2004 page 115

Problem change 

Increased polydrug use 

Decline in users’ perception of harm 

Increased progression to use of other drugs 

Increased THC potency of marijuana 

Earlier initiation of marijuana use 

Decline in social disapproval (e.g., peers, parents, etc.) 

Increased severity of addiction among clients 

Increased overall difficulty in treating the addiction 

Glamorization by entertainment industry 

Glamorization by news media 

Increased court referrals involving marijuana possession 

Increased court referrals involving marijuana sales 

0 1 23 45

Extent complicated treatment

Not at all Extremely

Marijuana-using clients: To what extent have changes in the following problems complicated their 

treatment over the past 10 years?

NR

NR

0

0

0

0

0

0

!"Non-methadone treatment respondent

#"Methadone treatment respondent

What they have to say...

! Court referrals have increased.N In

some cities (such as Philadelphia), respondents consider that

change to have had a positive

effect on treatment; in others

(such as Atlanta), respondents

believe that change has had a

negative effect; in Dallas, however, that change has not complicated treatment in any way.

! Like many other Pulse Check

respondents, both Dallas treatment sources agree that the

news media appear to have had

little complicating effect.

Reason

01 23 45

Extent contributed

Not at all Extremely

0

0

0

0

0

0

0

0

0

Increase in indoor farms 

Decline in social disapproval (e.g., peers, parents, etc.)

Promotion of marijuana as “medicine” 

Decline in users’ perception of harm

Glamorization by entertainment industry 

Glamorization by news media 

Less emphasis by law enforcement and courts 

Increased THC potency

More local production 

Decline in price 

Widespread marijuana availability and use over the past 10 years: 

To what extent have the following contributed?

! More local production: With the decline in the economy, many use marijuana production for

income.E It is becoming easier to conceal, and therefore harder to detect local production.L

! Prices: Like in many other Pulse Check cities, prices have not changed.E

!"Law enforcement respondent

#"Epidemiologic/ethnographic respondent

What they have to say...

! Indoor farms: From closets to bedrooms to bathtubs—marijuana is

increasingly grown “anywhere you

can put a grow light.”E It is becoming easier to obtain equipment from

catalogs, head shops, and other

sources. Indoor grows yield

increased THC content.L

! Harm perception: “The public feels

it’s no big deal. They don’t think of it

as a gateway drug.”L This remark

echoes the sentiment of the majority of Pulse Check respondents.

! Social disapproval: One source

believes that parents’ and peers’

opinions make little difference in

marijuana use.E By contrast, another believes—like the vast majority of

Pulse Check respondents—that marijuana’s increasing social acceptability has contributed to widespread use.L

! Law enforcement/court emphasis:

One source believes marijuana is

given low priority relative to other

types of drugs.L
SNAPSHOT: DALLAS, TEXAS

page 116 Pulse Check: January 2004

How do users take methamphetamine?

Characteristic E N

Primary route of administration Smoking Injecting 

Other drugs taken Marijuana Marijuana 

Publicly or privately? Publicly Privately 

Alone or in groups? In groups/ Alone

among friends 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent

! While smoking predominates, many users inject

methamphetamine.E

! One source observes that methamphetamine

users generally don’t take other drugs—“they

like to stay up and feel the buzz.”E

! According to non-methadone treatment clients,

however, methamphetamine is combined with

PCP (in “jet fuel”), sildenafil (Viagra®) (in “tina”),

and marijuana plus a depressant (in a “christmas tree”).N

Who’s most likely to use ecstasy? 

Characteristic E N

Age group (years) 18–30 18–30 

Mean age (years) NR 25 

Gender 50% male 75% male

Race/ethnicity White White 

Socioeconomic status Middle Low 

Residence Suburbs Central city 

Referral source N/A Individual 

Level of education completed N/A Junior high 

Employment at intake N/A Unemployed 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Ecstasy is not a drug used by methadone

patients, who are much older than the 

ecstasy-using population.M

! While ecstasy users are predominantly 

White, some increase is noted in the Black

community.E

! Some ecstasy users also use heroin, amphetamine, and ketamine and other sedatives.N A

variety of slang terms for various ecstasy combinations are listed in the following box.

! Client characteristics remained stable

between spring and fall 2002.N

Who’s most likely to use methamphetamine?

Characteristic E N

Age group (years) 18–30 >30 

Mean age (years) 25 35 

Gender 80% male 58% male 

Race/ethnicity White White 

Socioeconomic status Middle Low 

Residence Suburbs Suburbs, rural areas*

Referral source N/A Individual 

Level of education completed N/A High school 

Employment at intake N/A Unemployed 

*

Rural and suburban areas are about a mile apart. 

Sources: E

Epidemiologic/ethnographic respondent; NNon-methadone treatment

respondent; MMethadone treatment respondent

! Few methamphetamine users take heroin, so the

number enrolled in the methadone program is

very small.M

! Increases are reported, both among methamphetamine users in general and within the gay community, which is an emerging user group.E

! To cover the cost of their drug use, users are

increasingly obtaining recipes from the Internet,

cooking methamphetamine themselves, and trying to sell it.E

! First-time methamphetamine admissions include

a higher percentage of males than methamphetamine admissions overall (72 versus 58 percent).

! Client characteristics remained stable between

spring and fall 2002.N
SNAPSHOT: DALLAS, TEXAS

Pulse Check: January 2004 page 117

Ecstasy plus amphetamine: “B-bombs,” “diamonds,” “hugs and kisses,” 

“super X,” “waffle dust”

Ecstasy plus LSD: “Candy flipping,” “troll”

Ecstasy plus PCP: “Elephant flipping”

Ecstasy plus depressants: “Disco biscuit”

Ecstasy plus depressants in gel form: “Jellies”

Ecstasy plus heroin: “H-bomb”

Ecstasy plus sildenafil: “Hammerheading”

Ecstasy plus nitrous oxide: “Nox”

Ecstasy plus flunitrazepam: “Rib”

Ecstasy plus crack: “Roca”

Ecstasy plus mescaline: “Love flipping” 

A “lexicon” of ecstasy combinations

Clients at the program directed by the Pulse Check non-methadone treatment source provided the following list of slang names for various drug combinations that include ecstasy:

Source: Non-methadone treatment respondent

WHERE ARE DRUGS USED AND

SOLD?

Heroin is sold primarily in central city

areasL,E in a host of locations:

! On the streetsL,E

! In open-air marketsL,E

! Around supermarketsL,E

! In hotels or motelsL,E

! In crack houses/shooting galleriesE

! In private residencesE

! In public housing developmentsE

! Around drug or alcohol treatment

clinicsE

Those sales settings are also generally

use settings. The new young smokers,

however, do not make their deals on

the street or in crack houses or shooting galleries. Compared with the

older injectors, they are more likely

to make deals in cars, private residences, nightclubs and bars, and private parties.

Crack sales are equally distributed

among central city, suburban, and

rural areas.L Sales settings, and usually

use locations, include the following:

! On the streetsL,E

! In open-air marketsL,E

! Inside private residencesL,E

! In public housing developmentsL,E

! In crack houses or shooting

galleriesE

! In hotels or motelsE

! Inside carsL

! In nightclubs or barsL

Powder cocaine is sold in central

cityE and suburbanL,E areas in indoor

locations, which are usually also use

settings:

! Inside private residencesL,E

! In public housing developmentsL

! In nightclubs or barsL,E

! At private partiesL,E

! In hotels or motelsL,E

! Inside carsL

! At concertsE

Marijuana is equally likely to be sold

in central city, suburban, and rural

areasL,E in a wide variety of outdoor

and indoor locations where it is often

also used:

! On the streetsL,E

! In open-air marketsL,E

! Inside private residencesL,E

! In public housing developmentsL,E

! In or around elementary, junior

high, or high schoolsL

! On college campusesL

! In nightclubs or barsL,E

! In or around shopping mallsL

! In playgrounds or parksL

! At private partiesL,E

! At ravesL

! At concertsL,E

! In hotels or motelsL,E

THE MARKET PERSPECTIVE
SNAPSHOT: DALLAS, TEXAS

page 118 Pulse Check: January 2004

Methamphetamine is usually sold in

rural areasL,E in both outdoor and

indoor sales and use settings,

although gay users tend to make their

deals only in the indoor locations:

! On the streetsE

! In open-air marketsE

! Inside private residencesL,E

! In nightclubs or barsL,E

! At private partiesE

! In hotels or motelsL

! Inside carsE

Local methamphetamine is manufactured in both rural and city areas in

“box labs” and in other clandestine

labs in trailers, residences, fields, and

a variety of other locations. The

“Nazi” (quick-cooking) production

method is the most common,L but the

“cold method,” which uses red phosphorus, is also reported.E Many users

manufacturer their own drug by getting recipes over the Internet and

stealing liquid fertilizer from farms

and feed stores.E

The ecstasy market is located in both

central city and suburban locations,

both outdoors and indoors:

! On the streetsL

! In open-air marketsL

! Inside private residencesL,E

! In public housing developmentsE

! In or around elementary, junior

high, or high schoolsL

! On college campusesL

! In nightclubs or barsL,E

! At private partiesL

! At ravesL

! At concertsL

! Inside carsE

! Through the mailL

Diverted OxyContin® is sold in central city, suburban, and rural areas,

usually inside private residences or at

private parties.L

WHO’S SELLING DRUGS, AND HOW?

Nearly all drug deals are hand-tohand transactions, with the exception

of ecstasy, which is sold either person

to person or through the mail.

Dealers generally communicate with

their buyers, suppliers, and fellow

dealers via cell phone. Ecstasy dealers

use both cell phones and the Internet

for communications.

! Heroin dealers generally operate

within an organized structure.

They tend to be older than 30, are

not very likely to use their own

drug, and they also sell other

drugs, such as methamphetamine,

crack cocaine, and marijuana.L

“One on one” refers to gangs selling cocaine and heroin in the central city.

! Crack cocaine dealers, like heroin

dealers, belong to organized structures. But they are younger

(18–30) and are somewhat likely

to use their own drug. They also

sometimes sell marijuana.L

! Powder cocaine dealers are similar

to crack dealers, with two exceptions: they are not very likely to

use their own drug, and they sell

methamphetamine and marijuana

in addition to the powder cocaine.L

! Marijuana dealers generally belong

to gangs. They tend to be older

than 30, are somewhat likely to

use their own drug, and are

involved in polydrug sales. More

new seller groups are being investigated than in the past.L

! Methamphetamine dealers, unlike

dealers of most other drugs, operate independently. They tend to be

young adults (18–30 years) who

are very likely to use their own

drug, and they sell no other drugs.L

! Ecstasy dealers, like marijuana

dealers, operate within a gang

structure. They tend to be young

adults (18–30 years) who are

somewhat likely to use their drug.

They sell a variety of other drugs,

including GHB, ketamine, PCP,

LSD, powder cocaine, marijuana,

and methamphetamine. Ecstasy

sellers used to be primarily White

males. But an increase is reported

in the number of Asian-American,

Black, and Mexican traffickers,

and the market is now expanding

into nightclubs in Black communities.L

! Diverted OxyContin® dealers 

operate independently. They are

generally young adults who are

very likely to use their own drug

and to sell other diverted prescription drugs, such as hydrocodone

products and benzodiazepines.
SNAPSHOT: DALLAS, TEXAS

Pulse Check: January 2004 page 119

Which drug sellers are associated with which crimes?

Crime Heroin Crack Powder Marijuana Metham- Ecstasy

cocaine cocaine phetamine

Gang-related activity $$ $

Violent criminal acts $$$

Nonviolent criminal acts $$ $

Sources: Law enforcement respondent; epidemiologic/ethnographic respondent

! Dealers in diverted OxyContin® are often

involved in theftE

, as are methamphetamine

dealers.L They are also involved in fraud.L

! Assault is the violent crime most associated with

heroin, crack, and powder cocaine dealers.L

! Some heroin users are also sometimes

involved in violent crime.E

Beyond cash: What else is accepted in exchange for drugs?

Heroin

Cash

Crack cocaine

Marijuana Methamphetamine

56%

Shoplifted merchandise

Other stolen merchandise (e.g., 

electronic equipment)

Property/Merchandise

Transporting the drug

Drug buying services 

Lookout services

Pawning

Stolen chemicals/manufacturing 

Guns

“Other” includes different items for different drugs: 

for heroin, it includes other stolen merchandise (4

percent) and food stamps (1 percent); for crack, it includes

pawning, drug buying services, and drug transport services

(3 percent each) plus guns and lookout services (<1 percent

each); for powder cocaine, it includes guns and other drugs

(<1 percent each); and for methamphetamine, it includes

shoplifted merchandise and drug transport services (3 percent each) plus other stolen merchandise (<1 percent).

Sex

84%

43%

33%

6%

5%

9%

4%

1%

6%

3%

3%

6%

13%

5%

20% 17%

7%

13%

11%

7%

7%

10%

33%

Powder cocaine

62%

1%

10%

3%

10%

7%

7%

Source: Mean of response ratings given by law enforcement, epidemiologic/ethnographic, nonmethadone treatment, and methadone treatment respondents; the epidemiologic/ethnographic

source did not provide percentages for cocaine exchanges; the methadone treatment source did

not provide information for methamphetamine exchanges.

! Cash-only transactions appear much fewer in Dallas compared with those in the other Pulse Check cities, except in the case of marijuana. Conversely, a greater number of transactions in Dallas involve exchanging various goods and services, particularly for crack

and methamphetamine.

! Clients in the non-methadone program, in particular, do not conduct cash transactions because they are an indigent group.N

! Dealers are increasingly distributing free drugs in order to gain and maintain market share.N

! Middleman transactions (drug buying services) have increased because, according to non-methadone clients, “you gotta know somebody who knows somebody.”N

! Users are increasingly becoming involved in the manufacturing process in order to obtain methamphetamine.N

! The exchange of guns for marijuana has increased. “More youngsters are trading and carrying.” Many of these youth get their guns

from a large gun show that comes through Dallas annually.E
SNAPSHOT: DALLAS, TEXAS

page 120 Pulse Check: January 2004

How much do illegal drugs cost? 

Drug Unit Price

Mexican black 0.25 g $20–$25N

tar heroin 1 g $150–$250L

1 oza $800–$2,000L 

1 kgb $35,000–$45,000L

Powder cocaine 1 g $50–$100L 

Crack cocaine One rock $10–$40L 

Mexican marijuana One cigarette $2L

1/4 oz $25–$124N

1 lb $450–$750L

Methamphetamine 1 g $70–$100L

1 oz (ice) $700L 

Ecstasy One pill $7.50–$15L 

Bags (1,000 pills) $9,000L

a

5–6% pure, b22–28% pure

Sources: LLaw enforcement respondent; NNon-methadone treatment respondent

! Heroin ounce prices rose after September 11, 2001, but

returned to earlier levels in the late spring.L,N

! Heroin purity at the kilogram level increased slightly

between spring and fall 2002.L

! Prices for ice are lower as availability increases with the

growing involvement of Mexican organizations.L

! Heroin is sometimes adulterated with diphenhydramine

(Benadryl®).L,N Other adulterants are listed below.

! Bags of 1,000 ecstasy pills are known as “K-lots.”L

! All other reported prices and purity levels remained stable between spring and fall 2002.L

Drug marketing innovations and tools over the past 10 years: To what degree

have they complicated efforts to detect or disrupt drug activity in Dallas?

01 23 45

Degree of complication

Not at all Extremely 

Throwaway cell phones 

Increased communications via Internet 

Polydrug dealers

More organized networks 

Expansion of drug sales beyond the central city 

Relocation of sales settings within the community 

Unique packaging 

Less organized networks

More or changing brand names

Fewer brand names 

Illicit marketing innovation/tool

THE MARKET PERSPECTIVE: A 10-YEAR VIEW

“stacks” refers to crack adulterated

with ecstasy (or the other way

around), although it also refers to

ecstasy adulterated with heroin; and

“chocolate ecstasy” refers to crack

made brown by adding chocolate

milk during production.

! Powder cocaine: Baby laxatives,

alprazolam, baking soda

! Methamphetamine: Baby laxatives, dextrose, niacin, sugar, red

sulphur (crack cut with red sulphur is known as “red phosphorous”), Drano® crystals, ephedrine

What they have to say...

! As in most other Pulse Check cities,

brand name changes have had little

impact on detection or disruption activities, but throwaway cell phones have

posed a challenge.

! Even though sales settings often relocate within the community, police are

keeping up with them.E

! Rather than expanding beyond the

central city, drug sales have been 

moving from the outside in.E

! The Internet is used primarily for passing

recipes and for setting up parties and raves.E

! Networks have not changed in their degree

of organization, except for methamphetamine networks in rural areas.E

WHAT SUBSTANCES ARE USED AS 

ADULTERANTS? 

Clients at the program directed by

the Pulse Check non-methadone treatment source provided the following

list of adulterants they have encountered in various drugs:

! Heroin: Baking soda, epsom salts,

diphenhydramine

! Crack: “Pseudocaine” refers to crack

cut with phenylpropanolamine;

!"Law enforcement respondent

#"Epidemiologic/ethnographic

respondent

0

0

0

0

0

0
SNAPSHOT: DALLAS, TEXAS

Pulse Check: January 2004 page 121

Heroin prices increased for a short

time after September 11 but subsequently came back down.L,N

Additionally, three possible longer

term effects are noted:

! Some trafficking organizations

may be transiting through Dallas 

because security measures are tight

on the East Coast.L

! Some nonprofit organizations that

are hurting financially attribute

their hardships to both the economic slump and the diversion of

funds to New York.E

! Methadone treatment enrollment

spiked a few months after

September 2001 and into early

2002 and is continuing at a slightly higher level than usual. Some of

this slight elevation might be related

to a supply decline resulting from

the general tightening of the borders

and the initial war in Afghanistan,

when the poppy fields were

burned.M

Compared with respondents in other

Pulse Check cities, those in Dallas

seem to consider their community’s

antidrug strategies as less effective.

! Task forces: Because of budgetary

constraints, the DEA relies heavily

on task forces with State and local

counterparts.L Unlike the majority

of Pulse Check respondents, the

epidemiologic/ethnographic source

believes that these joint efforts are

not changing the level of drug

activity.E

! Precursor laws: Texas recently

enacted legislation making it harder to obtain some of the chemicals

essential to making methamphetamine. But traffickers are finding

other types of chemicals, such as

anhydrous ammonia, which they

steal from rural farms.L

! Drug courts: Texas has recently

enacted a program with a limited

number of drug courts. It is too

early to assess their effectiveness.L

! Prescription drug monitoring:

“Doctor shopping” remains a

chronic problem.E

! Crack house laws: Crack houses

are being bought and bulldozed,

but the people who frequent them

just move to other locations.E

! Drug-free zone laws: Despite these

laws, youth are still selling drugs 

in schools and are being arrested

for it.E

! Sentencing changes: Texas has

one of the largest criminal populations in jail, but that has had no

impact on the drug situation.E

! Recommendation: County jails,

which are constantly full and are

facing major cuts across the board,

need more educational and treatment services.E

COMMUNITY INNOVATIONS AND TOOLS OVER THE PAST 10 YEARS: HOW SUCCESSFUL HAVE THEY BEEN?

SEPTEMBER 11 FOLLOWUP
SNAPSHOT: DENVER, COLORADO

page 122 Pulse Check: January 2004

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

All four Pulse Check sources believe the overall drug problem in Denver has

remained stable. A few changes, however, are reported:

! According to the non-methadone treatment source, treatment percentages

there have remained relatively stable between spring and fall 2002, with

slight decreases in heroin and powder cocaine as primary drugs of abuse

and a decrease in the abuse of prescription drugs.

! According to one treatment source, after increasing substantially last year,

methamphetamine use and admissions may be leveling off.N However,

other sources report that methamphetamine use has increased substantially

as the drug has become more available, and the availability and use of

ice (high-purity, smokable methamphetamine) may be increasing.L,E

According to one source, methamphetamine has replaced crack as the

second most widely abused drug.L

! Local meth labs continue to

increase, especially those using the

“cold method” with anhydrous

ammonia and the “Nazi” or quickcooking method that can produce

higher purity methamphetamine.E

! Use of club drugs, especially methylenedioxymethamphetamine (MDMA

or ecstasy), but also including dextromethorphan (DXM), ketamine,

and gamma hydroxybutyrate (GHB),

continues to increase.E,L

! Abuse of OxyContin® (oxycodone

hydrochloride controlled-release)

continues to emerge.M

Three sourcesL,E,N consider the illegal

drug problem very serious, and oneM

considers it somewhat serious. The

drug associated with the most serious

consequences varies by source: two

sourcesL,M name methamphetamine as

What drugs do clients in a methadone

program use+? (Fall 2002)

Percentage 

Heroin Benzodiazepines

Powder

cocaine

Diverted

OxyContin®

Drug (primary + secondary + tertiary)

+

Includes any use, whether as a primary, 

secondary, or tertiary drug; responses for

crack, methamphetamine, and ecstasy were

“0”; response for marijuana was “don’t know.”

Source: Methadone treatment respondent

*The census data in this table are provided as a frame of reference for the information given by Pulse Check sources. Whenever possible the data

given by the law enforcement and epidemiologic/ethnographic sources reflect the metropolitan area. DENVER PRIMARY METROPOLITAN

STATISTICAL

AREA PROFILE:

Most widely abused drug:

MarijuanaL,E

MethamphetamineN

HeroinM

No reported changes between spring

and fall 2002L,E,N,M

Second most widely abused drug:

Powder cocaineE,M

MethamphetamineL

CrackN

Changes between spring and fall 2002:

Methamphetamine has replaced crack .L

Drug related to the most serious 

consequences:

MethamphetamineL,N

Powder cocaineE

HeroinM

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the second most

serious consequences:

CrackL,N

HeroinE

Powder cocaineM

No reported changes between spring

and fall 2002L,E,N,M

Emerging drugs:

Ecstasy activity continues to increase.L

Club drug activity continues to increase.E

Diverted OxyContin®M

Sources: LLaw enforcement, E

Epidemiologic/ethnographic, 

N

Non-methadone treatment, and

MMethadone treatment respondents

Note: These symbols appear throughout this

city profile to indicate type of respondent.

contributing to the most serious consequences, one sourceE names powder

cocaine, and oneM names heroin. Two sourcesL,E believe that marijuana continues

as the most widely abused drug, anotherN names methamphetamine, and the

methadone treatment source—not surprisingly—names heroin.

100

80

60

40

20

0

! Total population:. . . 2,109,282 

! Median Age: . . . . . . 34.1 years 

! Race:

! White . . . . . . . . . . . . . . 79.4%

! Black . . . . . . . . . . . . . . . 5.5%

! American Indian/

Alaska Native . . . . . . . . 0.9%

! Asian/Pacific Islander 0.4%

! Other race . . . . . . . . . . . 8.1%

! Two or more races . . . . 3.0%

! Hispanic (of any race): 18.8%

! Unemployment rate: . . . . 2.8%

! Median household 

income: . . . . . . . . . . . $51,191

! Families below Poverty Level 

with Children <18 years: 8.3%

Source: U.S. Census 2000*

95

5 4 10

(N=267)
SNAPSHOT: DENVER, COLORADO

Pulse Check: January 2004 page 123

Methamphetamine use indicators are

mixed:

! After increasing dramatically in

spring 2002, methamphetamine

treatment admissions seem to be

leveling off.N

! Methamphetamine use has

increased, and there are more

mentions of ice.E

! Local labs manufacturing methamphetamine using the “Nazi method”

have increased in the past 6 months

and are making a higher purity

form of the drug. Local labs that

manufacture ice have also increased.E

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic respondent

Note: SA=South American (Colombian) heroin; SWA=Southwest Asian heroin; SEA=Southeast

Asian heroin; Ice=highly pure methamphetamine in smokable form; GHB=gamma hydroxybutyrate; and BC bud=British Columbian marijuana.

Undercover policeL UsersE

! As reported in the majority of Pulse Check

cities, marijuana is not difficult at all for users

and undercover police to purchase.L,E Mexican

heroin, powder and crack cocaine, and

methamphetamine are also relatively easy to

purchase.

! Since spring 2002, sources report no changes

in the difficulty of purchasing drugs.

0

Not

difficult

at all

1

2

3

4

5

6

8

7

10

9

Marijuana (all forms)

Heroin (in general, Mexican black

tar, and brown); crack, powder

cocaine; methamphetamine (in

general, locally produced, and

Mexican)

SA, SEA, SWA; diverted OxyContin®

Sinsemilla and hydroponic

marijuana

Heroin (in general, Mexican

black tar, and brown) 

Powder cocaine

Crack

Ketamine

Diverted OxyContin®

Marijuana (in general, local commercial); methamphetamine (in

general, locally produced, and

Mexican)

Ice Ice; ecstasy; GHB

Ecstasy

BC bud 

SA, SEA, SWA

Extremely

difficult

The heroin problem may be dissipating, according to several indicators:

! The number of primary heroin

admissions to treatment has

declined, and the number of primary heroin users new to treatment has declined substantially.N

! Heroin use and sales on college

campuses have declined.E

Marijuana sales and use remain 

relatively stable.L,E,N,M Marijuana

remains widely available and is considered the most abused drug by two

sources.L,E

Overall, the powder and crack

cocaine problems appear relatively

stable. The non-methadone treatment

source reports a slight decline in 

powder cocaine use.

MARIJUANA

HEROIN

COCAINE

METHAMPHETAMINE
SNAPSHOT: DENVER, COLORADO

page 124 Pulse Check: January 2004

WHAT’S HAPPENING IN TREATMENT?

! The Pulse Check non-methadone

treatment respondent, whose 20-

bed inpatient facility operates at

maximum capacity, reports

methamphetamine as the primary

drug of abuse among the majority

of clients. Treatment percentages

there have remained relatively stable between spring and fall 2002,

except for slight decreases in heroin

and powder cocaine as primary

drugs of abuse, a leveling off in

methamphetamine as a primary

drug of abuse (after increasing 

dramatically during the previous 6

months), and a decrease in the

abuse of prescription drugs.

! The methadone treatment respondent is with a facility that is nearly

at maximum capacity (267 slots

filled of 300), with capacity based

on funding and staff. Nearly all

clients (95 percent) abuse heroin

as their primary drug, and 4–5 

percent abuse OxyContin® as their

primary drug. (See bar chart on the

first page of this chapter.) Common

secondary and tertiary drugs abused

include benzodiazepines (among 10

percent of clients) and powder

cocaine (among 5 percent of clients).

! Methadone treatment is available

only in selected parts of the metropolitan area. Public and private

methadone treatment facilities

reportedly have adequate capacity,

and treatment availability has

remained stable between early and

late 2002.E

! The non-methadone treatment

provider reports a recent increase

in drug abuse admissions (especially

among female clients) who report

suicidal thoughts and attempts.

Lack of trained staff to treat 

comorbidity remains a common

problem, as does limited slot

capacity. The non-methadone treatment provider also believes that

the recent decline in the Federal

and State economies has limited

the services that drug treatment

facilities are able to provide.

! As reported by many methadone

treatment sources across Pulse

Check cities, hepatitis C has

increased among drug abusers.

The increase is most likely due to

improved testing. The methadone

source also reports an increase in

severe abscesses among heroin

injectors, most likely caused by a

change in the way heroin has been

adulterated or processed by distributors. Mood disorders, especially

depression and bipolar disorders,

are a common problem and have

increased in the last 6 months. The

methadone source explains that

more people are being screened for

the disorders; thus, more are being

diagnosed and treated. 

WHO USES ILLICIT DRUGS? 

The Pulse Check epidemiologic, 

non-methadone treatment, and

methadone treatment sources were

asked to describe the populations

most likely to use heroin, cocaine,

marijuana, methamphetamine, and

ecstasy. They were also asked to

depict any emerging user groups and

to report on how the drugs are used.

As shown in the following pages, user

characteristics vary by drug. Further,

because of the different perspective

each brings, the three sources sometimes describe quite different populations and use patterns for each drug.

For example, all methadone clients

are primary opiate users who may use

drugs other than opiates in a secondary or tertiary manner.

THE USE PERSPECTIVE

DIVERTED OXYCONTIN®

OTHER DRUGS

Although diverted OxyContin® remains

difficult to buy on the street, abuse has

increased since spring 2002 (as it has in

14 other Pulse Check cities):

! The methadone treatment source

reports an increase in primary and

secondary OxyContin® abusers,

nearly all of whom are new to

treatment for any drug.M

! Of the 2–3 percent of admissions

in the methadone treatment clinic

who were primary OxyContin®

abusers, most were older than 30,

White, and split evenly between

genders. Clients tend to be 

suburban residents of middle

socioeconomic status who abuse

OxyContin® only and take it orally.M

! GHB and ketamine: GHB and ketamine are relatively easy to buy,

and availability remains stable.

GHB sells for $5–$10 per capful.E

! Benzodiazepines: No clients at

the methadone treatment program

are primary benzodiazepine users,

but about 10 percent (a relatively

stable proportion) use the drug as

a substitute for heroin.M

MDMA (ECSTASY)

The methadone treatment source

reports no use among clients, and the

non-methadone treatment source

reports low levels of secondary and

tertiary use among clients. However,

two sources report increasing club

drug activity.L,E
SNAPSHOT: DENVER, COLORADO

Pulse Check: January 2004 page 125

Who’s most likely to use heroin?

Characteristic E N M

Age group (years) >30 18–30 >30 

Mean age (years) 37 NR 30–35 

Gender 68% male Split evenly 60% male 

Race/ethnicity 66% White; White White 

20% Hispanic 

(any race)

Socioeconomic status Low and middle Low Low 

Residence Central city Suburbs Suburbs 

and suburbs

Referral source N/A Alcohol/drug abuse or Individual 

other health care providers 

Level of education 

completed N/A High school High school 

Employment at intake N/A Part time Unemployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Two sources report heroin users as most likely to be White, non-Hispanic males over 30 of low

to middle socioeconomic status.E,M

! Predominant user characteristics appear stable between spring and fall 2002.E,N,M

! Heroin users new to treatment have a much younger mean age than those among the overall

treatment population (28.2 versus 37 years); furthermore, a higher proportion of heroin users

new to treatment are White compared with users among the general treatment population (72

versus 66 percent).E

How do users take heroin?

Characteristic E N M 

Primary route of 

administration Injecting Smoking Injecting

Other drugs taken Powder Powder Powder 

cocaine cocaine cocaine (speedball);

(speedball) (speedball) benzodiazepines 

(as a substitute)

Publicly or privately? Privately Privately Privately 

Alone or in groups? Alone and Alone Alone

in groups

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment 

respondent; MMethadone treatment respondent

Use patterns appear stable with two

exceptions:

! Snorting and injecting (versus smoking) heroin

continue to increase, especially among heroin

users new to treatment.E

! Heroin users new to treatment tend to either

snort or smoke (evenly split). Among heroin

users in general, injection as a route of

administration continues to decline.N
SNAPSHOT: DENVER, COLORADO

page 126 Pulse Check: January 2004

Who’s most likely to use marijuana?

Characteristic E N

Age group (years) 18–30 18–30

Mean age (years) 24.8 NR

Gender 75% male Split evenly 

Race/ethnicity 54% White; 11% Black; White and Black split evenly

26% Hispanic (any race)

Socioeconomic status Divided evenly among all Middle 

Residence Divided evenly among all areas Suburbs 

Referral source N/A Criminal justice and other

health care providers

Level of education completed N/A High school 

Employment at intake N/A Full time

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent

! Marijuana use continues to

span all races, ethnicities,

socioeconomic strata, and

geographic areas of the city.

! Marijuana users new to 

treatment tend to be much

younger (mean age of 16.7

years) than marijuana treatment admissions in general

(mean age of 24.8 years).E

! Increased THC potency and

earlier initiation of marijuana

use have complicated treatment for marijuana-using

clients. This source believes

that glamorization of marijuana use by both the entertainment industry and news

media has decreased in the

past 10 years.N

Who’s most likely to use cocaine?

Crack Powder cocaine

Characteristic E N E N

Age group (years) <30 18–30 <30 18–30

Mean age (years) 34.9 NR 35 NR 

Gender 55% male 70% female 67% male Male 

Race/ethnicity 37% White; Black 48% White Black

29% Black;

26% Hispanic 

( any race)

Socioeconomic

status Low Low Low and middle Low 

Residence Central Central Distributed equally Central

city city among all areas city

Referral source N/A Criminal N/A Criminal justice, other

justice and health care providers,

social services and social services 

Level of education Junior High

completed N/A high N/A school 

Employment 

at intake N/A Unemployed N/A Full time

Note: The methadone treatment source reported no primary, secondary, or tertiary crack admissions to 

treatment, no primary powder cocaine admissions to treatment, and 13 secondary and tertiary powder 

cocaine admissions (5 percent of total admissions). 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent

Sources report several

shifts in cocaine user characteristics between spring

and fall 2002:

! Among powder cocaine

users in general, Blacks have

increased slightly. Among

powder cocaine users new to

treatment, Whites have

decreased as Hispanics and

Blacks have increased.E

! Heroin admissions who use

powder cocaine as a secondary drug tend to be younger

than heroin-only users.M

! Among crack users new to

treatment, Whites and those

of middle socioeconomic status are increasing, and the

mean age is rising.E
SNAPSHOT: DENVER, COLORADO

Pulse Check: January 2004 page 127

source reports that some marijuana

joints are laced with crack cocaine

and referred to as “premos.”E

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

Respondents associate marijuana,

used either alone or with other drugs,

with the following consequences, 

which appear stable between spring

and fall 2002:

! Drug-related deaths (in which one

of the drugs is marijuana)E

! Drug-related emergency room visitsE

! Drug-related arrestsE,N

! Automobile accidentsE

! Short-term memory lossE,N

! Deteriorating family/social

relationshipsE,N

! Poor academic performanceE,N

! School absenteeism, truancy, or

dropping out of schoolE

! Poor workplace performanceE

! Workplace absenteeismE,N

Widespread marijuana availability and use over the past 10 years: To what extent have the following contributed?

Reason

What they have to say...

! Indoor farms: Indoor growth is

becoming more difficult to detect,

with larger quantities of marijuana

grown in smaller spaces.E

! Increased THC: The increase of

high-quality BC bud (“kind bud”) on

the market has contributed to the

increased THC level of marijuana in

Denver. In addition, certain varieties of marijuana from Alaska have

a THC content of up to 29 percent.E

WHAT ELSE DO USERS TAKE WITH

MARIJUANA?

As in other cities, users often take

many other drugs with or around

marijuana. For example, methamphetamine is often taken sequentially

after marijuana, and a new practice

has emerged of dipping marijuana

joints in formaldehyde (the dipped

joints are called “wets”).N Another

Who’s most likely to use methamphetamine?

Characteristic E N

Age group (years) >30 18–30

Median age (years) 30 NR

Gender 53% male Split evenly 

Race/ethnicity 80% White; 

13% Hispanic White

Socioeconomic status Low and middle Middle 

Residence Divided evenly Suburbs 

among all areas and rural

Referral source N/A Individual and 

social services

Level of education 

completed N/A High school 

Employment at intake N/A Full time

Sources: EEpidemiologic/ethnographic respondent; N

Non-methadone treatment respondent

Sources report several shifts in user characteristics between

spring and fall 2002:

! Females as a proportion of methamphetamine treatment admissions are increasing, and

the gender split is now

even.N

! Methamphetamine use

is spreading from rural

and suburban areas to all areas, including the central city.N

! The proportion of Hispanic methamphetamine users has increased

as the proportion of Whites has declined.E

! Many blue collar workers use the drug to stay awake and work longer

hours.E

01 2 3 4 5

Extent contributed

Decline in social disapproval 

Promotion of marijuana as “medicine”

Less emphasis by law enforcement and courts

Decline in users’ perception of harm

More local production

Increased THC potency

Increase in indoor farms

Decline in price

Glamorization by entertainment industry

Glamorization by news media

!""Law enforcement respondent Not at all

#""Epidemiologic/ethnographic respondent

0

0

0

0

0

0

Extremely
SNAPSHOT: DENVER, COLORADO

page 128 Pulse Check: January 2004

HOW ARE PEOPLE USING 

METHAMPHETAMINE?

Methamphetamine is primarily

smoked and is often used sequentially with marijuana.E,M The epidemiologic source notes that smoking (52

percent) and injecting (31 percent)

have increased as routes of methamphetamine administration, while

snorting (14 percent) has declined.

WHO’S USING ECSTASY?

Ecstasy users tend to be adolescents

and young adults of both genders.

Whites are more likely to use ecstasy

than other races/ethnicities and are

overrepresented compared with the

general population. Ecstasy users 

are primarily of middle or high

socioeconomic background and

reside mostly in central cities and

suburbs. Common combinations

include “candy flipping” (ecstasy

combined with lysergic acid diethylamide [LSD]) and “kitty 

flipping” (ecstasy combined with 

ketamine).E Sources report no

changes in user or use characteristics.

WHERE ARE DRUGS USED AND SOLD?

Heroin, crack and powder cocaine,

marijuana, and methamphetamine are

sold in a variety of public and commercial venues including the following:L,E

! Streets/open-air markets 

! Crack houses/shooting galleries

(excluding methamphetamine)

! Public housing developments

! Around drug treatment clinics

(excluding crack and methamphetamine)

! Playgrounds/parks

! Around supermarkets

! Parking lots (excluding cocaine)

Drugs are also sold through prearranged meetings via cell phones in

more private areas:L,E

! Private residences

! Hotels/motels

! Nightclubs and bars

! College campuses 

! Inside cars

Additionally, methamphetamine and

ecstasy are sold at raves and concerts,

and marijuana is sometimes sold via

the Internet. Although most sales settings have remained similar between

spring and fall 2002, sales of heroin

in open-air markets and on college

campuses have declined.E

The majority of these sales settings

also serve as use settings.

WHO SELLS ILLEGAL DRUGS, AND

HOW DO DRUGS GET FROM SELLER

TO BUYER?

Most dealers in Denver are polydrug

dealers likely to distribute heroin,

powder and crack cocaine, marijuana, and methamphetamine. Most are

associated with Mexican trafficking

organizations.E However, the trafficking organizations don’t have much

oversight on street sales and streetlevel dealers (who are organized into

autonomous “street cells”). Drugs

sold by these polydrug dealers are

sold hand-to-hand in streets or

through meetings prearranged via 

cell phones.

Moreover, Mexican trafficking

organizations transport adolescents

and young adults from Mexico and

Central America to Denver and provide them with cheap motel rooms

and cars from which to sell the

drugs.E If these sellers are apprehended by the police they are deported,

and no leads connect them to the

trafficking organizations. 

Which drug sellers are associated with which crimes?

Crime Heroin Powder Crack Mari- Metham- Ecstasy

cocaine cocaine juana phetamine

Prostitution $ $

Gang-related activity $$ $ $ $

Violent criminal acts: assaults $ $ $$ $ $

Non violent criminal acts:

fraud and theft $

Domestic violence $

Drug-assisted rape $

No crimes associated $ $

Source: LLaw enforcement and E Epidemiologic/ethnographic respondents

! Dealers who sell primarily methamphetamine tend to be associated with

more types of crime—including domestic violence—than other drug dealers.

! Heroin and crack dealers continue to be associated with prostitution, street

gangs, and violent assaults.

THE MARKET PERSPECTIVE
SNAPSHOT: DENVER, COLORADO

Pulse Check: January 2004 page 129

Based on the drug sold, several Beyond cash: What else is accepted in exchange for drugs?

differences in sales persist: 

! Dealers who sell primarily crack

are more independent than heroin

or powder cocaine dealers, and

crack distribution is becoming

more intertwined with street

gangs.E

! Dealers who sell primarily marijuana tend to be less sophisticated

in communication techniques than

heroin and cocaine dealers.E

Marijuana dealers are also less

likely than other dealers to be

involved in gangs and prostitution.

! Two tiers of methamphetamine

sellers exist: (1) independent lab

owners who distribute methamphetamine only, and (2) distributors involved in polydrug sales

(mentioned above) who are connected to Mexican meth labs and

trafficking organizations.E

! Dealers involved primarily in

methamphetamine sales tend to be

“harder to deal with” than dealers

who primarily sell heroin, cocaine,

or marijuana. Buyers trying to 

purchase methamphetamine are

said to be “chasing the bag.”

Moreover, methamphetamine sales

are less likely to occur on the street

than heroin or cocaine sales.E

! Unlike sellers of other drugs, 

ecstasy sellers tend to sell only

ecstasy. Ecstasy sales are run both

by independent sellers and street

gangs, and sales are often venueoriented (at nightclubs, raves, and

concerts) as they are in many

cities. However, some sales do

occur on the streets hand to hand.

According to the epidemiologic

source, Asian gangs who sell ecstasy have emerged in fall 2002 and

have nearly taken over the ecstasy

market.

Note: The epidemiologic/ethnographic and

methadone treatment sources did not respond to

this question.

Source: Mean of response ratings given by law

enforcement and non-methadone treatment

respondents 

Heroin

Cash

Crack and powder cocaine

Methamphetamine

Marijuana

90%

Shoplifted merchandise

Other stolen merchandise

(e.g., electronic equipment)

Property/Merchandise

Other drugs

Drug buying services

Transporting the drug

Sex 100%

74%

80%

5% 5%

3% or less

for each

5%

5%

5%

10%

6%

5%

What they have to say...

! One source states that when it comes to

exchanges for drugs, “cash is king”—particularly in the case of marijuana.E This

pattern is more prounced in Denver than

in the majority of other Pulse Check cities.

! Pulse Check sources report that goods

and services exchanged for drugs have

remained relatively stable over the past

10 years in Denver.

! Merchandise is second to cash as the

most common item exchanged for drugs,

followed by other drugs, sex, guns, and

transporting the drug.E
SNAPSHOT: DENVER, COLORADO

page 130 Pulse Check: January 2004

How potent is marijuana, and how much does it cost?

Form Unit THC content Price

Commercial 1 oz NR $100–$200L

grade 3–10% $200–$300E

“Kind bud” 

(high-quality 

hydroponic), 

BC bud 1 oz 16–20% $700–$1,000E

Sources: LLaw enforcement respondent; EEpidemiologic respondent

! Most sources report stable marijuana prices in fall 2002, with

one exception: pound prices for commercial grade marijuana

declined slightly since spring.E

! Marijuana in general is not difficult to purchase. Local commercial grade is the most common form available, followed by 

sinsemilla and hydroponic, both of which are somewhat difficult

to purchase.L

! A wide variety of marijuana is available for purchase, including

commercial grade, sinsemilla, BC bud, and hydroponic.E

How pure is methamphetamine,

and how much does it cost?

Unit Purity Price

1 g NR $100L

1 g 8–12% $80–$100E

1 oz 8–12% $700–$1,000E

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

! Mexican methamphetamine is low quality

and looks like peanut brittle, while local

methamphetamine has a higher purity

and is mostly powder.E

! Locally produced and Mexican varieties of

methamphetamine are not difficult at all to

buy, and ice is only slightly more difficult to

buy than the lower purity form.L,E

! Purity at the gram and ounce levels

declined between spring and fall 2002

(from 10–20 percent to 8–12 percent).E

How pure is cocaine, and how much does it cost?

Form Unit Purity Price Change?

Crack One rock (“yay”) NR $20L None

$10–$20E Prices down from $20–$30

since spring 2002

1 oz NR $900–$1,000E Prices down from $900–$1,250

since spring 2002

Powder 1 g NR $100L None

30–90% $100–$125E None

1 oz 65–85% $500–$900E Purity up since spring 2002

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic respondent

! Powder cocaine prices were stable between spring and fall 2002, but purity

increased at the ounce level.E

! Crack prices declined at lower (rock) levels and higher (ounce) levels.E

! Most crack cocaine is processed from powder locally.L,E The epidemiologic

source states that much more of it is being processed locally than during

the last reporting period.

How pure is Mexican black tar 

heroin, and how much does it

cost? 

Unit Purity Price

1 g NR $100L

8–64% $100–$150E

1 oz 40% $1,500–$3,000E

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

! The most common form of

heroin is Mexican black

tar, and its purity on the

street varies widely. 

! Since spring 2002, purity

and most prices have

remained stable, with the

exception of prices at the

ounce level, which have

declined slightly.E

HOW PURE ARE ILLEGAL DRUGS, AND HOW MUCH DO THEY COST? 

How much does ecstasy cost?

Ecstasy prices are stable at

$15–$25 per pillL,E. When sold in

large quantities, pills cost

$10–$12 each.E
SNAPSHOT: DENVER, COLORADO

Pulse Check: January 2004 page 131

COMMUNITY INNOVATIONS AND

TOOLS OVER THE PAST 10 YEARS

Several innovations over the past 10

years have helped combat illegal drug

activity and use:

! Increased use of task forces:L,E

Additions of larger task forces

have increased law enforcement’s

ability to investigate large criminal

drug operations.L Small police

departments often have small budgets, but task forces have helped. For

example, if a task force obtains a

drug seizure, the amount of money 

involved is split among those agencies involved in the task force.E

! Precursor laws: New State laws

have increased penalties for small,

clandestine labs. Child abuse and

neglect laws have been expanded

to address the manufacturing of

methamphetamine around

children.L,E Additionally, there is

now a civil fine for companies that

sell large amounts of methamphetamine precursors to individuals.E

! Drug-free zone laws: Selling within

1,000 feet of a school enhances

sentencing, and probationers must

stay away from certain “risk areas.”E

! Drug courts: Only one drug court

exists in the metropolitan area.

Although the drug court is seen as

very effective by the epidemiologic

source, it will be phased out to a

regular court of law within the

next year.E

! Air reconnaissance support from

the National Guard: Air surveillance operations in conjunction

with counterdrug operations have

allowed narcotics enforcement 

to fully identify drug source and

supply routes.L

SEPTEMBER 11 FOLLOWUP

None of the four Denver Pulse Check

sources believes that the September

11 attacks and their aftermath have

had any continuing effects on the

drug abuse problem.

THE MARKET PERSPECTIVE: 

A 10-YEAR VIEW

Drug marketing innovations and tools over the past 10 years: To what degree have

they complicated efforts to detect or disrupt illicit drug activity in Denver?

012 3 4 5

Degree of complication

Not at all Extremely complicated

Throwaway cell phones

Expansion of drug sales beyond the central city

Relocation of sales settings within the community

Increased communications via Internet

Polydrug dealers

More organized networks

More or changing brand names

Fewer brand names 

Unique packaging

Less organized networks

! Law enforcement respondent 

# Epidemiologic/ethnographic respondent 

What they have to say...

! As reported in many Pulse

Check sites, throwaway cell

phones have created problems

for law enforcement because

they cannot be wiretapped.E

Also, they tend to complicate

efforts for tracing high-level

dealers more than those for

locating street-level dealers.L

! According to the law enforcement source, unique packaging of drugs is rare in Denver.

The epidemiologic source

agrees, with one exception:

in the past 10 years, the 

compression of marijuana 

into tighter packages helps

conceal the drugs. 

0

0

0

0
SNAPSHOT: DETROIT, MICHIGAN

page 132 Pulse Check: January 2004

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

Overall, three of the four Pulse Check respondents state that Detroit’s drug

problem is stable, with the fourth perceiving a slight worsening in the situation.

All four agree, however, that the current drug problem remains very serious.

Some changes are reported since spring 2002, both positive and negative:

! The number of crack cocaine users is decreasing somewhat, possibly because

users perceive the drug as less popular or of lower status.E

! Demand for gamma hydroxybutyrate (GHB) has declined.E

! Diverted methadone is increasingly available on the street. As in eight

other Pulse Check cities, it is described as an emerging drug of abuse.E

! The prevalence of methamphetamine continues to increase throughout

Detroit as it does in other Pulse Check cities. Labs are spreading out

throughout the State. Currently, the problem in Detroit is not as great as

in western Michigan.E

! The number of violent deaths associated

with drug abuse has increased to a high

level, primarily involving children

caught in the crossfire.N

! Hepatitis C diagnoses have increased

significantly, perhaps attributable to

more aggressive screening within

treatment programs.M

The drug market has also changed in

several ways:

! The number of methamphetamine

seizures by State police is expected to

double between 2001 and 2002.E

! Pseudoephedrine, a precursor for

methamphetamine, is now trafficked

over the Internet.L

! More diverted OxyContin® (oxycodone hydrochloride controlledrelease) appears to be arriving from

Canada.E

While all the Pulse Check respondents

agree that Detroit’s drug problem is

very serious, they differ on the most

widely abused drug based on the different populations with which they work.

However, they generally agree that

heroin is associated with the most serious consequences.L,E,M

Most widely abused drug:

MarijuanaL,E

CrackN

HeroinM

No reported changes between spring

and fall 2002L,E,N,M

Second most widely abused drug:

CrackE,M

Heroin/CrackL

MarijuanaN

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the most serious

consequences:

HeroinL,E,M

CrackN

No reported changes between spring

and fall 2002L,E,N,M 

Drug related to the second most

serious consequences:

CrackL,E,M

MarijuanaN

No reported changes between spring

and fall 2002L,E,N,M

New or emerging problems:

MethamphetamineE

Abused methadoneE

Sources: LLaw enforcement, EEpidemiologic/ 

ethnographic, NNon-methadone treatment,

and MMethadone treatment respondents 

Note: These symbols appear throughout this

city profile to indicate type of respondent.

What are the primary drugs of abuse

among clients in a non-methadone

treatment program? (Fall 2002)

Powder cocaine

Heroin

Marijuana

Crack cocaine

Source: Non-methadone treatment respondent

22%

5%

65%

8%

DETROIT PRIMARY METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Total population:. . . 4,441,551 

! Median age: . . . . . . 35.5 years 

! Race (alone):

! White . . . . . . . . . . . . . . 71.2%

! Black . . . . . . . . . . . . . . 22.9%

! American Indian/

Alaska Native . . . . . . . . 0.3%

! Asian/Pacific Islander 2.3%

! Other race . . . . . . . . . . . 1.1% 

! Two or more races . . . . 2.1% 

! Hispanic (of any race): 2.9% 

! Unemployment rate: . . . . 5.9% 

! Median household 

income:. . . . . . . . . . . . $49,175 

! Families below poverty level 

with children <18 years: 14.8% 

Source: U.S. Census 2000* 

*The census data in this table are provided as a frame of reference for the information given by Pulse Check sources. Whenever possible, the data given by

the law enforcement and epidemiologic/ethnographic sources reflect the metropolitan area. 

(N= 280)

What drugs do clients in a methadone

program use+? (Fall 2002)

+

Includes primary, secondary, and tertiary use

Source: Methadone treatment respondent 

Heroin

Crack cocaine

Percent who abuse the drug

0 20 40 60 80 100

(N=748)

! Treatment percentages among nonmethadone clients are stable for all

drugs of abuse between spring and 

fall 2002. Crack cocaine remains the

most common primary drug of abuse.N

! The methadone treatment program

reports an increase in the number of primary heroin users since spring 2002.M
SNAPSHOT: DETROIT, MICHIGAN

Pulse Check: January 2004 page 133

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Not

difficult

at all

Undercover policeL UsersE

Marijuana (in general, local

commercial grade, Mexican

commercial grade)

Crack, powder cocaine

Heroin (in general, SWA);

marijuana (sinsemilla)

Ecstasy

Heroin (Mexican black tar,

Mexican brown); ice

Methamphetamine (locally

produced)

SWA heroin; methamphetamine

(Mexican); diverted OxyContin®;

GHB

SEA heroin; hydroponic

marijuana

Hydroponic marijuana

Crack cocaine;

methamphetamine

SWA heroin

Heroin (in general, SWA)

Marijuana (in general); ecstasy (in

the suburbs)

4

3

2

1

0

5

6

7

8

9

The overall use of heroin is stable,

but some negative developments are

noted:

! There is increasing evidence of

heroin abuse in the suburbs.E

! Hospital emergency room mentions involving heroin increased,

and a record number of deaths in

Detroit/Wayne County involved

the drug in 2002.E

! The number of heroin users

increased in the methadone 

program, but this was due to the

referral of clients from other

recently closed methadone programs in the area.M

MARIJUANA

The marijuana problem in Detroit

appears stable, although use remains

at high levels.E,N

! Two respondents continue to consider marijuana the city’s most

widely abused drug,L,E and another

considers it the second most

widely abused drug.N

! Marijuana is often used in combination with alcohol and crack

cocaine.N

While the use of crack cocaine remains

pervasive (see pie and bar charts on

the first page of this chapter), two

changes are noted:

! The combination of crack cocaine

with marijuana (or some form of

tobacco), called “51,” is increasingly used.N,M

! Outdoor use of crack cocaine (for

example, in parks) decreased during fall 2002 due to the cold climate in Detroit.M

COCAINE

Marijuana (sinsemilla)

Diverted OxyContin®

Powder cocaine; ecstasy (in

the city)

Heroin (SEA, Mexican black tar,

Mexican brown)

BC bud

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic

respondent

Note: SA=South American

(Colombian) heroin; SWA=Southwest

Asian heroin; SEA=Southeast Asian

heroin; Ice=highly pure methamphetamine in smokable form; BC

bud=British Columbian marijuana;

and ecstasy=methylenedioxymethamphetamine or MDMA

! SEA (white) heroin, Mexican brown

heroin, and black tar heroin

remain very difficult to purchase.L,E

! Undercover law enforcement officers 

have found it easier to purchase

methamphetamine during this reporting period.L

! While marijuana remains widely available throughout the city, there is

somewhat of a seasonal effect: in

Detroit’s cold fall/winter climate,

small local plots decline in productivity, leading to a slight decline in availability.E

! The availability of diverted OxyContin®

varies, but the drug is still not widely 

available in the city.E

! It is more difficult to purchase GHB.E

METHAMPHETAMINE

Few methamphetamine users enter

treatment, but the drug is becoming

more prevalent.

! Methamphetamine use continues

to increase, and new users are

increasingly female.E

! Most users make the drug 

themselves in small labs or

receive it from friends, rather

than purchase it from a dealer.E

Extremely

difficult

10

HEROIN
SNAPSHOT: DETROIT, MICHIGAN

page 134 Pulse Check: January 2004

Use of ecstasy remains stable at 

low levels,N,M but two changes are

reported:

! Seizures of ecstasy increased.E

! Purity declined during the reporting period, and a variety 

of other drugs are being sold as

ecstasy.E

! Diverted OxyContin®: Many 

pharmacies now post signs stating

that they do not stock OxyContin®

in order to prevent burglaries.L

Sellers continue to work independently and are not very likely

to abuse the drug.L,E 

! GHB: There is reduced demand for

GHB since the spring.E Those who

do sell the drug range from adolescents to young adults, and they

typically work as part of a larger

organization.L

! Dextromethorphan (in Coricidin

HBP®): The number of individuals

abusing this over-the-counter drug

has decreased slightly.E

WHAT’S HAPPENING IN TREATMENT?

! The Pulse Check non-methadone

treatment facility serves an average

300 outpatients each month.

Among these clients, the primary

drug of abuse is crack cocaine,

with marijuana the distant second

(see pie chart on the first page of

this chapter). Treatment percentages for all drugs remained stable

between spring and fall 2002.N

! The methadone treatment facility

can accommodate 750 clients (an

increase from 600 just 3 years

ago), and is operating at full

capacity. While the number of

heroin users in treatment has

increased since spring 2002, this

increase is largely due to referrals

from recently closed area

methadone programs.M

! Detroit has a central diagnostic

and referral system contracted by

the city Health Department’s

Bureau of Substance Abuse.

! While the capacity of private treatment programs has increased

somewhat,E limited slot capacity

remains the most significant barrier to treatment.M

! A lack of transportation remains a

common barrier for individuals

needing drug treatment.N

! Motivation among treatment

clients continues to be an issue:

since most clients are referred

through the criminal justice system, they view treatment as punishment.N

! Treatment providers cite the need

for increased funds for both prevention and longer courses of

treatment to reduce recidivism and

improve long-term outcomes.N

! After clients complete treatment,

they need stable “recovering communities” that provide support

and reinforcement as a part of

daily life.N Some practitioners

report that recovering users find 

it difficult to manage in halfway

houses when they have just completed treatment.N

! The methadone program recently

instituted an in-house testing 

program for hepatitis C. Also,

mobile units now test individuals

throughout the community for 

the disease.M

! The rate of human immunodeficiency virus (HIV) remains very

low among clients in the

methadone program. As one of the

few programs in the city that routinely test clients, it checks

approximately 600 individuals

each year.M 

WHO USES ILLICIT DRUGS?

The Pulse Check epidemiologic, nonmethadone treatment, and methadone treatment sources were asked

to describe the populations most likely to use heroin, cocaine, marijuana,

methamphetamine, and ecstasy. They

were also asked to describe any

emerging user groups and to report

on how the drugs are used. As shown

on the following pages, user characteristics vary by drug. Further,

because of the different perspective

each brings, the three sources sometimes describe quite different populations and use patterns for each drug.

For example, all methadone clients

are primary opiate users who may use

drugs other than opiates in a secondary or tertiary manner.

THE USE PERSPECTIVE

MDMA (ECSTASY)

OTHER DRUGS

! Diverted methadone: Availability

is increasing.E

! Hydrocodone (Vicodin®): The number of individuals in treatment for

abusing this opiate has increased

somewhat, possibly indicating an

increase in demand.

OTHER DRUGS
SNAPSHOT: DETROIT, MICHIGAN

Pulse Check: January 2004 page 135

Who’s most likely to use heroin?

Characteristic E N M

Age group (years) >30 >30 >30

Mean age (years) 40 45 38

Gender 60% male 90% male 55% male

Race/ethnicity White Black Black 

Socioeconomic status Low/Middle Low Low

Residence Central city/suburbs Central city Central city

Referral source N/A Criminal justice Criminal justice

Level of education completed N/A Junior high Junior high 

Employment at intake N/A Unemployed Unemployed

Note: Only four clients in the non-methadone program report heroin as their primary drug of abuse 

(two men and two women, whose mean age is 36). 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

How do users take heroin?

Characteristic E N M

Primary route of Snorting/

administration Injecting Snorting Injecting

Other drugs taken Powder Crack, marijuana Crack,

cocaine marijuana

Publicly or privately? Privately Privately Privately

Alone or in groups? Both Alone In groups

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone 

treatment respondent; MMethadone treatment respondent

! Methadone treatment clients tend to inject heroin, while

non-methadone treatment clients tend to snort the

drug.N,M

! Users in both methadone and non-methadone programs

continue to take the drug along with crack cocaine and

marijuana.N,M

! The shooting gallery environment for the sale and use of 

heroin has waned in popularity. The drug is sold more

often on the street and then used in private locations.M

Who’s most likely to use cocaine?

Characteristic Crack Powder cocaine

E N M EN

Age group (years) >30 18–30 >30 >30 >30

Mean age (years) NR 28 38 30 40

Gender 50% male 55% female 65% male 50% male 75% male

Race/ethnicity White Black Black White Black

Socioeconomic status All Low Low All NR

Residence All areas Central city Central city All areas Central city

Referral source N/A Detroit Health Department’s Detroit Health Department’s N/A Criminal

Diagnostic & Referral system Diagnostic & Referral system justice

Level of education 

completed N/A Junior high Junior high/high school N/A Junior high

Employment at intake N/A Unemployed Unemployed N/A Unemployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent 

! Cocaine users are typically Black, of lower socioeconomic status, and reside in the central city.N,M

! Crack cocaine users in methadone programs tend to be older than 30 and predominantly male.M In non-methadone

programs, however, they tend to be young adults and the majority are female; they are also slightly less educated.N

! Powder cocaine users are typically older Black males living in the central city.N

! Users take cocaine with marijuana, alcohol, or heroin.N

For the most part, characteristics of

heroin users remain stable. The typical

user is older than 30, male, Black, of low

socioeconomic status, and lives in the

central city.N,M Fewer heroin users seeking treatment are younger than 30.M
SNAPSHOT: DETROIT, MICHIGAN

page 136 Pulse Check: January 2004

Who’s most likely to use marijuana?

Characteristic E N

Age group (years) 13–17, 18–30, >30 Young adults 

Mean age (years) 30 26

Gender 50% male 80% male

Race/ethnicity White Black

Socioeconomic status All Low

Residence All Central city

Referral source N/A Criminal justice

Level of education completed N/A Junior high

Employment at intake N/A Full time 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent

01 2 3 4 5

Complicated treatment

Increased overall difficulty in treating the

addiction

Increased progression to other drugs

Decline in users’ perception of harm

Decline in social disapproval (e.g., peers, 

parents, etc.)

Not at all Extremely

! As reported by the majority of Pulse Check sources (in 22 cities), two Detroit

sources consider marijuana the most widely abused drug.L,E

! Marijuana users range from adolescents to young adults,E although users who

enter treatment for primary marijuana use are typically young adults.N

! Marijuana users in treatment are predominantly male.N

Marijuana-using clients: To what extent have changes in the following

problems complicated their treatment over the past 10 years?

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

Respondents associate marijuana,

used either alone or with other

drugs, with the following consequences, which remained stable

between spring and fall 2002:

! Drug-related emergency room

visitsE

! Drug-related arrestsE,N

! Automobile accidentsE

! Short-term memory lossE,N

! Deteriorating family or social

relationshipsE,N

! Poor academic performanceE

! School absenteeism or truancyE

! Dropping out of schoolE

! Workplace absenteeismE

! Unemployment ratesN

WHO’S MOST LIKELY TO USE

METHAMPHETAMINE?

! Methamphetamine users are typically White young adults who live

in the suburbs or rural areas.E

! While all routes of administration

are reported, more users now

smoke the drug. Users commonly

take methamphetamine in combination with marijuana.E

! Most users make the drug themselves or share with friends, rather

than purchase it from a dealer.E

WHO’S MOST LIKELY TO USE 

ECSTASY? 

Ecstasy users are typically White

young adults from the middle and

upper income levels who live in 

suburban and rural areas.E

Source: Non-methadone treatment respondent

! Declines in users’ perception of harm and social disapproval of marijuana use

have made treatment of marijuana-using clients more difficult.N The normalization of drug use in general has also complicated the city’s drug problem.N 

! The progression from marijuana to other drugs creates difficulty in treating 

marijuana-using clients.N

! There are still not enough treatment facilities to address the marijuana problem, particularly among adolescents.N

Problem change
SNAPSHOT: DETROIT, MICHIGAN

Pulse Check: January 2004 page 137

Widespread marijuana availability and use over the past 10 years: To what extent have the following contributed?

Reason

01 23 45

Extent contributed

Extremely

Glamorization by entertainment industry

Glamorization by news media

Decline in social disapproval (e.g., peers, parents, etc.)

Decline in users’ perception of harm

Increase in indoor farms

More local production

Promotion of marijuana as “medicine”

Less emphasis by law enforcement and courts

Increased THC potency

Other: Increased availability of sinsemilla

Not at all !""Law enforcement respondent

#""Epidemiologic/ethnographic respon0

0

NR

What they have to say...

! Declines in users’ perception

of harm and social disapproval

by peers and parents have significantly contributed to the

widespread use of marijuana.L,E

! Glamorization of marijuana use

by both the entertainment

industry and the news media

has contributed to significant

increases in marijuana use

over the past decade.L,E

! Marijuana availability has

increased somewhat due to an

increase in indoor farms and

local production.L,E

! A proposed law to legalize 

marijuana use for medicinal

purposes did not make it to the

ballot in Detroit.L

NR=Not reported

WHERE ARE DRUGS USED AND

SOLD?

Marijuana is used and sold “everywhere” in the city.L,E

Also pervasive are heroin, crack

cocaine, and powder cocaine, which

are used and sold in the following

venues:L,E

! Streets/open-air markets

! Crack houses/shooting galleries

! Private residences

! Playgrounds/parks

! Private parties

! Around drug treatment clinics

! Inside cars

New or emerging heroin users do not

generally take the drug in outdoor settings like parks and playgrounds as do

typical heroin users; they also purchase the drug in a new place: around

drug or alcohol treatment clinics.E

Methamphetamine is sold in private

residences, public housing developments, nightclubs/bars, inside cars, and

in hotels/motels. It is generally used 

in private residences, inside cars, and

at concerts.E

Ecstasy is both sold and used in private residences, on college campuses,

and at private parties, raves, and concerts. It is also sold around elementary,

junior high, and high schools; at nightclubs and bars; inside cars; and via the

Internet.L,E

Sales of diverted OxyContin® generally

take place in rural areas.L

HOW DO DRUGS GET FROM SELLER

TO BUYER?

! Heroin is sold primarily in the

central city through prearranged

meetings or through drop-offs at

designated locations.E

! Dealers sell both forms of cocaine

in the central city, suburbs, and

rural areas.E Transactions usually

take place directly between sellers

and users and are sometimes prearranged. They communicate via

cell phones or intermediaries.E

! Methamphetamine is typically

made by users in small mobile labs

using the “Nazi” method.L,E Users

who do not make their own generally barter something for it or

receive it through friends.E

! Ecstasy dealers operate in the suburbs, communicating with most

users through word of mouth 

at the sales setting.E The dealers

communicate with their suppliers

through the Internet.E

! Diverted OxyContin® is generally

sold through direct meetings in

suburbs or rural areas.E

THE MARKET PERSPECTIVE

0
SNAPSHOT: DETROIT, MICHIGAN

page 138 Pulse Check: January 2004

Beyond cash: What else is accepted in exchange for drugs?

Source: Mean of response ratings given by law enforcement, non-methadone treatment, and methadone treatment respondents

Heroin

Cash

Crack cocaine

Marijuana Methamphetamine

76%

Shoplifted merchandise

Property/Merchandise

Drug buying

services

Other: Includes items accounting for 2 percent or less of transactions for all five drug,

such as lookout and injecting services, food stamps, guns, other drugs, other stolen

merchandise (e.g., electronic equipment), and transporting the drug

Sex

95% 95%

73%

5%

9%

5%

1%

1%

1%

2%

5%

8%

4%

4%

2%

2% 3%

1%

2%

11%

Powder cocaine

90%

Which drug sellers are associated with which crimes?

Crime Heroin Crack Powder Marijuana Metham- Ecstasy Diverted GHB

cocaine cocaine phetamine OxyContin®

Gang-related activity $$ $

Violent criminal acts $$ $

Nonviolent criminal acts $$ $$ $ $ $

Prostitution $$ $$

Domestic violence $ $

Drug-assisted rape $

No crimes associated $ $

Sources: Law enforcement respondent; epidemiologic/ethnographic respondent

Both sellers and users of heroin and cocaine are involved in nonviolent crimes such as breaking and

entering, burglaries, and larceny.E

What they have to say...

! The practice of sex-for-drugs has

increased dramatically, particularly

with regard to heroin and crack

cocaine. This increase may be

attributable to the increase in

female drug abuse.M

! Michigan switched from food

stamps to vouchers, making it

more difficult for users to

exchange this benefit for drugs.E,N

Sources in five other Pulse Check

cities report similar phenomena.

! As in most Pulse Check cities,

cash has remained the primary

form of payment for drugs over

the past decade.L,E,N

5%
SNAPSHOT: DETROIT, MICHIGAN

Pulse Check: January 2004 page 139

WHO’S SELLING HEROIN?

! Heroin dealers are quite varied.

They range in age from young

adults (18–30) to older adults (>30)

who work either independently or

as part of a larger organization.L,E

! Heroin dealers typically use the

drug themselves.L,E

! Sellers are often involved in prostitution, gang-related activity, and

violent crimes,L as well as nonviolent criminal acts such as robberies

and breaking and entering.L,E

WHO’S SELLING COCAINE?

! Dealers of powder and crack

cocaine are also varied in demographics and structure. They range

in age from young adults to older

adults, and work either independently or as part of an organization.L,E

! Powder cocaine dealers are often

involved in nonviolent criminal

acts such as breaking and entering,

robbery, and larceny.L,E Prostitution

and domestic violence are also

common among these dealers.L

! Crack cocaine dealers are typically

involved in prostitution, gangrelated activity, violent criminal

acts, and nonviolent criminal acts.L,E

WHO’S SELLING MARIJUANA?

! Marijuana dealers range in age

from young adults (18–30) to 

older adults (>30). They work

either independently or as part 

of an organization.E

! Many marijuana dealers are part 

of a larger organization that has a

“lock” on a particular area of 

the city.L

! Marijuana dealers almost always

use the drug themselves.L

! While marijuana dealers are not

generally involved in violent

crimes, they are sometimes

involved in nonviolent criminal

acts as well as prostitution and

gang activity.L,E

WHO’S SELLING METHAMPHETAMINE?

! Methamphetamine dealers are

either younger and older users

working independently,E or

younger non-users working within

a larger organization and catering

to a specific area of town.L

! Methamphetamine dealers are

often involved in nonviolent criminal acts as well as domestic abuse.E

WHO’S SELLING ECSTASY?

! Ecstasy dealers range in age from

adolescents to young adults. They

generally use the drug themselves.

They operate independently or

within an organized structure that

has a specific territory within the

city.L,E

! Ecstasy dealers often sell the drug

in exchange for sex, as well as for

money.E

! In addition to nonviolent criminal

acts, ecstasy dealers are also commonly involved in drug-assisted

rape.L

How much does heroin* cost? 

Unit Price 

0.2 g $10L

One hit $10–$12E

1 g $100–$150L

One bundle (10 hits) $100–$200E

*

Unspecified source and form

Sources: L

Law enforcement respondent; E

Epidemiologic/ethnographic respondent

All reported prices are stable

between spring and fall 2002.

How much does marijuana cost? 

Unit Price 

One bag $10L

1/4 oz $50–$200E

1/2 oz $100–$400E

1 lb $750–$3,000L

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

! The wide variability in the

price of marijuana

reflects the availability

and grade of the drug.L

! All reported prices are

stable between spring

and fall 2002.

How much does cocaine cost? 

Form Unit Price 

Powder 1 g $75–$100L

$75–$125E

Crack One rock $10L

$50–$200E

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

All reported prices are stable

between spring and fall 2002. How much does ecstasy cost?

Unit Price

One pill $20–$30L 

$20–$40E

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

How much does diverted

OxyContin® cost?

Unit Price

1 mg $1L

40 mg $40–$60E

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

All reported prices are stable

between spring and fall 2002.

According to one source, the price of diverted

OxyContin® has risen up $1 to $1–$2 per

milligram.E All other reported prices are stable between spring and fall 2002.
SNAPSHOT: DETROIT, MICHIGAN

page 140 Pulse Check: January 2004

!""Law enforcement respondent

#""Epidemiologic/ethnographic respondent

Drug marketing innovations and tools over the past 10 years: To what degree have they complicated

efforts to detect or disrupt illicit drug activity in Detroit?

012 3 4 5

Degree of complication

Not at all Extremely complicated

THE MARKET PERSPECTIVE:

A 10–YEAR VIEW

Increased communications via Internet

Throwaway cell phones

Expansion of drug sales beyond the central city

Less organized networks

Fewer brand names

Relocation of sales settings within the community

Unique packaging

More organized networks

Other: Mobile delivery/prearranged meetings

0

0

0

0

NR

What they have to say... 

! Drugs are more available today than in a long time, which has led to an increase in the

number of users.M

! As mentioned in the majority of Pulse Check cities, technological advances over the past

decade, particularly throwaway cell phones and communication via the Internet, have

severely complicated efforts to disrupt drug activity.L,E

! More organized networks that are both expanding drug sales beyond the central city and

relocating sales settings within the community have complicated efforts to address the

problem.E

! Unique packaging of drugs has diminished over the past decade,L,E making it somewhat

easier to crack down on dealers. However, the use of brand names has also decreased,

which makes it more difficult to identify the sources supplying the drugs.L

NR=Not reported
SNAPSHOT: DETROIT, MICHIGAN

Pulse Check: January 2004 page 141

Community innovations and tools over the past 10 years: How successful have they been?

NR=Not reported

Prescription drug monitoring

Increased use of task forces

Crack house (nuisance abatement) laws

Precursor laws

Drug courts

Drug user recognition education (DRE) 

for law enforcement

Rescheduling of prescription drugs

Sentencing changes

Other: Drug Abuse Resistance Education (DARE) program

!""Law enforcement respondent 

#""Epidemiologic/ethnographic responWhat they have to say... 

! Local task forces throughout the

State have been successful in

addressing the increasingly complex drug market.L,E

! Because of Detroit’s location as a

port city on the Canadian border, it

has historically been a transshipment point for ephedrine and

pseudoephedrine. However, precursor laws for ephedrine and

pseudoephedrine have significantly slowed the flow of these drugs

from Canada.L

! Prescription drug monitoring

through the Triplicate Prescription

Program (TPP) has been largely

successful. It will soon be

replaced by the Official

Prescription Program.E

! Nuisance abatement laws have 

succeeded in shutting down

some rave promoters.L

! One source expresses concern

about pain clinics, given the

recent proliferation of methadone

as a drug of abuse.E

0 1 23 4 5

Degree of success

Not at all Extremely successful

NR

NR

NR

SEPTEMBER 11 FOLLOWUP 

Both positive and negative effects are still being felt as a result of the terrorist attacks of September 11, 2001:

! Drug use: Users in treatment indicate that the terror attacks have not impacted their desire to use drugs.M However,

because of increased security measures, users are aware that they may have increased difficulty maintaining their

personal drug supply. They are therefore more willing to use a variety of drugs or to make their own drugs.N

! Changing trafficking patterns: Tighter border security continues to contribute to an increased number of arrests for

transporting drugs, which is significant for this port/border city.E,N

0

NR
SNAPSHOT: HOUSTON, TEXAS

page 142 Pulse Check: January 2004

*The census data in this table are provided as a frame of reference for the information given by Pulse Check sources. Whenever possible, the data given by

the law enforcement and epidemiologic/ethnographic sources reflect the metropolitan area. 

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

Three of the Pulse Check respondents

consider Houston’s drug problem very

serious.L,E,N Two sources consider the

problem stable,L,N while two observe a

worsening situation.E,M

Houston’s many multiple-agency task

forces continue to successfully

address the unique challenges posed

by the city’s proximity to the

Mexican border. These task forces

include professionals from local law

enforcement, the U.S. Border Patrol,

FBI drug squads, U.S. Customs, and

the High Intensity Drug Trafficking

Area (HIDTA).L

Several developments are reported in

the drug market:

! Operation White Terror, a joint

effort by the DEA and FBI, resulted

in many arrests in connection with

the seizure of $25 million in militarygrade weapons that were being used

in guns-for-cocaine transactions.L

! A large increase is noted in the 

presence of hashish in Houston,

coinciding with the defeat of the

Taliban in Afghanistan, which had

forbidden hashish production. Some

Afghans now grow and export the

drug to generate income.E

! As mentioned in several other Pulse

Check cities, an increase in diverted

methadone on the street is

observed.N

Many changes are also observed in

Houston’s drug-using population:

! Hotlines and emergency departments have encountered large

numbers of injecting drug users

who have mixed diluted bleach

with heroin or cocaine. These users

present with arms turning black

and report adding the bleach to

protect themselves against HIV

transmission.E

! Marijuana use increased somewhat, particularly among new drug

users.E

! More marijuana users, particularly

new users, report combining the

drug with formaldehyde,E,N referred

to as “wet,”E,N “water,”E or “fry.”E,N

Marijuana and formaldehyde are

also increasingly combined with

phencyclidine (PCP)E (similar to

reports in Minneapolis/ St. PaulM).

! “Triple C” is the term for Coricidin

HBP®, an increasingly abused overthe-counter cold medication 

containing dextromethorphan, as

reported in three other Pulse Check

sites (Denver,E Portland, [OR]L, and

Tampa/St. PetersburgN,M.)

! New street names have appeared

for various drugs since the

spring:N “chalk” or “po coke” for

methamphetamine; “clarity” for

methylenedioxymethamphetamine

(MDMA or ecstasy); and “hillbilly

high” for abused OxyContin®

(oxycodone controlled-release).

Overall, respondents identify crack

cocaineE,N and heroinL,M as the drugs

related to the most serious consequences in Houston. Many drugs are

also emerging as new or growing

problems in the city.

What are the primary drugs of abuse

among clients in a non-methadone

treatment program? (Fall 2002) 

What are the primary drugs of abuse

among clients in a methadone program? (Fall 2002)

Crack cocaine

Marijuana

Ecstasy 

Heroin

Methamphetamine

Diverted OxyContin®

Diverted flunitrazepam

(Rohypnol®)

Source: Methadone treatment respondent 

Note: These numbers may include client reports

of two primary drugs of abuse. 

Source: Non-methadone treatment respondent

Heroin

Hydrocodone (Vicodin®)

Diverted OxyContin®

0 20 40 60 80 100

48

17

5

3

74%

22%

4%

21

8

23

HOUSTON PRIMARY METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Total population: . . . 4,177,646

! Median Age: . . . . . . 31.6 years 

! Race (alone):

! White: . . . . . . . . . . . . . 61.1%

! Black: . . . . . . . . . . . . . 17.5%

! American Indian/

Alaska Native: . . . . . . . 0.4%

! Asian/Pacific Islander: 5.3%

! Other race: . . . . . . . . . 12.9%

! Two or more races: . . . 2.8%

! Hispanic (of any race): 29.9% 

! Unemployment rate: . . . . 4.1% 

! Median household 

income: . . . . . . . . . . . . $44,665 

! Families below poverty level 

with children <18 years: 14.8%

Source: U.S. Census 2000* 

! Primary abuse of heroin has increased since the spring 2002 among non-methadone

treatment clients.N

! The methadone program is unusual in that nearly one-quarter of its clients report

hydrocodone, rather than heroin, as a primary drug of abuse. 

(N=189)

Percent 

(N=220)
SNAPSHOT: HOUSTON, TEXAS

Pulse Check: January 2004 page 143

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

Not

difficult

at all

Undercover policeL UsersE

Powder cocaine

Heroin (in general)

Methamphetamine (in general, 

locally produced, and ice); hashish

Marijuana (local commercial grade)

Marijuana (hydroponic)

BC bud; methamphetamine

(Mexican); diverted OxyContin®

Crack cocaine; marijuana (in general

and Mexican commercial grade)

Ice

Heroin (in general and Mexican

black tar); crack and powder

cocaine; ecstasy

SWA; marijuana (sinsemilla)

SA; BC bud; 

diverted OxyContin®

SEA

Codeine-laced cough syrup

Heroin (Mexican brown)

Methamphetamine (locally produced)

Marijuana (hydroponic); methamphetamine (in general and

Mexican)

Ecstasy Marijuana (in general and local commercial grade)

! It has become less difficult for users to purchase hashish

since spring 2002, although they typically need to know a

dealer personally in order to obtain the drug.E

! While Colombian white heroin is reported on the street, law

enforcement has not encountered it.L 

! As with four other cities in the Pulse Check South region, it

became less difficult for undercover law enforcement to purchase ice.L

! There is anecdotal evidence that users are moving from

cocaine to ecstasy because it is less expensive and more

readily available.L

Most widely abused drug:

CrackE,N

MarijuanaL

HeroinM

No reported changes between spring

and fall 2002L,E,N,M

Second most widely abused drug:

MarijuanaN

Ecstasy (<30 years)L

Cocaine (>30 years)L

PCPE

HydrocodoneM

Change reported between spring and

fall 2002: PCP replaced “wet” or

“water” (combination of formaldehyde

and marijuana).E

Drug related to the most serious

consequences:

CrackE,N

HeroinL,M

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the second most

serious consequences:

MethamphetamineL

PCPE

HeroinN

BenzodiazepinesM

Change reported between spring and

fall 2002: PCP replaced “wet” or

“water” since the spring.E

New or emerging problems:

Diverted OxyContin®N

Diverted methadoneN

HashishE

“Water” or “wet”E

IceL

Sources: LLaw enforcement, E

Epidemiologic/ethnographic, 

N

Non-methadone treatment, and MMethadone treatment respondents

Note: These symbols appear throughout this

city profile to indicate type of respondent

0

1

2

3

4

5

6

7

8

9

Extremely

difficult

10

Note: SA=South American

(Colombian) heroin;

SWA=Southwest Asian heroin;

SEA=Southeast Asian heroin; and

ice=highly pure methamphetamine in smokable form; and BC

bud=British Columbian marijuana
SNAPSHOT: HOUSTON, TEXAS

page 144 Pulse Check: January 2004

MDMA (ECSTASY)

OTHER DRUGS

METHAMPHETAMINE

Methamphetamine use is stable at

very low levels.E,N,M However, primary

methamphetamine users are increasingly female and middle class.N

Ecstasy use remains high among

treatment clients,N and appears to be

growing among some segments of the

Houston population.E

! Ecstasy users are initiating use of

the drug at younger ages.N

! Ecstasy use is growing among a

subculture of gay youth in

Houston.E

COCAINE

MARIJUANA

Crack cocaine is considered the most

common primary drug of abuse

among both young adults and adults.N

But neither crack nor powder cocaine

is a drug of abuse among methadone

treatment clients.M

! Crack cocaine use is stable among

treatment clients,N,M although an

increase in crack use is noted in

Houston overall since spring

2002.E

! New crack users are increasingly

younger.E

! Crack users in treatment report

taking the drug with alprazolam

(Xanax®) instead of with

diazepam, which had been more

common. This new combination is

called “handlebars.”N

HEROIN

Heroin treatment numbers are mixed, but

users’ characteristics indicate an overall

increase in Houston’s heroin problem.

N

! Primary heroin use in the

methadone program has continued

to decline slowly over the past 2

years, with corresponding increases

in primary hydrocodone and

OxyContin® abuse.M However, primary heroin abuse among nonmethadone treatment clients

increased since spring 2002.N

! Primary heroin users present to

treatment at younger ages,N,M and

clients report younger ages of

first-time use.N

! Clients in treatment report becoming addicted more quickly to heroin than in the past.N This effect may

be due to increased heroin purity,

as reported by other sources.L,E

! Diverted OxyContin®: The proportion of primary OxyContin®

abusers in treatment increased

since spring 2002.N,M More treatment clients use diverted

OxyContin® as a substitute for

heroin,N while others use it

sequentially with hydrocodone or

alprazolam.M

! Methadone: The amount of

diverted methadone on the street

has increased since spring 2002.N

! PCP: Use is up in Houston.E

! Hashish: Use of hashish increased 

sharply. It is used often to accentuate the effects of marijuana.E

! Flunitrazepam (Rohypnol®): While

treatment numbers remain low

when compared with other drugs,

a large increase is noted in the

proportion of clients in treatment

for abuse of flunitrazepam. While

most flunitrazepam treatment

clients are male (98 percent),

these young men also give the

drug to females as a date-rape

drug, often after alcohol or marijuana use.N

! Dextromethorphan (in Coricidin

HBP Cough & Cold®): A large

increase is noted in the number of

adolescents abusing this over-thecounter medication (“triple C”),

particularly in combination with

alcohol. It is easily obtainable and

relatively inexpensive.E This particular brand contains the highest

concentration of dextromethorphan, making it the most popular

among users.

! Codeine (in the form of cough

syrups): Codeine is being added 

to cola drinks, with pockets of

epidemics within the city.E

Marijuana is the most common primary drug of abuse among preadolescents and adolescents in Houston.N

! Marijuana use is stable among

drug treatment clients.N,M

! However, negative consequences

associated with marijuana use are

reported by youth at younger

ages: signs and symptoms of marijuana abuse are occurring at a

mean age of 13 years.N

! New users do not perceive marijuana as an illicit drug due to media

coverage of its use as “medicine.”

New users therefore view the drug

as safe.E

! The practice of smoking “wet” 

or “water” (marijuana with

formaldehyde) has increased

recently.E,N This practice can cause

serious brain damage.E
SNAPSHOT: HOUSTON, TEXAS

Pulse Check: January 2004 page 145

WHAT’S HAPPENING IN TREATMENT?

Treatment capacity and availability

! The Pulse Check non-methadone

treatment source is with a facility

that has the capacity to serve 196,

and a current enrollment of 189.

Crack cocaine is the most common

primary drug of abuse among its

clients (see bar chart on the first

page of this chapter). Interestingly,

more users are in non-methadone

treatment for primary ecstasy abuse

than for primary heroin abuse.N

! The methadone treatment source is

with a program whose capacity is

230, with current enrollment at

220. This program is unusual in

that only three-quarters of its

clients report heroin as their primary drug of abuse (see pie chart

at the bottom of this chapter’s first

page). Most of the remaining

clients report hydrocodone as their

primary drug. Also unlike in other

Pulse Check cities, neither crack

nor powder cocaine are significant

secondary or tertiary drugs among

these clients. Rather, half of them

also abuse marijuana, and onequarter abuse alprazolam.

! Whites are overrepresented in the

methadone program despite the

the area’s predominantly Hispanic

population. The respondent

explains that Hispanic and Black

drug users do not seek treatment

because of a lack of trust in treatment programs.M

! Maintenance methadone treatment is available in only select

areas of Houston. Three or four

private clinics are within close

proximity to each other; there are

no other methadone clinics and

no public clinics in the city at all.E

Consequences of drug use

! Heroin and cocaine users who inject

now present at emergency rooms

and hotlines with black patches on

their arms as the result of mixing the

drug with diluted bleach. They add

the bleach to protect themselves

from HIV transmission.E

! Further, heroin users who inject

either intravenously or intramuscularly present at treatment with

more abscesses, indicating more

adulterants (bleach or other substances) in the drug.M

! Drug-related automobile accidents

are stable at very high levels

among Houston treatment clients:

more people are driving while

under the influence of drugs rather

than alcohol.N

! The incidence of tuberculosis in

Houston, and among drug treatment

clients in particular, is on the rise.

Hepatitis C is stable, but remains at

high levels,N as high as 85 percent in

the methadone program.M

Co-occurring disorders

! In general, Houston’s drug treatment programs are not equipped

to treat dually diagnosed clients

effectively.M

Changes over the past 10 years

! The declining cost of crack cocaine

over the past decade (from $10 to

$2 per “starter rock”) has severely

complicated the drug abuse problem in Houston.N

! The abuse of prescription drugs is

at peak levels, particularly for

OxyContin® and hydrocodone.

Further, addiction to these licit

drugs is more difficult to treat.N

! Both the declining cost of drugs

and the increased availability of

new and substitute drugs have

severely complicated Houston’s

drug problem, particularly among

youth.N,M Younger users can now

afford more dangerous drugs such

as heroin,M which is also more

pure than it was a decade ago, and

crack.N Adolescents as young as 12

are entering treatment for

cocaine—something not seen 10

years ago.N

! Treatment programs have to increase

the length of stay for recovering

clients because they lack stable 

housing opportunities in the community. Clients who are released

into an unstable environment and

then relapse tend to become homeless within 6 months.N

! The increased purity of heroin in

recent years has led to a new practice, particularly among youth, of

squirting the drug up their noses

(“shebanging”).M

! Polydrug abuse has increased, particularly among heroin users, who

use prescription drugs like alprazolam along with, or in place of,

heroin.M

WHO USES ILLICIT DRUGS? 

The Pulse Check epidemiologic, 

non-methadone treatment, and

methadone treatment sources were

asked to describe the populations

most likely to use heroin, cocaine,

marijuana, methamphetamine, and

ecstasy. They also were asked to

describe any emerging user groups

and to report on how the drugs are

used. As shown on the following

pages, user characteristics vary by

drug. Further, because of the different

perspective each brings, the three

sources sometimes describe quite different populations and use patterns

for each drug. For example, all

methadone clients are primary opiate

users who may use drugs other than

opiates in a secondary or tertiary

manner.

THE USE PERSPECTIVE
SNAPSHOT: HOUSTON, TEXAS

page 146 Pulse Check: January 2004

Who’s most likely to use cocaine?

Crack cocaine Powder cocaine 

Characteristic E N E N 

Age group (years) 18–30, >30 >30 13–17 >30

Mean age (years) 26 37 NR 35

Gender 60% female Split evenly 65% male Split evenly

Race/ethnicity Black Black White Black

Socioeconomic status Low Low High Low

Residence Central city Central city Rural Central city

Referral source N/A Individual N/A Individual

Level of education N/A Did not com- N/A High school

completed plete school

Employment at intake N/A Unemployed N/A Unemployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent

How do users take heroin?

Characteristic E N M 

Primary route of Injecting Injecting Injecting

administration

Other drugs taken Powder cocaine (speedball Powder cocaine Hydrocodone, 

or “cocoa”); metham- alprazolam

phetamine (speedball)

Publicly or privately? Privately Privately Privately 

Alone or in groups? In groups Alone Alone

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! While injecting is the most common

route of administration for heroin

users,N,M some users report the practice

of shebanging.M

! Less speedballing (combining heroin

with cocaine) is reported since the

spring.N

! Primary heroin users often take

hydrocodone or alprazolam in sequence

with heroin. The combination of heroin

and alprazolam is called “bars.” M

Who’s most likely to use heroin?

Characteristic E N M

Age group (years) >30 >30 18–30; >30 

Mean age (years) 35 33 27

Gender Split evenly Split evenly 55% male

Race/ethnicity White Black White

Socioeconomic status Low Low Middle 

Residence Central city Central city and rural areas Central city

Referral source N/A Individual Individual 

Level of education N/A High school High school

completed school

Employment at intake N/A Unemployed Full time

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Younger clients are entering treatment for heroin

abuse.M

! While most primary heroin

users are self-referred, an

increasing number are

now referred by other

treatment providers.N

! The epidemiologic/ethnographic respondent has heard reports of users taking

crack cocaine in a combination called “cheese,” and powder cocaine in a combination called “white girl” or “white pony”; however, the other components of these

combinations are unknown.E

! Crack users are often involved in prostitution, gang-related activity, and violent criminal

acts such as drive-by shootings.E

! Crack users in Houston overall are

more likely to be female (60 percent),

particularly new or emerging crack

users (90 percent).E

! Powder cocaine users in treatment are

typically older, Black, low-income

adults,N while powder cocaine users

throughout the city are White, higher

income adolescents.E

! Crack users sometimes take alprazolam

and/or hydrocodone along with crack.

Alprazolam has replaced diazepam in

this practice. The combination of crack

and alprazolam is called “handlebars.”N

! Users often combine powder cocaine

with heroin (“boy,”N “bellushi,”N speedball,N or eightballE

). Speedballing is

considered a “party thing,” common

among groups of friends.N
SNAPSHOT: HOUSTON, TEXAS

Pulse Check: January 2004 page 147

Who’s most likely to use marijuana?

Characteristic E N M

Age group (years) 18–30, >30 13–17 >30

Mean age (years) NR 15 42

Gender Split evenly Split evenly 80% male

Race/ethnicity White, Black, NR White

Hispanic (any race)

Socioeconomic status Middle Low Middle

Residence Central city Central city, rural areas Central city

Referral source N/A Criminal justice Individual 

Level of education N/A Junior high or high High school 

completed school

Employment at intake N/A Unemployed Full time

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent. 

Marijuana-using clients: To what extent have changes in the following problems complicated their treatment

over the past 10 years?

! As a result of the decreased

perception of harm associated

with marijuana, people are

using it at younger ages.

Further, the marijuana that

youth smoke today is more

potent it was 10 years ago.N

! Rap songs about marijuana use

(“tokin” and “smokin”), as well

as the publicity given to celebrities who use drugs, have complicated treatment of young marijuana users.N

! Over the past decade, marijuana use by dealers has

increased, shedding light on a

dual addiction: addiction to the

drug and addiction to fast

money. As a result, there is

great difficulty in treating dealers, because this is how they

make their living.N

! While the overall marijuana-using 

population in Houston includes young

adults and older adults (“aging hippies”), most new and emerging users

are adolescents.E This trend is similar

to that noted in Dallas.N

! More marijuana users in treatment

are smoking blunts instead of joints

since spring 2002.N

! In the community overall, marijuana

users generally either smoke the drug

in blunts or pipes.E

Problem change

Increased severity of addiction among clients

Decline in users’ perception of harm

Glamorization by entertainment industry

Glamorization by news media

Increased THC potency of marijuana

Increased progression to use of other drugs

Increased overall difficulty in treating the addiction

Increased polydrug use

Earlier initiation of marijuana use

Increased court referrals involving marijuana possession

Increased court referrals involving marijuana sales

Decline in social disapproval (e.g., peers, parents, etc.)

Other: Increased number of dealers who also use

NR=Not reported

0

0

0

0

0

0

0

0

NR

01 2 3 4 5

Extent complicated treatment 

!" Not at all Extremely Non-methadone treatment respondent

#"Methadone treatment respondent
SNAPSHOT: HOUSTON, TEXAS

page 148 Pulse Check: January 2004

Widespread marijuana availability and use over the past 10 years: To what extent have the following contributed?

Reason

What they have to say...

Houston respondents share the concerns of respondents from other sites about the impact of declines in users’ perceptions

of harm and in social disapproval, and the promotion of marijuana as “medicine.” They note other specific issues as well:

! Because Mexican marijuana is so prevalent in Houston, local production does not impact availability of marijuana 

in the city.L,E

! Marijuana use continues to increase among individuals who do not perceive it as a drug. Media attention to the 

decriminalization of marijuana for “medicinal” purposes is a significant contributor to this phenomenon.E

! Users consider marijuana as simply an herb that has no effect on driving and other activities; they consider it 

safer to use than alcohol.E

! The widespread availability of marijuana in Houston is largely due to the fact that multi-ton shipments arrive 

wholesale from Mexico.L

! The glamorization of marijuana use by two facets of the entertainment industry has worsened the marijuana problem

among young people in particular:E

- Musicians promote marijuana use in their songs.

- More athletes are found to be using marijuana.

!" Law enforcement respondent 

#""Epidemiologic/ethnographic respondent

NR=Not reported

NR

0

0

0

0

0

0

0

0123 45

Extent contributed

Not at all Extremely

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

Respondents associate marijuana,

used either alone or with other drugs,

with the following consequences:

! Drug-related emergency room visitsN

! Drug-related arrestsE,N,M

! High-risk pregnanciesN

! Short-term memory lossN,M

! Deteriorating family/social

relationshipsE,N

! Poor academic performanceE,N

! School absenteeism or truancyE,N

! Dropping out of schoolE,N

! Poor workplace performanceE

! Workplace absenteeismE

! Unemployment ratesE,M

Since spring 2002, clients are reporting these negative consequences at

younger ages.N

Glamorization by entertainment industry

Promotion of marijuana as “medicine”

Decline in users’ perceptions of harm

Less emphasis by law enforcement and courts

Decline in social disapproval (e.g., peers, parents, etc.)

Glamorization by news media

Other: Wholesale bulk transportation from Mexico

Increased THC potency

Increase in indoor farms

More local production
SNAPSHOT: HOUSTON, TEXAS

Pulse Check: January 2004 page 149

Who’s most likely to use ecstasy?

Characteristic E N

Age group (years) 13–17 13–17

Mean age (years) NR 15 

Gender Split evenly Female

Race/ethnicity White White, Black and Hispanic (any race)

Socioeconomic position Middle/high Low and middle

Residence Central city Central city

Referral source N/A Criminal justice, individual, and public schools

Level of education completed N/A Junior high or high school 

Employment at intake N/A Unemployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent

Who’s most likely to abuse other drugs?

Characteristic MethamphetamineN OxyContin® AlprazolamM HashishE Coricidin HBP®E FlunitrazepamN

Age group (years) 13–17, 18–30 18–30M, >30N >30 >30 13–17 13–17, 18–30

Mean age (years) NR 34N NR 45 NR 18

Gender 60% female Split evenlyN,M 55% male 75% male Split evenly 98% male

Race/ethnicity White White and BlackN

, WhiteM NR White White, Black, and White

Hispanic (any race)

Socioeconomic Low/middle Low,N middleM NR Middle Low Middle

position

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Methamphetamine: More females are in treatment

for primary methamphetamine abuse than in spring

2002. Also, more primary methamphetamine users

in treatment are middle class and reside in rural

areas, although the majority still reside in the suburbs.N

! Diverted OxyContin® Abusers of OxyContin® take the

drug either alternately with diazepamN or in combination with alprazolamN,M or hydrocodone.M Some also

use the drug as an alternative to heroin when heroin is

not available.N

! Alprazolam: While adults older than 30 are the most

common abusers of alprazolam, new clients in treatment for the drug are young adults. Alprazolam

abusers typically abuse hydrocodone as well.M

! Hashish: Hash users either mix the drug with marijuana or smoke it in a pipe by itself. Marijuana users

often take hash as “dessert” to increase their high.E

! Dextromethorphan cold medications: A large

increase is noted in the number of youth abusing

Coricidin HBP Cough & Cold® (“triple C”). Youth often

take the cough syrup with alcohol.E

! Ecstasy users in treatment

report earlier ages of first

use.N

! Ecstasy use has grown in 

a subculture of young gay

youth in Houston.E

! Ecstasy users are just as

likely to use the drug alone

as in groups/among

friends.E
SNAPSHOT: HOUSTON, TEXAS

page 150 Pulse Check: January 2004

What they have to say...

! The practice of exchanging sex for drugs has

declined significantly over the past decade

due to increased awareness of HIV. In past

years, men and women known as “rock

stars” frequented crack houses to trade sex

for crack; this practice is very rare now.N

! As reported in several Pulse Check sites,

recent changes in Texas’s food stamp program have significantly cut down on the

practice of trading food stamps for drugs.

The State has gone from a paper system to

one similar to a debit card. Some users do,

however, exchange food for drugs.N

! Dealers sometimes exchange large items,

such as automobiles, for a kilogram of

cocaine at the wholesale level; they also may

“front a shipment in exchange for jewelry.”L

! Operation White Terror, conducted by the DEA

and the FBI, addressed the problem of large

guns-for-cocaine transactions. Many arrests in

the fall involved seizing of approximately $25

million in military-grade weapons.L

! While cash is the most common form of

payment for powder cocaine in most cities,

one Houston respondent estimates that 80

percent of transactions involve the

exchange of sex for the drug.E

Beyond cash: What else is accepted in exchange for drugs?

Source: Mean of response ratings given

by epidemiologic/ethnographic, nonmethadone treatment, and methadone

treatment respondents. Note: The law

enforcement source did not provide information for this question, and neither the

non-methadone nor methadone treatment sources provided information on

powder cocaine and methamphetamine.

Heroin Cash Crack cocaine

Methamphetamine

Marijuana

42%

Shoplifted merchandise

Other stolen merchandise

(e.g., electronic equipment)

Property/merchandise

Transporting the drug

Drug buying services

Injecting services

Lookout services

Other: Includes items accounting for less than 2 percent of

transactions for all drugs,

such as food stamps. It also

includes items specifically

added by respondents, such

as dealing.

Sex

87% 50%

35%

22%

12%

Powder cocaine

80%

20%

10%

7%

8%

5%

5% 5%

5%

5%

50%

18%

8%

WHERE ARE DRUGS USED AND SOLD?

Heroin transactions take place in

street marketsL,E and private

residencesL located primarily in the

central city.L Use is fairly limited to

shooting galleries; new heroin users,

however, also use the drug in 

abandoned warehouses in the city.E

Crack and powder cocaine sales are

equally distributed throughout all

areas of Houston (central city, suburbs, and rural areas),E although sales

identified by law enforcement are primarily located in the central city.L The

two drugs are sold in many of the

same settings, including street markets, crack houses, public housing

developments, private parties,

hotels/motels, and inside cars.L,E Crack

is also sold in nightclubs/bars and

playgrounds/parks,E while powder

cocaine transactions take place on

college campuses and at raves.L,E

Transactions involving both forms 

of cocaine occur most often in the

central city.L

Crack users typically take the drug 

in crack houses, playgrounds/parks,

private parties, and inside cars.

Powder cocaine use takes place in 

fewer settings: private residences, 

public housing developments, and

hotels/motels.E

Marijuana is sold throughout

Houston’s central city, suburbs, and

rural areas,E in settings such as street

markets, private residences, public

housing developments, college campuses, nightclubs/bars, raves, concerts,

and hotels/motels.L,E However, it is

generally used only in private residences, public housing developments,

and around supermarkets.E New marijuana users also commonly buy and

use the drug in and around schools

and at private parties.E

Dealers sell methamphetamine in

street markets, private residences,

nightclubs/bars, and at concerts.L

Ecstasy transactions take place in 

private residences, nightclubs/bars,

private parties, raves, and concerts.L,E

Nearly all of these venues serve as use

settings for ecstasy as well.E

THE MARKET PERSPECTIVE

3%

3%

3%

4%

2% 3%

2%

2%

2%

2%
SNAPSHOT: HOUSTON, TEXAS

Pulse Check: January 2004 page 151

How pure is heroin, and how much does it cost?

Unit Purity Price

1 g (Black tar-most common) 28% average (range: 13–58%) $150 

1 oz (Black tar-most common) 28% average (range: 13–58%) $1,000–$2,500 

1 kg (Black tar-most common) 28% average (range: 13–58%) $39,000–$60,000 

1 oz (Mexican brown) NR $1,000–$1,200

1 kg (Colombian) NR $62,000

Source: Law enforcement respondent

! All reported prices are stable since spring 2002.L

! Heroin purity is up statewide between 2001 and

2002, which has led to a large increase in overdoses.L

How much does cocaine cost?

Form Unit Price

Crack 1 g $100

1 oz $325–$600 

1 kg $1,300–$1,800

Powder 1 g $60–$100 

1 oz $400–$650

1 kg $14,000–$18,500

Source: Law enforcement respondent

! All reported prices are stable

since spring 2002.L

! The price of cocaine depends

on the quantity purchased,

the relationship between

buyer and seller, and how far

the sale takes place from

border checkpoints.L

How much does marijuana cost?

Unit Price

1 g (Mexicanmost common) $5

1 oz (Mexicanmost common) $100

1 lb (Mexicanmost common) $300–$500

0.25 lb (hydroponic) $120

1 lb (sinsemilla) $600

Source: Law enforcement respondent

All reported prices are stable

since spring 2002. 

HOW DO DRUGS GET FROM SELLER

TO BUYER?

Heroin buyers typically approach

dealers on known corners for handto-hand transactions. Sometimes

they negotiate over price. When

communicating with suppliers, 

heroin dealers use cell or pay

phones and pagers.L

Transactions involving crack cocaine

and marijuana are equally distributed throughout all areas of

Houston,E although most transactions identified by law enforcement

take place in the central city.L As

with heroin, crack users often

approach dealers on a known corner

and negotiate a sale.L Dealers of

crack and marijuana also arrange

deliveries or pick-ups of the drug

with buyers.E To purchase powder

cocaine, buyers generally have to

know someone; these transactions

generally occur in the central city.L

Dealers primarily selling methamphetamine also sell drugs such as

ecstasy and marijuana. The methamphetamine found in Houston is typically produced locally in small mobile

(“box”) labs or in labs hidden in

warehouses and moved often.E

Ecstasy dealers also distribute powder

cocaine, marijuana, gamma hydroxybutyrate (GHB), and ketamine.L

WHO’S SELLING HEROIN?

! Heroin dealers in Houston are

typically part of either Black or

Hispanic gangs or organizations.L

! Heroin dealers often give away

free samples of marijuana as a

marketing device to attract 

business.L

WHO’S SELLING COCAINE?

! Crack cocaine dealers are typically

young adults working independently.E

! Powder cocaine dealers often sell

ecstasy as well, while crack dealers

are more likely to distribute marijuana and cough syrup.L

WHO’S SELLING MARIJUANA?

! Marijuana dealers are typically

older adults working either independently or as part of a larger

organization. They are somewhat

likely to be marijuana users as well.E

! These dealers are generally not

involved in any criminal activity

other than dealing.
SNAPSHOT: HOUSTON, TEXAS

page 152 Pulse Check: January 2004

Drug marketing innovations and tools over the past 10 years: To what degree have they complicated efforts

to detect or disrupt illicit drug activity in Houston?

0

0

0

0

Throwaway cell phones

Increased communications via Internet

Unique packaging

Polydrug dealers

Expansion of drug sales beyond the central city

Relocation of sales settings within the community

More organized networks

More or changing brand names

Fewer brand names

!"Law enforcement respondent

#"Epidemiologic/ethnographic respondent

0123 45

Degree of complication

Not at all Extremely complicated

How much does methamphetamine

cost?

Unit Price

1 oz $500–$800

1 lb $6,000–$11,000

1 kg $18,000–$20,000 

Source: Law enforcement respondent

All reported prices are stable

since spring 2002. 

What they have to say... 

! Unique packaging by dealers seems to have posed a greater challenge to law enforcement in Houston than in most other Pulse

Check cities.

! By contrast, similar to reports in other cities, detection and disruption efforts have not been hampered much by increased or

decreased use of brand names.L

! Wholesale dealers have developed two additional ways to avoid detection:L

- Hiding drugs in false floors and other vehicle compartments.

- Liquifying the drug and storing it in a bottle or saturating clothing with it, and then reconverting it after reaching the destination.

How much does ecstasy cost?

Unit Price

1 tablet $8 (wholesale) $20–$30 (at raves)

500 tablets $3,500–$10,000

1,000 tablets $8,000 

Source: Law enforcement respondent

THE MARKET PERSPECTIVE: A 10-YEAR VIEW

All reported prices are stable

since spring 2002. 
SNAPSHOT: HOUSTON, TEXAS

Pulse Check: January 2004 page 153

Community innovations and tools over the past 10 years: How successful have they been?

While neither of the Pulse Check

treatment respondents note any continuing effects on their clients as a

result of the September 11 attacks,

the law enforcement and epidemiologic/ethnographic sources observe a

continued impact on Houston’s drug

problem:

! Emerging drugs: Hashish had not

been detected in Houston in a

decade, but it is now reemerging

as a problem. This reemergence is

attributed to removal of the

Taliban from power in Afghanistan

following the September 11

attacks. The Taliban previously

suppressed hashish production;

Afghans now sell the drug again to

generate income.E

! Drug use: Abuse of alcohol and

marijuana continues at high levels among the middle class since

September 11, reflecting

increased levels of anxiety and

escapism.E

! Drug trafficking: The Coast

Guard’s emphasis continues to be

on security rather than interdiction.L

NR

NR

NR

NR

NR

NR

NR= Not reported

!"Law enforcement respondent

#"Epidemiologic/ethnographic respondent

0123 45

Degree of success

Not at all Extremely successful

! A mentoring program representing a partnership between the DEA and the Boys and Girls Clubs of Houston has been largely

successful in steering youth away from drugs and improving academic performance. The program alternates activities between

education and recreation, and pairs each student with a mentor.L

! The Domestic Monitor Program has been very successful as a baseline to measure heroin purity.L

! One source recommends more controls on the distribution of alprazolam because the detox process is so dangerous, involving

seizures and hallucinations.M

! Tracking and monitoring gang activity more closely would help to cut down on drug activity in Houston, as well as crimes associated with gangs and drug use, such as car thefts and graffiti.E

! While all Pulse Check cities report successful use of task forces to fight the drug problem, Houston’s task forces are unique: they

involve numerous agencies that are effective in meeting the challenges associated with the city’s geographic location near the

Mexican border. These task forces include professionals from local law enforcement, the U.S. Border Patrol, FBI drug squads, U.S.

Customs, and the HIDTA.L

Prescription drug monitoring

Increased use of task forces

Drug user recognition (DRE) for law enforcement

Other: DEA partnership with Boys and Girls Clubs of Houston

Other: Domestic Monitor Program

Onsite lab tests

Drug-free zones

Use of crack house (nuisance abatement) laws

SEPTEMBER 11 FOLLOWUP
SNAPSHOT: LOS ANGELES, CALIFORNIA

page 154 Pulse Check: January 2004

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

Two Pulse Check sourcesL,M believe the city’s overall drug problem has

remained stable, and twoE,N believe it has increased somewhat. Similarly, two

sourcesL,N believe the overall drug problem is very serious, and twoE,M believe it

is somewhat serious. A few developments are noted:

! With the new Proposition 36, younger users, females, and those never

before in treatment are increasingly entering treatment.E

! The number of people entering Los Angeles treatment programs for primary crack cocaine use declined slightly.E

! The number of admissions to the methadone treatment program increased.M

! An increasing number of primary methamphetamine users entered treatment.E

! Methylenedioxymethamphetamine

(MDMA or ecstasy) use as a secondary or tertiary drug increased 

somewhat.N

! Raves, where ecstasy is the drug of

choice, have become more prevalent

and mainstream.L Ecstasy use is also

spreading to private settings, such

as residences and parties.

Additionally, the drug market is changing in a few ways:

! Undercover police have had more

difficulty purchasing heroin and

hydroponic marijuana.L

! Crack prices and purity have

declined.L,E

! Methamphetamine purity increased,

and prices declined.L,E

Drugs reported as most widely abused

include marijuana, crack, and heroin.

Ecstasy and gamma hydroxybutyrate

(GHB) use is still emerging.L,E

Most widely abused drug:

MarijuanaE,N

CrackL

HeroinM

No changes reported between spring

and fall 2002L,E,N,M

Second most widely abused drug:

HeroinL,E

CrackE,M

MethamphetamineN

No changes reported between spring

and fall 2002L,E,N,M

Drug related to the most serious

consequences:

HeroinE,M

CrackL

MethamphetamineN

No changes reported between spring

and fall 2002L,E,N,M

Drug related to the second most

serious consequences:

CrackE,M

HeroinL

MethamphetamineL,E

MarijuanaN

No changes reported between spring

and fall 2002L,E,N,M

New or emerging problems:

Ecstasy use continues to increase.L,E

GHB use continues to increase.E

Sources: LLaw enforcement, EEpidemiologic/ 

ethnographic, N

Non-methadone treatment,

and MMethadone treatment respondents 

Note: These symbols appear throughout this

city profile to indicate type of respondent.

What are the primary drugs of abuse

among clients in a non-methadone

treatment program? (Fall 2002)

Methamphetamine

Crack cocaine

Powder cocaine

Marijuana

! Treatment percentages in the nonmethadone program remained relatively

stable between spring and fall 2002,

with the exception of an increase in secondary and tertiary ecstasy use.

! The number of methadone treatment

admissions, in general, increased

between spring and fall 2002.

Source: Non-methadone treatment respondent

75%

10% 10%

5%

LOS ANGELES PRIMARY METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Total population:. . . 9,519,338

! Median age: . . . . . . 32.0 years 

! Race (alone):

! White . . . . . . . . . . . . . . 48.7%

! Black . . . . . . . . . . . . . . . 9.8%

! American Indian/

Alaska Native . . . . . . . . 0.8%

! Asian/Pacific Islander 12.2%

! Other race . . . . . . . . . . 23.5% 

! Two or more races . . . . 4.9% 

! Hispanic (of any race): 44.6% 

! Unemployment rate: . . . . 5.0% 

! Median household 

income: . . . . . . . . . . . $42,189

! Families below poverty level 

with children <18 years: 19.9% 

Source: U.S. Census 2000* 

*The census data in this table are provided as a frame of reference for the information given by Pulse Check

sources. Whenever possible, the data given by the law enforcement and epidemiologic/ethnographic sources

reflect the metropolitan area. 

What drugs do clients in a methadone

program abuse+? (Fall 2002)

(N=120)

Heroin

OxyContin®

Crack or 

powder cocaine

Clonazepam (Klonopin®)

+

Includes any use, whether as a primary, secondary, or tertiary drug; response for methamphetamine was “very small”; response for ecstasy was

“0”; this program does not track marijuana use.

Source: Methadone treatment respondent

0 20 40 60 80 100

7

(N=242)

Percentage 

30

40

90
SNAPSHOT: LOS ANGELES, CALIFORNIA

Pulse Check: January 2004 page 155

Heroin use patterns and market activity appear stable. Two demographic

shifts are reported:

! Fewer Blacks (who still predominate) and more Whites and

Hispanics are in treatment.E

! Young males increased among new

heroin treatment clients.M

Two declines are noted:

! Crack cocaine treatment admissions

declined slightly between spring

and fall 2002.E

! Crack prices and purity declined.L,E

No changes are reported in use or

market activity between spring and

fall 2002.

No changes are reported in use or

market activity between spring and

fall 2002.

Several indicators show an increase in

methamphetamine use and activity

between spring and fall 2002:

! The number of primary methamphetamine users presenting to

treatment increased.E

! Methamphetamine purity

increased, as prices declined.L,E

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Sources: LLaw enforcement

respondent; EEpidemiologic/

ethnographic respondent

Note: SA = South American

(Colombian) heroin; SWA = Southwest

Asian heroin; SEA = Southeast Asian

heroin; ice = highly pure methamphetamine in smokable form; BC

bud=British Columbian marijuana; and

OxyContin® =oxycodone hydrochloride

controlled-release

Not

difficult

at all

Undercover policeL UsersE

Crack, powder cocaine;

marijuana (in general);

methamphetamine (in

general, locally produced,

and Mexican); ecstasy 

Mexican heroin

4

3

2

1

0

5

6

7

8

9

Local commercial grade 

marijuana, BC bud 

Extremely

difficult

10

Mexican black tar heroin; 

marijuana (in general, commercial grade) 

Heroin (in general and Mexican

brown); ecstasy

Sinsemilla; diverted OxyContin®

SA, SEA, SWA

BC bud, hydroponic marijuana 

Powder cocaine; ice

Crack; methamphetamine (in

general, locally produced, and

Mexican) 

Heroin (in general); sinsemilla;

diverted OxyContin®

Ice

SA, SEA, SWA; hydroponic 

marijuana

HEROIN

POWDER COCAINE

Several indicators show an increase in

ecstasy use between spring and fall

2002:

! Ecstasy use as a secondary or 

tertiary drug increased somewhat.N

CRACK COCAINE

MARIJUANA

METHAMPHETAMINE

MDMA (ECSTASY)

! As in other western Pulse Check cities, sources agree that it is extremely

difficult to purchase white powder heroin (Colombian and Asian).L,E

! Undercover police have had more difficulty purchasing heroin (in 

general) and hydroponic marijuana since spring 2002.L

! Sources agree that crack, marijuana, and methamphetamine are 

relatively easy to purchase.L,E

! Raves, where ecstasy is the drug of

choice, have become more prevalent and mainstream.L

! Ecstasy use is also becoming more

prevalent in private settings, such

as residences and parties.E
SNAPSHOT: LOS ANGELES, CALIFORNIA

page 156 Pulse Check: January 2004

Who’s most likely to use heroin?

Characteristic E N M

Age group (years) >30 18–30 >30 

Mean age (years) 35–46 NR 38 

Gender 65% male Split evenly 60% male 

Race/ethnicity 40% Black Hispanic 50% White

30% White (any race) 40% Hispanic 

30% Hispanic (any race)

(any race) 

Socioeconomic status Low Low Low 

Residence Central city Central city Suburbs 

Referral source NA Criminal justice Individual

and other health 

care provider 

Level of education completed NA High school None 

Employment at intake NA Unemployed Unemployed 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Two sources agree that heroin users

tend to be adults older than 30 and

male.E,M

! More Whites and Hispanics and fewer

Blacks have presented to treatment for

heroin use over the past few Pulse

Check reporting periods.E

! All heroin-using clients in the nonmethadone treatment program are

secondary or tertiary users of the drug. 

! New heroin treatment clients are likely

to be male and much younger than the

overall treatment population.M 

THE USE PERSPECTIVE

WHAT’S HAPPENING IN TREATMENT?

! The Pulse Check non-methadone

treatment respondent, whose 120-

slot facility of 12–24-year-olds

operates at full capacity, reports

marijuana as the primary drug of

abuse among three-quarters of that

program’s clients (see pie chart on

the first page of this chapter).

Treatment percentages appear relatively stable between spring and

fall 2002.N

! The non-methadone treatment

source reports an increase in slot

capacity since spring 2002,

although waiting lists remain a

problem.

! The methadone treatment respondent is with a private facility that

is at half capacity (220 of 500 slots

filled). The number of admissions

increased between spring and fall

2002.M

! Methadone maintenance treatment

is available throughout the metropolitan area. Public and private

methadone treatment availability

remained adequate and stable

between spring and fall 2002.E

! Nearly all females entering adolescent treatment centers are primary

methamphetamine users; nearly all

males are primary marijuana users.E

! The most common barrier (and an

increasingly common one) to

methadone treatment is a financial

one. The treatment program is 

private, and thus it is difficult for

clients to pay.M

! The most common impediment to

treatment in the non-methadone

facility, which treats adolescents

and young adults, is a language

barrier. Many clients and parents

of clients speak only Spanish, while

many staff speak only English.N

WHO USES ILLICIT DRUGS?

The Pulse Check epidemiologic, 

non-methadone treatment, and

methadone treatment sources were

asked to describe the populations

most likely to use heroin, cocaine,

marijuana, methamphetamine, and

ecstasy. They were also asked to

describe any emerging user groups

and to report on how the drugs are

used. As shown in the following

pages, user characteristics vary by

drug. Further, because of the different perspective each brings, the three

sources sometimes describe quite 

different populations and use patterns for each drug. For example, 

all methadone clients are primary 

opiate users who may use drugs

other than opiates in a secondary 

or tertiary manner. 
SNAPSHOT: LOS ANGELES, CALIFORNIA

Pulse Check: January 2004 page 157

How do users take heroin?

Characteristic E N M

Primary route of 90% inject Injecting Injecting

administration followed by smoking 

Other drugs taken Crack, Marijuana Crack, powder

benzodiazepines (sequentially) cocaine (speedball), 

clonazepam (Klonopin®) 

Publicly or privately? Privately Privately Privately 

Alone or in groups? Alone Alone and in groups Alone 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Injecting is, by far, the most common

route of heroin administration.E,N,M

Smoking is also common.N

! Heroin users often combine crack,

marijuana, or benzodiazepines with

heroin.E,N,M

! Use patterns appear stable between

spring and fall 2002.

Who’s most likely to use cocaine?

Crack Powder cocaine

E N M E N M

Age group (years) >30 13–30 >30 >30 13–30 >30 

Mean age (years) 35–38 NR NR NR NR NR 

Gender 60% male Split evenly Split evenly Male Split evenly Split evenly 

Race/ethnicity Black Hispanic White and White Hispanic White and 

(any race) Black (any race) Hispanic 

(any race)

Socioeconomic status Middle Low Middle Middle Low Middle 

Residence Central city Central city Suburbs Suburbs Central city Suburbs 

Referral source N/A Criminal justice, Individual N/A Criminal justice Individual

other health care and school

provider, and 

parental 

Level of education completed N/A Junior high None N/A Junior high None 

Employment at intake N/A Unemployed and Unemployed N/A Unemployed Unemployed

full-time student and full-time 

student 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! The epidemiologic source notes a slight decrease in the

number of people coming into Los Angeles treatment

programs for primary crack cocaine use. 

! Two sourcesE,M agree that most cocaine users are adults

older than 30, but the cocaine-using population in the

non-methadone treatment program includes mostly adolescents and young adults. 

! Cocaine users often take marijuana in combination with

crack.E,N Powder cocaine may be rolled in a marijuana

joint, which is then referred to as a “premo.”N

! Sources report no changes in cocaine user demographics between spring and fall 2002.

Characteristic
SNAPSHOT: LOS ANGELES, CALIFORNIA

page 158 Pulse Check: January 2004

Who’s most likely to use marijuana?

Characteristic E N

Age group (years) 13–30 13–17 

Gender Male Split evenly 

Race/ethnicity White and Black Hispanic (any race) 

Socioeconomic status Middle Low 

Residence Central city and suburbs Central city 

Referral source N/A Criminal justice, school, parental 

Level of education completed N/A Junior high or high school 

Employment at intake N/A Unemployed and full-time students 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; the methadone treatment respondent did not provide information on marijuana use.

! As in other cities, marijuana users tend to

span a broad range of

demographics. 

! Sources report no

changes in user characteristics between

spring and fall 2002.

How do users take marijuana?

Characteristic E N

Primary delivery vehicle Varies widely Varies widely 

Other drugs taken Phencyclidine (PCP) Powder cocaine (premo)

in combination 

Publicly or privately? Both Both 

Alone or in groups? Both Both 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; the

methadone treatment respondent did not provide information on marijuana use.

! Marijuana is taken in a variety of ways

(including joints, pipes, blunts, and bongs)

and contexts.E,N

! Sources report no changes in marijuana

use patterns between spring and fall 2002.

Decline in social disapproval (e.g., peers, parents, etc.) 

Promotion of marijuana as “medicine” 

Increase in indoor farms 

More local production 

Less emphasis by law enforcement and courts

Glamorization by entertainment industry 

Glamorization by news media 

01 23 45

Extent complicated treatment

Not at all Extremely

Widespread marijuana availability and use over the past 10 years: 

To what extent have the following contributed?

Source: Law enforcement respondent

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

Respondents associate marijuana,

used alone or with other drugs, with

the following consequences, which

remained stable between spring and

fall 2002:

! Drug-related arrestsE,N

! Automobile accidentsN

! High-risk pregnanciesN

! Short-term memory lossE,N

! Deteriorating family and social

relationshipsN

! Poor academic performanceE,N

! School absenteeism or truancyE,N

! Dropping out of schoolE,N

! Poor workplace performanceE,N

! Workplace absenteeismN

! Unemployment ratesE,N

Reason

What they have to say... 

The law enforcement respondent believes that

decline in social disapproval of marijuana and

the promotion of marijuana as “medicine” are

the main contributors to increased marijuana

use over the past 10 years. 
SNAPSHOT: LOS ANGELES, CALIFORNIA

Pulse Check: January 2004 page 159

Who’s most likely to use methamphetamine?

Characteristic E N

Age group (years) >18 18–30 

Mean age (years) 28–32 NR 

Gender 55% male Split evenly 

Race/ethnicity White Hispanic (any race) 

Socioeconomic status Low and middle Low 

Residence Suburbs Central city 

Referral source N/A Criminal justice, other health care 

provider, parental 

Level of education completed N/A High school 

Employment at intake N/A Unemployed and full-time students 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; the methadone

treatment respondent did not provide information on methamphetamine use.

! An increasing number of 

primary methamphetamine

users presented for treatment in the last 6 months.

This source believes the

increase is fueled by

Proposition 36.E

! Females entering adolescent

treatment centers are 

nearly all primary methamphetamine users, while

males are nearly all primary

marijuana users.E

How do users take methamphetamine?

Characteristic E N

Primary route of administration Smoking Snorting 

Other drugs taken Marijuana Marijuana

(in combination) (sequentially) 

Publicly or privately? Privately Both 

Alone or in groups? Alone Both 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment

respondent; the methadone treatment respondent did not provide information on

methamphetamine use.

! Several routes of methamphetamine administration are reported: according to the epidemiologic source, smoking is most common, followed

by snorting and injecting; according to the nonmethadone treatment source, snorting is most

common, followed by injecting.

! Adolescent methamphetamine users tend to take

“a little bit of everything,” including marijuana,

lysergic acid diethylamide (LSD), and ecstasy.E

Who’s most likely to use ecstasy?

Characteristic E N

Age group (years) 13–30 >30 

Mean age (years) 18–20 NR 

Gender Split evenly Females 

Race/ethnicity White Hispanic 

(any race) 

Socioeconomic status Middle and high Low 

Residence Central city Central city 

and suburbs

Referral source N/A Other health care 

provider and school 

Level of education completed N/A High school 

Employment at intake N/A Unemployed 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; the methadone treatment respondent did not provide information on ecstasy use.

! Ecstasy use as a secondary or tertiary drug increased

somewhat between spring and fall 2002.N

! Drugs combined with ecstasy include methamphetamine, GHB, ketamine, and LSD. When “coming down”

from ecstasy, users often take benzodiazepines or

antidepressants.E 

WHO’S MOST LIKELY TO ABUSE OXYCONTIN®?

! Primary OxyContin® abusers constitute

about 5 percent of the methadone treatment population—a stable percentage

since spring 2002.M

! OxyContin® abusers’ mean age is about

40 years, 70 percent are male, and nearly

all are White.M

! Sources report no changes in OxyContin®

abuser characteristics between spring and

fall 2002.
SNAPSHOT: LOS ANGELES, CALIFORNIA

page 160 Pulse Check: January 2004

WHERE ARE DRUGS USED AND

SOLD?

Heroin and crack cocaine are sold in

a variety of public and commercial

places, including the following: 

! Streets and open-air marketsL,E

! Crack houses and shooting

galleriesL,E

! Public housing developmentsL,E

! Playgrounds and parksE

! Around drug or alcohol treatment

clinicsE

! Inside carsE

Additionally, crack is sold inside private residences and hotels/motels.E

Powder cocaine sales settings tend to

be more private and include the following:

! Inside private residencesL,E

! Nightclubs and barsL

! Private partiesL

! Public housing developmentsE

Marijuana sales settings are similar to

heroin and crack sales settings, with

the addition of the following:L,E

! In or around schools 

! College campuses

! Nightclubs and bars

! Raves 

! Supermarkets

Methamphetamine and ecstasy sales

occur in a variety of public and commercial places:

! Streets and open-air marketsL,E

! Inside private residencesL,E

! Nightclubs and barsE

! Private partiesE

! RavesE

Additionally, methamphetamine is

sold around playgrounds and parks,

hotels and motels, supermarkets, and

inside cars.E Web sites that focus on

male-to-male sex sell methamphetamine online.E

Along with the list above, ecstasy

sales settings also include college

campuses and gay circuit parties.E

The epidemiologic source notes that

ecstasy is becoming more prevalent in

private settings, such as residences

and parties.

OxyContin® is obtained or diverted

from the Internet and doctors’ offices.L

HOW DO DRUGS GET FROM SELLER

TO BUYER?

Although open-air drug markets exist

in Los Angeles, most drug sales occur

when a buyer contacts a dealer via

cell phone to arrange for a delivery.L

Individual dealers tend to sell one

type of drug, with a few exceptions:

dealers who primarily sell heroin may

also sell crack and powder cocaine,

and dealers who sell primarily powder cocaine may also sell marijuana. 

The sales method for diverted

OxyContin® differs from that for

other drugs. Buyers and sellers visit

Internet chat rooms to arrange meetings for drug sales.L

THE MARKET PERSPECTIVE

Cash

Shoplifted merchandise

Property/

Merchandise

Food stamps

Drug buying services

Sex

Other stolen merchandise

(e.g., electronic equipment)

Heroin Crack cocaine and

methamphetamine 

75% 88% 90%

8%

3%

3%

3% 3% 3% 5%

7%

3%

7%

Beyond cash: What else is accepted in exchange for drugs?

Powder cocaine

and marijuana 

Source: Mean of response ratings given by law enforcement, nonmethadone treatment, and methadone treatment respondents. The

methadone treatment source provided information for heroin only,

and the epidemiologic/ethnographic source did not respond.

What they have to say... 

! As in other cities, nearly all illegal drug transactions

(75–90 percent) involve cash.L,N,M

! Sources report no changes in means of exchange for illegal drugs over the past 10 years.
SNAPSHOT: LOS ANGELES, CALIFORNIA

Pulse Check: January 2004 page 161

Which drug sellers are associated with which crimes?

Crime Heroin Crack and Marijuana Metham- Ecstasy

powder cocaine phetamine

Gang-related activity $$ $

Violent criminal acts $ $ $$

Non violent criminal acts $ $ $ $$

Domestic violence $ $

Other: child endangerment $

Sources: Law enforcement and epidemiologic/ethnographic respondents

Illegal drug dealers in Los Angeles 

continue to be highly involved in crime.

Heroin, cocaine, and marijuana sales

often involve gangs and violent criminal

acts. Methamphetamine sales often

involve domestic violence and child

endangerment.

Who’s most likely to sell illegal drugs?

Primary drug sold Affiliation Age (years)

L E L E 

Heroin Independent Organized: Mexican 18–30 13–30

trafficking organizations 

Crack Independent Organized: local 13–30 13–30

and organized street gangs 

Powder cocaine Independent and Organized: Mexican 13–30 13–30

organized trafficking organizations

Marijuana Independent and Independent 13–17 13–30

organized 

Methamphetamine Independent and Independent >18 13–30 

organized and organized

Ecstasy Independent NR 13–30 NR 

Diverted OxyContin® Independent and NR 18–30 NR 

organized 

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic respondent

! Drug sellers tend to

be fairly young, and

the organization of

the seller groups

varies widely across

the city.L,E

! The sales scene in

Los Angeles has

remained relatively

stable between

spring and fall

2002.L,E

How much do illegal drugs cost?

Drug Unit Purity Price 

Mexican black tar or brown heroin One balloon (0.1 g) NR $20L

One “pedazo” NR $700–$800E

Crack cocaine 0.2 g NR $10L

1 oz 78% $500–$600E

Powder cocaine 1 g 80% $100L

Marijuana (commercial grade) Dime bag (1 g) NR $10L

Methamphetamine 1/16 oz 40% $125L

1 oz 30–35% $450–$550E

Ecstasy One pill (40 mg) NR $10–$20 

NR $25–$40 

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic respondent

Most reported drug purity and

prices remained stable in the

past 6 months, with two

exceptions:

! Crack cocaine prices and

purity declined.L,E

! Methamphetamine purity

increased, and prices

declined.L,E
SNAPSHOT: LOS ANGELES, CALIFORNIA

page 162 Pulse Check: January 2004

Over the past 10 years, to what degree have the following changes in the drug market and in the nature of drug

users made your community’s drug abuse problem more complex? 

01 23 45

Degree of complication

Not at all Extremely complicated

Change

Lack of housing opportunities for recovering clients 

Lack of jobs and job training opportunities for recovering clients

Spread of use among all age groups

Earlier first use of more dangerous drugs

Increasing availability of new and substitute drugs 

Declining cost of drugs

Normalization of drug use 

Increased court referrals to treatment 

Increased treatment case loads 

More polydrug use

What they have to say...

! Consistent with comments in the majority of other Pulse

Check sites, treatment sources agree that the largest 

problems exacerbating the community’s illegal drug problem are the lack of housing opportunities, jobs, and job

training opportunities for recovering clients.N,M

! The methadone treatment source adds that clients who

increasingly present with primary OxyContin® abuse and

with secondary clonazepam abuse have made methadone

treatment more difficult over the past 5 years.M

NR=Not reported

!"Non-methadone treatment

#"Methadone treatment 

NR

NR

NR

NR

THE USE AND MARKET PERSPECTIVES: A 10-YEAR VIEW
SNAPSHOT: LOS ANGELES, CALIFORNIA

Pulse Check: January 2004 page 163

SEPTEMBER 11 FOLLOWUP

The law enforcement source notes that shipments of all drugs are steady despite a brief decline following September 11,

2001. Moreover, after September 11, many narcotics officers were diverted to security/antiterrorist duty. The absence of the

officers allowed drug dealers to feel that they could deal drugs without being arrested. Now that officers are returning to

narcotics duty, they are finding more drugs on the street than before September 11.L

Drug marketing innovations and tools over the past 10 years: To what degree have they complicated efforts to detect

or disrupt drug activity in Los Angeles?

Illicit marketing innovation/tool 

More organized networks 

Less organized networks 

Throwaway cell phones 

Expansion of drug sales beyond the central city 

Increased communications via Internet 

Relocation of sales settings within the community 

Unique packaging 

Polydrug dealers

More or changing brand names 

Fewer brand names 

0 1 2 3 45

Degree of success

Not at all Extremely successful

!"Law enforcement respondent

What they have to say...

! As in the majority of Pulse Check sites, detection and disruption efforts have not

been hampered much by dealers using unique packaging or by the increased or

decreased use of brand names.

! Again, consistent with Pulse Check cities across the country, throwaway cell phones

and the reorganization of dealer networks rate as the most common innovations

that have complicated law enforcement efforts to disrupt drug activity.L

! On the other hand, increased use of task forces, crack house (nuisance abatement) laws, and methamphetamine precursor laws have been fairly successful in

combating illegal drug use and activity in the past 10 years.L
SNAPSHOT: MIAMI, FLORIDA

page 164 Pulse Check: January 2004

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

The three responding Pulse Check sources report the illegal drug problem in

Miami as somewhat worse.L,E,N Sources report specific changes between the two

reporting periods:

! Crack cocaine use has decreased somewhat. Powder cocaine use among

new drug users is on the rise.E 

! Heroin and diverted prescription opiates replaced powder and crack

cocaine as the drugs associated with

the most serious consequences.E

! As reported in 13 other Pulse Check

cities, methamphetamine use continues to increase. One source reports it

as a “P and P” or “party and play”

drug often used in combination with

ecstasy and sildenafil citrate

(Viagra®).

E That source further states

that methamphetamine is often associated with high-risk sexual activity.

Another source reports that, in particular, ice (a high-purity, smokable

form of methamphetamine) is

increasingly available.L

! Use of methylenedioxymethamphetamine (MDMA or ecstasy) and

OxyContin® (oxycodone hydrochloride controlled-release) continues to

increase.N

! Ecstasy and club drug users are 

now using powder cocaine to bolster the effects of club drugs. Club

drugs are now used in settings

beyond just clubs and raves. As the

venues shift, the varieties of drugs

used and combined are increasing.E

Two sources cite the illegal drug 

problem as very serious.E,N One source

cites it as somewhat serious.L Because

of the different perspective each

brings, the sources differ in their 

perception of which drug is most 

widely abused and which leads to 

the most serious consequences.

Most widely abused drug:

MarijuanaL,E

Powder cocaineL

CrackN

No reported changes between spring

and fall 2002L,E,N,M

Second most widely abused drug:

Crack and powder cocaineL,E

CrackL

MarijuanaN

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the most serious

consequences:

Crack and ecstasy used in

combinationL

CrackN

Heroin and diverted prescription

opiatesE

Changes between spring and fall 2002:

Heroin and prescription opiates replaced

powder and crack cocaine.E

Drug related to the second most

serious consequences:

EcstasyL

Crack and powder cocaineE

HeroinN

No reported changes between spring

and fall 2002L,E,N,M

New or emerging problems:

Methamphetamine and iceL,E

Ecstasy and diverted OxyContin®N

Diverted sildenafil citrate (Viagra®)

used in combination with

methamphetamineE

Sources: LLaw enforcement, EEpidemiologic/

ethnographic, NNon-methadone treatment 

Note: These symbols appear throughout this

city profile to indicate type of respondent.

The methadone treatment source in Miami did 

not respond.

What are the primary drugs of abuse

among clients in a treatment 

program? (Fall 2002)

Heroin

Marijuana

Other drugs, including methamphetamine,

ecstasy, and diverted OxyContin®

(oxycodone hydrochloride controlled-release)

Crack cocaine

Powder cocaine

Treatment percentages for primary

drugs of abuse remained stable between

spring and fall 2002.N

Source: Non-methadone treatment respondent

43%

35%

12%

3% 7%

MIAMI PRIMARY METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Total population:. . . 2,109,282 

! Median age: . . . . . . 34.1 years 

! Race (alone):

! White . . . . . . . . . . . . . . 79.4%

! Black . . . . . . . . . . . . . . . 5.5%

! American Indian/

Alaska Native . . . . . . . . 0.2%

! Asian/Pacific Islander 1.4%

! Other race . . . . . . . . . . . 4.6% 

! Two or more races . . . . 3.8% 

! Hispanic (of any race): 57.3% 

! Unemployment rate: . . . . 5.0% 

! Median household 

income: . . . . . . . . . . . $35,966 

! Families below poverty level 

with children <18 years: 19.3% 

Source: U.S. Census 2000* 

*The census data in this table are provided as a frame of reference for the information given by

Pulse Check sources. Whenever possible, the data given by the law enforcement and epidemiologic/

ethnographic sources reflect the metropolitan area. 

(N= 575)
SNAPSHOT: MIAMI, FLORIDA

Pulse Check: January 2004 page 165

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic respondent

Note: SA=South American (Colombian) heroin; SWA=Southwest Asian heroin; SEA=Southeast

Asian heroin; Ice=highly pure methamphetamine in smokable form; and BC bud=British

Columbian marijuana.

Not

difficult

at all

Extremely

difficult

Undercover policeL UsersE

Powder cocaine

Crack; marijuana (in general,

commercial grade)

Heroin (in general, SEA, SWA);

locally produced methamphetamine; ice

Methamphetamine (in general

and Californian); diverted

OxyContin®

SA; sinsemilla marijuana

Mexican heroin; BC bud

SEA, SWA; locally produced

methamphetamine

Local commercial grade 

marijuana; diverted OxyContin®

Methamphetamine (in general,

Mexican/Californian, and ice)

Mexican heroin

Hydroponic marijuana

Heroin (in general, SA);

crack and powder cocaine;

marijuana (in general, sinsemilla, hydroponic); ecstasy;

diverted benzodiazepines

4 GHB precursors; LSD

3

2

1

0

5

6

7

8

9

10

! The numbers of heroin users

admitted to treatment remained

relatively stable.N

! Users find it easier to purchase

South American heroin than 

previously.E

! Along with prescription opiates,

heroin replaced cocaine as the

drug related to the most serious

consequences.E

MARIJUANA

! Marijuana use remains widespread. Two of three sources

believe it is the most widely used

drug in Miami.L,E

! Marijuana activity, use, and user

characteristics remained relatively

stable between spring and fall

2002.L,E,N

! Crack cocaine use decreased

between spring and fall 2002.E

! Crack (followed by marijuana) is 

the most common primary drug of

abuse in this non-methadone treatment program.N

! Powder cocaine use among new

users increased somewhat between

spring and fall 2002.E These individuals tend to be club drug users

who now take cocaine to bolster

ecstasy (to “bump up”).

HEROIN

BC bud

COCAINE

! Diverted OxyContin® is now more difficult for users to purchase because

fewer doctors are prescribing it: they

are more aware of its abuse. However,

many OxyContin® abusers have

switched to diverted methadone.E

! Undercover police purchased methamphetamine and ice more easily in

fall 2002 than in the previous spring,

particularly within the gay community.L

! As reported in three other Pulse Check

cities (Atlanta, Chicago, and

Pittsburgh), users can purchase

methamphetamine more easily.E

! Users can purchase South American

white heroin more easily.E

! Gamma hydroxybutyrate (GHB) analogs

and lysergic acid diethylamide (LSD) are

more difficult for users to purchase.E
SNAPSHOT: MIAMI, FLORIDA

page 166 Pulse Check: January 2004

WHAT’S HAPPENING IN TREATMENT?

! Availability of public methadone

treatment has remained relatively

stable between spring and fall 2002,

but for private treatment, availability has increased.E Public methadone

treatment programs reportedly have

adequate capacity; private programs

have a waiting list of about 1

month, although capacity for private programs has increased somewhat since spring 2002.E

! The Pulse Check non-methadone

treatment respondent, whose 300-

slot facility operates at full capacity,

reports crack cocaine as the primary

drug of abuse among 43 percent of

clients followed by marijuana at

35.4 percent (see pie chart on the

first page of this chapter). Treatment 

percentages remained stable

between spring and fall 2002.N

! The non-methadone treatment

provider lists HIV/AIDS and 

hepatitis C as relatively common

illnesses among clients. Moreover,

that source states that hepatitis C

is not only high among injecting

drug clients but also among clients

who snort drugs: “Snorting powder cocaine through a straw in a

group is another common mode 

of passing on the disease.”

! Comorbid diagnoses among clients

have remained relatively stable

between spring and fall 2002, but

many are stable at relatively high

levels, including antisocial or conduct disorder, mood disorders, suicidal thoughts/attempts, and posttraumatic stress disorder (PTSD).N

! The number-one barrier to treatment for the non-methadone 

treatment program is limited slot

capacity. The program has a waiting list and a “waiting list for the

waiting list.”N

! Methadone treatment is available

in selected areas only. 

WHO USES ILLICIT DRUGS? 

The Pulse Check epidemiologic and

non-methadone treatment sources

were asked to describe the populations

most likely to use heroin, cocaine,

marijuana, methamphetamine, and

ecstasy. They were also asked to

depict any emerging user groups and

to report on how the drugs are used.

As shown in the following pages, user

characteristics vary from drug to

drug. Further, because of the different

perspective each brings, the three

responding sources sometimes

describe quite different populations

and use patterns for each drug. 

THE USE PERSPECTIVE

MDMA (ECSTASY) AND 

OTHER CLUB DRUGS

METHAMPHETAMINE

! Methamphetamine continues to 

increase in availability.L,E Ice, in 

particular, is increasingly available,

especially within the gay community.L

! Methamphetamine use continues

to increase dramatically. Its use in

combination with ecstasy and

sildenafil has also increased.E

! Although ecstasy use continues to

increase, the numbers of users in

treatment remain low and stable.N

! Club drugs are now used in settings

beyond just clubs and raves. As the

venues shift, the varieties of drugs

used and combined are increasing.E

OTHER DRUGS

! Diverted Xanax®: Alprazolam

abuse and misuse have increased,

as has the practice of using the

drug in combination with prescription opiates or ecstasy.E

! Viagra®: Abuse of sildenafil has

increased, especially among new

drug users and in combination with

marijuana, ecstasy, or methamphetamine. Moreover, the increase

among new users is particularly

marked among adolescent males.E

DIVERTED 

PRESCRIPTION OPIATES

! Diverted OxyContin® is more difficult to buy now than in the past,

and abusers may have consequently

switched to diverted methadone.E

! Along with heroin, prescription

opiates replaced cocaine as the

drugs related to the most serious

consequences.E

! Methadone abuse has increased,

especially among new users. An

increase in deaths involving the

drug occurred in the first half of

2002. Methadone tablets are

believed to be diverted from pain

management prescriptions (not

clinics).

! OxyContin® abuse among admissions to treatment is increasing.N

Its abuse in combination with 

alprazolam (Xanax®) and

methadone has increased.E

! One source reports that pain 

management clinics are prescribing

OxyContin® improperly. 
SNAPSHOT: MIAMI, FLORIDA

Pulse Check: January 2004 page 167

Who’s most likely to use cocaine?

Crack Powder cocaine 

Characteristic

E N E N 

Age group (years) >30 >30 >30 >30 

Mean age (years) NR 40.25 37 38.71 

Gender Evenly split 59% male 65% male 65% male 

Race/ethnicity Black Black White Black 

Socioeconomic 

status Low Low Middle Low 

Residence Central city Central Suburbs Central

and rural areas city city

Referral source N/A Individual N/A Individual 

Level of education completed N/A High school N/A High school 

Employment 

at intake N/A Unemployed N/A Unemployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment 

respondent 

Who’s most likely to use heroin?

Characteristic E N

Age group (years) 18–30 >30

Mean age (years) NR 44

Gender 80% male 69% male

Race/ethnicity White White

Socioeconomic status Low NR

Residence Suburbs Central city 

Referral source N/A Individual

Level of education completed N/A High school 

Employment at intake N/A Unemployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent

How do users take heroin?

Characteristic E N

Primary route of administration Injecting Injecting 

Other drugs taken Powder cocaine (speedball) NR 

Diverted OxyContin®

Publicly or privately? Privately Both 

Alone or in groups? Alone Both

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment

respondent

! Heroin users tend to inject. No changes in 

route of administration are noted.E,N

! Other drugs commonly taken include powder

cocaine (injected in a speedball) and diverted

OxyContin® (as a substitute for or sequentially 

with heroin).E

! New heroin users often use ecstasy sequentially

after heroin.E

! Although powder and crack cocaine users tend to

be older than 30, they differ demographically in

other ways: crack users are more likely than powder cocaine users to be female, and they are

more likely to be Black and of low socioeconomic

status.E,N

! Powder cocaine users new to treatment tend to

be much younger than treatment clients overall

(23.87 years versus 38.71 years). Also, users 

new to treatment are more often Hispanics 

and females than treatment clients overall.N

! Powder cocaine use among new users has

increased somewhat between spring and fall

2002.E These individuals tend to be club drug 

users who now take cocaine to bolster ecstasy 

(to “bump up”). 

! Other drugs commonly taken with crack include

heroin or alprazolam sequentiallyE and ecstasy.L

! Sources reported no shifts in crack or 

powder cocaine demographics between spring

and fall 2002.E,N 

! Heroin users tend to be White, 

non-Hispanic males.E,N

! New users tend to be Hispanic

adolescents of middle economic

status.E

! No sources report shifts in

demographics between spring

and fall 2002. 
SNAPSHOT: MIAMI, FLORIDA

page 168 Pulse Check: January 2004

Who’s most likely to use marijuana?

Characteristic E N

Age group (years) 18–30 13–17 

Mean age (years) 32 15.66

Gender 70% male 65% male

Race/ethnicity Hispanic (any race) Hispanic (any race)

Socioeconomic status All Low

Residence All Central city

Referral source N/A Criminal justice

Level of education completed N/A High school

Employment at intake N/A Full time

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent

Widespread marijuana availability and use over the past 10 years: To what extent have the following contributed?

Reason

0123 45

Extent contributed

Extremely

Increase in indoor farms

More local production

Decline in users’ perception of harm

Decline in social disapproval

Promotion of marijuana as “medicine”

Increased THC potency

Glamorization by entertainment industry

Glamorization by news media

Not at all

!""Law enforcement respondent

#""Epidemiologic/ethnographic respondent

NR

NR

NR

NR

! Marijuana is most often smoked in joints, but blunts, bongs, and pipes are also common.E

! Sildenafil is often abused sequentially with marijuana, especially among adolescent males. This

combination is a carryover from the practice of combining ecstasy with sildenafil.E

! Respondents report no shifts in marijuana user or use characteristics. 

! While Hispanics remain

the predominant marijuana user group, use cuts

across all ethnic groups.E,N

Whites are represented

about equally to the 

general population, 

and Blacks are overrepresented compared with the

general population.E

! The average age of marijuana users in the general

population is about 32

yearsE

; the average age of

marijuana users in the

non-methadone treatment

program is about half that

(15.66 years).N

! Law enforcement and epidemiologic

sources agree that the increase in indoor

farms and more local production of marijuana has greatly contributed to the widespread use and availability of marijuana

over the past 10 years.

! The law enforcement respondent

believes that some local media “are

quick to report on legalization efforts

and ‘medicinal’ uses [of marijuana],”

but not on its harmful effects.

NR=Not reported
SNAPSHOT: MIAMI, FLORIDA

Pulse Check: January 2004 page 169

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

Respondents associate marijuana,

used either alone or with other drugs,

with the following consequences,

which remained stable between spring

and fall 2002:E

! Drug-related deaths (in which one

of the drugs is marijuana)

! Drug-related emergency room visits

! Drug-related arrests

! Automobile accidents

! Short-term memory loss

! High-risk pregnancies

! Deteriorating family/social relationships

! Poor academic performance

! School absenteeism, truancy, or

dropping out of school

! Poor workplace performance

! Workplace absenteeism

! Unemployment rates

! High-risk sexual behavior

MARIJUANA-USING CLIENTS: 

To what extent have changes in 

marijuana and marijuana use patterns complicated treatment over 

the past 10 years? 

According to the non-methadone treatment source, increased THC potency

and earlier initiation of marijuana use

have complicated treatment for marijuana-using clients. Moreover, this

source believes that glamorization of

marijuana use by the entertainment

industry and news media has declined

in the past 10 years.

Who’s most likely to use methamphetamine?

Characteristic E N

Age group (years) >30 >30 

Mean age (years) 33 35 

Gender Male 80% male 

Race/ethnicity White White 

Socioeconomic status Middle NR 

Residence Suburbs Central city 

Referral source NA Individual 

Level of education completed NA 2-year college 

Employment at intake NA Full time 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent

How do users take methamphetamine?

Characteristic E N

Primary route of administration Snorting Injecting 

Other drugs taken Ecstasy (“hugs and kisses”) NR 

Sildenafil (“crystal d--k”) 

Publicly or privately? Privately Both 

Alone or in groups? In groups/among friends Both

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent

Who’s most likely to use ecstasy?

Characteristic E N

Age group (years) 18–30 NR 

Mean age (years) 24 18 

Gender Split evenly Male 

Race/ethnicity White White 

Socioeconomic status Middle NR 

Residence Suburbs Central city

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent

! Ecstasy use continues mostly among White,

non-Hispanic young adults.E,N

! Ecstasy users tend to take a variety of drugs in

combination, including marijuana, GHB, alprazolam (“Zany bars”), cocaine, methamphetamine, and ketamine.E

! Sources report no shifts in user characteristics

between spring and fall 2002.

! The number of users increased dramatically between spring and fall 2002.E

! Methamphetamine users tend to be

adult, White, non-Hispanic males.E,N

! Use is spreading from the gay male and 

the techno-dance scenes to females and 

heterosexual males.

E

! Methamphetamine use is associated

with a dramatic increase in high-risk sexual behavior.E

! Methamphetamine is taken in a variety of ways in

Miami, including snorting, injecting, and smoking

the high-purity form of the drug (ice).L,E,N

! Methamphetamine is often used in combination

with other drugs including marijuana, ecstasy,

and sildenafil.L,E
SNAPSHOT: MIAMI, FLORIDA

page 170 Pulse Check: January 2004

THE MARKET PERSPECTIVE

WHERE ARE DRUGS USED AND SOLD?

Nearly all illegal drug sales in Miami

reportedly occur in central city areas.

Heroin, powder cocaine, and crack

are sold in a variety of places, including the following:L,E

! Streets/open-air markets

! Crack houses/shooting galleries

! Private residences

! Public housing developments

! Nightclubs and bars

! College campuses

! Playgrounds and parks

! Private parties

! Raves

! Hotels and motels

Additionally, powder cocaine is sold

around elementary, junior high, or

high schools, around drug treatment

clinics, and in parking lots. Both

forms of cocaine are also sold around

shopping malls and supermarkets. 

Marijuana and ecstasy are also sold

on the streets and in open-air markets

as well as at the following venues:

! Public housing developments

! College campuses

! Nightclubs and bars

! Raves

! Concerts

! Hotel and motels

Methamphetamine is not typically

sold on the streets; however, it is sold

at private residences, college campuses, nightclubs and bars, private parties, raves, and hotels/motels.

OxyContin® is often misprescribed at

pain management clinics,E which “are

popping up on every corner”; thus,

the availability of the drug illegally

has increased.L

HOW DO DRUGS GET FROM SELLER

TO BUYER?

Dealers on the street often sell heroin,

diverted OxyContin®, crack, powder

cocaine, and marijuana. Dealers in

nightclubs and bars may sell heroin,

powder cocaine, ecstasy, GHB, prescription drugs, and marijuana.

! Heroin, powder and crack

cocaine, and diverted OxyContin®:

These drugs are sold using similar

techniques: certain neighborhoods

are known for drug dealing; a

buyer goes to one neighborhood,

makes an acquaintance on the

street who tells the buyer where

and from whom to get the drug,

and the drug is then exchanged

hand to hand. After the initial sale,

the buyer may contact a dealer by

beeper, cell phone, or two-waycommunication cell phone to set up

a meeting for the exchange of the

drug.L,E Additionally, powder

cocaine sales may be venue oriented (in nightclubs and party scenes),

and sales by these dealers may

include alprazolam, ecstasy, and

marijuana.E Crack cocaine sales are

more out in the open than heroin

and powder cocaine sales.L

! Marijuana: Sales methods vary

widely depending on the venue.

For example, at bars or nightclubs,

potential buyers can ask around

for the location of dealers. As with

heroin and powder and crack

cocaine, in certain neighborhoods,

buyers may ask around for the

location of dealers. Communication

modes also vary and include in

person, cell phones, beepers, and

two-way-communication cell

phones. Marijuana sales, according

to one source, are very open.L

! Methamphetamine and ecstasy:

Sales for these drugs are less open

than for other drugs. One source

states that “you must know the

crowd to be able to buy,” and

dealers communicate with buyers

in person, by beeper, cell phones,

two-way-communication cell

phones, the Internet, and e-mail.

That source also notes that ecstasy

sales are becoming less open than

in the past and that ecstasy dealers

are “learning how to avoid law

enforcement.”L

Which drug sellers are associated with which crimes?

Crime Heroin Powder and crack cocaine, Methamphetamine

marijuana, and ecstasy

Prostitution $ $

Gang-related activity $ $

Violent criminal acts $ $

Nonviolent criminal acts $

Domestic violence $$ $

Drug-assisted rape $$ $

Source: Law enforcement respondent

According to the law enforcement respondent, illegal drug sellers in Miami are

highly involved in other crimes. Powder and crack cocaine, marijuana, and ecstasy

dealers are especially involved in a variety of violent and nonviolent criminal acts.
SNAPSHOT: MIAMI, FLORIDA

Pulse Check: January 2004 page 171

What they have to say...

! Although cash is reportedly the most common item exchanged for illegal drugs, 

several other goods and services are commonly exchanged for drugs, particularly

shoplifted merchandise, sex, and other drugs.L,E

! Sex exchanged for crack cocaine or methamphetamine is relatively common.E The

epidemiologic source explains that methamphetamine is a relatively new drug to

Miami and is being introduced in sexual situations and parties. 

! The law enforcement source explains that women pay very little cash for club drugs

(especially ecstasy). Often they receive the drugs as a gift or in exchange for sex.

Beyond cash: What else is accepted in exchange for drugs?

Source: Mean of response ratings given by law enforcement and epidemiologic/ethnographic

respondents.

Heroin

Cash

Crack cocaine

Methamphetamine

Marijuana and

Powder cocaine

63%

Shoplifted merchandise

Other stolen merchandise

(e.g., electronic equipment)

Property/merchandise

Guns

Food Stamps

Other: Includes items

accounting for 3 percent

or less of transactions for

all five drugs, including

other drugs, stealing the

drug, drug buying services,

injecting services, and

lookout services

Sex

88%

52%

8%

69%

8%

8%

5% 5%

8%

13%

10%

WHO SELLS DRUGS?

According to the epidemiologic

source...

Illegal drug dealers tend to be 

18–30 years old, and their level of

organization depends on the type of

drug sold. For example, heroin, powder cocaine, and methamphetamine

dealers tend to be independent,

whereas crack cocaine, ecstasy, GHB,

and diverted OxyContin® dealers are

organized. Marijuana dealers are

organized into small sales teams of

five independents who work for a

grower. 

According to the law enforcement

source...

! Heroin, powder, and crack

cocaine dealers are organized into

small groups, including some

street gang members, but the sales

groups are not controlled by the

gangs. Heroin sellers tend to be

18–30 years old. Powder and crack

cocaine dealers tend to be somewhat younger and often include

adolescents.

! Marijuana sellers are more organized than heroin, powder cocaine,

and crack sellers. The organization protects the grow houses and

is more hierarchical than loosely

organized heroin, powder cocaine, 

and crack organizations. Sellers

tend to be 13–30 years old, and

growers tend to be older (18–30

years old).

! Methamphetamine and ecstasy

sellers are organized in loose

acquaintance networks.

! Diverted OxyContin® sellers are

organized. Sellers recruit several

addicts or users on Medicare. The

sellers take those users to fill their

prescriptions. Those who fill their

prescriptions keep some of the

drug for personal use and sell the

rest to their accompanying seller

who, in turn, sells the drug illegally.

5%

3% 5%

5%

4%

4%

4%

3%

13%

5%

4%

5%

3% 4%
SNAPSHOT: MIAMI, FLORIDA

page 172 Pulse Check: January 2004

What they have to say...

! Throwaway phones greatly

contribute to difficulty in 

disrupting drug activity in

Miami.L,E These phones make

it particularly difficult to track

those involved in higher level

drug smuggling, and two-waycommunication cell phones

have recently added to the

difficulty in tracking drug 

distributors.L

! Polydrug dealers are also a

particular problem for law

enforcement, especially in

the club and rave scenes.L,E

Drug marketing innovations and tools over the past 10 years: To what degree have they complicated

efforts to detect or disrupt illicit drug activity in Miami?

THE MARKET PERSPECTIVE: A 10-YEAR VIEW

012 3 4 5

Degree of complication

Not at all Extremely complicated

Throwaway cell phones

Polydrug dealers

Expansion of drug sales beyond the central city

Two-way-communication cell phones

Less organized networks

Increased communications via Internet

Relocation of sales settings within the community

!""Law enforcement respondent 

#""Epidemiologic/ethnographic respondent 

How much do illegal drugs cost? 

Drug Unit Price

sold

Colombian 

heroin 1 oz $2,100 

Crack One rock $10–$20 

Powder 

cocaine 1 oz $650 

Ecstasy One pill $11–$18

Source: Law enforcement respondent

Reported drug prices in Miami remained relatively stable between spring and

fall 2002.L,E Sources did not report on specific prices for marijuana, but the epidemiologic respondent stated that marijuana prices increased in the past 6

months. The increase is most likely due to the higher THC levels of hydroponic

marijuana and the customers’ demands for these high-potency levels.

NR

NR

NR

NR

NR=Not reported
SNAPSHOT: MIAMI, FLORIDA

Pulse Check: January 2004 page 173

SEPTEMBER 11 FOLLOWUP 

Since the September 11 attacks, Miami’s ecstasy supply has been unstable. The

supply from the Belgium and Luxemburg region route was cut off, and more

adulterated products sold as ecstasy are now on the market. 

Community innovations and tools over the past 10 years: How successful have they been?

NR

NR

NR

NR=Not reported

Onsite lab tests

Increased use of task forces

Rescheduling of prescription drugs

Drug-free zone laws

Drug courts

Crack house (nuisance abatement) laws

Precursor laws

Drug user recognition education (DRE)

for law enforcement

Sentencing changes

!""Law enforcement respondent

#""Epidemiologic/ethnographic respondent

0 1 23 45

Degree of success

Not at all Extremely successful

What they have to say...

! Onsite lab tests: Rated as

extremely successful by law

enforcement and epidemiologic

sources, onsite lab tests can be

interpreted as testing the substance itself or testing a person

for substance use. Often, during

driving while intoxicated (DWI)

stops, officers test drivers for

drugs.E

! Increased use of task forces: As

reported in most Pulse Check

cities, sources rate task forces,

which include State task forces on

club drugs and prescription drug

abuse and High Intensity Drug

Trafficking Areas (HIDTA) task

forces for heroin and other drugs,

as extremely successful.L,E

! Prescription drug monitoring:

Both sources agree that more 

prescription drug monitoring is

needed. The epidemiologic source

believes that new prescription

drug monitoring legislation will

pass during 2003.L,E
SNAPSHOT: MINNEAPOLIS/ST. PAUL, MINNESOTA

page 174 Pulse Check: January 2004

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

Two of the Pulse Check sources believe that the area’s overall drug problem

has remained stable,E,N while the other two believe it has worsened

somewhat.L,M Specifically, several developments are reported:

! Heroin, crack and powder cocaine, marijuana, and methamphetamine are

being sold on the streets or in open-air markets—a major development over

the past few years in a metropolitan area that never used to have a street

scene.L,E

! As mentioned in eight other Pulse Check cities, diverted methadone is an

emerging problem.M Local pain clinics have been shifting from prescribing

OxyContin® (oxycodone hydrochloride controlled-released) to prescribing

methadone. Many patients referred from methadone treatment to a higher

level of care go, instead, to pain clinics, feigning pain. Physicians at these

clinics then prescribe the drug—not because they are unscrupulous, but

because they are naive in identifying people with coexisting opioid problems. 

! Cooking methamphetamine in rented hotel rooms and in cars is a recently

increasing trend.L

! Undercover police find it easier to purchase BC bud (British Columbian marijuana) since the previous reporting period because of a new pipeline to

Seattle.L Three other sources in Pulse Check cities report a similar change

(Seattle,L St. Louis,E and Portland, ORL

). While marijuana dealers tend to

operate independently, recent gang activity is also reported in relation to BC

bud—again, similar to reports in Seattle.L

! The use of “sherms” and “water” (phencyclidine [PCP], embalming fluid,

and marijuana combined) has increased over the past few months (similar

to an increase reported in HoustonE

), according to methadone patients in a

small telephone focus group jointly conducted by the methadone treatment

source and the Pulse Check discussant.F The epidemiologic source also

reports an increase in this combination (“wet sticks” or “dipped joints”).E 

! Khat is an emerging drug among the area’s Somalian community, which is the

largest in the country.L

! An increase is reported in pills sold as “ecstasy” that actually contain no

methylenedioxymethamphetamine (MDMA).E

Three of the Pulse Check sources believe the area’s overall drug 

problem is very serious, while oneM describes it as “somewhere between

somewhat and not very serious.”

Because of the different perspective

each brings, the sources vary in

their perception of which drugs are

most commonly abused and which

have the most serious consequences.

For example, the law enforcement

source considers crack the drug

related to the most serious consequences because of its association

with homicides. Similarly, the

methadone treatment source 

What are the primary drugs of abuse

among clients in a non-methadone

treatment program? (Fall 2002)

Methamphetamine

Crack cocaine

Powder cocaine

Marijuana

Spring vs fall 2002...

! Crack and methamphetamine

increased slightly as primary drugs of

abuse in the non-methadone program.

! Treatment percentages in the methadone

program remained relatively stable.

Source: Non-methadone treatment respondent

80%

10% 5% 5% MINNEAPOLIS/ST. PAUL METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Total population:. . . 2,968,806

! Median age: . . . . . . 34.2 years 

! Race (alone):

! White . . . . . . . . . . . . . . 86.1%

! Black . . . . . . . . . . . . . . . 5.3%

! American Indian/

Alaska Native . . . . . . . . 0.7%

! Asian/Pacific Islander 4.1%

! Other race . . . . . . . . . . . 1.6% 

! Two or more races . . . . 2.1% 

! Hispanic (of any race): . . . 3.3% 

! Unemployment rate: . . . . 3.5% 

! Median household 

income: . . . . . . . . . . . $54,304

! Families below poverty level 

with children <18 years: 6.5% 

Source: U.S. Census 2000* 

*The census data in this table are provided as a frame of reference for the information given by Pulse Check

sources. Whenever possible, the data given by the law enforcement and epidemiologic/ethnographic sources reflect

the metropolitan area. 

What drugs do clients in a methadone

program use+? (Fall 2002)

(N=70)

Heroin

Pharmaceutical

opiates

Crack cocaine

Powder cocaine

Marijuana

0 20 40 60 80 100

50

10

(N=471)

Percentage 

100

+Includes any use, whether as a primary, secondary, or tertiary drug; program does not test

for marijuana, so figure is based on selfreports; pharmaceutical opiates include hydromorphone (Dilaudid®), butorphanol tartrate

(Stadol®), hydrocodone (Vicodin®), and oxycodone (Percodan®, Percocet®).

Source: Methadone treatment respondent

50

50
SNAPSHOT: MINNEAPOLIS/ST. PAUL, MINNESOTA

Pulse Check: January 2004 page 175

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Sources: LLaw enforcement

respondent; EEpidemiologic/

ethnographic respondent

Note: SA=South American (Colombian)

heroin; SWA=Southwest Asian heroin;

SEA=Southeast Asian heroin;

ice=highly pure methamphetamine in

smokable form; GHB=gamma

hydroxybutyrate; and BC bud=British

Columbian marijuana.

Not

difficult

at all

Undercover policeL UsersE

Crack, powder cocaine

4

3

2

1

0

5

6

7

8

9

Mexican black tar heroin; 

marijuana (in general, 

sinsemilla, BC bud); 

methamphetamine 

(in general, Mexican)

! Minneapolis/St. Paul is one of eight Pulse Check cities where users can purchase heroin (in general) with no difficulty at all. It is also one of five cities where

users can purchase Mexican methamphetamine with no difficulty at all.E

! BC bud is fairly easy to purchase, by both users and undercover police, as is

the case in only a handful of other Pulse Check cities.

! Undercover police find it less difficult to purchase BC bud since the previous

reporting period because of a new pipeline to Seattle.L Only three other cities

report a similar change (Seattle,L St. Louis,E and Portland, ORL

).

! Users and undercover police can purchase most drugs with a fairly similar degree

of ease, with two exceptions: users find it more difficult than undercover police to

purchase ice; conversely, undercover police find it more difficult than users to purchase SA and Mexican brown heroin.

! Users find it less difficult to purchase diverted prescription pain medications

in fall 2002 than in the previous spring.E

Extremely

difficult

10

Heroin (in general, SA, and

Mexican brown); marijuana (in

general, local commercial, and

Mexican commercial); Mexican

methamphetamine 

Mexican black tar heroin;

crack; sinsemilla, BC bud,

hydroponic marijuana

Local methamphetamine;

ecstasy; diverted OxyContin®,

other prescription pain 

medications, and methadone

SEA, SWA

Ice

GHB

Powder cocaine; methamphetamine (in general) 

Ice; ecstasy 

SA

Hydroponic marijuana

Heroin (in general); local

commercial marijuana;

local methamphetamine

SEA, SWA, and Mexican

brown heroin; sinsemilla 

Most widely abused drug:

MarijuanaE,N

CrackL

HeroinM

No reported changes between spring

and fall 2002L,E,N,M

Second most widely abused drug:

Powder cocaineL,M

CrackE,M

MethamphetamineN

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the most serious

consequences:

HeroinE,M

CrackL

MarijuanaN

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the second most

serious consequences:

HeroinL

MarijuanaE

MethamphetamineN,F

Benzodiazepines, cocaineM

No reported changes between spring

and fall 2002L,E,N,M

New or emerging problems:

KhatL

Diverted/abused prescription pain 

medicationsE

EcstasyN

Methadone diverted from pain clinicsM

“Sherms” and “water” (PCP + 

embalming fluid + marijuana)F

Sources: LLaw enforcement, EEpidemiologic/ 

ethnographic, N

Non-methadone treatment, MMethadone treatment, and F

Focus group

respondents

Note: These symbols appear throughout this

city profile to indicate type of respondent.

considers benzodiazepines the

drugs with the most serious consequences second to heroin, because

of their involvement in overdoses

when combined with opiates, and

also names cocaine, because of its

involvement in crime.

THE BIG PICTURE (continued)
primary drug, and 10 percent

abuse it as a primary, secondary, or

tertiary drug. Further, among

intakes (not regular clients), about

one-third of pharmaceutical addicts

abuse OxyContin®. These individuals are middle-class suburban “medical addicts, not street people,” who

take the drug orally and get it

through physicians at pain clinics.M

! Misuse of pain medication was diagnosed in a series of 44 pain clinic

patients who entered methadone

treatment. Their problems included

“lost” prescriptions, early prescription refills, and unsuccessful pain

treatment. About half of them subsequently dropped out of the pain

clinics, indicating that they have

addictive disorders and are using the

methadone as a substitute.

! Abuse of other pharmaceutical opiates, including hydromorphone

(Dilaudid®), butorphanol tartrate

(Stadol®), hydrocodone (Vicodin®),

and oxycodone formulations

(Percodan® and Percocet®) accounts

for a steady 15 percent of primary

drug problems in the methadone

program. The majority (60 percent)

of these clients are female.M

! Opium is shipped from California

once a month to the area’s large

Hmong refugee population, many

of whom use welfare checks to support their $250-per-month habit.M

! Khat is overnight-mailed or

shipped in luggage on airplanes

from Kenya to Somali refugees in

the Minneapolis/St. Paul area. This

natural stimulant, which loses

potency in 48 hours, has leaves

that contain psychoactive ingredients structurally and chemically

similar to d-amphetamine.E

! Marijuana use has increased in the

suburbs.E

! The use of marijuana combined

with PCP and formaldehyde (“wet

sticks” or “dipped joints”) has

increased.E

! According to high school counselors, use is moving into younger

age groups.E

! The percentage of clients who are

methamphetamine users has

increased somewhat.N

! The number of ecstasy users has

increased somewhat.E

! Use is increasing in both suburban

and rural areas.E

! The percentage of clients who use

ecstasy as a secondary or tertiary

drug has increased sharply (to 30

percent), both in the general treatment population and among firsttime clients.N

! Diverted OxyContin® is increasingly mentioned in emergency department, medical examiner, poison

control, and law enforcement

data.E

! While 90 percent of abusers are

White, American Indians are overrepresented at 10 percent. Users

tend to be older than 30 and

reside in central city, suburban,

and rural areas. Injecting is the

primary route of administration.E

! For the first time, 5 percent of

new clients in the methadone program abuse OxyContin® as their

SNAPSHOT: MINNEAPOLIS/ST. PAUL, MINNESOTA

page 176 Pulse Check: January 2004

! Purity has increased, price is low,

and supplies are plentiful.E,M

! Opiate-related deaths continue to

increase, recently surpassing

cocaine-related deaths for the first

time.E

! Increases are reported in overdoses, smoking and snorting, and use

in the suburbs.E

! Street sales have increased. The

area never used to have a street

scene.E

! While crack is readily available,

and it increased slightly as a primary drug of abuse between

spring and fall 2002, it is “an

adult drug. Kids look down on

it.” The few adolescents who use

it tend to be hooked up with

older people and have moved off

the street and into the business.N

! The number of crack users has

declined somewhat, among both

younger and older adults.E

! The number of clients in treatment for powder cocaine abuse

has remained stable.N

! The number of marijuana users

has increased somewhat among

younger and older adolescents.E

! More people are in treatment for

marijuana than for other drugs.E

! Minneapolis/St. Paul has the highest marijuana-positive arrestee 

urinalysis levels among all the

cities in the Arrestee Drug Abuse

Monitoring (ADAM) program.

COCAINE

HEROIN

MARIJUANA

METHAMPHETAMINE

MDMA (ECSTASY)

DIVERTED OXYCONTIN®

OTHER DRUGS
SNAPSHOT: MINNEAPOLIS/ST. PAUL, MINNESOTA

Pulse Check: January 2004 page 177

THE USE PERSPECTIVE

WHAT’S HAPPENING IN TREATMENT?

! Treatment capacity and availability:

At the time of the Pulse Check discussion, the non-methadone treatment respondent’s program was

operating slightly under its capacity of 85 beds. This program serves

adolescent boys, accounting for

the high percentage of marijuana

and the absence of heroin as a primary drug of abuse (see pie chart

on the first page of this report).

Because its demographics represent the school system population,

this program is well positioned to

alert the community to new and

emerging drug problems and user

groups.N The methadone treatment

respondent is with a two-site program operating slightly under its

capacity of 500 (which is a staffing

criterion, based on historical experience with neighbors, logistics,

and caseloads).M While all clients

at the program use heroin, large

proportions also use crack, powder

cocaine, or prescription opiates

(see bar chart on the first page of

this report). Furthermore, sometimes those drugs are the primary

drugs of abuse, rather than heroin.

Methadone maintenance treatment

is available throughout the

Minneapolis/St. Paul area.

Treatment availability in public programs has remained stable between

spring and fall 2002, but fewer slots

are available in private programs.

Both public and private programs

have adequate capacity.E

! Recidivism: In the non-methadone

program, 50 percent of crack

clients, 33 percent of powder

cocaine clients, 25 percent of marijuana clients, and 10 percent of

methamphetamine clients are

return clients.N In the methadone

program, 98 percent of the 

heroin clients have had prior 

non-methadone treatment, and 70

percent have had prior methadone

treatment.M

! Women in treatment: While nearly

half of the heroin clients in this

program are female, most other

programs have a 3:1 male-tofemale ratio.M Women are more

interested in full-service hospitalbased programs than other community-based programs.M

! Marijuana use: More people in

the area are in treatment for marijuana than for any other drug.

! Consequences of drug use: One

treatment source notes that highrisk pregnancies are stable at high

levels, elaborating that five to

eight boys in treatment at any time

are fathers or prospective fathers.

Many of those teens have multiple

children from multiple mothers.N

Criminal behavior has increased as

a result of drugs: Younger teens are

committing more serious offenses—

something not seen 5 years ago.

They act out and are involved in

car theft, gang activity, guns in

school, violence in school, drive-by

shootings, and drug sales. These

youth are increasingly certified as

adults and are treated as such in the

criminal justice system.N

Methadone overdoses doubled

(from 6 to 12) in the last year.M

! Co-occurring disorders: Antisocial

disorders or conduct disorders are

the most common co-occurring disorders among the adolescents in

this program.N Mood disorders

have increased, as have suicidal

thoughts. In the past year, two 

adolescents (not in the program)

committed suicide.N Mood disorders in the other Pulse Check

source’s programM are stable at a

high rate (41 percent of people at

admission). The hepatitis C rate has

!" Gamma hydroxtbutyrate (GHB)

and ketamine continue to be used

by White, sophisticated, suburban

“clubbers,” although they are

occasionally used in the central

city. GHB is part of the weekend

rave drug culture among a group

of young gay males.M

!" Flunitrazepam (Rohypnol) is occasionally, but more rarely, used by

clubbers.N

!" Lysergic acid diethylamide (LSD)

use, which rebounded in the

1990s, continues a low upward

trend. Once used primarily by

Whites, it is now getting into

other racial/ethnic groups.N

! PCP is “out there,” but the large

supplies of LSD might detract

from its use.N

! Methylphenidate (Ritalin®) is sold

to friends by adolescents who

have legitimate prescriptions. 

Cells of adolescent users crush

and snort the pharmaceutical.N

! Ephedra-based drugs are combined experimentally with other

drugs. Users tend to be White and

sometimes hook up with methamphetamine dealers or producers

who get them supplies.N

! Other substances: Five different

area school counselors report that

youth scrape off sulfuric acid that

has accumulated on car batteries,

roll it, and smoke it. They call it

“lithium.” Snorting Kool Aid® is

another practice reported in schools.
SNAPSHOT: MINNEAPOLIS/ST. PAUL, MINNESOTA

page 178 Pulse Check: January 2004

Who’s most likely to use heroin?

Characteristic E M

Age group (years) >30 >30 

Mean age (years) 35 42 

Gender 70% male 53% male 

Race/ethnicity White White 

Socioeconomic status NR Low 

Residence Central city All areas 

Referral source N/A County assessment 

Level of education completed N/A High school 

Employment at intake N/A Unemployed

Note: Heroin is not a drug of abuse at the non-methadone program, which serves adolescent boys.

Sources: E

Epidemiologic/ethnographic respondent; MMethadone treatment respondent

! Heroin use in the suburbs has

increased slightly.E

! While nearly half of the heroin clients

in this program are female, most other

programs have a 3:1 male-to-female

ratio. Women appear more interested

in full-service hospital-based programs

than other community based programs.M

How do users take heroin?

Characteristic E M

Primary route of Injecting Snorting 

administration 

Other drugs taken Powder cocaine Benzodiazepines 

(speedballs), methadone

Publicly or privately? Privately Privately 

Alone or in groups? Alone Alone 

Sources: EEpidemiologic/ethnographic respondent; MMethadone treatment respondent

! Injecting has declined, while snorting and smoking have increased.E

! Methadone overdoses have increased.E

! Heroin injectors use in networks of 4–6 users.M

! Clonazepam (Klonopin®, or “pins”) is the most

commonly used benzodiazepine.M

increased to 92 percent now that

the program is testing for the disease. Tuberculosis cases increased

(from 0 to 6), mostly among

Hmong clients. Diagnoses of other

serious medical conditions are stable at high levels in this aging population, with advanced cases of diabetes, liver disease, and other agerelated comorbidity. The program

recently began assessing clients for

chronic pain, which has increased.M

! Barriers to treatment: The most

serious barrier is the delay prior to

treatment: with the current 2- to

4-week referral process, many drug

users drop off before their number

comes up.M Many adolescent drug

users have low-income working

parents with inadequate insurance

that prohibits treatment. Others

are from families with no insurance, and some have no permanent address, move frequently, live

in shelters, and frequent soup

kitchens.N

! Changes over the past 10 years:

The largest changes include the following: the increase in polydrug

use, which makes it hard to “get to

the bottom of what they’re using”;N

the increased availability and purity

of heroin, its declining cost,M and

the corresponding use of smokable

heroin by young adults;N the

advent of designer drugs, such as

ecstasy and GHB;N and the increase

in methamphetamine.

WHO USES ILLICIT DRUGS?

The Pulse Check epidemiologic, nonmethadone treatment, and

methadone treatment sources were

asked to describe the populations

most likely to use heroin, cocaine,

marijuana, methamphetamine, and

ecstasy. They were also asked to

depict any emerging user groups and

to report on how the drugs are used.

As shown in the following pages, user

characteristics vary by drug. Further,

because of the different perspective

each brings, the three sources sometimes describe quite different populations and use patterns for each drug. 
SNAPSHOT: MINNEAPOLIS/ST. PAUL, MINNESOTA

Pulse Check: January 2004 page 179

Who’s most likely to use cocaine?

Characteristic Crack Powder cocaine

E N M E N M

Age group (years) >30 13–17* >30 >30 13–17* >30 

Mean age (years) 31 17* 42 34 16* 42 

Gender 70% male 100% male* 53% male 70% male 100% male* 53% male 

Race/ethnicity Black Black White 50% White, All White 

50% Black

Socioeconomic status NR Low Low NR Low/Middle Low 

Residence Central city Central city All areas All areas Suburbs All areas 

Referral source N/A Criminal justice County N/A Criminal justice County

assessment assessment

Level of education completed N/A Junior high High school N/A Junior high High school 

Employment at intake N/A Unemployed Unemployed N/A Full-time student Unemployed

*The non-methadone program serves adolescent boys.

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! The percentage of crack users has declined somewhat, among both younger and older adults.E

! Among first-time admissions, the percentage in

treatment for crack has declined somewhat. Among

the overall treatment population, the percentage for

crack has increased slightly, but the numbers are

low. The percentage of clients in treatment for powder cocaine abuse has remained stable.N

! While crack is readily available, it is “an adult drug.

Kids look down on it.” The few adolescents who use

it tend to be hooked up with older people, and have

moved off the street and into the business.N

! Crack and powder cocaine as primary drugs of

abuse each account for 12.5 percent of clients in

the methadone program. These percentages have

remained stable.M However, focus group participants from that program believe that powder

cocaine snorting and injecting have increased,

while crack use has declined. They attribute this

change to the declining cost and increasing purity

of powder cocaine.F

! Among powder cocaine users, Whites are underrepresented and Blacks are overrepresented relative to

the general population.E

! Among methadone clients, a higher percentage of

primary cocaine (crack and powder) are Blacks

than among primary heroin users.M

! While powder cocaine is usually snorted, smoking

has increased.E Both snorting and smoking are

reported among powder cocaine users in treatment.N

! Crack is often combined with marijuana, while powder cocaine is combined with heroin in speedballs.E

Powder cocaine users in treatment combine the

drug with marijuana.N

! Crack users in the methadone program take a “high

dose of methadone plus crack on the side.”F Powder

cocaine users in the program inject that drug with

heroin, stating, “You can’t ‘blow’ [inject heroin] without a ‘mo’ [powder cocaine].” 
SNAPSHOT: MINNEAPOLIS/ST. PAUL, MINNESOTA

page 180 Pulse Check: January 2004

Who’s most likely to use marijuana?

Characteristic E N M

Age group (years) 13–17 13–17* >30 

Mean age (years) 15 NR NR 

Gender Evenly split 100% male* 75% male 

Race/ethnicity White White White 

Socioeconomic status Middle Low/middle Low 

Residence Suburbs, rural areas Central city, suburbs All areas 

Referral source N/A Criminal justice County assessment 

Level of education completed N/A Junior high High school 

Employment at intake N/A Full-time student Unemployed 

*The non-methadone program serves adolescent boys.

Sources: E

Epidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! The number of marijuana users has increased somewhat, among both

younger and older adolescents.E

! More people are in treatment for marijuana than for other drugs.E

! Marijuana use has increased in the suburbs.E

! While Whites predominate, marijuana use crosses all races/ethnicities.N

! Treatment percentages remain stable for primary, secondary, and tertiary 

marijuana use.N,M

How do users take marijuana?

Characteristic E N M

Primary delivery vehicle “One-hitter pipes” “One-hitter bongs” Joints 

Other drugs taken PCP and embalming “Crank” (methamphe- None

fluid tamine), hashish, opium, 

PCP, embalming fluid

Publicly or privately? Both Both Privately 

Alone or in groups? In groups/ Both Alone 

among friends

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone

treatment respondent

! The use of marijuana combined with PCP and embalming fluid (“wet sticks” or

“dipped joints”) has

increased.E

! Methadone clients who use

marijuana do not take other

drugs. Most are successfully

recovering, functional

methadone patients.

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

One source lists “amotivational

syndrome” as a negative consequence of marijuana use, describing

users with this syndrome as “underemployed, inactive, using marijuana

as a substitute for hobbies or social

activities, and generally not doing

as well in life as they should be

doing.” Additionally, respondents

associate marijuana, used either

alone or with other drugs, with the

following consequences, which

remained stable between spring and

fall 2002:

! Drug-related emergency room

visitsE,N

! Drug-related arrestsE,N

! Automobile accidentsE,N

! High-risk pregnanciesE,N

! Short-term memory loss N

! Deteriorating family/social

relationshipsE,N

! Poor academic performanceE,N

! School absenteeism or truancyE,N

! Dropping out of schoolE,N

! Poor workplace performanceE,N

! Workplace absenteeismE,N
SNAPSHOT: MINNEAPOLIS/ST. PAUL, MINNESOTA

Pulse Check: January 2004 page 181

Problem

Increased polydrug use 

Earlier initiation of marijuana use 

Glamorization by entertainment industry 

Glamorization by news media 

Increased severity of addiction among clients 

Increased THC potency of marijuana 

Increased progression to use of other drugs 

Increased overall difficulty in treating the addiction 

Decline in social disapproval (e.g., peers, parents, etc.)

Decline in users’ perception of harm

01 23 4 5

Extent complicated treatment

Not at all Extremely

012 345

Extent contributed

Not at all Extremely

Marijuana-using clients: To what extent have changes in the following

problems complicated their treatment over the past 10 years? What they have to say... 

! Marijuana potency has increased only

moderately compared with 10 years

ago, but it has increased sharply compared with 20 years ago.N

! The non-methadone respondent

attributes greater impact to the news

media’s glamorization of marijuana

than do the majority of respondents

in other Pulse Check cities.

! In general, changes over the past

decade seem to have had greater

impact on marijuana users in the

non-methadone program than those

in the methadone program.

Decline in social disapproval (e.g., peers, parents, etc.) 

Decline in users’ perception of harm 

Promotion of marijuana as “medicine” 

Glamorization by entertainment industry 

Increased THC potency

Less emphasis by law enforcement and courts 

Glamorization by news media 

Increase in indoor farms

More local production 

Decline in price 

Widespread marijuana availability and use over the past 10 years: To what extent have the

following contributed? Reason

!"Non-methadone treatment respondent

#"Methadone treatment respondent

!"Law enforcement respondent

#"Epidemiologic/ ethnographic respondent

! While the decline in users’ perception of harm has had a huge impact over the past 10 years, this perception has been

stable for the past 3 years.E

! Mainstream media, particularly magazines that target youth, have perpetuated the public debate regarding the harmfulness of marijuana. By exploring the issue in debate form, rather than presenting the scientific facts, they have contributed

greatly to the widespread use of marijuana.E

! Indoor farms have had an impact because, outdoor farming is difficult with the short growing season.E

! Promotion of hemp products to youth has also contributed greatly to widespread marijuana use and availability.E

! As in the majority of Pulse Check cities, declining price has not affected use or availability. On the contrary, most prices

have remained stable over the past 10 years, and some have actually gone up.L,E

0

0

0

0

0

0

0

0

0

0

What they have to say... 

! In agreement with the majority of

respondents in other Pulse Check cities,

both the law enforcement and epidemiologic respondents believe that three

changes over the past decade have particularly contributed to marijuana’s

widespread availability and use: the

decline in social disapproval, the

decline in users’ perception of harm,

and the promotion of marijuana as

“medicine.”L,E
SNAPSHOT: MINNEAPOLIS/ST. PAUL, MINNESOTA

page 182 Pulse Check: January 2004

WHERE ARE DRUGS USED AND

SOLD?

Heroin, crack, and powder cocaine

are sold in central city and suburban

areas. Marijuana, methamphetamine,

and ecstasy are also sold in those

areas, and in rural areas as well.

Diverted OxyContin® is sold in central city and rural areas.

The law enforcement and epidemiologic sources agree that heroin, crack

and powder cocaine, marijuana, and

methamphetamine are all sold on the

streets or in open-air markets—a

major development over the past few

years in a metropolitan area that

never used to have a street scene.

Both sources also agree that those

drugs, plus ecstasy, are sold in the following settings—most of which,

according to the epidemiologic

source, are also settings for drug use:

! Inside cars

! In private residences

! On college campuses

! In nightclubs and bars

! In playgrounds and parks

Heroin, crack, and powder cocaine

are also sold in crack houses or

shooting galleries; additionally, they

are sold in shopping malls, at raves,

and at concerts, as are marijuana and

ecstasy; they are also sold in hotels

and motels, as are methamphetamine

and ecstasy; and they are sold in

public housing developments, as is

methamphetamine. 

Methamphetamine is not just used

and sold in rented hotel rooms and

in cars: it is also cooked in those

settings—another recently increasing

trend.L

Who’s most likely to use methamphetamine?

Characteristic E N

Age group (years) 18–30 13–17* 

Mean age (years) 27 NR 

Gender 60% male 100% male 

Race/ethnicity White White 

Socioeconomic status NR Low, middle 

Residence Suburbs, rural areas Central city, suburbs 

Referral source N/A Criminal justice 

Level of education completed N/A Junior high 

Employment at intake N/A Unemployed or full-time student 

*The non-methadone program serves adolescent boys.

Sources: E

Epidemiologic/ethnographic respondent; NNon-methadone treatment respondent

! The percentage of clients who are

methamphetamine users has

increased somewhat.N

! According to high school counselors, use

is moving into younger age groups.E

! The new group of adolescent users includes

an equal number of girls and boys.E

! While methamphetamine-using clients

are predominantly White, a large 

proportion of the program’s Hmong

population also use the drug.N (The

Minneapolis/St. Paul area has the

Nation’s largest Hmong population,

and one-third of the program’s clients

are of that race/ethnicity.)N

! Methadone clients generally do not use methamphetamine.M

! Smoking is generally the primary route of administration.E Eighty percent of the

methamphetamine-using clients smoke the drug; the other 20 percent snort it.N

! Snorting methamphetamine is known as “getting glassed.”E

Who’s most likely to use ecstasy? 

Ecstasy users are predominantly young

(13–17 years) White males (about 60

percent) who live in central city, suburban, and rural areas.E,N While ecstasy-using clients are primarily White,

the program has a fair representation

of Blacks, Hispanics, and Asian/Pacific

Islanders.N No ecstasy users are reported in the methadone program.M A few

changes are reported:

! The number of ecstasy users has

increased somewhat.E

! Use is increasing in both suburban

and rural areas.E

! The percentage of clients who use

ecstasy as a secondary or tertiary

drug has increased sharply (to 30

percent), both in the general treatment population and among firsttime clients.N

THE MARKET PERSPECTIVE
SNAPSHOT: MINNEAPOLIS/ST. PAUL, MINNESOTA

Pulse Check: January 2004 page 183

HOW DO DRUGS GET FROM SELLER

TO BUYER?

! Heroin, crack, and powder cocaine

can be purchased in several ways,

including the following:L

1. The buyer goes to a location

known for the type of drug

being sold (sometimes multiple

drugs in one location) and asks

someone where to find that particular drug.

2. The buyer and seller then identify one another via eye contact

or body language.

3. The actual transaction is usually

hand to hand.

In the case of powder cocaine, the connection is also sometimes made in clubs.

Sometimes cell phones or two-way communication devices are also involved. 

! Marijuana and methamphetamine

can be purchased similarly on the

street, but they are also commonly

obtained via acquaintance networks, word of mouth, and prearranged meetings.

! Ecstasy is obtained via word of

mouth within a closed network,

often at parties, sporting events,

or school events. It is also purchased by mail or by dropoff in a

public place.

! Diverted OxyContin® is obtained

via word of mouth.

! GHB is obtained by word of mouth

or via the Internet or e-mail.

As shown below, the majority of these

transactions involve cash, especially in

the case of methamphetamine. A variety of other commodities, however,

are often exchanged—particularly in

the case of crack and heroin. 

Cash

Property/Merchandise

Shoplifted merchandise

Other stolen merchandise (e.g.,

electonic equipment)

Sex

Transporting the drug

Drug buying services

Injecting services

Shoplifting merchandise converted

to cash

Other: includes items accounting

for less than 3 percent of transactions for all five drugs, such as

guns, other drugs, stealing the

drug, and lookout services.

Heroin Crack cocaine 

Methamphetamine 

67% 65% 69% 2%

7%

3%

7%

10%

75%

5%

2%

8%

6%

83%

3%

3%

3%

3%

6%

4%

5%

8%

13% 4%

8%

6%

4%

5%

Beyond cash: What else is accepted in exchange for drugs?

Powder cocaine

Marijuana 

Source: Mean of response ratings given by law enforcement, epidemiologic/ethnographic, non-methadone treatment, and methadone treatment respondents.

What they have to say... 

! As drug use—especially of marijuana—

has increased among young people

over the last decade, shoplifting of

items such as compact discs (CDs) has

increased.E

! The exchange of sex for heroin has

increased over the past 10 years.M

! Stolen farm equipment is often used in

exchange for methamphetamine.E

! The exchange of stolen precursor chemicals for methamphetamine is a relatively new phenomenon.E

! While street-level transactions tend to

be cash-only, at higher levels drugs are

increasingly “fronted”: a supplier typically gives a kilogram of a drug to a seller, who goes out and sells it, and then

returns to the supplier with the cash

payment.L

! An increase is reported in “ripping off”

drugs from dealers or friends.N

! An increasing number of incidents

involve teens who buy cars from crack

addicts for small amounts of money

(typically $50) and then go joyriding.N

! Hmong refugees use welfare checks to

support their opium smoking—a $250-

per-month habit. The drug comes from

California once per month.M

2%

2%

3%

2% 4%

3%
SNAPSHOT: MINNEAPOLIS/ST. PAUL, MINNESOTA

page 184 Pulse Check: January 2004

How much does heroin cost?

Form Unit Price 

Mexican Bindle $10–$50E

Paper $50M

1 g $300–$400L 

Unspecified “powder” NR $20–$25M

Sources: LLaw enforcement respondent; EEpidemiologic/

ethnographic respondent; MMethadone treatment respondent

Which drug sellers are associated with which crimes?

Crime Heroin Powder Crack Marijuana Metham- Ecstasy

cocaine phetamine

Prostitution $$$

Gang-related activity $$$

Violent criminal acts $$$ $

Nonviolent criminal acts $ $$

Domestic violence $

Drug-assisted rape $

Source: Law enforcement respondent

Gang activity is generally associated

with powder and crack cocaine. While

marijuana dealers tend to operate 

independently, recent gang activity is

reported in relation to BC bud. 

! Purity has increased, price has

declined, and supply is plentiful, especially over the last year or two.E,M

! The gram price has increased since

last year (from $200 to $300).L

WHO’S SELLING DRUGS?

! Heroin:L Reports over the past year

or two describe Nigerian sources

coming through Chicago, as well

as Mexican sources. Generally,

heroin sellers still tend to operate

independently and usually sell only

heroin, although some sell powder

cocaine. They are generally 20–40

years old, but some are in their

forties. They are very likely to use

their own drug.

! Crack cocaine:L All crack used to

be processed locally by Black

gangs; now, Mexicans cook up

about 20 percent of the supply and

sell it to the local gangs. These

gang members are either adolescents or young adults who do not

sell any other drugs and are somewhat likely to use their own drug.

! Powder cocaine:L Powder cocaine

dealers are generally part of gangs

or cartels. They are young adults

who sometimes also sell methamphetamine and marijuana (and, in

rare cases, heroin). They are very

likely to use their own drug.

! Marijuana:L Marijuana dealers

tend to operate independently,

although recent gang activity is

reported in connection to BC bud.

Sellers are young adults who

sometimes also sell powder

cocaine. They are very likely to

use their own drug. 

! Methamphetamine:L

Methamphetamine dealers are

usually part of Mexican gangs.

They are young adults who sometimes also sell powder cocaine.

They are somewhat likely to use

their own drug.

! Ecstasy:L Dealers are usually part

of organized crime groups from Las

Vegas, Los Angeles, and other big

cities. They tend to be young adults

who are somewhat likely to use

their own drug. Sales activity has

reportedly increased recently.
SNAPSHOT: MINNEAPOLIS/ST. PAUL, MINNESOTA

Pulse Check: January 2004 page 185

How much does cocaine cost?

Form Unit Price 

Crack Rock $20L,M

1 g $100L

1 oz $900–$1,200L 

Powder 1 g $100E

1 oz $800–$1,200L 

1 kg $20,000–$30,000L

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic

respondent; MMethadone treatment respondent

All reported prices are stable between

spring and fall 2002.

How much does marijuana cost?

Form Unit Price 

Local Joint $5E

1.5 oz $300L

1 lb $700L

BC bud 1 lb $7,000–$12,000L

Sources: LLaw enforcement respondent; EEpidemiologic/

ethnographic respondent

How much does methamphetamine cost?

Unit Price 

1 g $100L,E

1 oz $1,000L

1 lb $12,000–$15,000L

1 kg s$20,000–$30,000L

Sources: LLaw enforcement respondent; EEpidemiologic/

ethnographic respondent

! All reported prices are stable between

spring and fall 2002.

! Adulteration with dimethylsulphone

(DMSO, or “horse medicine”) is stable.E

! Prices listed in the table are stable

between spring and fall 2002.

! Focus group participants believe that

“weed” quality has increased, while the

price has declined. A dime bag ($10) of

hydroponic marijuana used to be enough 

for just one joint; now it has enough for

two or three joints.F

How much do various other drugs cost?

Drug Unit Price 

Ecstasy One pill $20L,E

Diverted OxyContin® 1 mg $1E

GHB 2 oz (2 dosage units) $20E

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic

respondent

! An increase is reported in pills sold as

“ecstasy” that actually contain no MDMA.E

! All reported prices are stable between

spring and fall 2002.
SNAPSHOT: MINNEAPOLIS/ST. PAUL, MINNESOTA

page 186 Pulse Check: January 2004

Illicit marketing innovation/tool 

Throwaway cell phones 

Expansion of drug sales beyond the central city 

More organized networks

Relocation of sales settings within the community 

Less organized networks 

Polydrug dealers 

Unique packaging 

Increased communications via Internet 

More or changing brand names 

Fewer brand names

Drug marketing innovations and tools over the past 10 years: To what degree have they complicated efforts to

detect or disrupt illicit drug activity in Minneapolis/St. Paul? 

01 2 3 45

Degree of complication

Not at all Extremely complicated

! As in the majority of Pulse Check cities, the increased or decreased use of brand names by

dealers has had little impact on law enforcement detection and disruption efforts.L

! Throwaway cell phones, by contrast, have posed a great challenge to market detection and

disruption efforts—again, similar to reports in the majority of other Pulse Check cities.L

! One source believes that Internet communications have posed a great problem in market

detection and disruption.E Another source, however, believes this effect is limited to club

drugs.L

NR=Not reported

NR

NR

NR

NR

NR

NR

NR

THE MARKET PERSPECTIVE: A 10-YEAR VIEW

!"Law enforcement respondent

#"Epidemiologic/ethnographic respondent

What they have to say...
SNAPSHOT: MINNEAPOLIS/ST. PAUL, MINNESOTA

Pulse Check: January 2004 page 187

SEPTEMBER 11 FOLLOWUP

One source notes that during the first 6 months after September 11, 2001, increased border security slowed down the

Mexican influx and drove up prices—but subsequently, everything went “back to normal.”L Another believes that some of

the best narcotics officers have been reassigned to Homeland Security.E During the Pulse Check discussion just before the

war in Iraq, the methadone treatment source reported methadone patients hoarding the drug. One focus group participant

elaborated: “People are scared, worried about the war, depressed.” Another added: “People say, ‘I’m going to die anyway, so

I might as well have a good time.’ Or maybe that’s just an excuse...”

Community innovations and tools over the past 10 years: How successful have they been?

01 2 3 45

Degree of success

Not at all Extremely successful

What they have to say...

Community innovation/tool

Onsite lab tests 

Increased use of task forces 

Crack house (nuisance abatement) laws 

Drug user recognition education (DRE) for law enforcement 

Rescheduling of prescription drugs 

Precursor laws 

Other: DEA training of retail store owners 

Drug-free zone laws 

Prescription drug monitoring 

Sentencing changes 

Drug courts 

NR=Not reported

NR

NR

N/A 

NR

NR

0

0

0

!"Law enforcement respondent

#"Epidemiologic/ethnographic respondent

! Task forces: The county sheriff’s office and the Minneapolis

Police Department pool their resources for large cases, such as

wiretaps.L As drug sales move out of central city areas, more

pooling of resources through multidisciplinary law enforcement

task forces is enabling small towns to go after bigger dealers.E

! Precursor laws: Minnesota was one of the first States with laws

on anhydrous ammonia.E Also, this source recommends encouraging retail sellers to voluntarily limit sales of pseudoephedrine

and other ephedrine products.E

! Training of retail store owners: The DEA’s extensive training of

hardware and other retail store owners regarding meth lab ingredients and people who purchase them has significantly

increased the reporting of suspicious activity to law

enforcement.E

! Crack house (nuisance abatement) laws: One source believes

these laws are not effective because crack houses are mobile

and transitory.E Another believes that city ordinances have been

effective, despite increased licensing issues. For example, a new

ordinance requiring landlords to evict renters arrested on their

property for narcotics charges is controversial, but it does move

drug activity out.L

! Prescription drug monitoring: The Forgery Unit forwards cases to

the Narcotics Unit, but more resources are needed to follow up.L

! Drug courts: The law enforcement source is one of the few Pulse

Check respondents who believes drug courts to be ineffective,

primarily because they treat users and dealers in the same way.

Some dealers get four or five chances. Many cases are therefore

prosecuted federally in order to avoid drug court.L The epidemiologic source considers drug courts somewhat more effective and

recommends having an alcohol court.E

! Drug user recognition (DRE) for law enforcement: One source

rates DRE in-service classes as minimally effective, stating that

training could be improved if it were biannual and ongoing because

of changing drug trends.L Another source rates DRE as highly effective and recommends expanding the training to more officers.E
SNAPSHOT: NEW YORK, NEW YORK

page 188 Pulse Check: January 2004

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

All four Pulse Check sources believe the city’s overall drug problem has remained

stable, particularly the situation regarding cocaine, heroin, and marijuana. 

Only a few changes are reported:

! The methadone treatment source believes that job opportunities have increased

since 1996 legislation focused on work as part of recovery. Employment

increased 75 percent at a model methadone program studied over a 3- to 4-

year period.M

! Methamphetamine labs and seizures have increased.L New York is one 

of 15 Pulse Check cities where sources consider methamphetamine an

emerging or intensifying problem. 

The numbers, however, are low.

! Methylenedioxymethamphetamine

(MDMA or ecstasy) is making its 

initial appearance in the treatment 

population.M Massive pill shipments

continue to be smuggled into the city.L

! The sale of diverted prescription 

drugs on the street is growing.

! Uncontrolled substances, such as

ulcer medications, are illegally sold

in immigrant communities.E

! Patients with human immunodeficiency virus (HIV) are selling their

medications on the street, outside of

hospitals and pharmacies.E

Additionally, the drug market is changing

in a few ways:

! Polydrug sales, usually involving

cocaine plus one other drug—such as

heroin, ecstasy, marijuana, a diverted

prescription drug, or ketamine—have

been increasing over the past 2 years.L

Most widely abused drug:

Crack and powder cocaineL

MarijuanaE

CrackN

HeroinM

No reported changes between spring

and fall 2002L,E,N,M

Second most widely abused drug:

Synthetics (ecstasy, ketamine,

PCP, LSD, GHB, and RohypnolL

)

HeroinE

MarijuanaN

CrackM

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the most serious

consequences:

CrackL,E,N,M

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the second most

serious consequences:

HeroinL,E

MarijuanaN

Pills (benzodiazepines, antidepressants, phenobarbital)M

No reported changes between spring

and fall 2002L,E,N,M

New or emerging problems:

MethamphetamineL

Diverted prescription drugsE

Sources: LLaw enforcement, E

Epidemiologic/ethnographic, 

N

Non-methadone treatment, and MMethadone treatment respondents

Note: These symbols appear throughout this

city profile to indicate type of respondent.

What are the primary drugs of abuse

among clients in a treatment 

program? (Fall 2002)

Heroin

(N=1,030)

Marijuana

Other (unspecified)

Crack cocaine

NEW YORK PRIMARY METROPOLITAN

STATISTICAL 

AREA PROFILE:

Except for a slight increase in heroin as a

primary drug of abuse, treatment percentages in this program remained relatively

stable between spring and fall 2002.

Source: Non-methadone treatment respondent

75%

5%

10% 10%

! Traffickers are becoming more savvy in using the Internet and other communications technology to manage their business and stay one step ahead of the law.L

! One source believes that terrorism and drug trafficking are linked, and all

groups are getting involved (for example, the illegal diversion of pseudoephedrine is linked to terrorist groups).L

All four sources consider the city’s drug problem very serious, and they all

believe crack remains the drug associated with the most serious consequences.

Because of the different perspective each brings, the sources differ in their perception of which drug is most widely abused.

! Total population: . . . 9,314,235

! Median Age: . . . . . . 34.6 years

! Race (alone):

! White: . . . . . . . . . . . . . 48.8%

! Black: . . . . . . . . . . . . . 24.6%

! American Indian/

Alaska Native: . . . . . . . 0.5%

! Asian/Pacific Islander: 9.2%

! Other race: . . . . . . . . . 12.3%

! Two or more races: . . . . 4.6%

! Hispanic (of any race): 25.1%

! Unemployment rate: . . . . 5.1%

! Median household 

income: . . . . . . . . . . . . $41,053

! Families below poverty level

with children <18 years: 23.3%

Source: U.S. Census 2000* 

*The census data in this table are provided as a frame of reference for the information given by

Pulse Check sources. Whenever possible, the data given by the law enforcement and

epidemiologic/ethnographic sources reflect the metropolitan area. 
SNAPSHOT: NEW YORK, NEW YORK

Pulse Check: January 2004 page 189

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Note: SA=South American (Colombian) 

heroin; SWA=Southwest Asian heroin;

SEA=Southeast Asian heroin; and 

ice=highly pure methamphetamine 

in smokable form.

Sources: L

Law enforcement respondent; E

Epidemiologic/ethnographic respondent

Not

difficult

at all

0

1

2

3

Undercover policeL UsersE

Heroin (in general, SA); crack,

powder cocaine; marijuana 

(in general, sinsemilla, local

commercial, hydroponic)

SWA and Mexican brown heroin;

methamphetamine (in general)

SEA and Mexican black tar heroin;

ecstasy

Ice

Mexican black tar and brown heroin

SEA heroin; methamphetamine 

(in general, Mexican 

methamphetamine, and ice) 

SWA heroin

Diverted OxyContin®

Heroin (in general, SA); crack,

powder cocaine; marijuana 

(in general, sinsemilla, local

commercial, hydroponic); 

ecstasy; diverted OxyContin®, 

synthetic drugs

Locally produced methamphetamine

4

5

6

7

8

9

10

The heroin problem appears 

relatively stable between spring and

fall 2002 with a few exceptions:

! South American (SA) heroin

remains the most available form,

but it has become easier to purchase Southeast Asian (SEA) and

Southwest Asian (SWA) heroin.L

! The percentage of primary heroin

users has increased slightly (to

about 10 percent of the clients in

one treatment program).N

! Most patients are self-referred, but

criminal justice referrals to treatment continue to increase.M

HEROIN

COCAINE

Between spring and fall 2002, three

shifts are reported:

! The number of high school- and

college-age users is increasing.E

! Sinsemilla and hydroponic 

marijuana have become even 

easier to purchase than before.L

! Grow operations have become

more sophisticated over the last

few years, with more information

available on the Internet.L

Although the numbers are still low,

between spring and fall 2002 five

minor developments are reported:

! Undercover police find it easier to

purchase methamphetamine.L

! Methamphetamine use continues to

increase in the gay community.E The

drug is increasingly mentioned in

anecdotal emergency department

reports about that population—a

population that is often a bellwether, as in the case of ketamine

and ecstasy.L

Between spring and fall 2002, the

powder and crack cocaine problems

appear stable.

! Crack remains the drug associated

with the most serious consequences

in the city.L,E,N,M

! Two sources consider crack the

city’s most widely abused drug.L,N

MARIJUANA

METHAMPHETAMINE

! Some adolescents are snorting

methamphetamine in one Bronx

neighborhood, where it is known

as “bling bling.”E

! Mexican methamphetamine 

users are increasingly using a

Manhattan needle exchange.E 

! For the first time, a few small

meth labs have been noted in The

Bronx and on Long Island.

However, the drug is still less

available than other drugs. Most

seizures are Mexican ice from

California, found in clubs, in both

pill and powder form.L

Extremely

difficult

and hydroponic marijuana, and methamphetamine (in general) more easily in fall

2002 than in the previous spring.L

! Users can purchase ecstasy more easily.E

! Ease-of-purchase ratings are similar for both groups with regard to crack, powder

cocaine, marijuana, and the more common forms of heroin. Ecstasy, diverted

OxyContin®, methamphetamine, and ice show more variability—possibly because

they are used by more specific populations.

! New York is one of only two Pulse

Check cities (the other is Philadelphia) where sources believe SEA and

SWA can be purchased with no difficulty at all.

! Undercover police can purchase

SEA and SWA heroin, sinsemilla
SNAPSHOT: NEW YORK, NEW YORK

page 190 Pulse Check: January 2004

WHAT’S HAPPENING IN TREATMENT?

! The Pulse Check non-methadone

treatment respondent, whose

1,070-bed facility operates at nearly

full capacity, reports crack cocaine

as the primary drug of abuse among

three-quarters of that program’s

clients (see pie chart on the first

page of this chapter). Treatment 

percentages appear relatively 

stable between spring and fall 2002,

except for a slight increase in heroin

as a primary drug of abuse.N

! The methadone treatment respondent is with a facility that includes

two methadone, one outpatient,

and three residential programs.

With a combined monthly capacity

of 1,300, the facility operates at

nearly full capacity.

! Methadone maintenance treatment

is available throughout the metropolitan area. Public and private

methadone treatment availability

remained stable between early and

late 2002.E

! Treatment providers are addressing

issues they didn’t have to years

ago. More people are presenting

with mental health issues due to

increased trauma in their lives,

such as lifelong sexual abuse (both

men and women).N

! Increases in patients presenting

with post-traumatic stress disorder

(PTSD), mood disorders, and psychosis might be attributed to nondrug-related external events and

changes in the environment—for

example, September 11, changes in

Medicaid, and growing unemployment due to the slowing economy.

These increases might also be partly

due to the traumatizing course of

addiction and its associated

lifestyle, and they may partially be

an artifact of increased staff awareness of mental health issues.M

! Staff trained to treat co-occurring

psychiatric and substance abuse

disorders are becoming scarcer.M

! Both treatment sources believe 

the situation over the past decade

has been complicated by increased

court referrals and by lack of

housing opportunities for recovering clients.

! The non-methadone treatment

source believes that lack of jobs

(but not training opportunities) for

recovering clients has somewhat

exacerbated the situation over the

past decade.

! The methadone treatment source

believes the situation has been

moderately complicated over the

past 10 years by the declining cost

of drugs (particularly high-purity

heroin) and by the advent of 

hepatitis C (with 75 percent of

needle users testing positive).

! Both treatment sources believe

that caseloads have remained 

relatively stable over time. Staffing

levels, however, have declined, 

and individual cases have become

more complex.

WHO USES ILLICIT DRUGS?

The Pulse Check epidemiologic, 

non-methadone treatment, and

methadone treatment sources were

asked to describe the populations most

likely to use heroin, cocaine, marijuana, methamphetamine, and ecstasy.

They were also asked to depict any

emerging user groups and to report on

how the drugs are used. As shown in

the following pages, user characteristics vary by drug. Further, because of

the different perspective each brings,

the three sources sometimes describe

quite different populations and use

patterns for each drug. For example,

all methadone clients are primary opiate users who may use drugs other

than opiates in a secondary or tertiary

manner.

As recently as 5 years ago, ecstasy

was considered an emerging problem.

It now appears endemic, as suggested

by the following reports:

! Ecstasy is making its inital appearance in the treatment population,

according to anecdotal information.M

! While users are predominantly

White, the number of Black 

and Hispanic users is increasing,

particularly addicts who spike

heroin with ecstasy.E

! Ecstasy shavings are included 

in heroin bags as marketing 

innovations (“on the ball” or

“moon stone”).E

! People are starting to change their

perception of ecstasy: they no

longer regard it as harmless.L

! Users are finding it easier to purchase ecstasy, compared with the

previous reporting period.E Undercover police, however, are finding

no change in ease of purchase.L

! “A tidal wave” of million-pill shipments has been coming in from

Belgium, the Netherlands,

Luxemburg, and Germany.L

! Diverted OxyContin® (oxycodone

hydrochloride controlled-release):

The numbers have increased 

slightly but are still small.M

! Synthetic drugs: Together with

ecstasy, these drugs—including ketamine, phencylidine (PCP), lysergic

acid diethylamide (LSD), gamma

hydroxybutyrate (GHB), and flunitrazepam (Rohypnol)—remain the

second most widely abused in the

city. Since the last reporting period,

undercover police have found them

easier to purchase.L

MDMA (ECSTASY)

OTHER DRUGS

THE USE PERSPECTIVE
SNAPSHOT: NEW YORK, NEW YORK

Pulse Check: January 2004 page 191

Who’s most likely to use cocaine?

Crack Powder cocaine 

Characteristic E N M E N M 

Age group (years) >30 18–30 >30 >30 >30 NR 

Mean age (years) 36 27 NR 35 NR NR 

Gender >50% 70% NR >50% >50% 65% 

male male male male male

Race/ethnicity Black Black Hispanic Black Black Hispanic

Hispanic Hispanic

Socioeconomic 

status Low Low Low Low Low Low 

Residence Central Central Central Central Central Central

city city city city city city

Referral source N/A Criminal Individual N/A Criminal Individual

justice justice

Level of educa- N/A Junior Junior N/A Junior Junior

tion completed high high high high

Employment N/A Unem- Unem- N/A Unem- Unemat intake ployed ployed ployed ployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent. 

Who’s most likely to use heroin?

Characteristic E N M

Age group (years) >30 >30 >30 

Mean age (years) 38 32.5 35 

Gender 70–75% male 67% male 65% male 

Race/ethnicity Hispanic White, Hispanic Hispanic 

Socioeconomic status Low Low Low 

Residence Central city Central city Central city 

Referral source N/A Criminal justice Individual 

Level of education completed N/A Junior high Junior high 

Employment at intake N/A Unemployed Unemployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

How do users take heroin?

Characteristic E N M 

Primary route of 

administration Snorting Smoking Injecting

Other drugs taken Powder cocaine Crack (“chasing Other opiates; powder 

(speedball); the dragon”); cocaine (speedball); crack; 

crack alcohol pills (benzodiazepines, antidepressants, phenobarbital) 

Publicly or privately? Privately Privately Privately 

Alone or in In groups/

groups? Alone among friends Alone

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Methadone treatment clients tend to

inject heroin, unlike the other two 

study populations, who tend to snort 

or smoke the drug.

! Use patterns appear stable between

spring and fall 2002 with one exception:

the emerging group of young suburban

heroin users continues to shift from

snorting to injecting drug use.E

! Cocaine users tend to be older males

from low socioeconomic backgrounds

who are unemployed and have little

education.E,N,M

! Cocaine users in the non-methadone 

program tend to be Black, while those

in the methadone program tend to 

be Hispanic.N,M

! User characteristics appear stable

between spring and fall 2002.E,N,M

! The epidemiologic and both treatment

sources agree that heroin users are 

predominantly older (>30 years) centralcity Hispanic males.

! Young (18–30) suburban Hispanics are

emerging as a user group.E

! Methadone treatment clients tend to be

self-referrals, while non-methadone

clients tend to enter treatment via the

criminal justice system.

! User characteristics appear stable

between spring and fall 2002.E,N,M
SNAPSHOT: NEW YORK, NEW YORK

page 192 Pulse Check: January 2004

Who’s most likely to use marijuana?

Characteristic E N M

Age group (years) 18–30 18–30 NR

Gender >50% male 80% male 65% male

Race/ethnicity Black Black, Hispanic Hispanic 

Socioeconomic status Low, middle Low Low 

Residence Central city Central city Central city 

Referral source N/A Criminal justice Individual 

Level of education completed N/A Junior high High school 

Employment at intake N/A Unemployed Unemployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent. 

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

Respondents associate marijuana, used

either alone or with other drugs, with

the following consequences, which

remained stable between spring and

fall 2002:

! Drug-related emergency room visitsE

! Drug-related arrestsE,N,M

! High-risk pregnanciesM

! Short-term memory lossM

! Deteriorating family or social

relationshipsE,N

! Poor academic performanceN,M

! School absenteeism or truancyN

! Dropping out of schoolN

! Poor workplace performanceN,M

! Workplace absenteeismN,M

! Unemployment ratesN,M

! Increased depressionM

Marijuana-using clients: To what extent have changes in the following problems

complicated their treatment over the past 10 years?

Problem change

012 34 5

Extent complicated treatment 

Not at all Extremely

Increased overall difficulty in treating the addiction

Increased severity of addiction among clients

Increased THC potency of marijuana

Earlier initiation of marijuana use

Glamorization by entertainment industry

Increased court referrals involving

marijuana possession

Increased court referrals involving marijuana sales

Other: Increase in co-occurring mental illness

Increased polydrug use

NR=Not reported

! Marijuana users tend to be young adult males, primarily Black or

Hispanic.E,N,M

! Marijuana users in the methadone program tend to have more education than those in the non-methadone program.N,M

! User characteristics appear relatively stable between spring and fall

2002. E,N,M

What they have to say...

! Perception of harm: Neither

treatment source believes that

user perception of harm has

declined over the past decade.

Users’ “never thought it was

harmful,” even 10 years ago.N

“The perception has gone the

other way.”M

! Entertainment industry: Rap

music videos portray teens

smoking blunts while drinking

alcohol.N

!""Non-methadone treatment respondent

#""Methadone treatment respondent

0

0

0

0

NR
SNAPSHOT: NEW YORK, NEW YORK

Pulse Check: January 2004 page 193

Widespread marijuana availability and use over the past 10 years:

To what extent have the following contributed?

Reason

01 2 3 4 5

Extent contributed

Extremely

Increased THC potency

Glamorization by entertainment industry

Promotion of marijuana as “medicine”

Increase in indoor farms

Glamorization by news media

Decline in users’ perception of harm

Decline in social disapproval 

(e.g., peers, parents, etc.)

Less emphasis by law enforcement

and courts

Decline in price

THE MARKET PERSPECTIVE

Not at all

What they have to say...

! Price: As in the vast majority of Pulse Check cities,

sources agree that price has not declined.L,E But

price ranges are more varied, with lower prices

contributing to use by adolescents.E

! Indoor farms: High-quality hydroponic marijuana,

much of it grown indoors, has increased over the

last 3 years. And indoor growing makes interdiction more difficult.L

! Perception of harm: Both sources agree that

users do not perceive marijuana as harmful. The

law enforcement source, however, believes that

users had that same misperception 10 years ago.

The epidemiologic source believes the promotion

of marijuana as “medicine” contributes to the misconception that it’s harmless.E

! Social disapproval: The epidemiologic source

notes a decline in social disapproval, especially

among pre-teens. The law enforcement source

believes social disapproval was lacking even 10

years ago and efforts to change perceptions have

been largely ineffective.

WHO’S MOST LIKELY TO USE

METHAMPHETAMINE?

Users tend to be sellers, generally

from one of these groups:

! The gay community

! Motorcycle gangs

! Lower income groups

! Persons attending discos or raves

WHO’S MOST LIKELY TO USE ECSTASY?

! Users are predominantly White

middle-class young adults (18–30

years). However, the number of

Black and Hispanic users is

increasing, particularly addicts

who spike heroin with ecstasy.E

! Ecstasy is making its initial 

appearance in the treatment population, according to anecdotal

information.M

WHERE ARE DRUGS USED AND SOLD?

Heroin, crack cocaine, powder cocaine, marijuana, and ecstasy are sold 

virtually everywhere, including the following:L,E

Except for crack, all of those drugs are also sold at raves and around drug 

treatment clinics. Additionally, marijuana and ecstasy are available in schools

(elementary, junior high, or high schools). Methamphetamine sales venues 

are limited to private residences, nightclubs and bars, and raves.

The majority of these sales venues also serve as use settings.

! Streets/open-air markets

! Crack houses/shooting galleries

! Private residences

! Public housing developments

! College campuses

! Nightclubs and bars

! Shopping malls

! The Internet

! Playgrounds/parks

! Private parties

! Concerts

! Around supermarkets

! Hotels and motels

! Inside cars

!"Law enforcement respondent #"Epidemiologic/ethnographic respondent

0

0

0

0

0

0
SNAPSHOT: NEW YORK, NEW YORK

page 194 Pulse Check: January 2004

! Heroin, crack cocaine, or powder

cocaine can be purchased in several ways, including the following:L,E

1. The buyer drives down a block

well known for drug sales.

2. One person asks what the buyer

wants.

3. Another person gets the drug

from the supplier.

4. A third person brings the drug to

the buyer.

5. Any step in this series can involve

cell phones, pay phones, runners,

or hand signals.

! Marijuana sales are more socially

based than other drug sales, with

sellers approaching and soliciting

potential buyers in a wide range of

social settings.

! To purchase ecstasy and other

designer drugs—such as GHB,

gamma butyrolactone (GBL), flunitrazepam, steroids, or ketamine—buyers are more likely to

go to a nightclub, a campus, some

other partygoing venue, or the

Internet.

! As shown below, the majority of

these transactions involve cash. A

variety of other commodities,

however, are often exchanged—

particularly in the case of crack.

Beyond cash: What else is accepted in exchange for drugs?

Heroin

Cash

Crack cocaine

Powder cocaine

Marijuana

88%

80%

67%

2%

7%

12%

5%

5%

5%

3%

74%

Shoplifted merchandise

Other stolen merchandise

(e.g., electronic equipment)

Guns

Food stamps

Drug buying services

Lookout services

Other

Sex

Note: The law enforcement

source did not respond to 

this question.

Source: Mean of response 

ratings given by epidemiologic/ 

ethnographic, non-methadone

treatment, and methadone

treatment respondents 

HOW DO DRUGS GET FROM SELLER TO BUYER?

What they have to say...

! Drug transactions have increasingly become “cash only” over the

past 10 years. The larger organizations of the past sometimes

sold drugs on consignment. But

today’s smaller, more independent, street-level dealers can’t

recoup any outlay quickly enough

to do so.E

! Heroin, in particular, is involved in

cash-only transactions—more so

than in the majority of other

Pulse Check cities.

! During the peak of the crack 

epidemic, transactions were more

diversified, with sex and bartered

stolen goods often accepted in lieu

of cash. Now one source estimates

that about 80 percent of crack

sales involve cash.M

! Sex is involved in as much as 

25 percent of crack transactions

among this treatment

population.N

! Shoplifting is involved in up to 

one-fourth of powder cocaine

transactions and 20 percent of

marijuana transactions: the

shoplifted items are often sold,

and the cash proceeds are used

to buy the drugs.N

3%

2%2%3%

Property/Merchandise

Transport the drug

2%

3% 2%

10%

3%

5% 5%

3%

3% 5%
SNAPSHOT: NEW YORK, NEW YORK

Pulse Check: January 2004 page 195

WHO’S SELLING HEROIN?L

At the trafficking level:

! SA heroin: Colombian, Mexican,

and Dominican groups

! SWA: Afghani, Pakistani, Indian,

Russian, and West African groups

! SEA: Chinese (Fukinese Province)

groups

At the street level:

! Sellers vary by neighborhood.

! Some are organized; some are 

independent.

! Many recent immigrants are

manipulated into selling.

WHO’S SELLING COCAINE?L

Crack cocaine:

! Sellers tend to be Black and

Hispanic—more so than 

distributors of other drugs.

! Some are organized; some are 

independent.

Powder cocaine:

! Sellers tend to be Colombian,

Mexican, and Dominican groups.

! Some are organized; some are 

independent.

WHO’S SELLING MARIJUANA?L

! Some are organized; some are 

independent.

! Organized crime is sometimes

involved.

How much does marijuana cost?

Form Unit Price 

“Normal” One bag $10E

1 oz $100–$200L 

1 lb $1,000–$2,000L 

“Hydro” One bag $20E

1 oz $300–$1,200L

1 lb $3,000–$5,000L

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

How much does heroin cost? 

Forma Unit Price 

SA One bag $10–$14L

One bundle (10 bags) $75–$100L

1 g $60–$80L

1 oz $2,000L

1 kgb $60,000–$75,000L

SWA 1 g $25–$45L

1 oz $1,000–$1,500L

1 kg $60,000–$100,000L

SEA 700 g $40,000–$80,000L

Unspecified 0.1 g packetc $10E

1 g bundled $80–$100E

a

SA=South American (Colombian); SWA=Southwest Asian; SEA=Southeast Asian

b

Purity 85–96%; cPurity >60%

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic respondent

How much does cocaine cost?

Form Unit Price 

Crack One vial $10–$20L

One bag $10 and $20E

1 g $25–$45L

Eightball $175L

1 oz $1,000–$1,500L

Powder bag $20–$25L

$25–$50E

1 g $25–$35L

Eightball $120–$150L

1 oz $600–$2,000L

1 kg $22,000–$24,000L

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic respondent

Which drug sellers are associated with which crimes?

Crime Heroin Powder cocaine Crack cocaine Marijuana

Prostitution $$ $

Gang-related activity $$ $ $

Violent criminal acts $$ $

Nonviolent criminal acts $$ $ $

Domestic violence $$ $

Drug-assisted rape $

Source: Law enforcement respondent

All reported

prices are stable

between spring

and fall 2002. 

All reported prices are stable

between spring and fall 2002. 

While marijuana is not generally associated with prostitution or violence,

it is associated with gang-related activity and nonviolent criminal acts.

Between spring and fall

2002:

! Crack dealers may be trying to sell larger quantities at higher prices to

reduce the number of

transactions and thereby

lower the likelihood of

being arrested.E

! All other reported prices

are stable.
SNAPSHOT: NEW YORK, NEW YORK

page 196 Pulse Check: January 2004

WHO’S SELLING ECSTASY?

The law enforcement source reports:

! Ecstasy sellers tend to be younger

than those who sell other drugs.

! “Everyone wants to get involved”

because of the high profit margin:

pills bought in bulk cost $0.50

each; at the next level, they sell for

$5 each; in clubs, they sell for $25

each. Thus, a $50,000 purchase can

make $2 million in profit.

! The primary trafficking groups are

Israeli, followed, in descending

order of magnitude, by Dominican,

Colombian, Chinese, Eastern

European, and Vietnamese groups.

How much does ecstasy cost?

Unit Price

Pill (wholesale) $1.50–$13L

Pill (street) $12–$25E

Pill (retail) $20–$28L

Pill (clubs) $25–$35E

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

How much do various other

drugs cost?

Drug Unit Price

Diverted

OxyContin® NR $15–$30L

Ketamine 10 mL $22–$100L

Ketamine 

hydrochloride 1 g $40–$50L

PCP 1 oz $300–$400L

Sources: LLaw enforcement respondent

How much does 

methamphetamine cost?

Unit Price

1 pill $10–$20L

One bag $20E

1 g $100–$300L

1 oz $1,600–$6,000L

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

Drug marketing innovations and tools over the past 10 years: 

To what degree have they complicated efforts to detect or disrupt illicit drug

activity in New York?

012 3 4 5

Degree of complication

Not at all Extremely complicated

Increased communications via Internet

More organized networks

Throwaway cell phones

Relocation of sales settings within 

the community

Unique packaging

More or changing brand names

Fewer brand names

Less organized seller networks

Polydrug dealers

Expansion of drug sales beyond 

the central city

THE MARKET PERSPECTIVE:

A 10–YEAR VIEW

All reported prices are stable between

spring and fall 2002. 

All reported prices are stable

between spring and fall 2002. 

All reported prices are stable

between spring and fall 2002. 

!""Law enforcement respondent

#""Epidemiologic/ethnographic respondent

What they have to say...

! The Internet is still new for law enforcement: traffickers are still one step ahead. As law enforcers

become better trained in the use of the Internet

for drug sales, the knowledge gap is expected to

close.L

! Lessening of organization within some networks

makes it easier to disrupt them.L

! Unique packaging makes it easier for law enforcement to identify dealers.L

! Relocation of sales settings within the community

can complicate disruption efforts, particularly

when they move indoors.L
SNAPSHOT: NEW YORK, NEW YORK

Pulse Check: January 2004 page 197

Not surprisingly, New York shows

more continuing effects than any

other Pulse Check site, particularly in

the following areas:

! Changing trafficking patterns:

Overall, September 11 did not

have a major impact on drug 

trafficking. However, informants

report that some traffickers are

afraid to fly directly to JFK Airport, so they go to other cities and

use rail, bus, car, and other means

of transportation. Some traffickers

have broken down shipments,

making them smaller, so interdiction doesn’t stop all traffic.L

! Southwest Asian heroin trends:

Even before September 11, prices

were dropping, purity was 

rising, and more groups were 

becoming involved in heroin sales.

September 11 accelerated the

process by disrupting normal 

patterns. Traffickers—Russians,

West Africans, and a possible new

French connection—became desperate to get rid of heroin already

in the pipeline.L

! Price and availability: Price and

availability of many drugs spiked

immediately after September 11

but returned to normal soon thereafter and have remained relatively

stable since then, except for

increased variability in the price of

cocaine bags. This variability might

indicate that people are less afraid

of the newer security measures,

believing that the measures are

aimed at terrorism, not illegal

drugs.E

! Drug use: Chronic drug users are

accustomed to hustling more than

other people, adapting to catastrophes every day. When interviewed, 

however, some users mentioned

using more drugs because of

increased stress. (The epidemiologic source is leading a team that will

conduct a followup survey to

obtain more information on the

degree of stress-related increases in

drug use after September 11).E No

rise in drug use is noted among

clients in the non-methadone 

treatment program.N

! Mental health issues: Clients at

this program, whose offices are

located five blocks from Ground

Zero and which continued operating throughout the day of the

attacks, exhibited exacerbated 

incidence of depression, PTSD,

and substance abuse. These findings are similar to those in a

NIDA-funded survey (see NIDA

Notes, Volume 17, Number 4,

November 2002), which showed

that residents living closest to the

World Trade Center were most

likely to suffer those symptoms.M

Community innovations and tools over the past 10 years: 

How successful have they been?

NR

NR

NR

NR

NR

NR

NR=Not reported

Increased use of task forces

Prescription drug monitoring

Rescheduling of particular 

prescription drugs

Other: Efforts to engage 

the community

Use of crack house (nuisance 

abatement) laws

Drug-free zone laws

Drug user recognition education

(DRE) for law enforcement

Sentencing changes

Drug courts

!"Law enforcement respondent #"Epidemiologic/ethnographic respondent

0 1 23 4 5

Degree of success

Not at all Extremely successful

FOLLOWUP: THE SEPTEMBER 11 ATTACKS AND THEIR AFTERMATH—

ANY CONTINUING EFFECTS ON THE DRUG ABUSE PROBLEM?

What they have to say...

! Task forces: New York has a particularly high

level of task force cooperation compared to the

rest of the country. For example, at least 15

units of police and agents are working together

or with the areas’s High Intensity Drug

Trafficking Area (HIDTA). Also, Mobile

Enforcement Teams (MET) are groups of special

agents who go to communities for a few months

to address a specific problem.L

! Prescription drug monitoring: The Drug

Enforcement Administration (DEA) Diversion Unit 

targets diversion from pharmacies, hospitals,

and doctors. It offers training opportunities,

such as a special school, refresher courses, 

and symposia.L

! Community engagement: Law enforcement

engages the community by educating the public,

providing information, and answering questions

via conferences, press releases, public forums,

college meetings, and the Internet.L
SNAPSHOT: PHILADELPHIA, PENNSYLVANIA

page 198 Pulse Check: January 2004

*The census data in this table are provided as a frame of reference for the information given by Pulse Check sources. Whenever possible, the data given by

the law enforcement and epidemiologic/ethnographic sources reflect the metropolitan area. 

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

All four Pulse Check respondents state that Philadelphia’s drug problem

remained stable with respect to the abuse of heroin, crack cocaine and marijuana. Three of the four sources consider the current drug problem to be very

serious, and the fourth considers it somewhat serious. 

Positive developments are noted with respect to the drug market:

! Operation Safe Streets has successfully shut down hundreds of outdoor

drug markets, making it more difficult to purchase heroin, crack and powder cocaine, and marijuana.E

! Diverted OxyContin® (oxycodone hydrochloride controlled-release) is also

more difficult to purchase on the

street. Law enforcement action has

made a difference, with large diversion cases, such as the arrest and

conviction of a significant dealer 

in the city.L,E

! Drug-related incarcerations have

increased due to law enforcement

efforts.N

Some increases are noted among users:

! Emergency department (ED) mentions involving diverted OxyContin®, heroin,E marijuana,E and

phencyclidine (PCP)L increased.

Mortality involving OxyContin®

increased as well.E

! The number of marijuana users

increased among first-time

methadone clients, who are entering treatment at increasingly

younger ages.M

Opinions vary about which drug is

the most widely abused in Philadelphia

due to the different perspective each

respondent brings. Three of the four

sources agree that heroin abuse is

responsible for the most serious drugrelated consequences, similar to reports

by 42 sources in 22 Pulse Check

cities.L,E,M Finally, several drug problems

are emerging: PCP, methylenedioxymethamphetamine (MDMA or ecstasy),

and diverted OxyContin®.

What are the primary drugs of abuse

among clients in a non-methadone treatment program? (Fall 2002) 

What drugs do clients in a methadone

program use?+ (Fall 2002) 

Heroin

Crack cocaine

Powder cocaine

Marijuana

Abused OxyContin®

Other (unspecified)

+

Includes primary, secondary, and tertiary use 

Source: Methadone treatment respondent

Source: Non-methadone treatment respondent 

Heroin

Alprazolam (Xanax®)

Marijuana

Crack cocaine

Diverted OxyContin®

Ecstasy 

Percent who abuse the drug

0 20 40 60 80 100

25%

25%

7%

5%

35%

3%

(N=314)

PHILADELPHIA PRIMARY METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Total population: . . . 5,100,931 

! Median Age: . . . . . . 36.4 years 

! Race (alone):

! White: . . . . . . . . . . . . . 72.1%

! Black: . . . . . . . . . . . . . 20.1%

! American Indian/

Alaska Native: . . . . . . . 0.2%

! Asian/Pacific Islander: 3.4%

! Other race: . . . . . . . . . . 2.5%

! Two or more races: . . . . 1.6%

! Hispanic (of any race): 5.1% 

! Unemployment rate: . . . . 6.2% 

! Median household 

income: . . . . . . . . . . . . $47,536 

! Families below poverty level 

with children <18 years: 14.4%

Source: U.S. Census 2000* 

Between spring and fall 2002:

! Treatment percentages rose slightly for

heroin, crack cocaine, and diverted

OxyContin® as primary drugs of abuse

in the non-methadone program.N

! The number of clients abusing marijuana increased in the methadone program, possibly because the program

began testing clients for marijuana.M

Most widely abused drug:

MarijuanaL,E

Crack and powder cocaineL

CrackN

HeroinM

No reported changes between spring and

fall 2002L,E,N,M

Second most widely abused drug:

HeroinL,N

CrackL,E

Crack and benzodiazepinesM

No reported changes between spring and

fall 2002L,E,N,M

Drug related to the most serious

consequences:

HeroinL,M,E

CrackN

No reported changes between spring and

fall 2002L,E,N,M

Drug related to the second most

serious consequences:

CrackL,E

HeroinN

Crack and benzodiazepinesM

No reported changes between spring and

fall 2002L,E,N,M

New or emerging problems:

PCPL,E

EcstasyE,M

Diverted OxyContin®E,M

Sources: LLaw enforcement, E

Epidemiologic/ethnographic, 

N

Non-methadone treatment, and MMethadone treatment respondents

Note: These symbols appear throughout this city

profile to indicate type of respondent.

(N=450)
SNAPSHOT: PHILADELPHIA, PENNSYLVANIA

Pulse Check: January 2004 page 199

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Note: SA=South American

(Colombian) heroin; SWA=Southwest

Asian heroin; SEA=Southeast Asian

heroin; Ice=high purity, smokable form

of methamphetamine

Sources: L

Law enforcement respondent; E

Epidemiologic/ethnographic

respondent

Not

difficult

at all

0

1

2

3

4

5

6

Extremely

difficult

Undercover policeL UsersE

Heroin (in general, SA); marijuana

(in general)

Powder cocaine

SEA, SWA, Mexican black tar, and

brown heroin

Hydroponic marijuana

Marijuana (in general)

SEA; locally produced

methamphetamine, ice

Sinsemilla; methamphetamine

(in general)

Mexican methamphetamine

SWA, Mexican black tar, and

brown heroin

Local commercial grade

Powder cocaine; ecstasy

Diverted OxyContin®

PCP

Crack cocaine

Heroin (in general, SA); crack

7

8

9

10

HEROIN

COCAINE

! During this reporting period, it became more difficult to purchase heroin in

the city. This may be attributable to a historical pattern of increased law

enforcement crackdowns during the days leading up to Election Day in

November.E

! South American (SA) remains the most available heroin form, and it remains

difficult for undercover officers to purchase other forms.L

! Southwest and Southeast Asian heroin are not difficult at all for users to buy,

as reported by sources in only one other Pulse Check city (New York). 

! It is slightly more difficult for users to purchase sinsemilla and both forms of

cocaine than during the previous 6 months.E

According to three of the four Pulse

Check respondents, heroin remains

the drug associated with the most

serious consequences.L,E,M

! Between spring and fall 2002, the

number of primary heroin users

increased slightly in the overall and

new treatment population.N

! The number of hospital emergency

department mentions of heroin

increased significantly.E

! The number of female heroin

users increased.E

Overall, the cocaine problem remains

stable at high levels.N

! Among non-methadone treatment

clients, crack cocaine remains the

most common primary drug of

abuse.N

! The percentage of crack users in

both the overall and first-time

treatment populations increased

slightly.N

! Powder cocaine users are increasingly snorting, rather than 

injecting, the drug.E

Marijuana use remains generally stable

between fall and spring 2002, with two

exceptions:

! The number of new users

increased slightly, and these new

users are younger than before.M

! One respondent reports a decrease

in female marijuana users. This is

likely due to a higher percentage

of first offenders in treatment,

who tend to be male.E

MARIJUANA
SNAPSHOT: PHILADELPHIA, PENNSYLVANIA

page 200 Pulse Check: January 2004

WHAT’S HAPPENING IN 

TREATMENT?

! The reporting non-methadone

treatment facility serves 450

clients and is operating at full

capacity. Among these clients, 

the primary drug of abuse is marijuana, followed closely by heroin

and crack cocaine (see pie chart 

on the first page of this chapter).

Treatment percentages for heroin,

crack cocaine, and OxyContin®

as the primary drugs of abuse

increased slightly between spring

and fall 2002.N

! The reporting methadone treatment facility is capable of treating

340 clients. Current enrollment is

314.M Despite the availability of

treatment slots, there is a 3- to 4-

week waiting period due to 

current understaffing.

! The most significant barriers to

treatment are limited slot capacityM

and paperwork.N “In the typical

work week, 25 of 45 hours are

spent on paperwork for managed

care, the State, the joint commission, or the county.”N

! An increase in the incidence of

hepatitis C among clients may be

attributable to increased diagnoses

rather than to an increased number of clients with the virus. A

recent hepatitis C problem within

the city’s fire department led to

increased community awareness

and, therefore, increased testing.N

! More treatment clients are presenting with antisocial disorders,

psychosis, mood disorders, and

aggressive behavior. This may be

due to the increased number of

clients transitioning from incarceration, during which their disorders

or symptoms were exacerbated.N

Another cause may be the lack of

resources available to low-income

individuals for treatment of mental

health problems.N

! Lack of transportation no longer is a

barrier to clients in some programs,

because recovery houses throughout

the city have their own vans. Many

treatment agencies help fund these

services. Programs also provide bus

tokens to clients not coming from

recovery houses.N On the other

hand, the methadone treatment

respondent cites a lack of transportation as an increased problem

among clients who are no longer

eligible for welfare assistance.M

! The number of clients with

HIV/AIDS increased slightly, possibly due to an increase in high-risk

behaviors (unprotected sex and

needle sharing) among younger

clients.M

WHO USES ILLICIT DRUGS? 

The Pulse Check epidemiologic, 

non-methadone treatment, and

methadone treatment sources were

asked to describe the populations

most likely to use heroin, cocaine,

marijuana, methamphetamine, and

ecstasy. They were also asked to

describe any emerging user groups

and to report on how the drugs are

used. As shown in the following

pages, user characteristics vary by

drug. Further, because of the different

perspective each brings, the three

sources sometimes describe quite different populations and use patterns

for each drug. For example, all

methadone clients are primary opiate

users who may use drugs other than

opiates in a secondary or tertiary

manner. 

OTHER DRUGS

THE USE PERSPECTIVE

! Clients abusing OxyContin®

increased among the overall treatment population and those entering treatment for the first time.N

! Since its resurgence in spring

2002, PCP use continues to

increase in the Philadelphia area.

Hospital ED admissions for PCP

use have been increasing, particularly among teens.E

Ecstasy indicators are mixed for the

reporting period.

! The number of treatment clients

reporting ecstasy use increased

slightly.M

! Fewer females are using ecstasy.E

This change leaves a fairly equal

number of male and female users.E,N

! A new name has appeared in the

city for the drug: “boogie.”M

! The practice of “candy flipping”

(taking ecstasy in combination with

PCP) continues.E

MDMA (ECSTASY) 

The methamphetamine problem

remains stable at low levels.

! The number of clients entering

treatment for primary methamphetamine use remains low.N,M

! It remains difficult to purchase

methamphetamine in the open-air

market. Price remains stable.L,E

! Methamphetamine continues to be

produced primarily in “box labs”

run by large, independent operations, generally using the quickcooking (“Nazi”) method and the

P2P method.L

METHAMPHETAMINE
SNAPSHOT: PHILADELPHIA, PENNSYLVANIA

Pulse Check: January 2004 page 201

Who’s most likely to use heroin?

Characteristic E N M

Age group (years) 18–30 18–30 18–30; >30 

Mean age (years) 29 26 48 

Gender 67% male 60% male 55% male

Race/ethnicity White Black White

Socioeconomic status Low Low Low 

Residence Central city Central city Central city 

Referral source N/A Recovery houses Individual 

Level of education completed N/A Junior high Junior high 

Employment at intake N/A Unemployed Unemployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

How do users take heroin?

Characteristic E N M 

Primary route of Injecting Injecting Injecting

administration

Other drugs taken Powder cocaine Crack or Diverted alprazolam 

(speedball); powder cocaine or clonazepam (Klonopin®

crack (speedball) or “Zs”); powder or crack

cocaine (speedball); 

diverted OxyContin®

Publicly or privately? Privately Privately Privately 

Alone or in In groups/ In groups/

groups? among friends among friends Alone

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

Use patterns changed in several ways

between spring and fall 2002:

! Among new users in the methadone

treatment program, approximately 80

percent now snort heroin, as opposed

to the overall treatment population,

who tend to inject.M

! More heroin abusers enrolled in the

methadone treatment programs are

abusing OxyContin® as a substitute for

heroin when it is available.M

! The practice of speedballing 

(combining heroin and powder

cocaine) appears to have decreased

significantly.E

Heroin users in the methadone versus 

non-methadone treatment programs 

differ notably:

! Primary heroin users in the nonmethadone program are more likely to be in their midtwenties and

Black, while methadone treatment

clients are more likely to be in their

forties and White.N,M

! As is the case in most Pulse Check

cities, patients in methadone programs are generally self-referred,

while those in non-methadone programs usually come from recovery 

houses in the city.N,M

! While most methadone treatment

clients are self-referred, an

increasing number are coming

from drug courts.M
SNAPSHOT: PHILADELPHIA, PENNSYLVANIA

page 202 Pulse Check: January 2004

Who’s most likely to use marijuana?

Characteristic E N M

Age group (years) 18–30 18–30 >30

Mean age (years) 29 26 37

Gender 78% male 60% male NR

Race/ethnicity Black Black White and Black

Socioeconomic status Low Low Low 

Residence Central city Central city Central city 

Referral source N/A Recovery houses Individual 

Level of education completed N/A Junior high Junior high 

Employment at intake N/A Unemployed Unemployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment 

respondent; MMethadone treatment respondent. 

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

Respondents associate marijuana,

used either alone or with other

drugs, with the following consequences, which remained stable

between spring and fall 2002:N,M

! Drug-related arrests

! Automobile accidents

! Chronic obstructive pulmonary 

disorder (COPD)

! Short-term memory loss

! Deteriorating family or social 

relationships

! Poor academic performance

! Dropping out of school

! Unemployment ! Marijuana appears to be used more in groups and among

friends, rather than alone as reported in the last Pulse Check.

N

! Marijuana users in treatment reported lower levels of education

than the same user group the last reporting period.N

Who’s most likely to use cocaine?

Crack Powder cocaine 

Characteristic E N M E N

Age group (years) >30 18–30 18–30; >30 18–30 18–30

Mean age (years) 35 26 48 26 NR

Gender 61% male 60% male 55% male Split evenly >60% male

Race/ethnicity Black Black White White Black

Socioeconomic

status Low Low Low Low Low

Residence Central city Central city Central city Central city Central city

Referral source N/A Recovery Individual N/A Recovery

houses houses

Level of education N/A Junior high Junior high N/A Junior high

completed

Employment at N/A Unemployed Unemployed N/A Unemployed

intake

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! The number of female

crack and powder

cocaine users is

increasing.E

! Between spring and fall

2002, the highest education level completed

declined from high school

to junior high for crack

and powder cocaine

users.N

! While methadone

clients are predominantly self-referred,

an increasing number

come from drug courts.M
SNAPSHOT: PHILADELPHIA, PENNSYLVANIA

Pulse Check: January 2004 page 203

Problem change

–2 –1 0 1 2 3 4 5

Extent complicated treatment 

Not at all Extremely

Increased court referrals involving marijuana possession

Increased court referrals involving marijuana sales

NR=Not reported

!""Non-methadone treatment respondent

#""Methadone treatment respondent

0

0

0

0

NR

NR

Reason

Less emphasis by law enforcement and courts

Decline in social disapproval (e.g., peers, parents, etc.)

Decline in users’ perception of harm

Decline in price

Increased THC potency

Increase in indoor farms

More local production

Glamorization by entertainment industry

Promotion of marijuana as “medicine”

Glamorization by news media

Other: Increased tolerance by users from the 1960s

and 1970s toward use by their children

What they have to say...

! Glamorization of marijuana use

by the entertainment industry

has significantly contributed to

use of the drug, particularly

among youth.L,E,N

! The fact that many youth today

are the children of marijuana

users from the 1960s and

1970s contributes to parents

tolerating, even approving of,

marijuana use by their

children.L,N

!"Law enforcement respondent #"Epidemiologic/ethnographic respondent

NR=Not reported

NR

0

0

01 2 3 4 5

What they have to say...

! Rather than hindering treatment efforts, as

reported in a few Pulse Check cities, increased

court referrals involving marijuana sales and

possession have served to help by getting 

people into treatment.M

! The increased THC content of marijuana is

seriously complicating treatment, both

because the drug has increased in strength

(two to three times stronger than in the

1970s)N and because some users mistake

their THC withdrawal as an effect of their

methadone treatment.M

! Both the entertainment industry and the news

media have complicated treatment of marijuana: the former by glamorizing a lifestyle of marijuana use, particularly in music videos geared

toward youth;M and the latter by reporting stories about marijuana legalization in a way that

implies the harmlessness of marijuana use.M

Extent contributed

Not at all Extremely

Increased overall difficulty in treating the addiction

Decline in social disapproval (e.g., peers, parents, etc.)

Glamorization by entertainment industry

Increased THC potency of marijuana

Increased severity of addiction among clients

Decline in users’ perception of harm

Earlier initiation of marijuana use

Increased progression to use of other drugs

Increased polydrug use

Glamorization by news media

Marijuana-using clients: To what extent have changes in the following

areas complicated their treatment over the past 10 years?

Widespread marijuana availability and use over the past 10 years: To what

extent have the following contributed?
SNAPSHOT: PHILADELPHIA, PENNSYLVANIA

page 204 Pulse Check: January 2004

What they have to say...

! Over the past 10 years, the practice of sex-for-crack has declined,

while exchange of property for

crack has increased. Further, more

stolen electronic equipment is

being used as payment for drugs,

particularly compact discs (CDs)

and CD players.E

! Sex, in lieu of cash, still accounts

for an estimated 11 percent of

drug transactions involving crack

cocaine—about the same as the

average percentage estimated by

other Pulse Check sources across

the country. The extent to which

sex is traded for powder cocaine,

however, is somewhat higher than

the Pulse Check average across

sites.L,E,N,M

! As drug trafficking organizations

have become more sophisticated,

the use of lookout services as a

form of payment for drugs has

decreased.L

! The methadone treatment respondent reports that users no longer

obtain drugs in exchange for injecting services, due to the recent

increase in those who snort rather

than inject heroin.M

THE MARKET PERSPECTIVE

HOW DO DRUGS GET FROM SELLERS

TO BUYERS?

! Heroin, crack and powder cocaine,

marijuana, and methamphetamine

are sold primarily through handto-hand transfers in vehicles or

residences. In addition, there is

still some open-air activity.L,E

! Ecstasy is sold at both the wholesale and retail levels:

! Wholesale transactions take

place via vehicle transport,

parcels from mail or shipping

services, or concealed in suitcases on airlines.L

! Retail sales are generally related

to particular venues, such as

concerts or rave parties.L

! OxyContin® is obtained by doctor

shopping and prescription fraud,

and then sold illegally.L,E

! Gamma hydroxybutyrate (GHB) 

is sold through hand-to-hand

transactions, as well as through the

mail. Users also find recipes for

the drug on the Internet and make

their own supply of GHB.L

Beyond cash: What else is accepted in exchange for drugs?

Source: Mean of response ratings given by law enforcement, epidemiologic/ethnographic,

non-methadone treatment, and methadone treatment respondents

Heroin

Cash

Crack cocaine

Methamphetamine

Marijuana

67%

Shoplifted merchandise

Other stolen merchandise

(e.g., electronic equipment)

Property/merchandise

Other: *Includes items accounting for less than 3

percent of transactions for all five drugs, such as

food stamps, other drugs, guns, stealing the drug,

injecting and lookout services, and transporting

the drug; includes drug buying services for all

drugs except marijuana; for methamphetamine, 

it also includes property/merchandise, other

stolen merchandise, and drug buying services.

Sex

73%

84%

68%

10%

Powder cocaine

64%

11%

5%

5%

5%

9%

13%

10%

9%

9%

3%

4%

4%

3%

4%

4% 3%

4%

9%

3%

4%

2%

11%
SNAPSHOT: PHILADELPHIA, PENNSYLVANIA

Pulse Check: January 2004 page 205

How much does heroin cost? 

Form* Unit Price 

SA One bag $10–$20L

One bundle

(10–13 bags) $70–$200L

1 g $67–$300L

1 g (multigram 

purchase $67L

Unspe- One hit (injection) $10E

cified One bag $20E

*

SA=South American (Colombian) 

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

How much does cocaine cost?

Form Unit Price 

Crack One “trey” $3E

One rock or vial $3–$10L

One rock $5E

1 g $18–$26L

Powder One bag $10–$20L

$20E

1 g (multigram

purchase) $30L

1 g $100–$125L

1 oz $800–$1,300L

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

All reported prices are stable

between spring and fall 2002.

Which drug sellers are associated with which crimes?

Crime Heroin Crack Powder Marijuana Metham- Ecstasy Diverted GHB PCP Ketamine

cocaine cocaine phetamine OxyContin®

Gang-related activity $

Violent criminal acts $$ $ $

Nonviolent criminal acts $$ $ $ $

No crimes associated $ $ $ $$

Source: Law enforcement respondent

All reported prices are stable

between spring and fall 2002.

WHERE ARE DRUGS USED AND

SOLD?

! Heroin and cocaine are used and

sold in most of the same settings:

crack houses/shooting galleries,

private residences, public housing

developments, private parties, and

inside cars.L,E Additionally, these

drugs are sold, but not generally

used, in open-air markets and in

hotels/motels.L

! Marijuana is used and sold

throughout the city in a variety of

settings, including open-air markets; crack houses and shooting

galleries; private residences; public

housing developments; elementary,

junior high, and high schools; college campuses; nightclubs and

bars; private parties; hotels and

motels; inside cars; and at concerts, raves, and speakeasies.L,E

! Diverted OxyContin® is sold in the

streets, particularly around drug

treatment clinics.E

! GHB is sold on college campuses,

in nightclubs and bars, at raves,

and over the Internet.E

As a result of Operation Safe Streets,

begun in May 2002, dealing has

increasingly moved indoors and into

cars, with more home deliveries, cell

phone use, and other indoor

dealings.E

WHO’S SELLING HEROIN?

! The predominant street-level heroin

sellers are young adults within

organized Dominican gangs; these

sellers are also likely to use heroin.L

! Dealers communicate with buyers

through two-way radios, text messaging, lookouts, and couriers. They

publicize cell phone numbers, addresses, and car descriptions via

business cards and word of mouth.L,E

! Heroin dealers also typically sell marijuana and crack. Sometimes they sell 

powder cocaine and ecstasy as well.E

WHO’S SELLING COCAINE?

! The typical cocaine dealer is

involved in an organized structure,

particularly Dominican gangs, and

engages in both violent and nonviolent criminal acts.L

! Powder cocaine dealers tend to be

young adults (age 18–30), while

crack cocaine dealers tend to be

older adults (older than 30).L
SNAPSHOT: PHILADELPHIA, PENNSYLVANIA

page 206 Pulse Check: January 2004

Drug marketing innovations and tools over the past 10 years: To what degree have

they complicated efforts to detect or disrupt illicit drug activity in Philadelphia?

012 3 4 5

Degree of complication

Not at all Extremely complicated

Throwaway cell phones

Increased communications via Internet

Relocation of sales settings within the community

Less organized seller networks

Expansion of drug sales beyond the central city

More organized networks

Polydrug dealers

More or changing brand names

Fewer brand names

!""Law enforcement respondent 

#""Epidemiologic/ethnographic respondent 

What they have to say... 

As mentioned by Pulse Check

sources in many cities, when

dealers use unique packaging

and brand names, disruption

efforts become easier. Such

has been the case in

Philadelphia.E

0

0

0

NR

NR

NR=Not reported

THE MARKET PERSPECTIVE: A 10-YEAR VIEW

WHO’S SELLING MARIJUANA?

! The typical marijuana dealer is a

young adult who also uses the

drug, and who deals independently from an organized network. 

! Most marijuana sales occur in various central city locations through

hand-to-hand transfers. Sales are

less visible than before as a result

of Operation Safe Streets. 

! Marijuana dealers in the city also

typically sell heroin, powder

cocaine, and crack.

WHO’S SELLING ECSTASY?

! Ecstasy dealers are typically young

adults who work independently

and also use the drug.L

! Ecstasy sales continue in all areas:

the central city, the suburbs, and

the rural areas.L

! Ecstasy sellers are not typically

involved in any other criminal

activity.L

How much does commercial

grade marijuana cost?

Unit Price 

One bag $5–$10E

One bag $5–$35L

1 oz $150–$200L

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

How much does ecstasy cost?

Unit Price

One pill $25E

One tablet $20–$35L

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

How much do other drugs cost?

Drug Unit Price

Diverted 1 mg $0.50–$1.25L 

OxyContin® $1–$2E

PCP One bag $5L

One fluid oz $250–$350L

GHB One vial or $10–$20L

dosage unit

Ketamine One vial or $10–$20L

dosage unit

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

The price of an ecstasy pill rose

from $20–$25 each to $25.E

All reported prices are stable

between spring and fall 2002.

Diverted OxyContin® has risen

in price from $1 to $1–$2 per

milligram, and is usually sold

as 20- and 40-milligram pills.E

All other reported prices are

stable between spring and fall

2002.
SNAPSHOT: PHILADELPHIA, PENNSYLVANIA

Pulse Check: January 2004 page 207

The residents of Philadelphia were

strongly affected by the terrorist

attacks of September 11 due to the

city’s proximity to New York City, as

well as to the site of the downed

plane in Pennsylvania. The nonmethadone respondent believes that

an increase in abuse of heroin, crack

cocaine, and diverted OxyContin®

among clients is attributable to the

aftermath of September 11.N

Community innovations and tools over the past 10 years: How successful

have they been?

NR

NR

NR

NR

NR NR= Not reported

Increased use of task forces

Rescheduling of particular prescription drugs

Sentencing changes

Drug-free zone laws

Drug courts

Use of crack house (nuisance abatement) laws

!""Law enforcement respondent 

#""Epidemiologic/ethnographic respondent

0123 4 5

Degree of success

Not at all Extremely successful

SEPTEMBER 11 FOLLOWUP 

What they have to say... 

! Operation Safe Streets identified

200–300 “hot” sales corners.

With the stationing of uniformed

law enforcement officers at

these corners, the markets relocated. Residents were given a

telephone number to call and

report locations of new markets.E

! This drug market relocation has

had an impact on users: they

are more reluctant to go to

indoor locations, knock on

strangers’ doors, or receive

home deliveries because of

fears about crime or being

robbed.E

! Like many other Pulse Check

cities that have effectively used

task forces, Philadelphia’s Drug

Enforcement Administration

(DEA) task force has made a 

significant impact on curbing the

drug problem as a result of

increased expertise among these

professionals.L

! In the past decade, the city began its Forensic Intensive Recovery (FIR) program, 

an effort to reduce prison overcrowding by giving some lower level criminals a conditional release to treatment. FIR has brought more people into treatment over the 

past 10 years.E

! In addition to the success of Operation Safe Streets, Operation Sunrise targeted a

high-sales area of the city, using both social services and law enforcement personnel.

Many people entered treatment as a result.E

! The rescheduling of prescription drugs, specifically glutethimide (used in combination

with liquid cough medicine or Tylenol 4) in the early 1990s, was highly successful in

curbing illicit use of the drug.E
SNAPSHOT: PHOENIX, ARIZONA

page 208 Pulse Check: January 2004

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

Three of the city’s Pulse Check sources consider the drug problem very

serious.L,E,N TwoL,M consider it stable, and two consider it somewhat worse since

spring 2002.E,N

Sources report several positive changes in drug use and activity:

! Recent increased use of task forces, precursor laws, and crack house (nuisance

abatement) laws has been relatively successful in combating drug activity.L

! HIV/AIDS among methadone treatment clients has decreased due to community services and prevention education.M

! Crack and powder cocaine indicators show declines: cocaine use in general

declined;E powder cocaine use declined among methadone treatment admissions;M and periodically during the last 6 months, crack was not available for

purchase.E

Sources report other changes related to specific drugs of abuse:

! Heroin has become more adulterated, and therefore more toxic.E

! Marijuana use increased in general, and particularly among

preadolescents.E

! Abuse of some prescription opiates increased: primary OxyContin® admissions to the methadone program increased,M diverted methadone became less

difficult to purchase (as reported in several other Pulse Check cities), and

methadone-related deaths increased.E

What are the primary drugs of abuse

among clients in a non-methadone

treatment program? (Fall 2002)

Heroin

Methamphetamine

Abused OxyContin®

Crack cocaine

Powder cocaine

Benzodiazepines

Among non-methadone treatment

admissions, the proportion of primary

methamphetamine users increased

slightly between spring and fall

2002. Proportions for the primary

use of other drugs remained relatively stable.N

! Powder cocaine use among

methadone treatment admissions

decreased slightly between spring

and fall 2002.N

! Primary OxyContin® (oxycodone

hydrochloride controlled-release)

abusers accounted for 1 percent of

methadone treatment admissions—

a slight increase from the spring.M

Source: Non-methadone treatment respondent

55%

10%

10%

15%

5% 5%

PHOENIX METROPOLITAN! Total population:. . . 3,251,876

! Median age: . . . . . . 33.2 years 

! Race (alone):

! White . . . . . . . . . . . . . . 77.0%

! Black . . . . . . . . . . . . . . . 3.7%

! American Indian/

Alaska Native . . . . . . . . 2.2%

! Asian/Pacific Islander 2.2%

! Other race . . . . . . . . . . 12.1% 

! Two or more races . . . . 2.9% 

! Hispanic (of any race): 25.1% 

! Unemployment rate: . . . . 3.1% 

! Median household 

income: . . . . . . . . . . . $44,752

! Families below poverty level 

with children <18 years: 12.7% 

Source: U.S. Census 2000* 

*The census data in this table are provided as a frame of reference for the information given by Pulse Check sources. Whenever possible, the data given by

the law enforcement and epidemiologic/ethnographic sources reflect the metropolitan area. 

What drugs do clients in a methadone

program use+? (Fall 2002)

(N=425)

(N=7,000) Heroin Powder Crack 

cocaine

+

Includes any use, whether as a primary, 

secondary, or tertiary drug; response for

methamphetamine was “very low”; response

for methylenedioxymethamphetamine (MDMA

or ecstasy) was zero; marijuana use is not

tracked, but reported as “fairly high.” 

Source: Methadone treatment respondent

100

80

60

40

20

0

99

5

15

STATISTICAL 

AREA PROFILE:

Percentage Methamphetamine use and activity

in particular have changed:

! Use and sales are common in

Phoenix and have increased.L,E

! Non-methadone treatment admissions increased.N

! Mexican nationals who distribute

methamphetamine from large

operations based in Mexico and

California have replaced independent dealers who sell methamphetamine manufactured in small, local

“mom and pop” labs.L

! Most methamphetamine available

in Phoenix is produced by the red

phosphorus method; however,

labs using the “Nazi” or quickcooking method increased.L

! Methamphetamine prices at all

levels declined.E
SNAPSHOT: PHOENIX, ARIZONA

Pulse Check: January 2004 page 209

Mexican black tar heroin remains

extremely easy to buy, and use

remains stable.L,E Heroin has become

more adulterated and more toxic in

the past 6 months.E

In general, cocaine use (crack and

powder) decreased slightly between

spring and fall 2002, and crack is

sometimes completely unavailable for

short periods of time.E Among

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

Note: SA=South American (Colombian) heroin;

SEA=Southeast Asian heroin; SWA=Southwest

Asian heroin; ice=highly pure methamphetamine in smokable form; and BC bud=British

Columbian marijuana.

Not

difficult

at all

Undercover policeL UsersE

Heroin (in general and

Mexican black tar); crack, 

powder cocaine; marijuana (in

general and local commercial

grade); methamphetamine 

(in general, locally 

produced, and Mexican)

Sinsemilla and 

hydroponic marijuana

4

3

2

1

0

5

6

7

8

9

Ecstasy; diverted OxyContin®

Most widely abused drug:

MethamphetamineE,N

MarijuanaL

HeroinM

No reported changes between spring

and fall 2002L,E,N,M

Second most widely abused drug:

CrackL,N,M

MarijuanaE

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the most serious

consequences:

MethamphetamineL,E,N

HeroinM

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the second most

serious consequences:

CrackL,E,N

BenzodiazepinesM

No reported changes between spring

and fall 2002L,E,N,M

New or emerging problems:

Ecstasy activity increasedL

PCPN

Diverted OxyContin®M

Sources: LLaw enforcement, EEpidemiologic/ 

ethnographic, N

Non-methadone treatment,

and MMethadone treatment respondents 

Note: These symbols appear throughout this

city profile to indicate type of respondent.

! As in more than half (15) of

Pulse Check cities, marijuana

remains extremely easy to buy.E

! Mexican black tar heroin and

methamphetamine are

extremely easy for users and

undercover officers to buy.L,E

! Crack is sometimes unavailable

for short periods of time.E

! Users have found PCP and

diverted methadone less difficult to buy since spring 2002.E

! Users and undercover police

found other drug availability

stable between spring and fall

2002.L,E

Extremely

difficult

10

Mexican brown heroin; ice

Heroin (in general and Mexican

black tar); marijuana (in 

general, commercial grade, 

sinsemilla, and hydroponic);

methamphetamine (in general,

locally produced, and Mexican)

SA; ecstasy 

PCP; diverted methadone

SEA, SA, SWA; BC bud 

Although the most widely abused

drug reported varies by source,

three sources report methamphetamine as the drug related to the

most serious consequences. New or

emerging drugs include ecstasy (as

reported in 15 other Pulse Check

cities), phencyclidine (PCP) (as

reported in 6 other cities), and

diverted OxyContin® (as reported

in 14 other cities). 

HEROIN

COCAINE

methadone treatment clients, powder

cocaine use declined.M

Marijuana remains widely available,L,E

and use increased between spring and

fall 2002.E One source reports that

marijuana use among preadolescents

is now a common phenomenon.E

MARIJUANA

THE BIG PICTURE (continued)
SNAPSHOT: PHOENIX, ARIZONA

page 210 Pulse Check: January 2004

Most sources cite methamphetamine

use and activity as relatively high,

and its use in general has increased in

the last 6 months.E Non-methadone

treatment admissions increased

slightly between spring and fall

2002.N

Ecstasy activity and use appear to be

increasing, and the drug continues to

emerge in Phoenix.L

! Diverted OxyContin®: Abuse of

OxyContin®, which is considered

an emerging drug of abuse, has

increased among methadone treatment admissions.M The drug continues to be diverted through

fraudulent prescriptions and pharmacy thefts.L,E

! Diverted methadone: Methadone,

often diverted, has become less

difficult to buy between spring

and fall 2002, and related deaths

increased.E

! PCP: Considered an emerging

drug of abuse, PCP (“sherm,”

“slum,” “cool or kool,” and

“dust”)N is less difficult to buy

since spring 2002.E Its use has

increased somewhat, especially

among young adult Black males,

who smoke the drug in combination with cigarettes or marijuana.E

! Abused steroids: One source

reports increased abuse of anabolic steroids, especially among

young adult White males who use

it for bodybuilding purposes.E

METHAMPHETAMINE

THE USE PERSPECTIVE

MDMA (ECSTASY)

OTHER DRUGS

WHAT’S HAPPENING IN TREATMENT?

Treatment capacity and availability

! The Pulse Check non-methadone

respondent is with a facility that treated more than 7,000 patients in 2002

in its outpatient detoxification, outpatient, and outreach programs. Heroin

remains the most common primary

drug of abuse (see pie chart on the

first page of this chapter), and treatment percentages were stable with the

exception of an increase in the methamphetamine treatment proportion.N

! The methadone treatment respondent is with a facility that operates

at about 70 percent capacity (425

of 600 slots).M About 20 percent of

its heroin clients also use some

form of cocaine (see bar graph on

the first page of this chapter). The

facility targets the Hispanic population in Phoenix and focuses on

comprehensive services.

Consequences of drug use and 

co-occurring disorders

! The methadone treatment source

states that HIV/AIDS among drug

treatment clients decreased due to

increased community services and

prevention education in Phoenix. 

! The most serious drug abuse-related

health consequence is hepatitis C,

which is increasing according to

treatment sources.N,M The methadone

treatment source explains that the

program “treats clients under the

assumption that they are positive

for hepatitis C.” The non-methadone treatment source also views

drug-related automobile accidents,

high-risk pregnancies (due to an

increase in sex for drugs on the

streets), drug overdoses (due to the

increase of drug potency and polydrug use), and abscesses as particularly common and increasing.

Needle sharing and contaminated

needles continue as common causes

of drug-related illnesses.N

! The most common co-occurring 

disorders among drug treatment

clients remain antisocial and conduct

disorders, psychoses, mood disorders, and suicidal thoughts or

attempts. The non-methadone treatment source explains that gaps in

coordination of treatment services

(e.g., detoxification, addiction counseling, and social services) make it

difficult to treat clients with dual

diagnoses. 

Barriers to treatment

! The non-methadone treatment

source reports several barriers to

treatment that increased between

spring and fall 2002: limited slot

capacity, lack of trained staff to

treat comorbidity, violent behavior

among presenting clients, and lack

of transportation or money for

transportation. 

! The methadone treatment source

cites lack of bilingual staff 

(Spanish and English speaking),

especially those who treat cooccurring disorders, as a common

barrier to treatment. 

WHO USES ILLICIT DRUGS?

The Pulse Check epidemiologic, 

non-methadone treatment, and

methadone treatment sources were

asked to describe the populations

most likely to use heroin, cocaine,

marijuana, methamphetamine, and

ecstasy. They were also asked to

describe any emerging user groups

and to report on how the drugs are

used. As shown on the following

pages, user characteristics vary by

drug. Further, because of the different

perspective each brings, the three

sources sometimes describe quite different populations and use patterns

for each drug. For example, all

methadone clients are primary opiate

users who may use drugs other than

opiates in a secondary or tertiary

manner. 
SNAPSHOT: PHOENIX, ARIZONA

Pulse Check: January 2004 page 211

How do users take heroin?

Characteristic E N M

Primary route of Injecting Injecting Injecting

administration 

Other drugs taken Powder cocaine Powder cocaine Powder cocaine

(speedball) (speedball) (speedball)

methamphetamine benzodiazepines

(in combination) (sequentially) 

Publicly or privately? NR Privately Privately 

Alone or in groups? Both Alone In groups 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent. 

Who’s most likely to use heroin?

Characteristic E N M

Age group (years) >30 >30 >30 

Mean age (years) Midforties 34 35 

Gender 66% male 55% male 55% male 

Race/ethnicity 50% White Hispanic (any race) 45% White

40% Hispanic (any race) 45% Hispanic (any race)

10% Native American 10% Black

Socioeconomic status NR Middle Low 

Residence Central city Central city Central city 

Referral source N/A Individual Individual 

Level of education N/A Junior high school High school 

completed 

Employment at intake N/A Unemployed and Unemployed 

part time (“odd jobs”)

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Most heroin users are males older than 30 who live in the central city.E,N,M

! Heroin (now often referred to as “lady”) use among females has increased over the last 5 years.M

! The Medicaid program was expanded recently, and more methadone admissions are insured by

Medicaid than in spring 2002. The Medicaid-insured population is of a lower socioeconomic status,

less likely to be employed, and has more other illnesses than non-Medicaid clients.M

! Users new to non-methadone treatment are more likely than the general heroin-using population to

be White (versus Hispanic), from the suburbs (versus the central city), and using only heroin (versus

speedball use).N

! Heroin users in Phoenix tend to

inject Mexican black tar heroin.E,N,M

! Speedball use (powder cocaine

injected with heroin) remains 

common.E,N,M

! Among methadone treatment

clients, smoking has increased as a

route of heroin administration since

spring 2002.M

! Sources report no other changes in

heroin use patterns since spring

2002.
SNAPSHOT: PHOENIX, ARIZONA

page 212 Pulse Check: January 2004

Who’s most likely to use cocaine?

Characteristic Crack Powder cocaine

E N M E N M

Age group (years) >30 >30 18–30 >30 >30 >30 

Mean age (years) NR 34 NR NR 34 NR 

Gender Female Split evenly Split evenly Male Split evenly 55% male 

Race/ethnicity Black Hispanic Black 65% White White White and 

(any race) 15% Hispanic Hispanic (any race)

Socioeconomic status Low Low Low NR Middle Low 

Residence Central city Central city Central city Central city Suburbs Central city 

Referral source N/A Individual Individual N/A Individual Individual 

Level of education N/A Junior high None N/A Junior high High school 

completed school school

Employment at intake N/A Unemployed Part time N/A Unemployed Unemployed 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! The epidemiologic respondent reports a decrease in crack and powder cocaine use since spring

2002.E

! Similar to heroin users, crack and powder cocaine users are most likely to be adults older than 30 of

low socioeconomic status who live in the central city. 

! Crack cocaine users are more likely than powder cocaine users to be Black or Hispanic and female.

! Powder cocaine users new to non-methadone treatment are much younger than the general powder

cocaine-using population (mean age of 26 versus 34 years), and they are more likely to be from the

suburbs.N

! Between spring and fall 2002, powder cocaine use declined among methadone treatment clients.

The methadone treatment source explains that most “heroin addicts didn’t realize that cocaine was

often present in heroin....Suppliers no longer cut heroin with cocaine because it’s too expensive”;

thus, the amount of powder cocaine a methadone treatment client ingests declined.M 
SNAPSHOT: PHOENIX, ARIZONA

Pulse Check: January 2004 page 213

How do users take cocaine?

Characteristic Crack Powder cocaine

E N M E N M

Primary route of administration Smoking Smoking Smoking Snorting Injecting Injecting 

Other drugs taken Varies Heroin Marijuana Heroin Heroin Heroin

(as a substitute) (in combination) (speedball) (speedball) (speedball) 

methamphetamine

(in combination)

Publicly or privately? NR Publicly Publicly Privately Privately NR 

Alone or in groups? NR In groups Alone NR Alone NR 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Sources agree that if crack is unavailable in Phoenix, other drugs are used as substitutes: “Crack users often use

any other drug available as a substitute”;E heroin is often taken as a substitute for crack.N

! Marijuana is often taken sequentially with crack: heroin- and crack-using methadone treatment admissions often

smoke marijuana while on methadone maintenance (when they no longer use heroin).M

! According to the epidemiologic source, powder cocaine is most often snorted, but it is also commonly injected with

heroin (speedball), and used in combination with methamphetamine.E According to both treatment sources, injecting is the most common route of administration for powder cocaine, most often with heroin in a speedball.N,M

! Respondents report no changes in cocaine use patterns between spring and fall 2002.

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

The epidemiologic respondent associates marijuana, used either alone or

with other drugs, with the following

consequences, which remained stable

between spring and fall 2002:

! Drug-related arrests

! Automobile accidents

! Illnesses, especially flu and asthma 

! High-risk pregnancies

! Short-term memory loss

! Deteriorating family and social

relationships

! Poor academic performance

! School absenteeism, truancy, or

dropping out of school

! Unemployment rates

Who’s most likely to use marijuana?

Characteristic E

Age group (years) 13–30 

Gender 65% male 

Race/ethnicity 55% White

27% Hispanic

12% Black 

Socioeconomic status Low and 

middle 

Residence All 

Source: EEpidemiologic/ethnographic respondent

! In general, marijuana use increased

since spring 2002.E

! The methadone treatment source

reports fairly high use among its

clients, but this program does not

track marijuana user demographics.M

! Preadolescents now use marijuana.E

! Among new marijuana users,

females, Whites, and those of middle

socioeconomic status increased

between spring and fall 2002. E

! Most marijuana users in Phoenix

smoke the drug in joints; it is also a

secondary substance and a substitute for many other drugs.E
SNAPSHOT: PHOENIX, ARIZONA

page 214 Pulse Check: January 2004

Characteristic E N

Age group (years) >30 18–30 

Mean age (years) 31–35 26 

Gender Split evenly Split evenly 

Race/ethnicity White White 

Socioeconomic status Low Middle 

Residence All Suburbs 

Referral source N/A Individual 

Level of education completed N/A Junior high school

Employment at intake N/A Unemployed 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment

respondent

01 2 3 4 5

Extent contributed NR=Not reported Not at all Extremely

0

0

NR

NR

NR

NR

NR

Decline in social disapproval (e.g., peers, parents, etc.)

Less emphasis by law enforcement and courts

Decline in users’ perception of harm

Glamorization by entertainment industry

Decline in price

Promotion of marijuana as “medicine”

Glamorization by news media

Increase in indoor farms 

Increased THC potency

Widespread marijuana availability and use over the past 10 years: To what extent have the following contributed?

What they have to say...

As in nearly all Pulse Check cities, respondents

agree that decline in social disapproval of marijuana has greatly contributed to widespread

use of the drug.L,E

!"Law enforcement respondent

#"Epidemiologic/ethnographic respondent 

! In general, between spring and fall 2002, use of

methamphetamine (known as “crank” and “go fast” 

in Phoenix) increased, as did non-methadone treatment admissions.E,N

! Methamphetamine users tend to be White and split

evenly between genders.E,N

! Methamphetamine and powder cocaine users seem

to live in opposite ends of the city: most methamphetamine use occurs in the East Valley, and most powder

cocaine use occurs in South Phoenix.E

! Injecting is the primary route of administration 

among methamphetamine users in Phoenix, followed

by smoking.E,N,M

! Heroin or cocaine is often used in combination with

methamphetamine.E

! User and use characteristics remained stable between

fall and spring 2002. 

Who’s most likely to use methamphetamine, and how do

they use the drug?

Reason
SNAPSHOT: PHOENIX, ARIZONA

Pulse Check: January 2004 page 215

Who’s most likely to use ecstasy? 

Most ecstasy users are White young

adults (18–30 years) of middle

socioeconomic status who live in the

central city or suburbs.E Ecstasy is

most often taken in private settings,

in groups, and among friends. The

drug is often used in combination

with marijuana.E Respondents report

no changes in use or user characteristics since spring 2002.

Other Drugs

! Abused OxyContin®: OxyContin®

treatment admissions increased

between spring and fall 2002.M

Most non-methadone primary

OxyContin® admissions are suburban White adults of middle socioeconomic status who are equally

likely to be male or female.N The

drug is taken orally, often in combination with marijuana. Another

form of oxycodone (Percodan®) is

often abused as a substitute for

OxyContin®.

M

! Abused benzodiazepines:

Alprazolam (Xanax®), diazepam,

and clonazepam (Klonopin®) are

commonly abused benzodiazepines. Treatment client demographics are similar to those of

OxyContin® clients.N

WHERE ARE DRUGS USED AND SOLD?

The majority of drug sales in

Phoenix occur in central city areas,

with heroin and powder cocaine sales

concentrated in the central city, and

crack, marijuana, methamphetamine,

and ecstasy sales spread equally

across all areas of the city. 

Heroin, crack and powder cocaine,

and marijuana are sold in a variety of

public and private settings: 

! Crack houses/shooting galleriesL,E

! Private residencesL,E

! Inside carsL,E

! Streets and open-air marketsL,E

! Public housing developments

(excluding heroin)L,E

! Hotels/motels (excluding heroin)L,E

! Around drug or alcohol treatment

clinics (excluding powder cocaine)E

Additionally, powder cocaine is sold

on college campuses and in nightclubs and bars.L,E Marijuana is also

sold at raves and concerts.L

Methamphetamine is sold in the 

following settings:

! Private residencesL,E

! Hotels/motelsL,E

! Inside carsL,E

! Around schoolsL

! College campusesL

! Private partiesL

! Streets and open-air marketsE

! Public housing developmentsE

Ecstasy is sold in the following settings:

! College campusesL,E

! Private partiesL,E

! RavesL,E

! ConcertsL,E

! Private residencesL

! Around schoolsL

! Nightclubs and barsE

! Private partiesE

HOW DO DRUGS GET FROM 

SELLERS TO BUYERS?

What follows is a typical drug-buying

scenario for most drugs, including

heroin, crack and powder cocaine,

methamphetamine (sold by organized

dealers), and marijuana:L

! A buyer is introduced to a dealer

via a mutual acquaintance.

! The dealer gives the buyer his or

her pager number.

! The buyer contacts the dealer via

pager to request drugs and set up

a meeting for the exchange of the

drug.

! The buyer and dealer meet (often

in the buyer’s private residence

or car) to exchange the drug

hand to hand. 

Additionally, to obtain crack, buyers

may simply enter crack houses to

purchase the drug. 

WHO SELLS ILLEGAL DRUGS?

Most drug dealers in Phoenix are

polydrug distributors who sell heroin, powder and crack cocaine, and

methamphetamine (produced by

large Californian or Mexican meth

labs). These organized sellers are

young adults associated with

Mexican trafficking organizations. 

Drugs sold mostly by independent

dealers include marijuana, methamphetamine (produced by independent, local meth labs), ecstasy, and

diverted OxyContin®. These dealers

tend to sell only one type of drug,

with the exception of ecstasy dealers,

who often sell ketamine or gamma

hydroxybutyrate (GHB). 

THE MARKET PERSPECTIVE
SNAPSHOT: PHOENIX, ARIZONA

page 216 Pulse Check: January 2004

! Respondents report that cash is the most common means of exchange for illegal drugs—but less so

compared with other Pulse Check cities. One source notes that over the past 10 years cash exchanges

for drugs declined.N

! Methamphetamine, in particular is much less likely to be obtained via cash than in other cities.

Common items exchanged for the drug include stolen merchandise (such as electronic equipment

and cars), sex (especially between female buyers and male dealers), guns, stolen identities and fraudulent documents, and chemicals for manufacturing methamphetamine. The exchange of stolen identities, fraudulent documents, and methamphetamine precursors for methamphetamine increased over

the past 10 years.N

! Ten years ago, buyers who exchanged sex for heroin were predominantly female; now they are just as

likely to be male.M

! The non-methadone treatment source reports that among outpatient detoxification clients, the practice of sending fellow users out to buy drugs in exchange for a “cut” of those drugs is much more

common than among general outpatient clients. This practice has increased over the past 10 years. 

Beyond cash: What else is accepted in exchange for drugs?

Heroin

Cash

Crack cocaine

Marijuana Methamphetamine

62% Shoplifted merchandise

Other stolen merchandise

(e.g., electronic equipment)

Property/Merchandise

Guns

Transporting the drug 

Other: Includes items accounting

for 4 percent or less of transactions

for each of the five drugs, such as

other drugs, stealing the drug, food

stamps, injecting services, lookout

services, and (for methamphetamine) manufacturing the drug.

Sex

65%

30%

40%

13%

12%

13%

13%

8%

8%

15% 8%

15%

8%

8%

10%

15% 13%

7%

8%

13%

13%

5%

5%

5%

5%

Powder cocaine

43%

12%

Source: Mean of response ratings given by law enforcement, non-methadone treatment, and methadone treatment respondents; the methadone treatment

respondent provided percentages for heroin exchanges only. 

13%

3% 3%

2%

3%

3%

3%

3% 3%

3%

3%
SNAPSHOT: PHOENIX, ARIZONA

Pulse Check: January 2004 page 217

Which drug sellers are associated with which crimes?

Crime Heroin Powder Crack Marijuana Metham- Ecstasy

cocaine cocaine phetamine

Violent criminal acts: $$ $ $

home invasions and 

homicides

Violent criminal acts: $ $$

aggravated assaults 

Nonviolent criminal acts: $ $

property crimes

Domestic violence $

Sources: Law enforcement respondent

Illegal drug sales are associated with

many violent and nonviolent crimes.L

The law enforcement source describes

methamphetamine sales, in particular,

as linked to high levels of violent

crimes (such as aggravated assaults,

homicides, robberies, and domestic

violence). 

COMMUNITY INNOVATIONS AND

TOOLS OVER THE PAST 10 YEARS:

HOW SUCCESSFUL HAVE THEY

BEEN?

The law enforcement source reports

that increased use of task forces, precursor laws, and crack house (nuisance abatement) laws have been relatively successful in combating drug

activity in Phoenix. 

Patrol precincts have uniform neighborhood enforcement teams specifically designed to take care of all

problems within one neighborhood.

These teams work with narcotics

detectives to solve problems in that

neighborhood. This program has

been ongoing for 5 years, but “has

really taken off in the past 2 years.”L

SEPTEMBER 11 FOLLOWUP

Three of four Phoenix Pulse Check

sources believe that the September 11

attacks and their aftermath have had

no effects on the drug abuse

problem.L,N,M The epidemiologic source

states that anxiety and depression

among the general population and

the drug-using population may be

more common and more severe, causing increased comorbidity among

drug treatment clients. 

How much do illegal drugs cost?

Drug Unit Price 

Mexican black tar heroin 100–200 mg (“a twenty”) $20

1 g $100–$120

Crack 200–300 mg $20 

Powder cocaine 0.25 g $20 

1.77 g (“teener”) $40–$60 

3.5 g $80–$100 

Commercial grade marijuana 6–7 g (dime bag) $20 

1 oz $60–$80 

Methamphetamine 1.77 g (teener) $80–$110 

0.125 oz (eightball) $120–$180 

Ecstasy One pill $20–$30 

Diverted OxyContin® 40-mg pill $20–$25 

Source: Law enforcement respondent

! Between spring and fall 2002, drug

prices remained relatively stable 

with one exception: all methamphetamine prices declined.L The law

enforcement source further states that

heroin prices declined drastically over

the past 5 years.

! Sources did not give drug purity levels,

but the epidemiologic source reports

that heroin has become more adulterated (and more toxic) since spring

2002, and that ecstasy sold at raves

is sometimes laced with heroin or

methamphetamine. 
SNAPSHOT: PITTSBURGH, PENNSYLVANIA

page 218 Pulse Check: January 2004

*The census data in this table are provided as a frame of reference for the information given by Pulse Check sources. Whenever

possible, the data given by the law enforcement and epidemiologic/ethnographic sources reflect the metropolitan area. 

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

Three of the city’s Pulse Check sources consider the drug problem very 

serious,E,N,M and three consider it to be somewhat worse.L,E,N Opiate use and

activity, in particular, have changed:

! All sources report that heroin use and activity have increased. Both treatment sources report an increase in heroin-using clients.N,M

! Heroin-related deaths have risen drastically since spring 2002.E

! Heroin use among adolescents, young adults, and females has increased

dramatically.E Heroin snorting has increased, especially among these 

populations.L,E

! Heroin purity has increasedL as Colombian white powder heroin availability

has grown.E Heroin brand names are

becoming more common as seller

groups become more organized.L

! The abuse of OxyContin® (oxycodone hydrochloride controlledrelease) has increased significantly.E

! Diverted methadone is considered

easy to buy, and its use has

increased.E

! Many OxyContin® abusers are

switching to abusing methadone

because diverted OxyContin® is 

more difficult to obtain.N

Methamphetamine use appears low and

stable, but lab activity and sales have

increased. Most methamphetamine is

sold north of Pittsburgh, but sales are

beginning to move south, and several

labs have been seized within the city.L,E

Cocaine and marijuana use and activity

remain at high but stable levels.

All four sources report heroin as the most

widely abused drug and the drug related

to the most serious consequences.

Most widely abused drug:

HeroinL,E,N,M

Changes between spring and fall 2002:

Heroin replaced diverted OxyContin®.

N

Second most widely abused drug:

CrackL,E

Prescription opiatesN

Powder cocaineM

Changes between spring and fall 2002:

Prescription opiates replaced crack.N

Drug related to the most serious

consequences:

HeroinL,E,N,M

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the second most

serious consequences:

CrackL,E,N

Powder cocaineM

No reported changes between spring

and fall 2002L,E,N,M

New or emerging problems:

Methamphetamine activities have

increased, and heroin purity has 

increased.L

Diverted Oxycontin® and methadone

and powder (snortable) heroinE

Methylenedioxymethamphetamine

(MDMA or ecstasy) and other club

drugs N

Sources: LLaw enforcement, E

Epidemiologic/ethnographic, 

N

Non-methadone treatment, and MMethadone treatment respondents

Note: These symbols appear throughout this

city profile to indicate type of respondent.

What are the primary drugs of abuse

among clients in a non-methadone

treatment program? (Fall 2002)

What drugs do clients in a methadone

program use?+ (Fall 2002)

Heroin

Crack cocaine

Powder cocaine

Marijuana

Abused OxyContin®

and other prescription

opiates

+

Includes any use, whether as a primary, secondary,

or tertiary drug; responses for methamphetamine and ecstasy were zero.

Source: Methadone treatment respondent 

Source: Non-methadone treatment respondent 

Heroin

Powder Cocaine

Benzodiazepines

Marijuana

Abused OxyContin®

Crack Cocaine 

Percent who abuse the drug

0 20 40 60 80 100

50%

13%

16%

9%

13% 2%

PITTSBURGH METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Among non-methadone treatment admissions, the proportion of primary heroin and

OxyContin® abusers increased somewhat between spring and fall 2002. Proportions

for the primary use of other drugs remained relatively stable.

! The number of primary heroin users admitted to the methadone treatment program

increased somewhat. Methadone percentages for secondary and tertiary drugs were

relatively stable, except for powder cocaine, which increased slightly. 

! Total population: . . . 2,358,695 

! Median age: . . . . . . 40.0 years 

! Race (alone):

! White: . . . . . . . . . . . . . 89.5%

! Black: . . . . . . . . . . . . . . 8.1%

! American Indian/

Alaska Native: . . . . . . . 0.1%

! Asian/Pacific Islander: 1.1%

! Other race: . . . . . . . . . . 0.3%

! Two or more races: . . . . 0.9%

! Hispanic (of any race): 0.7% 

! Unemployment rate: . . . . 2.6% 

! Median household 

income: . . . . . . . . . . . . $37,467 

! Families below poverty level 

with children <18 years: 12.7%

Source: U.S. Census 2000* 

Ecstasy

(N=529)

(N=635)
SNAPSHOT: PITTSBURGH, PENNSYLVANIA

Pulse Check: January 2004 page 219

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Not

difficult

at all

0

1

2

3

Extremely

difficult

Undercover policeL UsersE

Mexican black tar and

brown heroin

SA; ice

Heroin (in general); crack and powder cocaine; marijuana (in general

and local commercial grade);

methamphetamine (in general and

locally produced); ecstasy; diverted

OxyContin®; diverted methadone

BC bud 

Heroin (in general and SA); marijuana (in general and Mexican grown)

SEA, SWA; ice

6

7

8

9

10

All sources report that heroin use and

activity have increased since spring

2002:

! All sources report that heroin is

the most widely abused drug and

the drug related to the most 

serious consequences. 

! Heroin snorting (especially among

younger users) has increased.L,E

! Heroin purity has increased,L

as has Colombian white powder

heroin availability.E

HEROIN

COCAINE

MARIJUANA

4

Crack and powder cocaine; 

methamphetamine (in general and

locally produced); diverted 

OxyContin® 5

Sinsemilla and local commercial grade marijuana; Mexican 

methamphetamine; ecstasy

Mexican black tar and brown 

heroin; hydroponic marijuana

! Heroin and marijuana are 

relatively easy for users and

undercover officers to buy.L,E

! Users find several drugs less difficult to buy since spring 2002:E

!"Heroin (in general and South

American, in particular)

!"Methamphetamine (in general,

locally produced, and ice) 

!"Ecstasy (because local labs 

are starting to emerge in and

around the city)

!"Diverted OxyContin®

! Unlike the epidemiologic source,

the law enforcement source

believes ecstasy is relatively difficult to buy and has become more

difficult to buy since spring 2002

due to a recent bust of a trafficking organization in Pittsburgh. 

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

Note: SA=South American (Colombian) heroin;

SWA=Southwest Asian heroin; SEA=Southeast

Asian heroin; ice=highly pure methamphetamine in

smokable form; and BC bud=British Columbian

marijuana

Use of crack and powder cocaine is

stable at high levels:

! “The force driving the continuing

high levels of powder and crack

cocaine use is diminishing treatment capacity across the city.”E

! Nearly half of the heroin admissions to methadone treatment also

use powder cocaine, usually by

injecting the drug in combination

with heroin. This proportion of

secondary and tertiary powder

cocaine users increased between

spring and fall 2002.

As in the majority of Pulse Check

cities, sources report stable marijuana

use and sales activity at high levels.L,E
SNAPSHOT: PITTSBURGH, PENNSYLVANIA

page 220 Pulse Check: January 2004

Most sources consider ecstasy use as

relatively low and stable. The nonmethadone source states that it is an

emerging drug in Pittsburgh.

WHAT’S HAPPENING IN 

TREATMENT?

! The Pulse Check non-methadone

treatment respondent, whose facility’s 1,170-slot capacity is fully

utilized, reports that most clients

abuse heroin as their primary drug

(see pie chart on the first page of

this chapter). Most young adult

(age 18–30) admissions primarily

abuse heroin, while most adults

older than 30 primarily abuse prescription opiates—although heroin

use has increased among that age

group as well. Treatment percentages in the non-methadone program remained relatively stable

between fall and spring 2002,

except for an increase in heroin

and diverted OxyContin® as primary drugs of abuse.

! About half of primary heroin

treatment admissions to the nonmethadone program are repeat

clients for drug abuse treatment.

The recidivism rate for other drugs

is much lower (between 5 and 20

percent).

! The methadone treatment respondent, whose 655-slot capacity is

almost fully utilized, reports an

increase since spring 2002 in

demand for heroin treatment,

especially among young adults 

(age 18–30), and an increase in the

proportion of clients who also

abuse powder cocaine as a secondary or tertiary drug.

! Methadone treatment is available

only in selected areas of the city,

typically in the central city. Public

and private methadone treatment

are more available than they were

6 months ago, but both types of

programs have long waiting lists.

Capacity for methadone programs

has grown in response to the drastic increase in demand and because

programs tend to be very profitable.E A large non-methadone

treatment provider in the area

recently closed, so remaining nonmethadone treatment programs

have filled and nearly all have

waiting lists.

! Hepatitis C among injecting drug

users continues to be a major concern for treatment providers, with

prevalence rates up to 90 percent.

Moreover, heroin overdoses have

increased somewhat since spring

2002 due to the greater availability

of high-purity heroin.N

! Antisocial, conduct, and mood disorders are increasingly problems

for drug clients, as is the lack of

trained staff to treat comorbidity.N,M

! The methadone treatment source

reports that an increase in polydrug use and mental health disorders among clients is of major concern. The non-methadone treatment source reports a dramatic

rise in heroin use among the

younger population. Treatment of

this population is made more difficult by decreased funding for

treatment and the amount of time

allowed for treatment due to

recent cuts in public funding and

managed care.

WHO USES ILLICIT DRUGS?

The Pulse Check epidemiologic, nonmethadone treatment, and methadone

treatment sources were asked to

describe the populations most likely

to use heroin, cocaine, marijuana,

methamphetamine, and ecstasy. They

were also asked to describe any

emerging user groups and to report

on how the drugs are used. As shown

in the following pages, user characteristics vary by drug. Further,

because of the different perspective

each brings, the three sources sometimes describe quite different populaTHE USE PERSPECTIVE

OTHER DRUGS

MDMA (ECSTASY)

! Diverted OxyContin®: OxyContin®

is considered an emerging drug of

abuse.E Non-methadone treatment

percentages increased between

spring and fall 2002. As many as

20 percent of primary heroin

clients in the methadone program

abuse OxyContin® as a heroin

substitute or in combination with

heroin.M

! Diverted methadone: Diverted

methadone is considered easy to

buy, and its abuse has increased.E

Many OxyContin® addicts are

switching to diverted methadone

because diverted OxyContin® is

more difficult to obtain. 

! Benzodiazepines: As many as 35

percent of heroin users in the

methadone treatment program 

(a stable percentage) abuse a benzodiazepine as a secondary or tertiary drug.

METHAMPHETAMINE

Methamphetamine activity has been

increasing:

! Most methamphetamine is sold

north of Pittsburgh, but sales are

starting to move south.L

! Methamphetamine use is stable at

low levels; however, two labs were

recently detected in the city and use

is emerging on college campuses.E

! Methamphetamine (locally produced powder and ice) has become

less difficult to buy since spring

2002.E
SNAPSHOT: PITTSBURGH, PENNSYLVANIA

Pulse Check: January 2004 page 221

Who’s most likely to use heroin?

Characteristic E N M

Age group (years) >30 13–30 >30

Mean age (years) 25–40 23 34

Gender Male 60% male 62% male

Race/ethnicity White White and Black 65% White

Socioeconomic status Middle Low and middle Low 

Residence Suburbs Suburbs Central city 

Referral source N/A Varies widely Individual 

Level of education completed N/A High school High school 

Employment at intake N/A Varies widely Unemployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

How do users take heroin?

Characteristic E N M

Primary route of Snorting and 

administration Injecting injecting Injecting

Other drugs taken Powder or NR Powder cocaine 

crack cocaine (“double dutch”)

(speedball)

Publicly or privately? Publicly Privately Privately 

Alone or in In groups/ In groups/

groups? among friends among friends Alone

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Injecting is the most common route of

administration;E,M however, heroin

snorting has increased as a route of

administration since spring 2002. In

fact, among new heroin users, it is the

most common way to take the drug.E

! Heroin and powder cocaine injected in

combination has increased since

spring 2002.M

! No other changes in heroin use patterns are reported since spring

2002.E,N,M

! All three sources agree that males

predominate as heroin users, but

the two treatment sources report a

relatively high proportion of female

users (38–40 percent), and the epidemiologic source reports that

females have been increasingly

using the drug since spring 2002.

! Use among middle-class adolescents and young adults has

increased dramatically since spring

2002. A new trend among high

school students is the attempt to

snort the drug while in class.

Moreover, those who snort heroin

tend to switch quickly to injecting

the drug.E

! Heroin clients in the non-methadone

treatment program differ from

clients in the methadone program:

the non-methadone treatment program serves mostly heroin clients of

low and middle socioeconomic status in the suburbs, while the

methadone program serves clients

of low socioeconomic status in the

central city. The epidemiologic

source reports that heroin (and

crack and powder cocaine) is often

purchased in the city, but targeted

to the suburban community.

tions and use patterns for each drug.

For example, all methadone clients

are primary opiate users who may use

drugs other than opiates in a secondary or tertiary manner. 

The Pittsburgh epidemiologic respondent shares examples of the impact of

the increased use of heroin: 

! Treatment for heroin has increased

throughout the city.

! Heroin-related deaths are up drastically since spring 2002, including

several violent murders by young

adults who were using heroin. 

! High schools are trying to control

the heroin problem by holding

“grieving sessions” regarding heroin-related deaths and heroin

awareness nights.

! In the last 5 years, adolescent opiate use has increased by 45 percent, according to local surveys.

Most of these youth are snorting

powder heroin.
SNAPSHOT: PITTSBURGH, PENNSYLVANIA

page 222 Pulse Check: January 2004

Who’s most likely to use marijuana?

Characteristic E N

Age group (years) 18–30 13–30

Mean age (years) NR 22

Gender Male Split evenly

Race/ethnicity White White and Black

Socioeconomic status All Middle and high

Residence All Suburbs

Referral source N/A Criminal justice, 

individual, and school

Level of education completed N/A Junior high and high school

Employment at intake N/A Full-time students

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone 

treatment respondent

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

Respondents associate marijuana,

used either alone or with other

drugs, with the following consequences, which remained stable

between spring and fall 2002:

! Drug-related emergency room visits, especially related to respiratory

illnessesE

! Drug-related arrestsN

! Automobile accidentsE

! Short-term memory lossE

! Deteriorating family and social

relationshipsE

! Poor academic performanceE,N

! School absenteeism or truancyE,N

! Dropping out of schoolE

! Poor workplace performanceE,N

! Workplace absenteeismE

! New users of marijuana have increased since spring 2002. These users

tend to be adults older than 50.E

! Sources reported no other changes in marijuana user characteristics

between spring and fall 2002. 

! Marijuana is most often smoked in joints E,N and continues to be laced with

ecstasy.E

Who’s most likely to use cocaine?

Crack Powder cocaine 

Characteristic E N E N

Age group (years) 18–30 >18 >30 >18

Mean age (years) 18–25 30 NR 35

Gender Male 70% male Male 70% male

Race/ethnicity Black White and Black White and Black White and Black

Socioeconomic Middle and Middle and 

status Low Low and middle high high

Residence Central city Central city Suburbs and Suburbs

central city

Referral source N/A Criminal justice, individual, N/A Varies

and other alcohol/drug

abuse care provider

Level of education N/A High school N/A 4-year college

completed

Employment at intake N/A Unemployed N/A Full and part time

Note: Due to the low proportion of crack use (primary, secondary, and tertiary) the methadone treatment source did

not provide demographic user information. The demographic information for secondary and tertiary powder cocaine

users in treatment is identical to that of heroin users.

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent 

! Sellers tend to “push”

crack cocaine on Black

females (especially

prostitutes) as a sex

enhancer. Females are

increasingly using

crack, and the gender

gap is not as large as

that for heroin.E

! The number of white

collar workers using

crack cocaine has

increased slightly since

spring 2002.E
SNAPSHOT: PITTSBURGH, PENNSYLVANIA

Pulse Check: January 2004 page 223

Marijuana-using clients: To what extent have changes in the following 

problems complicated their treatment over the past 10 years?

Problem change

Extremely

Increased overall difficulty in treating the addiction

Increased court referrals involving marijuana possession

Increased THC potency of marijuana

Increased polydrug use

Earlier initiation of marijuana use

Increased progression to use of other drugs

Decline in users’ perception of harm

Decline in social disapproval (e.g., peers, parents, etc.)

Increased court referrals involving marijuana sales

Increased severity of addiction among clients

Glamorization by entertainment industry

Glamorization by news media

What they have to say...

! Increased severity of addiction

among clients: Increased addiction to marijuana may be caused by

greater availability of the drug and

increased potency, which in turn

causes increased withdrawal symptoms.N

! Increased difficulty in treating

the addiction: Along with

increased addiction to marijuana,

limits on treatment time for marijuana users by many managed care

programs may make clients more

difficult to treat.N By comparison,

Pulse Check respondents in other

cities generally attribute less importance to this aspect of the problem.

! Increased polydrug use and

increased progression to use of

other drugs: Marijuana users are

increasingly using other drugs of

abuse simultaneously or moving on

to the abuse of other drugs, such as

heroin, OxyContin®, and ecstasy.N

0 1 2 3 45

Extent complicated treatment 

Not at all !""Non-methadone treatment respondent

Widespread marijuana availability and use over the past 10 years: To what

extent have the following contributed?

Reason

Decline in users’ perception of harm

Decline in social disapproval (e.g., peers, parents, etc.)

Glamorization by entertainment industry

Increased THC potency

More local production

What they have to say...

! As in the majority of Pulse Check

cities, sources agree that the decline

in users’ perception of harm and the

decline in social disapproval of marijuana have increased the widespread availability and use of 

marijuana.L,E

! Both sources also agree that the

price of marijuana over the last 

10 years has not declined.L,E

!""Law enforcement respondent

#""Epidemiologic/ethnographic respondent

01 2345

Extent contributed

NR=Not reported

WHO’S MOST LIKELY TO USE

METHAMPHETAMINE, AND HOW 

IS IT USED?

Methamphetamine users are most

often young adult (18–30 years)

White males of low to middle socioeconomic status who live in rural

areas. The drug is mostly smoked

(often in combination with marijuana), although some is taken orally.

Methamphetamine use and sales are

emerging on college campuses.E

WHO’S MOST LIKELY TO ABUSE

OXYCONTIN®, AND HOW DO THEY

ABUSE THE DRUG?

White adults of low and middle

socioeconomic status who live in suburban and rural areas are most likely

to abuse OxyContin®.

E,N Abuse of the

drug has increased significantly

between spring and fall 2002.E

0

NR

NR
SNAPSHOT: PITTSBURGH, PENNSYLVANIA

page 224 Pulse Check: January 2004

WHERE ARE ILLEGAL DRUGS USED

AND SOLD?

! Most heroin, crack, powder

cocaine, and marijuana sales occur

in the central city on the streets;

however, the drugs are sold in a

variety of other locations including

the following:L,E

! Crack houses or shooting galleries

! Private residences

! Public housing developments

! Inside cars

Additionally, cocaine and marijuana

are sold around schools, college campuses, nightclubs and bars, raves, and

concerts, and at private parties. A

new sales venue for powder and

crack cocaine is pizza delivery restaurants: when customers place a pizza

order, they can request powder or

crack cocaine. The drugs are delivered to buyers’ houses inside pizza

boxes.E

Methamphetamine is sold in private

residences and on college campuses,

and ecstasy is sold in private residences, public housing developments,

and nightclubs/bars; on college campuses; at private parties, raves, and

concerts; and inside cars.L

HOW DO DRUGS GET FROM SELLERS

TO BUYERS?

Sales methods often vary by drug: 

! Heroin and cocaine: In addition to

typical street corner sales in neighborhoods known for drug activity,

heroin, crack cocaine, or powder

cocaine may be purchased in several ways, including the pizza

delivery method discussed previously. 

! Marijuana: Sales methods vary

widely. Dealers who sell primarily

marijuana may also sell prescription pills, such as diverted

hydrocodone (Vicodin®) and

methylphenidate (Ritalin®).E

! Methamphetamine: Buyers go

directly to the lab sites, most of

which are in rural areas, to purchase the drug.L

! Ecstasy: Sales tend to be venue

oriented (at parties and nightclubs). A buyer at a party may

“simply ask around” for ecstasy,

referred to as “eve,” “X,” and

“peace.”L Ecstasy sellers often 

distribute ecstasy with sildenafil

(Viagra®); other drugs sold include

ketamine, lysergic acid diethylamide (LSD), and mescaline.L

! Diverted OxyContin®: The drug is

diverted mostly through fraudulent prescriptions, and doctors

reportedly write false prescriptions

for sex.L There is a small illegal

market for the diverted drug, and

it sells for $1 per milligram.

People increasingly use the

Internet to fill prescriptions for

OxyContin® and to sell it illegally.

Most of the people who divert the

drug use it themselves.L Other

diverted prescription opiates, such

as meperidine (Demerol®) and codeine,

are often sold with the drug.E

WHO’S SELLING HEROIN AND CRACK

COCAINE?

According to the law enforcement

source:

! Most sellers are organized as

loose-knit street gangs or “crews.”

! Dealers are predominantly young

adults (18–30 years) who are very

likely to use the drug.

According to the epidemiologic source:

! Dealers can be grouped into two

categories: street gangs or people

who are connected to Colombian

traffickers.

! Sellers can also be grouped into

two age categories: young adults

and adults older than 30. The

younger sellers are somewhat likely to use the drug; in fact, for this

group, heroin use often precedes

heroin sales.

The law enforcement source states

that heroin, powder cocaine, and

crack are often sold by the same dealers. The epidemiologic source further

reports that on the streets individual

dealers may sell only one drug, but

that at private residences and parties,

they often sell heroin, crack, and powder cocaine.

THE MARKET PERSPECTIVE

Depending on the drug most readily

available, heroin users often switch to

OxyContin® abuse, and OxyContin®

abusers often switch to heroin or

methadone abuse.E,M In particular,

many heroin addicts with chronic

pain abuse OxyContin®.

M Similarly,

the non-methadone treatment source

reports that heroin users are increasingly switching to OxyContin® abuse,

typically by snorting and injecting the

drug.

WHO’S MOST LIKELY TO ABUSE

METHADONE, AND HOW DO THEY

ABUSE THE DRUG?

Heroin addicts often buy diverted

methadone to detoxify themselves.E

Frequently, methadone treatment

clients will not swallow the entire

daily dose of methadone in order to

sell the remainder illegally.M The epidemiologic source states that diverted

methadone has increased as a problem in the last 5 years due to the proliferation of for-profit methadone

treatment centers and the fact that

the State does not fix dosage standards for these clinics.
SNAPSHOT: PITTSBURGH, PENNSYLVANIA

Pulse Check: January 2004 page 225

How pure is South American heroin,

and how much does it cost? 

Unit Purity Price 

One bag NR $20M

One bundle 

(10 small bags) 60–90% $180–$200L

1 g 60–90% $300–$600L

Sources: LLaw enforcement respondent; MMethadone treatment respondent

How much does cocaine cost?

Form Unit Price 

Crack One rock $5E

$5–$20L

1 g $80–$100L

Powder One bag $5–$15E

1 g $75–$100L

0.25 oz $280–$350L

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

Which drug sellers are associated with which crimes?

Crime Heroin Crack Powder Marijuana Methamphetamine Ecstasy

Prostitution $$ $

Gang-related activity $

Violent criminal

acts: assaults $$ $ $

Nonviolent criminal $$ $ $

acts: fraud and theft

Domestic violence $

No crimes associated $

Sources: Law enforcement respondent epidemiologic/ethnographic respondent

! Powder and crack cocaine prices

fluctuate within the given range

depending on purity and availability.L

! When buyers are new to a dealer,

dealers often offer them special low

prices for a bag of powder cocaine.

The price then quickly rises from $5

per bag to $10 or $15 per bag for

subsequent sales.E

WHO’S SELLING POWDER COCAINE?

! Powder cocaine sellers fall into

two groups: (1) independent sellers who sell the drug on the street,

and (2) organized sellers who

deliver the drug to buyers.E

! Most powder cocaine dealers are

adults older than 30 and somewhat likely to use the drug.E

WHO’S SELLING MARIJUANA?

According to the law enforcement

source:

! Marijuana sellers fall into two

groups: (1) independent and (2)

organized sellers, but they are not

as organized as heroin, powder

cocaine, and crack sellers.

! Sellers tend to be young adults

(18–30 years) and are very likely

to use the drug.

According to the epidemiologic source:

! Most marijuana dealers are independent, with a wide age range,

and are very likely to use the drug.

WHO’S SELLING METHAMPHETAMINE?

! Methamphetamine sellers tend to

own the labs that produce the

methamphetamine. Most sellers 

are adults older than 30.L

! Methamphetamine sellers are not

as structured as heroin and cocaine

sellers; however, the sales structure

may become more organized as

the drug becomes increasingly common.L

! Most heroin available in Pittsburgh is

high-purity, snortable Colombian

white. According to the epidemiologic source, Colombian heroin is less

difficult to buy in fall 2002 than it

was in spring 2002.E

! The recent increase in heroin overdoses further suggests that the drug

is of high purity.E

! Heroin is often cut with fentanyl, a

synthetic narcotic.M

! The bags of heroin are stamped with

logos, such as “fly high,” “mo money,”

and “on de run.” Users often refer to

heroin by these brand names as well

as the standard street names (“H,”

“dope,” “junk,” and “mac”).E,M

! Sources report stable prices between

spring and fall 2002.L,E

! Marijuana sellers are

less involved in other

crimes than sellers of

other drugs.L,E

! Crack cocaine sellers

continue to be involved

in many crimes, including prostitution, gangrelated activity, assaults,

fraud, and theft.L,E
SNAPSHOT: PITTSBURGH, PENNSYLVANIA

page 226 Pulse Check: January 2004

Heroin

Cash

Crack cocaine

Marijuana Methamphetamine

75% Shoplifted merchandise

Stealing the drug

Property/merchandise

Other drugs

Transporting the drug

Other: Includes items

accounting for 3 percent 

or less of transactions for

each of the five drugs, such

as drug buying services,

guns, and other stolen merchandise (e.g., electronic

equipment)

Food stamps

Sex

85%

72%

11%

Powder cocaine

76%

5%

6%

HOW MUCH DOES MARIJUANA

COST?

Most marijuana available in

Pittsburgh is commercial grade and is

imported from the Western United

States.L One ounce of commercial

grade marijuana sells for $90–$150,

and prices have remained relatively

stable since spring 2002.L New names

for marijuana this reporting period

include “schwag” and “hydro.”N

HOW MUCH DOES METHAMPHETAMINE COST, AND HOW IS IT MANUFACTURED?

Locally produced powder methamphetamine costs $100–$200 per

gram, and is sold at the quarter-gram

level for $45.L Most methamphetamine is produced locally in small,

mobile labs (“box labs”). An increasing number of labs, especially north

of Pittsburgh in farms or mobile

home areas, have been detected in 

fall 2002.L,E

What they have to say...

! Drug transactions are increasingly cash only, according to all

sources. Although two sourcesE,N report other items and

services as often exchanged for drugs, the law enforcement

and methadone treatment sources report that 99–100 percent of transactions are cash only. 

! Often a buyer will steal merchandise, pawn it, and use the

money for drugs, but the actual exchange is nearly always

with cash.L Similarly, the methadone treatment source states

that buyers sell shoplifted property and stolen merchandise

to exchange the cash for drugs.

! Buyers increasingly shoplift meat, sell it, and then exchange

the money for drugs.E

Beyond cash: What else is accepted in exchange for drugs?

Source: Mean of response ratings given by law enforcement, epidemiologic/ethnographic, non-methadone

treatment, and methadone treatment respondents; the non-methadone treatment source did not provide

information for methamphetamine exchanges.

5%

5%

5%

5% 7%

7%

5%

7%

5%

5%

3%

3%

3%

2%

2%

1%

3%

1%

1%

4%

1%

1%

66%

1%

3%

3%

3%3%

4%

3%

1%
SNAPSHOT: PITTSBURGH, PENNSYLVANIA

Pulse Check: January 2004 page 227

None of the four Pittsburgh Pulse Check sources believes that the

September 11 attacks and their aftermath have had any effects on the

drug abuse problem.

Community innovations and tools over the past 10 years: 

How successful have they been?

0

NR

NR= Not reported

Prescription drug monitoring

Increased use of task forces 

Drug-free zone laws

Onsite lab tests

Drug courts

!""Law enforcement respondent 

#""Epidemiologic/ethnographic respondent 

01234 5

Degree of success

Not at all Extremely 

successful

SEPTEMBER 11 FOLLOWUP 

Drug marketing innovations and tools over the past 10 years: To what degree have

they complicated efforts to detect or disrupt illicit drug activity in Pittsburgh?

012 3 4 5

Degree of complication

Not at all Extremely complicated

Throwaway cell phones

Unique packaging

Increased communications via Internet

More or changing brand names

More organized networks

Relocation of sales settings within the community

Expansion of drug sales beyond the central city

!""Law enforcement respondent 

#""Epidemiologic/ethnographic respondent 

What they have to say... 

! Expansion of drug sales

beyond the central city:

As the economic situation

in Pittsburgh has declined,

middle class neighborhoods

have turned into “drug

neighborhoods.”L Few Pulse

Check sources elsewhere

attribute such a high

degree of importance to

this type of expansion.

! More organized networks and unique packaging: Heroin is generally

packaged by brand names

that indicate the dealer,

selling organization, and

quality of the drug. The

brands are becoming more

common as the seller

groups become more

organized.L

0

0

NR

NR

NR=Not reported

NR

NR

NR

What they have to say... 

! Onsite lab tests: The law enforcement

source rates the ability to test illegal drugs

seized onsite as very low. Unlike in most

other Pulse Check cities, local law enforcement “must send drugs to a regional office

for testing.” The epidemiologic source rates

store-bought urine tests as very successful

because parents are testing their children for

drugs.

! Prescription drug monitoring: Both sources

regard prescription drug monitoring efforts

as successful. “The Department of Welfare is

monitoring the prescriptions of OxyContin®

for Medicaid plans, which is forcing doctors

to revise their prescribing practices.”E
SNAPSHOT: PORTLAND, OREGON

page 228 Pulse Check: January 2004

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

Two of three Pulse Check respondentsL, M believe the city’s overall drug problem is very serious, and oneE believes it is somewhat serious. 

Sources report several positive changes in illegal drug activity in Portland: 

! The increased use of task forces has been successful in combating drug

distribution.L,E

! Methylenedioxymethamphetamine (MDMA or ecstasy) use may be leveling

off: The drug remains available at raves in the suburbs, but the number of

raves decreased.L

Heroin and other opiate abuse and activity appear to be increasing:

! New heroin users increased. This group of new users tends to present to

treatment as male-female couples.E

! OxyContin® (oxycodone hydrochloride controlled-release) abuse

increased somewhat,E and diverted

OxyContin® became more available.L

PORTLAND PRIMARY METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Total population:. . . 1,918,009

! Median age: . . . . . . 34.8 years

! Race (alone):

! White . . . . . . . . . . . . . 84.5 %

! Black. . . . . . . . . . . . . . . 2.7 %

! American Indian/

Alaska Native . . . . . . . . 0.9%

! Asian/Pacific Islander 5.4%

! Other race . . . . . . . . . . . 3.8% 

! Two or more races . . . . 3.3% 

! Hispanic (of any race): . . . 7.4%

! Unemployment rate: . . . . 3.9%

! Median household 

income:. . . . . . . . . . . . $47,007

! Families below poverty level 

with children <18 years: 9.7% 

Source: U.S. Census 2000* 

*The census data in this table are provided as a frame of reference for the information given by Pulse Check sources. When possible, the data

given by the law enforcement and epidemiologic/ethnographic sources reflect the metropolitan area.

Most widely abused drug:

MarijuanaL

MethamphetamineE

HeroinM

No reported changes between spring

and fall 2002L,E,M

Second most widely abused drug:

HeroinL, E

MethamphetamineM

No reported changes between spring

and fall 2002L,E,M

Drug related to the most serious

consequences:

HeroinL, E, M

No reported changes between spring

and fall 2002L,E,M

Drug related to the second most

serious consequences:

MethamphetamineE,M

CrackL

No reported changes between spring

and fall 2002L,E,M 

New or emerging problems:

Methadone overdosesL

DextromethorphanL

Diverted OxyContin®L

Sources: LLaw enforcement, E

Epidemiologic/ ethnographic, and

MMethadone treatment respondents

Note: These symbols appear throughout this

city profile to indicate type of respondent. 

The non-methadone treatment source did not

respond.

! Methadone-related overdose deaths increased, especially those with heroin or

OxyContin® present.L This occurrence may be due to budget cuts in the methadone treatment programs: methadone treatment clients may be “trying to

stretch the methadone with heroin or other drugs.”L

! Hydrocodone (Vicodin®) abuse has increased somewhat. Most new users are

young mothers without a history of drug use. These users may be feigning illness

to obtain the drug from doctors, pain management clinics, or dentists.E

Methamphetamine use and production increased:

! New methamphetamine users, who tend to be gay males of middle to high

socioeconomic status, increased.E

! Methamphetamine use replaced cocaine use in non-urban areas of

Portland.L

! Methamphetamine “superlab” seizures have increased (from 4 to 10 superlabs). Moreover, local labs continue to produce ice (high-purity, smokable

methamphetamine), and that form of the drug is preferred by users.

New marijuana sales groups are emerging:

! Organized dealers from Mexico and California who import the drug to

Portland

! Organized dealers (mostly biker and Asian groups) from Canada who

import British Columbian marijuana (BC bud).

The most widely abused drug reported varies by source, but all respondents agree

that heroin is the drug related to the most serious consequences. Emerging drugs

of abuse include OxyContin® (as reported in 14 other Pulse Check cities) and dextromethorphan (in Coricidin HBP® cold tablets). Ecstasy, gamma hydroxybutyrate

(GHB), and ketamine continue to be available since emerging in spring 2002.L
SNAPSHOT: PORTLAND, OREGON

Pulse Check: January 2004 page 229

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic respondent

Note: SA=South American (Colombian) heroin; SWA=Southwest Asian heroin; SEA=Southeast

Asian heroin; and ice=highly pure methamphetamine in smokable form

Not

difficult

at all

Extremely

difficult

Undercover policeL UsersE

Marijuana (in general and

hydroponic sinsemilla)

Heroin (in general and Mexican

black tar); BC bud; methamphetamine (in general, locally

produced, and ice)

Commercial grade marijuana;

Mexican methamphetamine 

Ice

Ecstasy; diverted OxyContin®

Mexican heroin

Heroin (in general and Mexican

black tar); crack, powder

cocaine; marijuana (all forms);

methamphetamine (in general,

locally produced, and Mexican) 

4

3

2

1

0

5

6

7

8

9

10

Heroin use and activity have

increased slightly:

! Smoking the drug is increasing as

a route of administration.E,M

! The number of new users increased

between spring and fall 2002.E

! Heroin-related overdose deaths

increased 6 percent between 2001

and 2002.E

MARIJUANA

COCAINE

Marijuana use and activity remain 

relatively stable at high levels. BC bud

is increasingly available as imports

from Canada have increased.L

Crack activity and use are low and

stable. Powder cocaine activity and

use are relatively high and stable.

SA, SEA, SWA

Powder cocaine

Mexican brown heroin

Psilocybin mushrooms

SA, SEA, SWA

! Both sources agree that Mexican

black tar heroin, marijuana, and

methamphetamine are relatively

easy to obtain.L,E

! Several drugs are less difficult for

undercover officers to buy in fall

2002: Mexican black tar heroin;

marijuana (all forms, especially BC

bud); methamphetamine (all

forms, including ice); and diverted

OxyContin®.

! Portland is one of only three Pulse

Check cities where it has become

easier to obtain BC bud. (The other

two are Minneapolis/St. PaulL and

St. Louis).E

! The epidemiologic source states

that between fall and spring 2002

the difficulty of obtaining drugs

remained stable. 

! Commercial grade marijuana is

difficult to obtain because few sellers carry it. High potency BC bud

and hydroponic marijuana have

taken over the market.E

METHAMPHETAMINE

Methamphetamine use and activity

have increased:

! Some increase is reported among

new methamphetamine users who

tend to be gay males of middle to

high socioeconomic status.E

! Methamphetamine use has

replaced cocaine use in nonurban

areas of Portland.L

! Methamphetamine superlab

seizures have increased since spring

2002, and local labs continue to

produce ice. 

HEROIN
SNAPSHOT: PORTLAND, OREGON

page 230 Pulse Check: January 2004

WHAT’S HAPPENING IN TREATMENT?

! The Pulse Check methadone treatment respondent, whose 680 outpatient and residential facility operates over capacity, reports stable

drug use. Methamphetamine continues as the most common secondary drug of abuse among primary

heroin clients.M

! Methadone maintenance treatment

is available throughout the metropolitan area, but in fall 2002, public and private treatment programs

have few or no slots available. The

epidemiologic source states that

funding has been seriously impacted by State budget cuts and

Medicaid budget changes and that

many methadone clinics have had

to close.E

! Hepatitis C among clients in the

methadone treatment program

remains a common problem, and

prevalence has increased since

spring 2002. Common comorbid

illnesses among methadone treatment clients include mood and personality disorders, which have

remained stable.

! Barriers to methadone treatment

include limited slot capacity and

lack of transportation or money for

transportation. Slot capacity has

become more limited due to a

funding crisis within the State.M

WHO USES ILLICIT DRUGS? 

The Pulse Check epidemiologic and

methadone treatment sources were

asked to describe the populations

most likely to use heroin, cocaine,

marijuana, methamphetamine, and

ecstasy. They were also asked to

describe any emerging user groups

and to report on how the drugs are

used. As shown on the following

pages, user characteristics vary by

drug. Because of the different perspective each brings, the sources

sometimes describe quite different

populations and use patterns for each

drug. For example, all methadone

clients are primary opiate users who

may use drugs other than opiates in a

secondary or tertiary manner. 

Who’s most likely to use heroin?

Characteristic E M

Age group (years) >30 >18

Mean age (years) NR 36

Gender Split evenly 58% male

Race/ethnicity White White

Socioeconomic status Low Low

Residence Central city Suburbs

Referral source N/A Individual

Level of education completed N/A High school 

Employment at intake N/A Unemployed

Sources: EEpidemiologic/ethnographic respondent; MMethadone 

treatment respondent

! The methadone treatment source reports no changes in

heroin user demographics since spring 2002.

! The epidemiologic source reports some increase in new

heroin users. This group of new users tends to present to

treatment as male-female couples.

! Heroin users new to methadone treatment tend to be

young adults of middle-to-high socioeconomic status and from

the suburbs, while heroin users overall tend to be adults older

than 30 who are of low socioeconomic status and live in the

central city.M

THE USE PERSPECTIVE

! Diverted OxyContin®: Between

spring and fall 2002, OxyContin®

abuse has increased somewhat,E and

the drug become more available.L

Heroin addicts may be substituting

OxyContin® for heroin.E

! Methadone: Methadone-related

overdose deaths have increased,

especially those with heroin or

OxyContin® present.L

! Hydrocodone (Vicodin®): Abuse has

increased somewhat. Most new

users are young mothers without a

history of drug use.E

! Ecstasy: Ecstasy use is relatively

low and stable. Raves appeared

less common in fall 2002 than

during spring 2002.L

! Dextromethorphan tablets (in

Coricidin HBP®): Among 12–17-

year-olds, dextromethorphanrelated overdoses increased.L

PRESCRIPTION OPIATES

OTHER DRUGS
SNAPSHOT: PORTLAND, OREGON

Pulse Check: January 2004 page 231

Widespread marijuana availability and use over the past 10 years: To what

extent have the following contributed?

Who’s most likely to use marijuana, and how is

the drug used? 

Characteristic E

Age group (years) >30 

Gender Split evenly 

Race/ethnicity White, Black, and 

Hispanic (any race) 

Socioeconomic status Low and middle

Residence All areas

Primary delivery vehicle Bongs and pipes 

Public or private? Both 

Alone or in groups? In groups 

Source: EEpidemiologic/ethnographic respondent

How do users take heroin?

Characteristic E M

Primary route of administration Injecting Injecting 

Other drugs taken Powder cocaine (speedball) Cocaine 

Publicly or privately? Both Privately 

Alone or in groups? Alone Alone

Sources: EEpidemiologic/ethnographic respondent; MMethadone treatment respondent

Most heroin users in Portland inject; 

however, several populations are switching 

to smoking:

! New heroin users (especially suburban

youth) tend to smoke the drug.E

! Some older heroin users have switched to

smoking heroin due to collapsed veins.M

WHO’S MOST LIKELY TO USE COCAINE?

Crack is not a large problem in

Portland.E

Powder cocaine users tend to be older

than 30, split evenly between the genders, White, and of low socioeconomic status.E Sources report no

changes in user characteristics since

spring 2002.E

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

Marijuana, used either alone or with

other drugs, is associated with drugrelated arrests and poor academic

performance (especially among new

marijuana users). These consequences

remained stable between spring and

fall 2002.E

! Marijuana use has

remained relatively stable between spring and

fall 2002.E

! A new group of marijuana users includes

homeless youth and

young adults in

college.E

! Due to the high THC

content of marijuana in

Portland, bongs and

pipes are the most

common delivery vehicles for the drug.E

Reason

01 2 3 4 5

Extent contributed

Not at all Extremely

Decline in users’ perception of harm

Decline in social disapproval

Promotion of marijuana as “medicine”

Less emphasis by law enforcement

Increased THC potency

Increase in indoor farms

More local production

Glamorization by entertainment industry

Glamorization by news media

!""Law enforcement respondent

#""Epidemiologic/ethnographic respondent 

NR

NR

NR

NR

What they have to say...

! These two sources agree that the

decline in users’ perception of harm, the

decline in social disapproval of marijuana, and the promotion of marijuana as

“medicine” have contributed greatly to

the widespread availability and use of

marijuana.L,E

! Less emphasis by law enforcement and

courts also rates as greatly contributing

to the widespread use of marijuana.L,E

The epidemiologic source believes that

marijuana possession laws in Portland

are too lenient.E (Marijuana possession

is a ticketed offense and not a misdemeanor.)

NR=Not reported
SNAPSHOT: PORTLAND, OREGON

page 232 Pulse Check: January 2004

WHO’S MOST LIKELY TO USE ECSTASY? 

Ecstasy use is present in gay and adolescent communities in Portland.

Who’s most likely to abuse OxyContin®, and how is it abused?

Characteristic E

Age group (years) >18 

Gender 70% male

Race/ethnicity White 

Socioeconomic status Low 

Residence Central city 

Primary route of administration Injecting and oral 

Other drugs taken Heroin (as a substitute or sequentially)

Source: Epidemiologic/ethnographic respondent

! Between spring and fall 2002, OxyContin® abuse has increased somewhat.E

! Now that funding for methadone treatment programs has been cut, the epidemiologic respondent believes that an increase in the abuse of OxyContin® could occur.

Heroin users increasingly are substituting OxyContin® for heroin.E

Who’s most likely to use methamphetamine, and how is the drug used? 

Characteristic E

Age group (years) >30 

Gender Split evenly 

Race/ethnicity White

Socioeconomic status Low

Residence Central city and rural

Primary delivery vehicle Injecting

Other drugs taken Marijuana (sequentially), heroin (speedball), 

ketamine, ecstasy, or GHB (in combination) 

Public or private? Private 

Alone or in groups? Both 

Source: Epidemiologic/ethnographic respondent

! Some increase is reported among new methamphetamine users who tend to be gay

males of middle-to-high socioeconomic status. This new group tends to smoke the drug

and often uses ketamine, ecstasy, or GHB in combination with methamphetamine.E

! Drug users who take methamphetamine and marijuana are referred to as “tweekers.”E

THE MARKET PERSPECTIVE

WHERE ARE DRUGS USED AND

SOLD?

Heroin and powder and crack

cocaine are sold mostly in central city

areas at the following locations:L

!"Streets/open-air markets

!"Crack houses and shooting galleries

!"Inside private residences

!"Public housing developments

!"In or around schools and college

campuses

!"Private parties

!"Hotels/motels

!"Inside cars

Additionally, heroin is sold around

drug treatment clinics, and powder

cocaine is sold at nightclubs, bars,

and concerts.L

Methamphetamine is sold in open-air

markets, inside private residences

(referred to as “drug houses”), and

inside cars.L

Ecstasy is typically sold at raves in the

suburbs, although the law enforcement

source states that few raves have been

held since spring 2002.L

HOW DO DRUGS GET FROM SELLER

TO BUYER?

Heroin, crack, powder cocaine, and

marijuana can be purchased in several

ways, including the following:L

! A buyer may approach a seller at

an open-air market in downtown

Portland for a hand-to-hand

exchange.

! A buyer may contact a seller via

cell phone for drug delivery.

Additionally, powder cocaine sales

may include Internet communication

between buyer and seller.

Methamphetamine sales, which occur

mostly in suburban and rural areas,

tend to take place at local residences.
SNAPSHOT: PORTLAND, OREGON

Pulse Check: January 2004 page 233

Beyond cash: What else is accepted in exchange for drugs?

WHO SELLS HEROIN, CRACK, AND

POWDER COCAINE?

! Heroin and powder cocaine sellers

are mostly young adults (18–30

years) organized into small “cells” or

groups. Within the group, a “leader”

supplies street sellers with small

quantities of the drug to sell. The

quantity is small enough to swallow

or get rid of easily.

! Crack sellers are organized similarly to heroin sellers, but they tend

to be more street-gang oriented. 

WHO SELLS MARIJUANA?

Marijuana sellers fall into several

groups, including the following:

! Independent dealers who sell marijuana grown in small, local “grows”

! Organized dealers who sell marijuana grown in large, local grows that

produce high-quality marijuana

! Organized dealers from Mexico

and California who import the

drug into Portland; this sales

group’s market share has increased

dramatically since spring 2002.

! Organized dealers (mostly biker

and Asian groups) from Canada

who import BC bud; these groups

have emerged since spring 2002. 

WHO MANUFACTURES AND SELLS

METHAMPHETAMINE? 

Methamphetamine sellers tend to be

young adults (18–30 years) who fall

into one of several groups:L,E

! Independent sellers who sell small

amounts of the drug produced in

small local labs

! Methamphetamine users who

manufacture their own “stash” in

“backpack labs” (small, portable

meth labs)

! Highly organized sellers who deal

methamphetamine from large

superlabs in Portland or who sell

imported methamphetamine from

superlabs in California or Mexico.

WHO SELLS ECSTASY?

Ecstasy sellers tend to be adolescents

(13–17 years) who sell the drug at

organized raves, which have

decreased since spring 2002. GHB is

often sold by ecstasy dealers. 

Source: Mean of response ratings given by law enforcement and epidemiologic/ethnographic respondents.

The epidemiologic/ethnographic respondent did not provide information for crack cocaine exchanges.

Heroin

Cash

Crack cocaine

Methamphetamine

Marijuana

65%

Shoplifted merchandise

Other stolen merchandise

(e.g., electronic equipment)

Property/merchandise

Transporting the drug

Food stamps

Manufacturing the drug

Other Drugs

95%

70%

90%

Powder cocaine

70%

14%

6%

4%

6%

6%

15%

16%

9%

5%

4% 9%

What they have to say...

! As in most cities, cash (followed by property and merchandise) is the most common form of exchange for illegal

drugs.L,E

! Between female buyers and male sellers, about half of

heroin exchanges are for sex.E

! The law enforcement source notes that property and

shoplifted merchandise are converted to cash prior to

exchange of the drug. 

1%

1%

1%

1%

1% 2% for each 1% for each
SNAPSHOT: PORTLAND, OREGON

page 234 Pulse Check: January 2004

Which drug sellers are associated with which crimes?

Crime Heroin, Powder and Crack Metham- Ecstasy

Cocaine, and Marijuana phetamine

Prostitution $ $

Gang-related activity $ $

Violent criminal acts: robberies $ $

Nonviolent criminal acts $ $

Domestic violence $

Drug-assisted rape $ $

Child abuse and neglect $ $

Source: Law enforcement respondent

How pure are illegal drugs, and how much do they cost?

Drug Unit Purity Price 

Mexican black tar heroin One balloon (0.2–0.4 g) 68–70% $20 

1 g $40–$100 

1 oz $800–$1,250 

Crack One rock (0.1 g) 62–83% $10 

1 g $45–$100 

Powder cocaine One balloon 83% $20–$40 

1 oz $400–$650 

Marijuana (local or BC bud) One bag (1 oz) 23–33% THC $250+ 

Methamphetamine 1/16 oz (“teener”) 8–42% $120–$150 

1 oz $550–$600 

Ecstasy One pill NR $15–$20 

Diverted OxyContin® One pill N/A $50 

Source: Law enforcement respondent

! While all illegal drug sellers in

Portland are associated with

many crimes other than drug

sales, methamphetamine sellers continue to be involved in

the most crimes, including

domestic violence and drugassisted rape.L

! The law enforcement source

adds that illegal drug sellers

are often involved in child

abuse and neglect.

! Heroin, crack, and powder cocaine prices

decreased at all unit levels between spring and

fall 2002. Purity

remained relatively stable.L

! Prices and purity for

other drugs remained

relatively stable between

spring and fall 2002.L

DRUG MARKETING INNOVATIONS AND TOOLS OVER THE PAST 10 YEARS: TO WHAT DEGREE HAVE THEY COMPLICATED

EFFORTS TO DETECT OR DISRUPT DRUG ACTIVITY IN PORTLAND?

The law enforcement source states

that the following have greatly contributed to difficulties in detecting or

disrupting drug activity over the last

10 years: 

! Throwaway cell phones

! More organized distribution networks

! Polydrug dealers

! Expansion of drug sales beyond

the central city

! Relocation of sales settings within

the community
SNAPSHOT: PORTLAND, OREGON

Pulse Check: January 2004 page 235

SEPTEMBER 11 FOLLOWUP

None of the three Portland Pulse Check respondents believes that the September 11 attacks and their aftermath have had any

effects on the drug abuse problem. 

Community innovations and tools over the past 10 years: How successful have they been?

NR

NR

NR=Not reported

Drug courts

Increased use of task forces

Crack house (nuisance abatement) laws

Drug user recognition education (DRE)

for law enforcement

Drug-free zone laws

Precursor laws

!" Law enforcement respondent 

#""Epidemiologic/ethnographic respondent 

0 1 23 45

Degree of success

Not at all Extremely successful

What they have to say...

! Task forces: As in most Pulse

Check cities, respondents agree

that the increased use of task

forces has been somewhat successful in combating drug distribution.L,E

! Precursor laws: The epidemiologic source states that new precursor laws have forced methamphetamine manufacturers to

change the way they make the

drug. The law enforcement source

believes that because the precursor laws are new, their success

cannot yet be measured.
SNAPSHOT: SACRAMENTO, CALIFORNIA

page 236 Pulse Check: January 2004

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

Three of the Pulse Check respondents agree that Sacramento’s drug problem is

stable,L,E,M while the fourth reports a worsening situation.N Three agree that the

problem is very serious.E,N,M Several developments are reported since spring 2002:

! The methamphetamine situation has improved somewhat in that legislation

has made it more difficult for manufacturers to obtain precursors.L

! Proposition 36, which took effect July 2001, mandates probation with

treatment for nonviolent drug offenders (until their third conviction, when

the law limits incarceration to 30 days). 

! Proposition 36 has helped to send many users to treatment rather than to

prison. This influx, however, has further limited treatment availability, particularly for indigents. N

! More males are entering treatment since the passage of Proposition 36, correlating to more male involvement in the criminal justice system.E

! The proportion of primary powder

cocaine and primary heroin users in

treatment has decreased somewhat

since the spring.N However, the use 

of heroin among White youth is

increasing.E

! Abuse of yaba (containing 80 percent

methamphetamine) is increasing. The

yaba found in Sacramento comes from

Asia and is marketed to Sacramento’s

Asian population.E

! Stimulant use, particularly of

methamphetamine and crack, is

increasing among Asian clients.M

! More marijuana is produced by local

businesses who use their legitimate

business to support their marijuana

production.L 

Overall, methamphetamine is considered

the most widely abused drug in

Sacramento by three of the four respondents.L,E,N It is the only Pulse Check city

where all four sources associate methamphetamine with the most serious drugrelated consequences.

Most widely abused drug:

MethamphetamineL,E,N

HeroinM

No reported changes between spring

and fall 2002L,E,N,M

Second most widely abused drug:

Crack cocaineL,N,M

MethamphetamineM

MarijuanaE

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the most serious

consequences:

MethamphetamineL,E,N,M

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the second most

serious consequences:

Crack cocaineL,E,N,M

No reported changes between spring

and fall 2002L,E,N,M

New or emerging problem:

Yaba (a form of methamphetamine) 

use is increasing, particularly among 

the Asian population.E

Heroin use is increasing among 

White youth.E

Sources: LLaw enforcement, EEpidemiologic/ 

ethnographic, N

Non-methadone treatment,

and MMethadone treatment respondents 

Note: These symbols appear throughout this

city profile to indicate type of respondent.

What are the primary drugs of abuse

among clients in a non-methadone

treatment program? (Fall 2002)

Heroin

Methamphetamine

Crack cocaine

Powder cocaine

Marijuana

Other (unspecified)

! Overall, the proportion of primary methamphetamine and crack users decreased but

the methamphetamine proportion increased among new treatment clients.N

! Methamphetamine use has declined slightly among methadone clients.M

! Smoked opium is the primary drug of abuse among 7 percent of methadone clients.M

Source: Non-methadone treatment respondent

23%

42%

14% 5%

15%

SACRAMENTO PRIMARY METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Total population:. . . 1,628,197

! Median age: . . . . . . 35.1 years 

! Race (alone):

! White . . . . . . . . . . . . . . 70.2%

! Black . . . . . . . . . . . . . . . 7.7%

! American Indian/

Alaska Native . . . . . . . . 1.1%

! Asian/Pacific Islander 9.4%

! Other race . . . . . . . . . . . 6.5% 

! Two or more races . . . . 5.2% 

! Hispanic (of any race): 14.4% 

! Unemployment rate: . . . . 3.9% 

! Median household 

income: . . . . . . . . . . . $46,602

! Families below poverty level 

with children <18 years: 13.1% 

Source: U.S. Census 2000* 

*The census data in this table are provided as a frame of reference for the information given by Pulse Check sources. Whenever possible, 

the data given by the law enforcement and epidemiologic/ethnographic sources reflect the metropolitan area. 

(N=474)

What drugs do clients in a

methadone program use+? (Fall 2002)

(N=1,100)

+

Includes any use, whether as a primary, 

secondary, or tertiary drug

Source: Methadone treatment respondent

91

4

12

22

Heroin

Methamphetamine

Crack cocaine

Opium

Diverted prescription 

drugs

Percent who abuse the drug

0 20 40 60 80 100

7
SNAPSHOT: SACRAMENTO, CALIFORNIA

Pulse Check: January 2004 page 237

! Marijuana is the primary drug of

abuse among preadolescents (13

and younger) and adolescents

(13–17) in Sacramento.N

! The proportion of primary marijuana users in treatment has increased

since spring 2002, likely due to the

impact of Proposition 36.N

How difficult is it for undercover police and users to buy drugs?

(Fall 2002)

Note: SA=South American

(Colombian) heroin; SEA=Southeast

Asian heroin; SWA=Southwest Asian

heroin; ice=highly pure methamphetamine in smokable form; and

OxyContin®=Oxycodone hydrochloride

controlled-release

Source: Law enforcement respondent

Not

difficult

at all

Undercover police

Heroin (in general, Mexican black

tar); crack and powder cocaine; marijuana (all forms); methamphetamine

(in general, locally produced,

Mexican); ecstasy

SA, SEA, and SWA

Ice

Heroin (Mexican brown)

4

3

2

1

0

5

6

7

8

9

Diverted OxyContin®

Extremely

difficult

10

Overall, the heroin problem is fairly

stable, with two changes noted:

! The proportion of primary heroin

users in non-methadone treatment

has decreased since 2002.N

! Throughout the city, heroin use

appears to be increasing among

White youth.E

The proportion of primary powder

cocaine users in treatment has

declined since spring 2002, among

both the overall treatment population and new treatment clients.N

COCAINE

MARIJUANA

Both declines and increases are noted:

! Manufacturers find it difficult to

obtain precursors, so they build

labs to make their own by breaking down pills.

! The overall proportion of primary

methamphetamine users in treatment

has decreased somewhat since spring

2002. It has, however, increased

among individuals new to treatment.N

! Methamphetamine use appears to

be increasing, particularly among

young adults.E

! The drug is produced in numerous

settings throughout Sacramento,

including small mobile labs, other

clandestine labs, and large operations, using both the “cold” (red

phosphorus) and “Nazi” (quickcooking) methods.L

MDMA (ECSTASY)

OTHER DRUGS

! As in most western cities,

undercover police have

no difficulty purchasing

methamphetamine or

black tar heroin.

! Overall, no changes in

availability are reported

since the spring.L

! Since emerging as a new drug 5

years ago, ecstasy has become

part of the city’s traditional drug

market.L

! Use among treatment clients

remains stable at low levels.N,M

! The abuse of diverted OxyContin®

and other prescription drugs such

as hydrocodone (Vicodin®)

remains stable at low levels.M

! Opium abuse remains a small, but

stable, problem among methadone

treatment clients.M

HEROIN

METHAMPHETAMINE
SNAPSHOT: SACRAMENTO, CALIFORNIA

page 238 Pulse Check: January 2004

WHAT’S HAPPENING IN TREATMENT?

Treatment capacity and availability

! The Pulse Check non-methadone

treatment source is with a facility

that can serve 425 outpatients, 40

residential clients, and 18 detox

patients. The program currently

serves 418 outpatients, 40 residential clients, and 16 detox

patients. The most common primary drug of abuse among these

clients is methamphetamine (see

pie chart on the first page of this

chapter), in contrast to most other

Pulse Check cities.N

! The methadone treatment respondent is with a three-clinic program

whose overall capacity is 1,275.

Current enrollment is 1,100.

Unlike methadone clients in many

other Pulse Check cities, these

heroin users’ most common secondary drug of abuse is methamphetamine (see bar graph on the

first page of this chapter).

M

Co-occurring disorders

! Staff are better trained to treat

comorbidities than they were in

the past, making treatment more

available to clients with dual diagnoses.N

! An estimated 25–50 percent of

clients have mental health issues in

addition to their drug addiction.N

! Noted increases in antisocial, conduct, and mood disorders are due

to more effective diagnostic efforts

in some treatment programs.N

! While antisocial and conduct disorders are common upon admission,

once clients are on methadone the

disorders tend to disappear.M

! Clients referred to treatment

through Proposition 36 are often

older users with mental health

problems; most are also new to

treatment.M

! Some treatment providers observe

an increase in psychosis among

clients. This change is attributed 

to Proposition 36, because mental

illness—particularly schizophrenia—

is common among arrestees.M

Barriers to treatment

! Limited slot capacity, which remains

the primary barrier to treatment,

has worsened since spring 2002 in

some treatment programs.N

! A lack of transportation is increasing as a barrier to treatment due to

the weakened economy.M

! Lack of funding remains a significant barrier to treatment for indigent patients.M

! A significant Russian population

resides in Sacramento, but drug

users in this community often do

not enter treatment due to cultural

and language barriers.M

! A lack of housing and employment

opportunities for recovering clients

represents a serious complication to

users’ long-term recovery.N,M

Consequences of drug use

! High-risk pregnancy has decreased

since spring 2002 among methadone treatment clients, although

it is still not uncommon.M

! Drug-related car accidents are 

stable at low levels as a result of

stiffer legal consequences.N

! Prevention efforts and early detection of HIV/AIDS has kept the

number of HIV-positive clients

either stable at, or decreasing to,

low levels.N,M 

! The incidence of hepatitis C

increased to high levels among

treatment clients, likely due to followup testing efforts by program

staff.N Nearly 100 percent of

injecting drug users are positive

for hepatitis C.M

! Heroin users present with more

severe abscesses as a result of

injecting heroin cut with pectin (a

fruit preservative).M

Changes over the past 10 years

! Significant price declines for 

heroin, crack cocaine, and

methamphetamine have exacerbated the drug problem.M

! The city’s drug problem increased

in complexity with the availability

of new and substitute drugs such

as ecstasy, gamma hydroxybutyrate

(GHB), and club drugs.N

! A significant change in the past

decade has been the spread of

drug use among youth—club drugs

and alcohol in particular.N

! Proposition 36 has added to the

complexity of Sacramento’s drug

problem by dramatically increasing

court referrals.N,M This influx of

clients added 100 new treatment

cases to the methadone program,M

and has increased the need for more

residential treatment programs.N

WHO USES ILLICIT DRUGS? 

The Pulse Check epidemiologic, nonmethadone treatment, and

methadone treatment sources were

asked to describe the populations

most likely to use heroin, cocaine,

marijuana, methamphetamine, and

ecstasy. They were also asked to

describe any emerging user groups

and to report on how the drugs are

used. As shown on the following

pages, user characteristics vary by

drug. Further, because of the different

perspective each brings, the three

sources sometimes describe quite different populations and use patterns

for each drug. For example, all

methadone clients are primary opiate

users who may use drugs other than

opiates in a secondary or tertiary

manner. 

THE USE PERSPECTIVE
SNAPSHOT: SACRAMENTO, CALIFORNIA

Pulse Check: January 2004 page 239

Who’s most likely to use heroin?

Characteristic E N M

Age group (years) >30 18–30 >30

Mean age (years) NR NR 42

Gender 56% male 73% male 60% male

Race/ethnicity White White White

Socioeconomic status NR Middle Low 

Residence NR Central city Central city

Referral source N/A Criminal justice Individual

Level of education completed N/A Junior high High school 

Employment at intake N/A Unemployed Unemployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

How do users take heroin?

Characteristic E N M

Primary route of Injecting Injecting Injecting

administration 

Other drugs NR Crack (speedball) Methamphetamine

Publicly or privately? NR Privately Privately

Alone or in groups? NR Alone Alone

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone 

treatment respondent

! Users sometimes adulterate heroin with lactose, instant coffee, horseshoe pack, quinine, and

sugar,N as well as shoe polish and various dyes.M

! Dealers often cut heroin with methamphetamine; as a result, treatment clients often test positive for

methamphetamine even though they claim to use only heroin.M

! Primary heroin users new to treatment are more likely to be polydrug users, in contrast to the overall heroin treatment population.M

! The proportion of primary heroin users in treatment decreased since spring 2002. This decline

may be related to changes in slot capacity rather than declines in use.N

! The proportion of females in treatment for primary heroin use is higher among clients new to

treatment than among the overall heroin treatment population.N

! While Whites represent the majority of primary heroin users in methadone treatment, Hispanic

clients represent 20 percent, twice the proportion of Black clients.M
SNAPSHOT: SACRAMENTO, CALIFORNIA

page 240 Pulse Check: January 2004

Who’s most likely to use marijuana?

Characteristic E N

Age group (years) 18–30 18–30 

Gender 61% male 58% male

Race/ethnicity White White/Black

Socioeconomic status NR Middle

Residence NR Central city 

Referral source N/A Criminal justice

Level of education completed N/A Junior high

Employment at intake N/A Unemployed 

Sources: EEpidemiologic/ethnographic respondent and NNon-methadone treatment respondent

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

Respondents associate marijuana,

used either alone or with other drugs,

with the following consequences,

which remained stable between spring

and fall 2002:N

! Drug-related arrests

! Automobile accidents

! Short-term memory loss

! Deteriorating family and/or social

relationships

! Poor academic performance

! School absenteeism or truancy

! Dropping out of school

! Poor workplace performance

! Workplace absenteeism

! Unemployment rates

Who’s most likely to use cocaine?

Characteristic Crack Cocaine Powder cocaine

E N M E N 

Age group (years) >30 13–17 >30 >30 18–30 

Mean age (years) NR NR 42 NR NR 

Gender Split evenly 60% male 60% male Split evenly 64% male 

Race/ethnicity Black Black White Black Black 

Socioeconomic status NR Low Low NR Middle 

Residence NR Central city Central city NR Central city 

Referral source N/A Criminal justice Criminal justice N/A Criminal justice 

Level of education completed N/A High school High school N/A High school 

Employment at intake N/A Unemployed Unemployed N/A Unemployed 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent 

! Blacks represent an increasing proportion of cocaine users, rising from 69 percent to 75 percent between spring

and fall 2002.E

! Primary crack cocaine users often combine marijuana (THC or weed) with crack.N

! Primary powder cocaine users often combine the drug with opiates (speedball).N

! Crack and powder cocaine users add adulterants to the cocaine such as baking powder, baking soda, ether (for

crack), and infant laxatives (for powder cocaine).N

! While the majority of primary marijuana users are

young adults, more than 20

percent are adolescents.E

! Primary marijuana users in

treatment are most often

referred by the criminal justice system for both possession and sale of the drug.N
SNAPSHOT: SACRAMENTO, CALIFORNIA

Pulse Check: January 2004 page 241

Increased overall difficulty in treating the

addiction 

Increased polydrug use 

Increased court referrals involving marijuana

possession 

Increased court referrals involving marijuana

sales

Decline in users’ perception of harm

Decline in social disapproval 

Increased severity of addiction among clients 

Increased THC potency of marijuana 

Increased progression to use of other drugs 

Earlier initiation of marijuana use 

Glamorization by entertainment industry 

01 2 3 4 5

Extent complicated treatment

Not at all Extremely

Marijuana-using clients: To what extent have changes in the following

problems complicated their treatment over the past 10 years?

Reason

01 2 3 4 5

Extent contributed

Not at all Extremely

Source: Law enforcement respondent

Increase in indoor farms

More local production

Less emphasis by law enforcement and courts

Decline in users’ perception of harm

Decline in social disapproval 

Promotion of marijuana as “medicine”

Glamorization by entertainment industry 

Glamorization by news media

Widespread marijuana availability and use over the past 10 years: To what extent have the following

contributed?

Source: Non-methadone treatment respondent

What they have to say...

! As in many other Pulse Check cities,

glamorization by the news media has

played a relatively minor role in increasing marijuana use and availability.

! Indoor farms run by larger businesses

have increased; these businesses sell

retail merchandise that supports the

marijuana production inside.L

! Proposition 215, which legalized 

marijuana for “compassionate use,” is

ambiguous because it doesn’t 

set forth specific thresholds; there are

also many loopholes in the 

legislation.L

! Perception of harm: The legalization of marijuana for “medicinal” purposes has added to a

decline in society’s perception of

harm associated with the drug.N

! Social disapproval: Not only

has social disapproval associated

with marijuana use declined over

the past 10 years, but in some

social settings, individuals are

looked down upon if they do not

use the drug.N

! Earlier initiation of marijuana use: Earlier first use among

youth age 9–13 has made treating the addiction more difficult.N

! Polydrug use: Polydrug use is

“everywhere.”N

! THC levels: The THC level in

marijuana has increased over

the past 10 years, complicating

treatment. In fact, among many

users, “THC” is the “in” drug.N

Problem Change 
SNAPSHOT: SACRAMENTO, CALIFORNIA

page 242 Pulse Check: January 2004

Who’s most likely to use methamphetamine?

Characteristic E N M

Age group (years) >30 18–30, >30 >30 

Mean age (years) NR NR 42 

Gender Split evenly 53% male 60% male 

Race/ethnicity White White White 

Socioeconomic position NR Low Low 

Residence NR Central city Central city

Referral source N/A Criminal justice Individual 

Level of education completed N/A Junior high High school

Employment at intake N/A Unemployed Unemployed 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Methamphetamine users in

Sacramento are older than those in

other Pulse Check cities (such as

Chicago and Detroit).E,N,M However,

the user population is now shifting

toward younger adults.E

! The most common route of administration among methamphetamine

users varies among different populations, from smokingE,N to injecting.M

! The majority of methamphetamine

users in treatment are referred by the

criminal justice system as a result of

Proposition 36.N

THE MARKET PERSPECTIVE

WHERE ARE DRUGS SOLD?

Heroin and crack cocaine are sold in

many of the same settings, including:L

! Streets/open-air markets

! Crack houses/shooting galleries

! Private residences

! Public housing developments

! College campuses

! Private parties

! Nightclubs/bars

! Hotels/motels

! Inside cars

Powder cocaine is sold in most of the

same settings as heroin and crack,

with the exception of crack

houses/shooting galleries, public

housing developments, and

hotels/motels. Crack cocaine is sold

around local schools.L

Marijuana transactions take place in

most of the same settings as the other

drugs.L

Methamphetamine and ecstasy are

sold in fewer settings, including in

private residences, nightclubs/bars,

and inside cars. Methamphetamine is

also sold on the streets and in

hotels/motels, while ecstasy is sold on

college campuses and at raves and

concerts.L

HOW DO DRUGS GET FROM SELLER

TO BUYER?

Drug transactions in Sacramento

nearly always take place hand to hand

from seller to buyer.L

Sellers of all drugs communicate with

both buyers and suppliers in various

ways: in person and by the telephone,

cell phone, pager, and two-way e-mail

pager.L

While powder cocaine, marijuana,

and ecstasy dealers generally sell just

one drug, dealers of heroin, crack

cocaine, and methamphetamine 

typically sell all three.L

WHO’S MOST LIKELY TO USE OTHER

DRUGS?

! Diverted prescription drugs:

Seventy percent of abusers of

diverted prescription drugs 

(primarily hydrocodone) are

women. Most prescription drug

abusers initially receive the drug

for treatment of chronic pain and

then become addicted. These

clients typically have mental disorders and are very difficult to

treat.M

! Opium: Primary abusers of smoked

opium represent 7 percent of

methadone treatment clients.

These individuals are older than

30, split evenly between male and

female, and are predominantly

Asian/Pacific Islander. Treatment

providers note an increase in the

abuse of methamphetamine and

crack among these clients.M
SNAPSHOT: SACRAMENTO, CALIFORNIA

Pulse Check: January 2004 page 243

THE CHANGING DRUG MARKET: THE LAST 10 YEARS

What they have to say...

! As reported in three other Pulse Check cities (Houston, Philadelphia, and San Francisco), the practice of exchanging sex

for drugs has declined over the past decade due to the risk of HIV/AIDS and hepatitis C.N,M

! Many users ship stolen property and merchandise to Mexico in exchange for drugs such as heroin, crack cocaine, and

methamphetamine.M

! Exchanging stolen merchandise for cash is much more difficult today due to stores’ more stringent return policies, therefore reducing the practice of stealing goods to pay for drugs.N,M

Beyond cash: What else is accepted in exchange for drugs?

Heroin

Cash

Crack cocaine

Marijuana Methamphetamine

70%

Shoplifted merchandise

Other stolen

merchandise

Property/

merchandise

Other drugs

Drug buying 

services

Other: Includes items accounting for

3 percent or less of transactions for

all five drugs, such as guns, transporting and stealing the drug, and

injecting and lookout services.

Sex

81%

66%

63%

10%

3%

8%

4%

10%

7%

6%

7%

8%

6%

7%

11%

Powder cocaine

73%

5%

1% 6%

5%

Source: Mean of response ratings given by law enforcement, non-methadone treatment, and methadone treatment respondents; the epidemiologic/ethnographic

respondent did not respond to this question; the methadone treatment respondent provided data for heroin, crack cocaine, and methamphetamine only. 

Which drug sellers are associated with which crimes?

Crime Heroin Crack Powder Marijuana Metham- Ecstasy Diverted

cocaine cocaine phetamine OxyContin®

Gang-related activity $ $

Violent criminal acts $$ $ $

Nonviolent criminal acts $$ $ $

No crimes associated $ $

Source: Law enforcement respondent

Marijuana sellers are often

involved in nonviolent criminal

acts such as receiving stolen

property and committing burglaries. They are also commonly charged with driving

under the influence (DUI).L

Food stamps

4%

3%

4%

3% 2% 2% 2%

4%

3%

3%

3%

2%

3%

1%

2%
SNAPSHOT: SACRAMENTO, CALIFORNIA

page 244 Pulse Check: January 2004

How much does heroin cost?

Unit (Black tar heroin) Price 

0.25 g $20–$40

1 g $90–$100

1 oz $500–$800

Source: Law enforcement respondent

! The ounce price of black tar heroin

(the most common form) changed from

$600–$750 in spring 2002 to a wider

range of $500–$800 in fall 2002.L

! Purity of black tar heroin is 16–18 percent, representing an increase between

spring and fall 2002.L

All reported prices are stable

between spring and fall 2002.

WHO’S SELLING HEROIN?

Heroin dealers tend to be young

adults working as part of structured

organizations, particularly Mexican

nationals, Mexican gangs, and 

Asian gangs.L

WHO’S SELLING COCAINE?

Crack and powder cocaine dealers

tend to be young adults involved in

larger organizations. Crack dealers

are typically part of traditional Black

street gangs, while powder cocaine

dealers are often Mexican nationals

or members of Mexican or Asian

gangs. Most of the crack cocaine sold

in Sacramento is locally processed.L

WHO’S SELLING MARIJUANA?

Most marijuana dealers are young

adults working independently and

are almost always users themselves.

Some members of organized crime

also sell marijuana in order to have it

as part of their “menu.”L

WHO’S SELLING METHAMPHETAMINE ? Methamphetamine dealers

are generally young adults working

within a larger organization. These

dealers are often users of the drug.L

WHO’S SELLING ECSTASY, AND HOW

MUCH DOES IT COST?

! Ecstasy dealers are generally young

adults working independently, who

are not involved in other criminal

activity; they are almost always

ecstasy users as well.L

! Ecstasy currently sells for $80 

per pill.

WHO’S SELLING OTHER DRUGS?

Individuals who sell diverted

OxyContin® do so independently.

Some are users of the drug themselves,

and they are generally not involved 

in any other criminal activity.L

How much does marijuana cost?

Unit Price 

1 g $25 

1 oz $200–$250 

1 lb $1,000–$1,200 

Source: Law enforcement respondent

How much does cocaine cost?

Form Unit Price 

Crack 0.2 g $20

1 g $100

1 oz $450–$750

Powder 1 oz $500–$600

1 g $80

1 kg $14,000–$17,000

Source: Law enforcement respondent

How much does methamphetamine

cost?

Unit Price 

1 g $80 

1 oz $300–$600 

Source: Law enforcement respondent

! The price for a gram of powder cocaine decreased from $100 to

$80 between spring and fall 2002, while the price of a kilogram

increased from $10,000–$15,000 to $14,000–$17,000.L

! The price of crack cocaine is unchanged.L

! Powder cocaine purity is 78 percent, while crack cocaine purity

ranges from 60 to 85 percent.L

! The ounce price of methamphetamine declined between

spring and fall 2002.L

! Methamphetamine purity

also declined slightly to

approximately 20 percent.L
SNAPSHOT: SACRAMENTO, CALIFORNIA

Pulse Check: January 2004 page 245

Community innovations and tools over the past 10 years: 

How successful have they been?

SEPTEMBER 11 FOLLOW UP

Three of the four Pulse Check

respondents note continuing effects

of the September 11 attacks and their

aftermath on Sacramento’s drug

problem.L,N,M

! The law enforcement respondent

notes that a shift in priority from

combating the drug problem to

fighting terrorism has put law

enforcement at a disadvantage,

particularly with respect to 

technical support systems such as

wiretaps.L

! A continued impact on mental

health is evidenced by a sustained

increase in referrals through a

dual diagnosis program.N This pattern is likely due to frightened

users turning more heavily to

drugs for relief.M

THE MARKET PERSPECTIVE: A 10-YEAR VIEW

Drug marketing innovations and tools over the past 10 years: To what

degree have they complicated efforts to detect or disrupt illicit drug

activity in Sacramento?

012 3 4 5

Degree of complication

Not at all Extremely complicated

Source: Law enforcement respondentL 

Throwaway cell phones

Increased communications via Internet

More organized networks

! Detection and disruption efforts have not been hampered much by more

organized networks.

! As in many cities across the Nation, advancing technologies such as cell

phones and the Internet have seriously complicated law enforcement’s

ability to detect and disrupt drug activity.L

What they have to say... 

! The methamphetamine situation has improved somewhat in that legislation has made it more difficult for

manufacturers to obtain precursors.L

! Onsite lab tests are very successful in disrupting

Sacramento’s drug markets.L,E This is beneficial not

just to law enforcement, but also to child protective

services, because it helps to ensure that parents are

not continuing drug activity while their children are in

out-of-home placements.E

! Sacramento law enforcement has three task forces

focused specifically on methamphetamine. They also

operate task forces with the Drug Enforcement

Administration (DEA), High Intensity Drug Trafficking Area

(HIDTA), California Multi-Jurisdictional Methamphetamine

Enforcement Team (Cal-MMET), and Crack Rock Impact

Sacramento (CRIPS).L

! All narcotic teams operating within law enforcement

are DRE certified; these individuals then train patrol

officers.L

! As reported in the majority of Pulse Check cities, drug

courts have met with great success.E Adult and

dependency drug courts operate currently. A juvenile

drug court is now awaiting funding.E

NR=Not reported

Onsite lab tests

Increased use of task forces 

Precursor laws

Drug-free zones

Drug courts 

Use of crack house (nuisance 

abatement) laws 

Drug user recognition education 

(DRE) for law enforcement 

Sentencing changes

!""Law enforcement respondent 

#""Epidemiologic/ethnographic respondent

01 23 4 5

Degree of success

Not at all Extremely successful

NR

NR

NR

NR

NR

NR
SNAPSHOT: ST. LOUIS, MISSOURI

page 246 Pulse Check: January 2004

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

Two Pulse Check sources believe the city’s overall drug problem is stable,L,N

while two believe it is somewhat worse.E,M Specifically, several developments 

are reported:

! Community efforts regarding methamphetamine are starting to pay off:

! Several statewide methamphetamine task forces, mostly through law enforcement agencies, have led to policy and legislation regarding clandestine labs

and precursor sales.E

! Legislation has increased penalties for possession of precursors and for

methamphetamine manufacture and distribution.E

! Because of legislation regarding sales of ephedrine-based products, large

retail stores are flagging anyone who purchases large quantities of cold

medicines, and they have been reducing store displays of such products.E

! Law enforcement conducted two major

seizures involving methamphetamine,

marijuana, and cocaine. The drugs originated in Mexico and arrived via Seattle.

This is the first time Seattle has been

identified as part of the drug trafficking

route to St. Louis.E

! Emerging problems, such as increased

involvement in emergency department mentions, are reported regarding narcotic analgesics (including methadone, hydrocodone,

and oxycodone) and phencyclidine (PCP).E

Three of the Pulse Check sources believe

the city’s overall drug problem is very serious, while oneL describes it as “somewhat

serious.” All but oneM also agree that marijuana is still the most widely abused drug in

St. Louis.L,E,N All four sources name crack as

the drug related to the most serious or second most serious consequences.

Most widely abused drug:

MarijuanaL,E,N

HeroinM

No reported changes between spring

and fall 2002L,E,N,M

Second most widely abused drug:

CrackL,E,M

MethamphetamineN

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the most serious

consequences:

CrackL,E

MethamphetamineN

HeroinM

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the second most

serious consequences:

Crack cocaineN,M

MethamphetamineL

MarijuanaE

Changes between spring and fall 2002:

Methamphetamine has replaced heroin

as the drug associated with the second

most serious consequences.L

New or emerging problems:

PCPE

Narcotic analgesics (hydrocodone, 

oxycodone, methadone)E

Sources: LLaw enforcement, EEpidemiologic/ 

ethnographic, NNon-methadone treatment,

and MMethadone treatment respondents 

Note: These symbols appear throughout this

city profile to indicate type of respondent.

What are the primary drugs of abuse

among clients in a non-methadonetreatment program? (Fall 2002)

Heroin

Methamphetamine

Crack cocaine

Powder cocaine

Marijuana

Ecstasy

Diverted OxyContin®

Other (unspecified)

SPRING 2002 VS FALL 2002

! While 30 percent of clients identify marijuana as their primary drug of abuse, 90

percent use it as either a primary, secondary, or tertiary drug.N

! More primary heroin users in the

methadone program are using crack as a

substitute for heroin when they cannot

afford to purchase heroin.M

Source: Non-methadone treatment respondent

30%

15%

5%

9% 2%

2%

10%

27%

ST. LOUIS METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Total population:. . . 2,603,607

! Median age: . . . . . . 36.0 years 

! Race (alone):

! White . . . . . . . . . . . . . . 78.3%

! Black . . . . . . . . . . . . . . 18.3%

! American Indian/

Alaska Native . . . . . . . . 0.2%

! Asian/Pacific Islander 1.4%

! Other race . . . . . . . . . . . 0.5% 

! Two or more races . . . . 1.2% 

! Hispanic (of any race): 1.5% 

! Unemployment rate: . . . . 3.7% 

! Median household 

income: . . . . . . . . . . . $44,437

! Families below poverty level 

with children <18 years: 11.2% 

Source: U.S. Census 2000* 

*The census data in this table are provided as a frame of reference for the information given by Pulse Check sources. Whenever possible, the data given by

the law enforcement and epidemiologic/ethnographic sources reflect the metropolitan area. 

What drugs do clients in a methadone

program use+? (Fall 2002)

(N=242)

Heroin

Methamphetamine

Benzodiazepines

Crack cocaine

Powder cocaine

+Includes any use, whether as a primary,

secondary, or tertiary drug

Source: Methadone treatment respondent

0 20 40 60 80 100

91

4

6

Percentage 

(N=600)

25

20
SNAPSHOT: ST. LOUIS, MISSOURI

Pulse Check: January 2004 page 247

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic respondent respondent.

Note: SA=South American (Colombian) heroin; SEA=Southeast Asian heroin; SWA=Southwest

Asian heroin; ice=highly pure methamphetamine in smokable form; and BC Bud=British

Columbian marijuana.

Not

difficult

at all

Undercover policeL UsersE

Heroin (in general, Mexican

black tar, and Mexican brown);

crack, powder cocaine; 

marijuana (in general and 

sinsemilla); ecstasy 

Diverted OxyContin®

4

3

2

1

0

5

6

7

8

9

Methamphetamine (in general 

and locally produced) 

! While users had difficulty purchasing

marijuana during October and November

2002, undercover law enforcement did

not have any difficulty purchasing the

drug.L

! Diverted OxyContin® (oxycodone

hydrochloride controlled-release) and

khat were more available in the fall than

in the spring.L

! It became more difficult to purchase

gamma hydroxybutyrate (GHB) in the fall.L

! The availability of liquid ecstasy

decreased.L

! BC bud became more available in recent

months (as reported in Minneapolis/St.

Paul and Seattle).E

! While ice could not be purchased at

times by users around St. Louis, it

became easier to purchase in western

Missouri around Kansas City.E

! St. Louis is the only midwestern Pulse

Check city where undercover law

enforcement found no difficulty in 

purchasing heroin in general.L

Extremely

difficult

10

Hydroponic marijuana Mexican black tar heroin; crack

cocaine; ecstasy 

Mexican methamphetamine;

PCP

BC bud; ice; diverted

OxyContin®

SA, SEA, SWA

Heroin (in general); hydroponic

marijuana; methamphetamine

(in general) 

Mexican brown heroin; 

powder cocaine; marijuana (in

general, sinsemilla, and local

and Mexican commercial

grade); methamphetamine

(locally produced)

Heroin (SA); local commercial

marijuana

SEA, SWA; BC bud; methamphetamine (Mexican, ice) 

HEROIN

COCAINE

MARIJUANA

Heroin use remains stable in St.

Louis.E,N,M

Three of the four respondents consider

crack cocaine the second most widely

abused drug in the city, after marijuana.L,E,M

! Crack use remains stable among

drug treatment clients,N,M except

for an increase among primary

heroin users: when they cannot

afford to buy heroin, they use

crack instead.M

! Abuse of powder cocaine is stable

among all treatment clients.N,M

Three of the four respondents consider marijuana St. Louis’s most widely

abused drug.L,E,NUse among treatment

clients, however, is stable.

METHAMPHETAMINE

Methamphetamine emerged as a new

problem drug in St. Louis 5 years

ago, and as reported in 14 other Pulse

Check cities, the problem continues

to grow:E

! Methamphetamine is associated

with either the most seriousN or

second most seriousL drug-related

consequences by two respondents,

surpassing crack cocaine several

years ago according to some treatment providers.N

! Most methamphetamine in St.

Louis is produced in small mobile

“box” labs using either the “cold”

(red phosphorus) or “Nazi”

(quick-cooking) method.L
SNAPSHOT: ST. LOUIS, MISSOURI

page 248 Pulse Check: January 2004

! Abused methadone: Emergency

department (ED) mentions involving methadone have increased.E

Heroin users often use the drug

along with or as a substitute for

heroin,M and crack users sometimes

take methadone along with crack.N

! Diverted OxyContin®: Abuse of

diverted OxyContin® remains stable

at low levels,N,M although ED mentions have increased since spring

2002.E

! Hydrocodone (Vicodin®): ED mentions involving hydrocodone have

increased since spring 2002.E

! PCP: The number of PCP users in

St. Louis increased between spring

and fall 2002. These adolescents

and young adults often dip marijuana joints in a PCP solution

(“dips”).E

! Benzodiazepines: Heroin users

often take benzodiazepines as a

substitute for heroin.M

! Khat: This plant from East Africa

and Southern Arabia, whose leaves

contain psychoactive ingredients

structurally and chemically similar

to d-amphetamine, increasingly

appeared on the drug market since

the spring. Law enforcement made

three seizures of the drug during

fall 2002.L

THE USE PERSPECTIVE

OTHER DRUGS

WHAT’S HAPPENING IN TREATMENT?

Treatment capacity and availability

! The Pulse Check non-methadone

treatment facility is currently operating at its maximum capacity of

600 clients. The two most common

primary drugs of abuse among

these clients are marijuana and

crack cocaine (see pie chart on the

first page of this chapter).

N

! The methadone treatment respondent is with a program whose current enrollment of 242 clients is

nearly at its capacity of 250. Onequarter of its heroin users also use

crack (see bar graph on the first page

of this report). They are increasingly

substituting crack when they cannot

afford to buy heroin.M

! Treatment slots have become less

available and waiting lists have

become longer since the spring.E,N,M

The decrease in treatment slots is

due to funding cuts and subsequent

closings of private clinics in the

area.E,N Public methadone programs

in particular have long waiting lists

(2 months on average).E

Barriers to treatment

! State budget cuts are also affecting

prevention efforts, and more treatment and prevention programs are

in danger of closing.E

! A lack of trained staff to treat

clients with dual diagnoses remains

a significant barrier to effective

treatment. While licensed professionals are on staff, there are not

enough of them to fully meet the

needs of all clients.N

! Transportation costs increased as a

barrier to treatment for clients in the

methadone treatment program.

Many of these clients’ families have

cut off social and financial support.

Many receive Supplemental Security

Income (SSI) and live on limited

incomes.M

! Treatment clients are experiencing

increased difficulty finding housing

opportunities and higher skill sustainable employment.N These problems contribute to instability and

the likelihood of relapse.

Consequences of drug use

! The incidence of HIV/AIDS among

treatment clients has declined since

the spring, likely due to education

and media attention.M

! The incidence of hepatitis C among

treatment clients has increased to

near epidemic levels. There is a

strong need for increased funding

to develop more effective treatment for the virus.N,M

! The number of clients reporting

high-risk pregnancies is extremely

high due to referrals from family

drug courtsN and the Division of

Family Services.M

Co-occurring disorders

! The number of clients presenting

with antisocial/conduct,N psychotic,M

and moodN disorders has increased,

for two reasons:

! Awareness of comorbidity has

increased, leading to more effective diagnoses and to increased

referrals from mental health 

centers.M

! Community mental health programs are not able to effectively

handle comorbid clients due to

reduced funding, so they end up

in drug treatment rather than in

mental health treatment.N

! The State is currently designing 

a method to make all mental health

and drug treatment programs competent to treat dually diagnosed

clients to reduce the strain on both

systems.N

! The incidence of suicidal thoughts

or attempts has decreased since the

Methylenedioxymethamphetamine

(ecstasy) emerged as a new drug in St.

Louis 5 years ago,L and there are

mixed reports on the nature of the

problem today:

! Use among treatment clients

remains stable at very low levels.N,M

! One source believes that ecstasy use

appears to be decreasing,L while

another observes continued growth

in St. Louis’s ecstasy problem.E

MDMA (ECSTASY)
SNAPSHOT: ST. LOUIS, MISSOURI

Pulse Check: January 2004 page 249

spring among methadone treatment clients.M

! Attention deficit hyperactivity 

disorder (ADHD) has increased

since the spring, particularly

among the younger treatment population. This may be attributable

to an increase in diagnoses rather

than in the number of people with

the disorder.N

WHAT HAS CHANGED OVER THE

PAST 10 YEARS?

! Users no longer appear to be

“maturing out” of their drug use.

Instead, more individuals are

becoming chronic, long-term drug

users. As a result, in addition to

more younger people using drugs

in recent years, use among older

people is getting worse as well.E

! Increased court referrals have

helped get individuals into needed treatment. The resulting

increase in treatment caseloads,

however, has made it difficult for

case managers and counselors to

keep up.N

! The normalization of marijuana

use has made it difficult to treat

marijuana-using clients,N,M particularly adolescents, who do not perceive the harm involved.N It is also

increasingly common for these

marijuana-using youth to have

marijuana-using parents, making it

more difficult to effectively communicate the message of harm

related to marijuana use.N

! A rise in the availability of crack,

heroin, and, most recently, methamphetamine, has complicated the

community’s drug problem.N

! Polydrug use has increased over

the last 10 years, complicating

treatment efforts.M

WHO USES ILLICIT DRUGS? 

The Pulse Check epidemiologic, nonmethadone treatment, and methadone

treatment sources were asked to

describe the populations most likely to

use heroin, cocaine, marijuana, methamphetamine, and ecstasy. They were

also asked to describe any emerging

user groups and to report on how the

drugs are used. As shown on the following pages, user characteristics vary

by drug. Further, because of the different perspective each brings, the three

sources sometimes describe quite different populations and use patterns for

each drug. For example, all methadone

clients are primary opiate users who

may use drugs other than opiates in a

secondary or tertiary manner.

Who’s most likely to use heroin?

Characteristic E N M

Age group (years) >30 18–30 >30

Mean age (years) 38 NR 32

Gender 70% male 60% female Split evenly

Race/ethnicity White/Black White White

Socioeconomic status Low Low Middle

Residence Central city All areas Suburbs

Referral source N/A Criminal justice Self-referral

Level of education completed N/A Junior high High school 

Employment at intake N/A Unemployed Unemployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

The proportion of heroin users who are unemployed has increased;

many receive SSI.M

How do users take heroin?

Characteristic E N M

Primary route of Injecting Snorting/Injecting Snorting/Injecting

administration 

Other drugs taken Narcotic analgesics, Marijuana, prescription Crack and powder

crack cocaine drugs, methadone cocaine (speedball) 

Publicly or privately? Privately Privately Privately 

Alone or in groups? Alone In groups Both 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! The practice of snorting heroin is

increasing, particularly among younger

users. These youth tend to snort rather

than inject because of fears of hepatitis C and HIV.M

! When speedballing, heroin users inject

powder cocaine or smoke crack

cocaine.M Speedballing is more common among younger users.E

! Users often take heroin along with marijuana, prescription drugs, or

methadone.E,N Narcotic analgesics are

sometimes used as a substitute for

heroin.E

! Heroin users often take the drug with

health food products such as Golden

Seal® and milk thistle, water, and

diuretics. These substances are generally taken as a way to “cleanse the system,” with users trying to achieve negative drug screens.M

! While the majority of heroin users take

the drug when alone, younger users

typically use it in groups.E
SNAPSHOT: ST. LOUIS, MISSOURI

page 250 Pulse Check: January 2004

Who’s most likely to use cocaine?

Characteristic Crack cocaine Powder cocaine

E N M E N M

Age group (years) 18–30 >30 18–30 18–30, >30 >30 >30 

Mean age (years) 28 32 NR 32 30 NR 

Gender 60% male Split evenly Split evenly 60% male 70% male Split evenly

Race/ethnicity Black Black White White White White 

Socioeconomic Low Low Low Middle/high Middle Middle 

status 

Residence Central city Central city Suburbs Suburbs Suburbs Suburbs 

Referral source N/A Criminal Self-referral N/A Criminal Selfjustice justice/self- referral 

referral 

Level of education N/A Junior high Junior high N/A High school High 

completed school 

Employment at N/A Unemployed/ Unemployed N/A Full time Full time 

intake part time 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent 

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

Respondents associate marijuana,

used either alone or with other

drugs, with the following consequences, which remained stable

between spring and fall 2002:

! Drug-related emergency department

visitsE,N

! Drug-related arrestsE

! Automobile accidentsE

! Short-term memory lossN

! Deteriorating family and social

relationships (especially for

youth)E,N

! Poor academic performanceN

! School absenteeism or truancyN

! Dropping out of schoolN

! Poor workplace performanceE

! Positive drug screens on the job

leading to probationN

! Unemployment ratesE

! Increase in marijuana-induced

paranoiaN

! Black crack users in treatment are overrepresented compared with

their proportion in the city’s population.E,N Whites are overrepresented

among powder cocaine users.E

! Methadone treatment clients reporting crack cocaine use are increasingly younger.M

! Crack users tend to use the drug along with marijuana,E,N diverted prescription drugs,E alcohol,E or methadone.E Powder cocaine users take

marijuana,E,N heroin,M or tranquilizersE along with cocaine.

! In the past, most powder cocaine users entered treatment on their own

initiative. Between spring and fall 2002, however, clients have become

evenly split between self-referrals and referrals from the criminal justice

system.N

! More crack users in treatment live in the central city since the spring.N
SNAPSHOT: ST. LOUIS, MISSOURI

Pulse Check: January 2004 page 251

Who’s most likely to use marijuana?

Characteristic E N

Age group (years) 13–17, 18–30, >30 18–30 

Mean age (years) 28 23 

Gender 70% male 75% male 

Race/ethnicity White, Black White, Black 

Socioeconomic status Low/middle Low/middle 

Residence Central city, Central city, 

suburbs, and suburbs, and

rural areas rural areas

Referral source N/A Criminal justice 

Level of education completed N/A High school 

Employment at intake N/A All categories 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment

respondents

! Primary marijuana users in treatment generally have

a history of abusing hallucinogens, licit drugs, and

ecstasy.N Marijuana users often take crack cocaine,

methamphetamine, or alcohol when they smoke

marijuana.E

! Whites and Blacks are equally represented among

primary marijuana abusers, but Blacks are

overrepresentedE,N and WhitesE are underrepresented compared with the overall St. Louis population.

! Marijuana users referred to treatment by the criminal justice system are typically individuals on probation who have a positive urine test.N

! As is the case in most Pulse Check cities, first use of

marijuana is occurring at younger ages, representing

the most significant complication to treating marijuana addiction among treatment clients—particularly

young clients—in St. Louis.N

Problem Change 

Earlier initiation of marijuana use 

Increased severity of addiction among clients 

Increased overall difficulty in treating the addiction

Decline in social disapproval

Glamorization by entertainment industry 

Increased progression to use of other drugs 

Increased THC potency of marijuana 

Increased polydrug use 

Decline in users’ perception of harm 

Glamorization by news media 

0 12 345

Extent complicated treatment

Not at all Extremely

Marijuana-using clients: To what extent have changes in the following 

problems complicated their treatment over the past 10 years?

! Severity of addiction and earlier initiation

of marijuana use: Many adolescents are

using marijuana on a daily basis at increasingly younger ages, which is contributing to

the severity of their addiction and, therefore, to the difficulty in treating them.N

! Social disapproval: One treatment

provider believes the inconsistency

between parental acceptance and institutional disapproval intensifies the marijuana problem among youth.N

! Polydrug use: As individuals start using

marijuana at younger ages, they also

progress to other drugs at earlier ages.N

! Court referrals: The non-methadone

respondent notes that court referrals involving marijuana are actually decreasing due

to lessened law enforcement focus on marijuana. Many young clients report that when

police stop them, officers simply take away

their marijuana and give them a warning.

Further, family drug courts do not deal with

drug-exposed babies if the only drug

involved is marijuana.N

NR

0

0

!"Non-methadone treatment respondent

#"Methadone treatment respondent

NR=Not reported
SNAPSHOT: ST. LOUIS, MISSOURI

page 252 Pulse Check: January 2004

Who’s most likely to use methamphetamine?

Characteristic E N M

Age group (years) 18–30 18–30, >30 18–30 

Mean age (years) 26 28 NR 

Gender 60% male 75% male Split evenly 

Race/ethnicity White White White

Socioeconomic position Low Low Middle 

Residence Rural areas Rural areas Rural areas 

Referral source N/A Criminal justice Self-referral 

Level of education completed N/A Junior high Junior high 

Employment at intake N/A Unemployed Unemployed 

Sources: EEpidemiologic/ethnographic respondents; NNon-methadone treatment, MMethadone treatment

respondents 

Reason

01 2 3 4 5

Extent contributed

Not at all Extremely

NR

0

0

0

Increased THC potency

Glamorization by entertainment industry

Less emphasis by law enforcement and courts

Decline in social disapproval

Decline in users’ perception of harm

Promotion of marijuana as a “medicine”

Glamorization by news media

Other: Deteriorating family and social relationships 

Increase in indoor farms 

More local production 

Decline in price

Widespread marijuana availability and use over the past 10 years: To what

extent have the following contributed?

!"Law enforcement

#"Epidemiologic/ethnographic respondents 

users. However, the drug is the primary drug of abuse for 35 percent of clients from rural areas.N

! The proportion of Whites among primary methamphetamine users

in St. Louis is an overrepresentation of their proportion in the city’s

overall population.E

! While the majority of methamphetamine users are unemployed, they often make money

by manufacturing and selling

the drug.M

! While primary methamphetamine users constitute 15 percent of non-methadone treatment clients, only 1.5 percent

of clients from the central city

are primary methamphetamine

What they have to say...

! St. Louis sources report many of the

same contributors to the marijuana problem as sources in most other Pulse

Check cities (such as the decline in social

disapproval and in users’ perception of

harm). However, respondents note that,

to a greater extent than in any other

Pulse Check city, increased THC potency

contributes to the widespread use of

marijuana in St. Louis.L,E

! While a decline in users’ perception of

harm contributed to a the drug problem over the past decade,L,E the public

is now becoming more aware of the

harm involved in drug use.L

! At the same time, however, a decline in

social disapproval related to marijuana

use is one of the most significant contributors to the increasing availability

and use of the drug over the past

decade.E

! Rather than declining in price, marijuana has become more expensive due

to recent shortages in supply.L

! According to one source, less emphasis on marijuana by law enforcement and

the courts has contributed to more widespread use in the community.E

NR= Not reported
SNAPSHOT: ST. LOUIS, MISSOURI

Pulse Check: January 2004 page 253

WHO’S MOST LIKELY TO USE OTHER

DRUGS?

! Diverted OxyContin®: Individuals

who primarily abuse OxyContin®

are older than 30, split evenly

between genders, live in the suburbs, and split between low and

middle class. These individuals

tend to abuse other prescription

opiates, and some are previous

heroin addicts.N

! PCP: Adolescents and young adults

are the most common users of

PCP, and the majority are Black

females. Users often dip marijuana

joints in a PCP solution, a combination referred to as “dips.”E

! Benzodiazepines: Benzodiazepines

are often abused as a substitute 

for heroin. Abusers are typically

White female adults living in the

suburbs.M

WHERE ARE DRUGS USED AND

SOLD?

Heroin, crack cocaine, and marijuana are sold in most of the same settings, including street markets; crack

houses/shooting galleries; private

residences; public housing developments; elementary, junior high and

high schools; nightclubs/bars; shopping malls; playgrounds/parks; and

private parties. Heroin and crack are

also sold in hotels/motels and

around drug treatment clients, while

marijuana transactions take place on

college campuses, at raves and concerts, and inside cars.L,E

Most sales settings are also use settings for marijuana and crack.

Heroin use is typically limited to

street markets, shooting galleries,

private residences, public housing

developments, and nightclubs/bars.L,E

Powder cocaine is sold in fewer settings than crack cocaine. It is used

primarily in private residences, at

college campuses and nightclubs/

bars, and inside cars.L,E

Methamphetamine is sold in private

residences, playgrounds/parks, 

private parties, hotels/motels, truck

stops, and over the Internet. Use is

generally confined to private residences, hotels/motels, and truck

stops.L,E

Ecstasy is used and sold in private

residences; at college campuses,

nightclubs/bars, private parties, raves,

concerts, and hotels/motels; and

inside cars.L,E

HOW DO DRUGS GET FROM SELLER

TO BUYER?

Heroin and cocaine are typically sold

through hand-to-hand transactions in

known locations,L,E while larger

amounts are transferred at scheduled

meeting places such as fast food

restaurant parking lots.L Sales involving powder cocaine tend to be more

high-tech and hidden than those

involving crack cocaine.E Buyers and

sellers of heroin and cocaine communicate via pagers, cell phones, and

walkie-talkies.L,E

While heroin and cocaine transactions are generally conducted in the

central city, marijuana sales are

equally distributed between the 

central city, the suburbs, and rural

areas.L,E Marijuana dealers tend to

Who’s most likely to use ecstasy?

Characteristic E N

Age group (years) 13–17, 18–30 18–30 

Median age (years) 23 NR 

Gender 60% male Split evenly 

Race/ethnicity White White 

Socioeconomic position Middle/high Middle 

Residence Suburbs Suburbs 

Referral source N/A Criminal justice 

Level of education completed N/A High school 

Employment at intake N/A Full time, part time, 

full-time students 

Sources:EEpidemiologic/ethnographic and NNon-methadone treatment respondents.

! The number of clients in treatment for 

primary ecstasy abuse is stable at low

levels (about 2 percent of the treatment population).N

! White ecstasy users are overrepresented relative to the overall community

population.E,N

THE MARKET PERSPECTIVE
SNAPSHOT: ST. LOUIS, MISSOURI

page 254 Pulse Check: January 2004

have more of a relationship with their

buyers than other drug dealers; they

are often family members, friends, or

acquaintances.E Most marijuana found

in St. Louis is locally produced in

basements using the hydroponic

method.L The marijuana grown outdoors typically comes from Mexico.L

Methamphetamine transactions usually take place in rural areas,L,E but production of the drug is moving more

to the central cityE

. Methamphetamine sales take place within small

networks of family and friends, often

in public venues such as truck stops.E

Buyer and seller communicate

through telephones and pagers, and

in places like fast food restaurant

parking lots. Dealers generally do not

sell other drugs.L,E

Ecstasy and GHB dealers sell the

drugs in both central city and suburban settings through hand-to-hand

transactions.L,E While ecstasy transactions used to be exclusively associated with raves, they are now moving

to the suburbs and rural areas.E

Ecstasy is sold at concerts, colleges,

and high schools, and dealers are easily identified.E Outside of these

impromptu transactions, dealers

communicate with buyers via pagers

and networking. They often make

home deliveries.L

For all drugs, dealers communicate

with each other using the “walkietalkie” feature of new cell phones.

Law enforcement is currently working to intercept this new technology.L

What they have to say...

Beyond cash: What else is accepted in exchange for drugs?

Heroin

Cash

Crack cocaine

Marijuana Methamphetamine

61%

Shoplifted merchandise

Other stolen merchandise

Property/Merchandise

Guns

Other: Includes items accounting for 1

percent or less of transactions for all five

drugs, such as other drugs, transporting

the drug, steal the drug, food stamps,

drug buying services, injecting services,

and lookout services

Sex

91% 76%

52%

11%

6%

6%

11%

10%

6%

10%

18%

9%

5%

Powder cocaine

85%

6%

Source: Mean of response ratings given by law enforcement, epidemiologic/ethnographic, non-methadone treatment, and methadone treatment respondents. 

1% 4% 1% 4% 4%

1%

4%

3% 3%

4%

1%

3% 1% 2%

3%

! The practice of exchanging sex for crack cocaineL,E and

for methampetamineE has increased over the past

decade.

! A recent ethnographic study in rural southwest Missouri

revealed two common settings where users exchange sex

for drugs: truck stops and libraries/book stores.E

! A decade ago, cash was typically the only form of payment accepted for crack cocaine. Now, crack dealers

commonly accept sex or merchandise for payment.L

! Like in many other cities, (such as Atlanta, Boston, Phoenix,

Seattle, and San Francisco), shoplifted merchandise in St.

Louis represents a significant proportion of currency for purchasing heroin. It is also often traded for crack (as in

Boston, Dallas, Houston, and Seattle).
SNAPSHOT: ST. LOUIS, MISSOURI

Pulse Check: January 2004 page 255

How much does cocaine cost?

Form Unit Price 

Crack Rock $20L,E

1 g $300–$400E

Powder 1 g $100L

$100–$125E

Sources : LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

WHO’S SELLING HEROIN?

! Heroin dealers are youngerL,E or

older adultsL working either

independentlyL or as part of

organized structures, particularly

gangs.L,ETheir criminal activity

includes violent crimes involving

weapons, and nonviolent crimes

such as larceny and robbery.E

WHO’S SELLING COCAINE?

! Powder cocaine dealers tend to

work independently. They are typically young adults who often use

powder cocaine themselves.L

! Crack cocaine dealers work both

independentlyL and as part of

organizations, particularly gangs.L,E

WHO’S SELLING MARIJUANA?

! The young adults selling marijuana

generally work independently.E

Older dealers work either independently or as part of a larger

organization trafficking marijuana

from Mexico.E

! Marijuana dealers are almost

always marijuana users as well.L,E

Which drug sellers are associated with which crimes?

Heroin Crack Powder Marijuana Metham- Ecstasy

Crime cocaine cocaine phetamine

Gang-related activity $$ $ $

Violent criminal acts $$ $ $ $

Non violent criminal acts $$ $ $ $

Prostitution $ $

Domestic violence $$ $

No criminal involvement $

Sources: Law enforcement respondent; epidemiologic/ethnographic respondent

! More armed robberies are associated with crack cocaine dealers than

with dealers of other drugs.E

! Both male and female methamphetamine sellers/buyers engage in

prostitution.E

How much does heroin cost?

Unit Price 

1 mg $3.53E

1 g $100L

$250–$600E

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

! The price for a milligram of heroin

increased from $2.72 to $3.53.E

There is some overlap between the

gangs selling heroin and crack

cocaine.E

!" Crack dealers range in age from

youngerL,E to older adults,L and

mayE or may notL use crack themselves.

! Powder cocaine purity is estimated to be 77 percent.E

! While crack cocaine generally

costs $300–$400 per gram, it is

sold for as little as $250 per gram

in rural areas.E

! All reported prices are stable

between spring and fall.L,E

How much does marijuana cost?

Unit Price 

Small bag $20

1 oz $100

1 lb $1,000–$1,100

Source: LLaw enforcement respondent

! The price of marijuana

increased from $700–$850

per pound in the spring to

$1,000–$1,100 per pound in

the fall.L
SNAPSHOT: ST. LOUIS, MISSOURI

page 256 Pulse Check: January 2004

THE MARKET PERSPECTIVE: A 10-YEAR VIEW

Drug marketing innovations and tools over the past 10 years: To what

degree have they complicated efforts to detect or disrupt illicit drug activity

in St. Louis?

01 23 45

Degree of complication

Not at all Extremely complicated

Throwaway cell phones

More organized networks 

Expansion of drug sales beyond the central city

Other: Calling cards with prepaid minutes 

Other: Two-way radio features of cell phones 

Unique packaging

Relocation of sales settings within the community

Increased communications via Internet 

Less organized networks

Polydrug dealers

More or changing brand names 

Fewer brand names

Complication

What they have to say...

! As in the majority of Pulse Check cities,

advances in technology, such as cell

phones and the Internet, have greatly

complicated efforts to combat the 

community’s drug problem.L,E

! Most recently, dealers have become

cautious about using traditional cell

phones. Instead, they are using disposable cell phones, cell phones with

“walkie-talkie” features, and prepaid

calling cards. These practices make it

difficult for law enforcement to write

affidavits on wiretaps.L

! There is great concern that recent

movies and media exposés have

revealed law enforcement secrets

(such as cloning phones and cloning

pagers) to the public, causing drug

dealers to change their practices.L

! One source believes that telephone

companies offer their new technologies

to the public before supplying the government with counter technology.L

NR=Not reported

!"Law enforcement respondent

#"Epidemiologic/ethnographic respondent

WHO’S SELLING METHAMPHETAMINE?

! Most methamphetamine dealers

identified by law enforcement

work independently and are very

likely to be users as well.L

! The epidemiologic source describes

methamphetamine dealers as young

adults who fall into two categories:

! Those selling locally produced

methamphetamine work independently and are very likely to

user the drug.E

! Those selling Mexican methamphetamine work as part of an

organization, and are not likely

to use methamphetamine themselves.E

How much does methamphetamine cost?

Unit Price 

1 g $100L

$37–$100E

1 oz $700–$1,300E

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

! The cost of methamphetamine is

higher in the suburban and rural

areas than in the central city.E

! Generally, methamphetamine is

sold in increments priced at $100

and higher.L

WHO’S SELLING OTHER DRUGS, AND

HOW MUCH DO THEY COST?

! Ecstasy: Dealers generally work

independently and are likely to be

users as well.L,E The cost of an

ecstasy pill ranges from $20–$30E

to $100.L

! GHB: Individuals selling GHB are

typically young adults who work

independently and do not use the

drug.L A capful of GHB costs $5,

while an ounce sells for $40.E

! PCP: One fluid ounce of PCP currently sells for $350.E

0

0

NR

NR
SNAPSHOT: ST. LOUIS, MISSOURI

Pulse Check: January 2004 page 257

Community innovations and tools over the past 10 years: How successful have they been?

The treatment respondents do not

observe any continuing effects of the

September 11 attacks on treatment

clients. The law enforcement and epidemiologic/ethnographic respondents,

however, note two continued effects:

! Drug trafficking: Tightened security

as a result of the September 11

attacks has continued to change the

way drugs are transported. Rather

than carrying drugs aboard airplanes in luggage and on their person, traffickers are relying more on

automobile transport.L

! Drug use: Although not exclusively

related to September 11, ripple

effects of the economy have

impacted the drug abuse problem.

What they have to say...

NR=Not reported

Sentencing changes 

Precursor laws 

Increased use of task forces

Use of crack house (nuisance abatement) laws 

Drug courts

Prescription drug monitoring 

Drug-free zones

!"Law enforcement respondent 

#"Epidemiologic/ethnographic respondent

01 2 3 4 5

Degree of success

Not at all Extremely successful

0

0

NR

! Sentencing changes, particularly with respect to penalties

involving possession of methamphetamine precursors and manufacture and distribution of methamphetamine, have been

largely successful in St. Louis.L,E

! Recent precursor laws involving ephedrine and ephedrine-based

products have been effective. For example, a large national retail

chain now “flags” anyone who purchases large quantities of cold

medicine, and has reduced store displays of such products.E The

success of these laws in curtailing trafficking of ephedrine products is similar to the progress reported in San Diego.

! Multijurisdictional enforcement efforts have met with some success in combating the methamphetamine problem.L,E These

efforts involve shutting down clandestine labs and monitoring

precursor chemicals.E

! Missouri is third in the Nation in the number of drug courts,

which one source believes have been highly effective.E Another

source, however, rates them as unsuccessful.L

! Recommended innovations in St. Louis are (1) more training in

pharmacy schools about prescription drug abuse, prescription

fraud scams, and diversion techniques;E and (2) construction of

larger jails.L

Innovation

SEPTEMBER 11 FOLLOWUP
SNAPSHOT: SAN DIEGO, CALIFORNIA

page 258 Pulse Check: January 2004

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002

VS FALL 2002)

Three of the four Pulse Check sources believe the city’s overall drug problem

has remained stable. The non-methadone treatment source, who considers

the city’s drug problem very serious, believes it has become somewhat

worse. The methadone treatment source likewise believes the situation to be

very serious, while the epidemiologic and law enforcement sources rate the

problem at a lesser “somewhat serious.”

Only a few changes since spring 2002 are associated with use:

! Use of methylenedioxymethamphetamine (MDMA or ecstasy), phencyclidine (PCP), and carisoprodol (Soma®) now is reported occasionally

among treatment admissions.N

! Use of gamma hydroxybutyrate

(GHB) remains at low levels, probably because word has gotten out

about the drug’s volatility and lethal

potential. Nevertheless, it continues 

to be involved in some deaths and

drug-assisted rapes.E

Additionally, the drug market is changing in a few ways:

! What people are calling “ice” and

“glass” is a marketing phenomenon:

a new presentation of the same

methamphetamine seen for years.L

! Increased focus by law enforcement 

has made it more difficult to purchase

diverted OxyContin® (oxycodone

hydrochloride controlled-release). A

particularly effective deterrent was the

arrest of a major supplier in Tijuana.L

! A Drug Enforcement Administration

(DEA) operation in September 2002

caused ketamine shipments to dry 

up, supplies to decline, and prices 

to triple.L

Because of the different perspective each brings, the sources vary in their perception of which drugs are most commonly abused and which have the most

serious consequences. For example, the epidemiologic and law enforcement

sources agree that methamphetamine is the drug related to the most serious

consequences. However, they differ about the second most serious drug problem. The epidemiologic source names heroin because it is associated with the

most serious health consequences. The law enforcement source names marijuana because of its pervasiveness.

Most widely abused drug:

MethamphetamineL,N

MarijuanaE

HeroinM

No reported changes between spring

and fall 2002L,E,N,M

Second most widely abused drug:

MethamphetamineE,M

MarijuanaL,N

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the most serious

consequences:

MethamphetamineL,E,N

HeroinM

No reported changes between spring

and fall 2002L,E,N,M 

Drug related to the second most

serious consequences:

HeroinE,N

MarijuanaL

MethamphetamineM

No reported changes between spring

and fall 2002L,E,N,M

New or emerging problems:

EcstasyE,N

GHB, “whispers” of diverted OxyContin®E

PCP, carisoprodol (Soma®)

N

Sources: LLaw enforcement, EEpidemiologic/ 

ethnographic, NNon-methadone treatment,

and MMethadone treatment respondents 

Note: These symbols appear throughout this

city profile to indicate type of respondent.

What are the primary drugs of abuse

among clients in a methadone treatment program? (Fall 2002)

Heroin

Methamphetamine

Crack cocaine

Diverted prescription 

drugs

Treatment percentages in this program

remained relatively stable between

spring and fall 2002.

Source: Non-methadone treatment respondent

92%

4%

4%

<1%

SAN DIEGO METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Total population:. . . 2,813,833 

! Median age: . . . . . . 33.2 years 

! Race (alone):

! White . . . . . . . . . . . . . . 66.5%

! Black . . . . . . . . . . . . . . . 5.7%

! American Indian/

Alaska Native . . . . . . . . 0.9%

! Asian/Pacific Islander 9.4%

! Other race . . . . . . . . . . 12.8% 

! Two or more races . . . . 4.7% 

! Hispanic (of any race): 26.7% 

! Unemployment rate: . . . . 3.6% 

! Median household 

income:. . . . . . . . . . . . $47,067 

! Families below poverty level 

with children <18 years: 13.3% 

Source: U.S. Census 2000* 

*The census data in this table are provided as a frame of reference for the information given by Pulse Check sources. Whenever possible, the data given by

the law enforcement and epidemiologic/ethnographic sources reflect the metropolitan area. 

(N= 114)
SNAPSHOT: SAN DIEGO, CALIFORNIA

Pulse Check: January 2004 page 259

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic respondent

Note: SA=South American (Colombian) heroin; SWA=Southwest Asian heroin; SEA=Southeast

Asian heroin; and Ice=highly pure methamphetamine in smokable form.

Not

difficult

at all

Undercover policeL UsersE

Heroin (in general and Mexican

black tar); crack; marijuana (in

general); methamphetamine

(in general, local, and Mexican)

Local commercial and Mexican

commercial marijuana

Sinsemilla, “BC bud”

Mexican brown heroin; ecstasy

SA, SEA, and SWA heroin

Ice

Diverted OxyContin®

Diverted OxyContin Powder cocaine ®; ketamine

Heroin (in general); crack; 

marijuana (in general)

Mexican brown heroin; “BC

bud,” hydroponic marijuana

Powder cocaine; local

commercial marijuana

Mexican black tar; methamphetamine (in general and Mexican)

4

3

2

1

0

5

6

7

8

9

The heroin problem appears relatively

stable between spring and fall 2002:

! Upper middle-class White youth,

reported as an emerging group 3 or

4 years ago, are declining as heroin

users—possibly due to the focus of

a local multi-agency task force

composed of law enforcement, 

education, treatment, and prevention specialists.E

! Approximately 15 percent of drug

court referrals in the northern section of San Diego are first-time

young injecting users from

wealthy families.N

MARIJUANA

No changes are reported between

spring and fall 2002, either in use or

marketing. The drug, either alone or

used with other drugs, continues to be

involved in negative consequences.

Use of crack appears to be low and

stable. Only one possible change is

reported regarding powder cocaine:

! A spring 2002 focus group and a

newspaper article reported couriers delivering powder cocaine to

suburban areas. These reports may

just be “blips”: they have not been

detected in any datasets, nor have

any incidents been mentioned since.E

HEROIN

COCAINE

Local methamphetamine, ice

SA, SEA, and SWA heroin

Sinsemilla; ecstasy

! As in most western cities, black

tar heroin and methamphetamine are easily obtainable. And, conversely,

it is extremely difficult to purchase white

heroin

! Both users and undercover police can purchase black tar heroin, crack, most

methamphetamine forms, and commercial

marijuana with relatively similar ease. More

variation is reported for powder cocaine and

higher grades of marijuana——possibly

because they are used by more

specific populations.

! Undercover police can purchase

ice and ecstasy more easily in fall

2002 than in the previous spring.L

! Conversely, undercover police find

it more difficult than before to

purchase diverted OxyContin® and

ketamine.

! From the user perspective, no

changes are reported in ease of

purchase for any drugs.E

Two declines are reported, along with

some shifts among users:

! Precursor laws have led to supply

declines: local manufacturers have

been forced to develop pill reduction labs to extract their own pseudoephedrine. Some labs make their

METHAMPHETAMINE

Extremely

difficult

10

own iodine because iodine sales have

been curtailed in feed stores. Some

make their own hydriotic acid. Most

methamphetamine is now from

Mexican labs that use the red phosphorous reduction method.

! The percentage of methamphetamine users among methadone

clients declined somewhat between

the two latest available reporting

periods: from 25 percent to 19 percent of both overall and first-time

admissions.M

! Hispanics continue to emerge as

methamphetamine users.E

! One source notes a shift over the

past 5 years from snorting methamphetamine to smoking it.N
SNAPSHOT: SAN DIEGO, CALIFORNIA

page 260 Pulse Check: January 2004

A few slight increases are reported

between spring and fall 2002:

! Despite much media attention and

a slight increase in the number of

users, ecstasy use remains low.E

! Undercover police can purchase the

drug more easily than previously.

! Shipments at the “boat” level

(1,000 pills) and higher come

from the Los Angeles area.

Availability appears to have declined

between spring and fall 2002:

The pharmaceutical’s manufacturer is

presumably exporting less of it to

Mexico. Consequently, less is diverted back into the United States from

Tijuana pharmacies—either via smalltime dealers or by Internet hookup.L

WHAT’S HAPPENING IN TREATMENT?

Treatment capacity and availability

! The Pulse Check non-methadone

treatment respondent’s program,

which operates at its maximum

capacity of 100 contract-funded

clients plus aftercare clients, covers

a county where methamphetamine

predominates. Thus, methamphetamine is the primary drug of abuse

among the vast majority of clients

(see pie chart on the first page of

this report).

N

! The methadone treatment respondent is with a facility that operates

close to its maximum capacity of

375 patients, as allowed by the

State.M Beyond that specific facility,

methadone maintenance treatment

is available throughout the area,

and programs have adequate capacity.

Public and private methadone

treatment availability and capacity

remained stable between early and

late 2002.E

! Slot capacity in general is increasingly limited. Increased demand,

combined with no new bed funding and “NIMBYism,” have resulted

in many wait lists. The respondent

sees a need to make more beds

available in the community

through increased funding rather

than through shortened stays.N

Community collaboration

One treatment source reports that 

the court and treatment systems have

worked together to address local drug

problems more effectively. The respondent perceives a need for similar collaboration between the treatment and

prevention communities as well as

with parents, grandparents, and the

community at large.N

Recidivism

Nearly all marijuana and methamphetamine clients have been in 

treatment in the past, although only 

a handful are return clients to this

particular program.N

Consequences of drug use

! One source notes increases in

high-risk pregnancies, drug-related

automobile accidents, and cases of

hepatitis C among treatment

clients. Incidence of drug-related

tuberculosis remains relatively low,

but it increases as one gets closer

to the U.S.–Mexican border.N

! Another source similarly reports

high-risk pregnancy as a relatively

common consequence of drug abuse

among treatment clients. The source

also notes that new users generally

do not have hepatitis C, but about

99 percent of the “old timers” are

positive for the disease. “The hepatitis C problem,” remarks the

respondent, “seems worse than

AIDS. Help is needed.”M

! Methamphetamine clients tend to

come in with numerous medical

and dental problems.N Chronic

heart problems are fairly common

among older methadone patients.M

Co-occurring disorders

! The number of patients presenting

with psychosis, mood disorders,

and violent behavior has increased,

probably due to their long-term

use of methamphetamine.N

! Antisocial disorders and conduct

disorders, very common among

methadone patients, tend to disappear once the patients are on

methadone.M

CHANGES OVER THE PAST 10 YEARS

! One treatment source believes that

San Diego’s drug abuse problem

has been moderately exacerbated

over the past decade by the declining price of heroin and by earlier

initiation of heroin use.M

A DEA operation in September 2002

caused ketamine shipments to dry up,

supplies to decline, and prices to

triple. A Mexico City manufacturer

and his Tijuana pharmacy distributor

were put out of business, and raw

materials were seized. This law

enforcement accomplishment has

national repercussions because more

than 80 percent of the ketamine in

the United States comes from Mexico

via San Diego.L

DIVERTED OXYCONTIN®

ECSTASY

THE USE PERSPECTIVE

KETAMINE
SNAPSHOT: SAN DIEGO, CALIFORNIA

Pulse Check: January 2004 page 261

! The other treatment source names

several particularly significant

changes: increased treatment caseloads because so many people are

trying to get into treatment; lack

of detox; lack of residential treatment; an increase in medical and

dental problems among clients

because they don’t qualify for benefits; and lack of “sober living”

housing opportunities for recovering clients. This source also names

some more moderately complicating changes: the “normalization”

of drug use within family history

and structure; an increase in polydrug use; the spread of drug use

among all age groups; and the lack

of jobs and job training opportunities for recovering clients.N

WHO USES ILLICIT DRUGS?

The Pulse Check epidemiologic, 

non-methadone treatment, and

methadone treatment sources were

asked to describe the populations

most likely to use heroin, cocaine,

marijuana, methamphetamine, and

ecstasy. They also were asked to

describe any emerging user groups 

and to report on how the drugs are

used. As shown in the following pages,

user characteristics vary from drug to

drug. Further, because of the different

perspective each brings, the three

sources sometimes describe quite different populations and use patterns for

each drug. For example, all methadone

clients are primary opiate users who

may use drugs other than opiates in a

secondary or tertiary manner.

Who’s most likely to use heroin?

Characteristic E M

Age group (years) >30 >30

Mean age (years) 35 45

Gender 70% male 61% male

Race/ethnicity White White 

Socioeconomic status Low NR

Residence Central city Suburbs

Referral source N/A Individual

Level of education completed N/A High school 

Employment at intake N/A 50% full time,

50% unemployed

Sources: EEpidemiologic/ethnographic respondent; Mmethadone treatment respondent

Note: Only four clients in the non-methadone program report heroin as their primary drug of

abuse: two men and two women, whose mean age is 36). 

How do users take heroin?

Characteristic E M

Primary route of 

administration Injecting Injecting 

Other drugs taken Cocaine (“speedball”); metham- Methamphetamine

phetamine (speedball) (speedball)

Publicly or privately? Both Privately

Alone or in groups? Both Alone

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone 

treatment respondent; MMethadone treatment respondent

! Injecting is also the primary route of administration among the four primary heroin clients.N

! Use patterns appear stable between spring and

fall 2002.M

! The methadone treatment source

describes a somewhat older, less maledominated, population than the broader heroin-using population described by

the epidemiologic source.

! Upper middle-class White youth, reported as an emerging group 3 or 4 years

ago, are declining as heroin users—possibly due to the focus of a multi-agency

task force aimed at this specific new

user group in the northern sector of

San Diego County.E

! However, approximately 15 percent of

drug court referrals in north county are

first-time young injectors from wealthy

families.N

! Mean age is tending to be slightly lower

than in the past because of youth in

their late teens who joined the user

population a few years ago.E

! Among new admissions, more males

are being noted than usual.M
SNAPSHOT: SAN DIEGO, CALIFORNIA

page 262 Pulse Check: January 2004

Who’s most likely to use marijuana?

Characteristic E N

Age group (years) 18–30 18–30 

Mean age (years) 26.5 31

Gender 80% male 65% male

Race/ethnicity Hispanic (any race) NR

Socioeconomic status All NR

Residence Suburbs NR 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent

Note: The methadone treatment source did not provide this information.

Who’s most likely to use cocaine?

Characteristic Crack Powder cocaine

Age group (years) >30 18–30 

Mean age (years) 36.5 NR 

Gender 60% male NR

Race/ethnicity Black White

Socioeconomic status Low Middle 

Residence Central city Suburbs

! Crack users and powder cocaine users are two

separate populations, different in all respects.E

! User characteristics appear stable between

spring and fall 2002.E

! None of the marijuana users in either

program reports that drug as a primary

problem.N,M

! While marijuana users in treatment are

predominantly Hispanic, marijuana use

cuts across all racial/ethnic groups.N

! Only one change is reported: “More

younger kids are coming in.”N

How do users take marijuana?

Characteristic E N

Primary delivery vehicle Joints Joints, bongs 

Other drugs taken Alcohol, methamphetamine Methamphetamine

Publicly or privately? Both Both

Alone or in groups? Both Both

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent

Note: The methadone treatment source did not provide this information.

! Both responding sources

describe similar use patterns.E,N

! Use patterns appear stable

between spring and fall 2002.E,N

Source: EEpidemiologic/ethnographic respondent

Note: Only one crack user and no powder cocaine users are in treatment at the non-methadone program.

None are reported in the methadone program.
SNAPSHOT: SAN DIEGO, CALIFORNIA

Pulse Check: January 2004 page 263

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

One source lists “amotivational syndrome” as a negative consequence of

marijuana use, pointing out that the

younger users, who are increasingly

admitted to treatment, never get

employed. Sometimes this lack of

motivation is a family norm.

Additionally, respondents associate

marijuana, used either alone or with

other drugs, with the following 

consequences, which remained stable

between spring and fall 2002:

! Drug-related emergency room

visitsE

! Drug-related arrestsE,N

! Automobile accidentsN

! High-risk pregnanciesN

! Short-term memory lossE,N

! Deteriorating family/social

relationshipsE,N

! Poor academic performanceE,N

! School absenteeism or truancyE,N

! Dropping out of schoolE,N

! Poor workplace performanceE,N

! Workplace absenteeismE,N

! Unemployment ratesN

Widespread marijuana availability and use over the past 10 years: To what extent have the following contributed?

Reason

01 2 3 4 5

Extent contributed

Extremely

Less emphasis by law enforcement and courts

More local production

Decline in social disapproval (e.g., peers, parents, etc.)

Promotion of marijuana as “medicine”

Increased THC potency

Increase in indoor farms

Decline in price

Decline in users’ perception of harm

Increased trafficking

Not at all

!""Law enforcement respondent 

#""Epidemiologic/ethnographic respondent 

0

0

NR

What they have to say...

! Price: As reported in most other

Pulse Check cities, price has not

declined, so it is not a contributing

factor.L

! Indoor farms: A moderate increase

in indoor farms has resulted in higher grade marijuana and less

detectable operations.E

! Law enforcement/court emphasis: At a recent focus group, users

agreed that “everyone turns a blind

eye, even though it’s everywhere.”E

! Perception of harm: The misperception of marijuana as harmless has

“always been a problem. We need to

continue pressuring youth on ‘no marijuana.’”E

! Medical marijuana: “It hasn’t

made that big a difference, though it

has given a platform to normalists.”E

! Trafficking: Increased movement

of marijuana from Mexico to San

Diego has resulted in increased

availability over the past decade.E

NR=Not reported
SNAPSHOT: SAN DIEGO, CALIFORNIA

page 264 Pulse Check: January 2004

Who’s most likely to use methamphetamine?

Characteristic E N M

Age group (years) >30 >30 >30 

Mean age (years) 32 31 45 

Gender 50% male 65% male 50% male 

Race/ethnicity White White White 

Socioeconomic status Low Middle Low 

Residence Suburbs Suburbs and Suburbs

rural areas 

Referral source N/A Criminal justice Individual 

Level of education completed N/A High school High school

Employment at intake N/A Unemployed 50% full-time, 

50% unemployed 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

How do users take methamphetamine?

Characteristic E N M

Primary route of

administration Smoking Smoking Injecting 

Other drugs taken Marijuana, Marijuana, Heroin

alcohol (“mota,” “smoke”) (speedball)

Publicly or privately? Privately Both Privately

Alone or in groups? In groups/

among friends Both Alone

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent 

Who’s most likely to use ecstasy?

Characteristic E

Age group (years) 18–30

Mean age (years) 19

Gender 50% male

Race/ethnicity White 

Socioeconomic status Middle

Residence Suburbs 

Note: No ecstasy use is reported in the two treatment programs.

Source: EEpidemiologic/ethnographic respondent

! Despite much media attention and a slight increase in the

number of users, ecstasy use remains low.E

! While ecstasy users are rare in this program, the problem is

larger on the north coast.N

! In earlier years, methamphetamine used to

be snorted. The shift to smoking continues.E

! The gradual shift from snorting to smoking is

due to the younger users coming in. Injecting

and snorting, however, are still common.N

! Injecting is the primary route of administration among methadone patients, who—unlike

most methamphetamine users—tend to combine methamphetamine with heroin. Snorting

is also common among this population. 

! All sources describe a predominantly

White user population.E,N,M However,

Hispanics have been emerging as

methamphetamine users since about

1995, when they got into production

and marketing. Use among that population continues to increase steadily.E

! Court referrals “have become huge”

over the past 5 years.N
WHERE ARE DRUGS USED AND SOLD?

Heroin and crack are generally sold

in central city areas. Powder cocaine

and ecstasy are sold in both central

city and suburban areas. Marijuana

and methamphetamine are equally

likely to be sold in central city, suburban, and rural areas. The majority of

the following specific sales settings

are also use settings:

! Heroin is sold on the streets and in

open-air markets,L,E in crack houses/shooting galleries,L in private residences,L in public housing developments,E in shopping malls,L in

hotels/motels,L,E around drug treatment clinics,L and inside cars.L,E

! Crack is generally sold in the

streets and in open-air marketsL or

in crack houses.L

! Powder cocaine is sold predominantly in private residencesL,E but

also in the streets and open-air

marketsL and on beaches.L

! Marijuana has the largest range of

sales settings: streets/open-air markets,L,E crack houses/shooting galleries,L private residences,L,E public

housing developments,L,E in or

around schools,L,E college campuses,L,E nightclubs and bars,L shopping

malls,L playgrounds/parks,L private

parties,L,E raves,L concerts,L,E around

supermarkets,L hotels/motels,L,E

around drug treatment clinics,L

and inside cars.L,E

! Methamphetamine sales settings

include the streets and open-air

markets,L inside private residences,L,E

public housing developments,E

nightclubs and bars,L private parties,L

around drug treatment clinics,L and

inside cars.L

! Ecstasy is sold on the streets and

in open-air markets,E on college

campuses,L in nightclubs and bars,L,E

at private parties,L,E at raves,L,E at

concerts,L in hotels/motels,L and

inside cars.L

HOW DO DRUGS GET FROM SELLER

TO BUYER?

Illegal drugs are generally sold hand to

hand. In the case of heroin, for example, such transactions often involve

runners at prearranged meetings in

public places such as shopping malls.

Cell phones, land lines, and pagers

play an important communications

role in sales involving heroin, powder

cocaine, and marijuana. Marijuana

sales also involve the Internet and parcel delivery, as do sales of diverted

OxyContin® and ketamine. Ecstasy

sales involve cell phones, pagers, and

e-mail. Methamphetamine transactions

involve less sophisticated communications, such as land lines. Crack transactions are even more “low-tech”:

they are likely to involve word of

mouth and purchasers knowing which

street corners to approach. 

As shown below, the majority of these

transactions involve cash. A variety of

other commodities and services, however, are often exchanged—particularly in the case of methamphetamine.

The most commonly mentioned items

are property or merchandise (for all

drugs), shoplifted or stolen merchandise (for marijuana), sex (for cocaine),

and guns (for cocaine).

SNAPSHOT: SAN DIEGO, CALIFORNIA

Pulse Check: January 2004 page 265

THE MARKET PERSPECTIVE

What they have to say...

! As in other Pulse Check cities, the majority of drug

transactions are “cash only.” Crack, powder cocaine,

and heroin transactions are even more frequently

cash only than in many other cities.

! Ten years ago, when labs were bigger, methamphetamine manufacturing was another service exchanged

for drugs. Such transactions are a thing of the past

because a large law enforcement task force has

effectively reduced the size and number of labs,

pushing them into neighboring areas.N

! No other changes are reported in the nature of drug

transactions over the past 10 years.

Beyond cash: What else is accepted in exchange for drugs?

Note: The epidemiologic source did not respond to this question. 

*Responses were the same for both crack and powder cocaine.

Source: Mean of response ratings given by law enforcement, non-methadone treatment,

and methadone treatment respondents

Heroin

Cash

Cocaine*

Marijuana Methamphetamine

82%

Shoplifted 

merchandise

Other stolen

merchandise

Property/

Merchandise

Other drugs

Guns

Transporting 

the drug

Other: Includes

drug buying

services, food

stamps, and

drug theft

Sex

75% 72%

85%

5%

5%

5%

5% 5%

6% 5%

6%

7%

5%

4%

<1%

1%

4%1% 1% 1%

1%

2%

1% 1%

4%

2%

3% 4% 2%
How much does cocaine cost?

Form Unit Purity Price 

Powder 1/10 g NR $10L

3 g NR $20–$30L

1 g 68–72%E $40–$80L,E

1 oz 54–90%L $300L 

1 kg 83%L $12,500–$18,000L

Crack 0.1 g NR $10L,E

(“tens”)

0.2 g NR $20L 

(“twenties”)

1 oz 68–70% NRL

Sources: LLaw enforcement respondent; EEpidemiologic/

ethnographic respondent

SNAPSHOT: SAN DIEGO, CALIFORNIA

page 266 Pulse Check: January 2004

WHO’S SELLING HEROIN?

The sales structure, controlled by

Hispanics, operates as follows:L

! An individual who controls a large

area takes the heroin to “dope

houses.”

! At the dope houses, the heroin is

divided into street-level units.

! The dope houses send runners,

mostly young Hispanic males, to

the buyers.

! Alternatively, buyers pick up heroin

at a dope house.

Sellers are not very likely to use their

own heroin. Some also sell powder

cocaine. 

How much does marijuana cost?

Form Unit Price 

Mexican 2-1 g 

weed (“Nickel bag”) $5L

1-3 g

(“Dime bag”) $10L

1 oz $60–$100L,E

Sinsemilla 3 oz $150L

2 oz $300L

1 oz $180–$250E

1 oz $450L

Domestic bud 1 lb* $3,000–$5,000L,E

*Up to 30% THC

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

How much does heroin cost? 

Form Unit Purity Price 

Black tar 0.1 g (“tens”) 14–70% $10L

3 g (“twenties”) 14–70% $20L

0.4 g (“forties”) 14–70% $40L

1 g 12–60% $50–$100E

1 oz NR $600–$1,200L

25 g (“Mexican NR $1,400–$1,500L

ounce”)

Mexican 1 g 12–60% $100–$150E

brown tar

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

! The current ounce

price ($600–$1,200)

represents a decline

from the previous

reporting period

($800–$1,500).L

! All other reported

prices are stable.L,E

All reported prices appear stable between

spring and fall 2002.

! All reported powder and

crack cocaine prices

are stable between

spring and fall 2002.

! Powder cocaine purity

at the kilogram level

has increased since the

last reporting period.

WHO’S SELLING COCAINE?

Powder cocaine sales have the same

sales structure and involve the same

people as heroin. Crack sellers, by

contrast, generally deal only in crack,

and they belong to one of two organizational structures:L

! The same organizations as those

who sell heroin and powder cocaine

! Street gang members

WHO’S SELLING MARIJUANA?

Marijuana sellers tend to operate

independently. They have the following characteristics:L

! They are generally young adults.

! They are very likely to use their

own drug.

! They do not sell other drugs.
SNAPSHOT: SAN DIEGO, CALIFORNIA

Pulse Check: January 2004 page 267

Which drug sellers are associated with which crimes?

Crime Heroin Powder Crack Marijuana Methamcocaine cocaine phetamine

Gang-related activity $

Violent criminal acts $

Nonviolent criminal acts

(burglaries, petty thefts) $$ $ $

Domestic violence $

Smuggling aliens $$ $

Source: Law enforcement respondent

! While crack is not considered one of the

major drugs in San Diego, its involvement in criminal activity exceeds that of

other drugs. 

! Methamphetamine is the only drug associated with domestic violence.

How much does ecstasy cost?

Unit Price

One pill $15–$25E 

One pill $20L

“Boat” (1,000 pills) $6,000–$10,000L,E

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

How much do various other

drugs cost?

Drug Unit Price

Diverted 20-mg $20L,E

OxyContin® pill

Ketamine 0.2 g $20–$25L

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

How much does 

methamphetamine cost?

Unit Price

3 g $20L

1 ga $40–$100E 

1 g $50–$75L

1 oz $500–$1,000L

1 lbb $3,500–$5,500E

1 lb $6,000–$10,000L

1 lb icec $9,000–$11,000L

a Purity 30–40%

bPurity 93–97% cPurity 50–90%

Sources: L

Law enforcement respondent; E

Epidemiologic/ethnographic respondent

What people are calling “ice” and “glass” is a

new presentation of the same substance

seen for years. In the early 1990s, high-purity

methamphetamine was coming from local

labs. Around 1995, shortly after the Mexicans

took over, purity started going down but prices

remained the same. Around 2000, this supposed “ice” was introduced at increased

prices. Within the last year or so it started

being cut again—with the vitamin supplement

dimethylsulfone (MSM). Prices, however,

remain at elevated levels, while purity ranges

widely.L

! Reported prices for these

drugs appear stable between

spring and fall 2002.

! Price information on diverted

OxyContin® comes from

Imperial County.

WHO’S SELLING METHAMPHETAMINE?

Methamphetamine sellers operate at

two levels:L

! Organized Hispanic groups sell at

higher-than-ounce levels.

! Younger, independent sellers operate at the ounce and lower levels.

These individuals are very likely to

use their own drug.

Some methamphetamine sellers also

sell marijuana. 

! Reported prices appear stable between spring and fall

2002.

WHO’S SELLING ECSTASY?

A two-tiered system is reported:L

! Sellers “at the high end of the

chain” are organized. 

! Street-level sellers operate more

independently. They are very likely

to use their own drug.

! College-educated White males

control sales of ecstasy, along with

ketamine, GHB, and diverted

OxyContin®.

! Some sellers also sell powder

cocaine and diverted sildenafil

(Viagra®)
SNAPSHOT: SAN DIEGO, CALIFORNIA

page 268 Pulse Check: January 2004

Community innovations and tools over the past 10 years: How successful have they been?

NR=Not reported

Onsite lab tests

Increased use of task forces 5

Precursor laws

Drug user recognition education

(DRE) for law enforcement 

Crack house (nuisance 

abatement) laws

Sentencing changes

Drug courts 

!""Law enforcement respondent

#""Epidemiologic/ethnographic 

respondent

0 1 23 4 5

Degree of success

Not at all Extremely successful

THE MARKET PERSPECTIVE:

A 10–YEAR VIEW

NR

NR

What they have to say...

! Onsite lab tests: “Narco band”

packages have been used

effectively in the field for 18

years.

! Task forces: The San Diego

Narcotics Task Force, one of

the first of its kind in the

Nation, has representatives

from every police agency in

San Diego County, under the

umbrella of the DEA. Various

other agencies, such as the

Border Patrol, participate from

time to time.L The Violent Gang

Task Force draws members

from Federal agencies, such as the Federal Bureau of Investigation (FBI) and the Bureau of Alcohol, Tobacco and Firearms (ATF), and

representatives from State and local entities.L The Meth Strike Force, ongoing since March 1996, has led to programs such as the

Meth Hotline (which the public uses to report suspected cooks, turn in dealers, and obtain help for users) and the Drug Endangered

Children program (which includes removing children of dealers for medical review, testing, and possible placement in the care of

another family member or a foster family).E A Club Drug Task Force is just getting started in the county.E

! Precursor laws: Making it tougher to acquire ephedrine, red phosphorus, iodine, and hydriotic acid forced the local manufacturers of

the early 1990s to extract these precursors themselves. Labs thus became smaller and spread to the rural areas across the country.

Thus, San Diego lost its dubious distinction as “Meth Capital of the World.”L

! Drug courts: Six operating courts include one for juveniles, one for dependency, and four for adults. Additional revenues are being

sought to expand the system.E One source opines that drug courts are not a deterrent because they give criminals a “free walk the

first time.”L

! Drug user recognition education: DRE has been ongoing and moving to neighboring counties through the Meth Strike Force and its

partners. In addition to being available to law enforcement, it has been available to educators, parents, and other interested parties.E

! Local summit activities (not rated): Annual substance abuse summits involving schools, the sports community, the media, and adolescents, have evolved from 1- or 2-day conferences to year-round outreach and prevention activities, including monthly meetings.

This year’s focus has been on substance abuse and sports, with local sports figures talking to the adolescents. Involving youth in

planning activities has been a particularly effective strategy.E

! Prevention funding process (not rated): Over the past 2 years, the county has moved toward larger funding allocations to fewer

providers. Prevention collaboratives throughout the region now focus on cohesive strategies all across the county, with more 

community responsibilities.E
SNAPSHOT: SAN DIEGO, CALIFORNIA

Pulse Check: January 2004 page 269

What they have to say...

! As in the majority of Pulse Check

cities, detection and disruption

activities have not been hampered

by dealers increasingly or decreasingly using brand names.

! Technological communications

advances have posed the most

challenges to detection and disruption efforts.

Drug marketing innovations and tools over the past 10 years: To what degree have

they complicated efforts to detect or disrupt illicit drug activity in San Diego?

012 3 4 5

Degree of complication

Source: Law enforcement respondent Not at all Extremely complicated L 

Note: The epidemiologic source did not

respond to this question.

SEPTEMBER 11 FOLLOWUP

Three of the four Pulse Check sources believe that the September 11 attacks and their aftermath have had no continuing

effects on the drug abuse problem. The law enforcement respondent, however, notes curtailed air trafficking as a result of

airport security measures.

Increased communications via Internet

More organized networks

Throwaway cell phones

Relocation of sales settings within the community

Unique packaging

Less organized seller networks

More or changing brand names

Fewer brand names

Polydrug dealers

Expansion of drug sales beyond the central city

0

0

0

0

0
SNAPSHOT: SAN FRANCISCO, CALIFORNIA

page 270 Pulse Check: January 2004

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

Use patterns of illegal drugs have remained relatively stable between spring and fall

2002, with a few exceptions:

! Methylenedioxymethamphetamine (MDMA or ecstasy) use has decreased

among methadone treatment admissions.M

! Heroin user characteristics have changed slightly: Hispanic and Black users

have decreased,E female users have increased,E and more users are unemployed.N

! Methamphetamine and OxyContin® (oxycodone hydrochloride controlledrelease) abuse has increased among methadone treatment admissions.M

Although most use patterns remain relatively stable, respondents report several

changes in the drug market: 

! Mexican brown heroin is more difficult for undercover officers to buy.L

! Many drugs are less difficult for undercover officers to buy.L

! Methamphetamine-related arrests have increased.L

! Ecstasy sales in public housing developments have emerged in the past 6 months.L

! Internet communication between buyers and sellers of both methamphetamine and ecstasy has increased.L,E 

Three of the city’s Pulse Check sources consider the drug problem very seriousL,N,M (as

do 77 percent of all Pulse Check respondents), and three consider it stable.E,N,M One

source believes the illegal drug problem is

much worse since spring 2002.L

Heroin and marijuana remain the most commonly abused drugs in San Francisco. (By

comparison, only eight other Pulse Check

respondents—not including methadone

treatment respondents—report heroin as the

most commonly abused drug, and nearly

half report marijuana as the most widely

abused drug). The drugs relating to the most

serious consequences in San Francisco

remain methamphetamine and heroin. Ice,

the high-purity, smokable form of methamphetamine, is an emerging drug in the city.L

What are the primary drugs of abuse

among clients in a non-methadone 

treatment program? (Fall 2002) 

Heroin

Methamphetamine

Crack cocaine

Powder cocaine

Marijuana

Abused OxyContin®

Between spring and fall 2002, drug use

among clients in the methadone treatment

program remained relatively stable with two

exceptions: ecstasy use decreased slightly

and methamphetamine and OxyContin® abuse

increased slightly.M

Source: Non-methadone treatment respondent

8%

27% 31%

4%

1% 27% SAN FRANCISCO PRIMARY METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Total population:. . . 1,731,183

! Median age: . . . . . . 37.3 years 

! Race (alone):

! White . . . . . . . . . . . . . . 58.6%

! Black . . . . . . . . . . . . . . . 5.3%

! American Indian/

Alaska Native . . . . . . . . 0.4%

! Asian/Pacific Islander 23.5%

! Other race . . . . . . . . . . . 7.7% 

! Two or more races . . . . 4.5% 

! Hispanic (of any race): 16.8% 

! Unemployment rate: . . . . 2.5% 

! Median household 

income: . . . . . . . . . . . $63,297

! Families below poverty level 

with children <18 years: 7.6% 

Source: U.S. Census 2000* 

*The census data in this table are provided as a frame of reference for the information given by Pulse Check

sources. Whenever possible, the data given by the law enforcement and epidemiologic/ethnographic sources reflect the metropolitan area. 

What drugs do clients in a methadone

program use+? (Fall 2002)

Heroin

Methamphetamine

Diverted OxyContin®

Benzodiazepines

Crack cocaine

+

Includes any use, whether as a primary, secondary, or tertiary drug; this program does not

track marijuana use.

Source: Methadone treatment respondent 

98

4

10

15

20

Most widely abused drug:

MarijuanaL,E

HeroinN,M

No reported changes between spring

and fall 2002L,E,N,M

Second most widely abused drug:

MethamphetamineL,N

HeroinE

CrackM

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the most serious

consequences:

MethamphetamineL,N

HeroinE,M

No reported changes between spring 

and fall 2002L,E,N,M

Drug related to the second most

serious consequences:

CrackL,E,M

HeroinN

No reported changes between spring

and fall 2002L,E,N,M

New or emerging problem:

Ice

Sources: LLaw enforcement, EEpidemiologic/

ethnographic, NNon-methadone treatment,

and MMethadone treatment respondents 

Note: These symbols appear throughout this

city profile to indicate type of respondents.

(N=250)

0 20 40 60 80 100

Percentage 

(N=758)
SNAPSHOT: SAN FRANCISCO, CALIFORNIA

Pulse Check: January 2004 page 271

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Note: SA=South American (Colombian)

heroin; SWA=Southwest Asian heroin;

SEA=Southeast Asian heroin; ice=highly

pure methamphetamine in smokable form;

BC bud=British Columbian marijuana

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

Not

difficult

at all

Undercover policeL UsersE

Heroin (in general and

Mexican black tar); crack,

powder cocaine; marijuana

(in general, sinsemilla, 

commercial grade, and

hydroponic); methamphetamine (all forms); ecstasy;

diverted OxyContin®; GHB 

4

3

2

1

0

5

6

7

8

9

Ecstasy

Extremely

difficult

10

Heroin (in general and 

Mexican black tar); crack; 

marijuana (in general)

Methamphetamine (in general) 

Powder cocaine; diverted

OxyContin®

SA, SEA, SWA; ice 

Mexican brown heroin

SA, SEA, SWA; BC bud 

Two respondents report heroin as the

most common drug of abuseL,M and

the drug related to the most serious

consequencesE,M. Heroin use remains

high and stable.

Powder cocaine use and activity

remain low, while crack cocaine use

and activity remain high. 

Marijuana use remains high and 

stable. Two sources report that it

remains the most widely abused

drug.L, N

Methamphetamine use is at high 

levels, and use and activity are

increasing: 

! Two sources report it as the drug

contributing to the most serious

consequences in San Francisco.L, N

! Methamphetamine use among

methadone treatment clients

increased slightly between spring

and fall 2002.M

! One source reports increased use,

especially in the gay community.L

! Methamphetamine arrests

increased between spring and fall

2002.L

! Methamphetamine injection may

be on the rise.E

! Ice is considered an emerging

drug of abuse.L

HEROIN

COCAINE

METHAMPHETAMINE

MARIJUANA

Ecstasy use has decreased among

methadone treatment admissions.M

Ecstasy sales are starting to take place

in public housing developments.L

Diverted OxyContin® sales increased.L

Primary and secondary OxyContin®

abuse has increased among

methadone treatment admissions.

MDMA (ECSTASY) DIVERTED OXYCONTIN®

! Drugs considered relatively easy to

purchase by both undercover officers and buyers include heroin,

crack, marijuana, methamphetamine, and ecstasy.L,E

! As in other western Pulse Check cities, Mexican black tar heroin is the most common

type of heroin available.L,E

! Undercover officers have found it easier to purchase Mexican black tar in the last 6

months, but Mexican brown has been more difficult to purchase.L

! Several other drugs have become easier for undercover officers to purchase in the

last 6 months: cocaine, marijuana (in general and hydroponic), methamphetamine

(all forms, including ice), ecstasy, diverted OxyContin®, and gamma hydroxybutyrate (GHB).L
SNAPSHOT: SAN FRANCISCO, CALIFORNIA

page 272 Pulse Check: January 2004

THE USE PERSPECTIVE

WHAT’S HAPPENING IN TREATMENT?

Treatment capacity and availability

! The Pulse Check non-methadone

treatment respondent’s program,

which operates at its maximum

capacity of 250 slots plus a waiting

list, sees a variety of drug clients,

most of whom use heroin,

methamphetamine, or crack

cocaine as their primary drug of

abuse (see pie chart on the first

page of this chapter). 

! Limited slot capacity and lack of

trained staff to treat comorbidity

are the most common barriers to

non-methadone treatment. Those

problems are increasing due to

budget and funding cuts.

Furthermore, there is an increasing

awareness of special needs populations, but the program doesn’t

have resources for higher staff

salaries.N

! The methadone treatment respondent is with a facility that operates

close to its maximum capacity of

700 methadone maintenance and

100 detoxification clients.M Many

of its clients have secondary and

tertiary drug problems (see bar

chart on the first page of this 

chapter).

! Methadone maintenance treatment

is available only in selected areas

of the community, and public programs have large waiting lists.E

! The most common barrier to

methadone treatment is the lack of

funding: the Pulse Check

methadone treatment source’s program is private and for profit, so

patients without medical insurance

typically cannot afford treatment. 

! The epidemiologic source states

that the difficulty of obtaining

public methadone treatment is

“dramatic,” and the demand has

increased over the years as the

heroin users have aged. That

source further states that the only

way for potential clients to get on

a waiting list is to present with

multiple diagnoses, such as heroin

addiction plus tuberculosis.

Moreover, methadone treatment

availability has declined in the past

6 months because the Department

of Public Health is reducing treatment slots.E

Consequences of drug use

! The treatment sources note that

drug abuse-related health 

consequences are relatively stable,

but several are noted as high,

including the following:

HIV/AIDSN,M hepatitis C,N,M

abscessesM (due to the decreasing

purity and increasing adulterants

of heroin), dental neglectM, poor

nutritionM, and skin rashesM.

! Several co-occurring disorders

have increased between spring and

fall 2002, including the following:

psychosis, which is related to

methamphetamine and its wider

availability,N and antisocial or conduct disorder, which is not that

common but is time consuming

for staff.M Mood disorders remain

the most common comorbid diagnosis among non-methadone

treatment clients.

Increased complications for drug

treatment over the past 10 years

! Increasing availability of new

drugs: Designer drugs, such as

ecstasy and GHB, have complicated treatment drastically, according

to one treatment source.N

Increases in OxyContin® and

other prescription drug abuse

have made methadone treatment

more difficult.M

! Increased treatment case loads:

“Increases in treatment loads create less flexibility for staff to tailor

treatment services to clients.” N

! Lack of housing opportunities for

recovering clients: According to

the non-methadone treatment

source, most post-treatment housing tends to be single-residency

hotel rooms in low socioeconomic areas of the city where drug

use is high, making it difficult for

recovering addicts to abstain from

drug use. The methadone treatment respondent reports a limited

number of recovery home slots,

especially slots that accept

methadone treatment outpatients.

! Lack of jobs and job training

opportunities for recovering

clients: Treatment respondents

report that “rents have increased,

and the economy has worsened,”M

and “there is a general lack of

resources for drug treatment.”N

WHO USES ILLICIT DRUGS?

The Pulse Check epidemiologic, nonmethadone treatment, and methadone

treatment sources were asked to

describe the populations most likely

to use heroin, cocaine, marijuana,

methamphetamine, and ecstasy. They

were also asked to depict any emerging user groups and to report on how

the drugs are used. As shown on the

following pages, user characteristics

vary by drug. Further, because of the

different perspective each brings, the

three sources sometimes describe

quite different populations and use

patterns for each drug. For example,

all methadone clients are primary opiate users who may use drugs 

other than opiates in a secondary or

tertiary manner. 
SNAPSHOT: SAN FRANCISCO, CALIFORNIA

Pulse Check: January 2004 page 273

Who’s most likely to use heroin?

Characteristic E N M

Age group (years) >30 >30 >18 

Mean age (years) 38 NR NR 

Gender 75% male 60% male 60% male 

Race/ethnicity White White White 

Socioeconomic status Low Low Low 

Residence Central city Central city Central city 

Referral source N/A Individual Criminal justice, other 

alcohol/drug abuse 

care providers, and other 

health care providers 

Level of education completed N/A High school High school

Employment at intake N/A Unemployed Varies widely 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

How do users take heroin?

Characteristic E N M

Primary route of administration Injecting Injecting Injecting 

Other drugs taken Crack diluted Powder cocaine Crack cocaine

with lemon (speedball) (speedball);

(speedball) methamphetamine

in combination

Publicly or privately? Publicly Privately Privately 

Alone or in groups? In groups Alone Both 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Heroin users tend to be adults older than

30E,N and White males.E,N,M

! Most heroin use characteristics are stable between spring and fall 2002, with

the following exceptions: Hispanic and

Black users have decreased;E female

users have increased;E and more users

are unemployed.N

! Heroin users new to treatment are more

likely than the general heroin-using population to be younger, of middle socioeconomic status, referred to treatment

by the criminal justice system, better

educated, and employed.N

! In San Francisco, injecting is the most

common route of heroin administration, and cocaine injected with heroin

(speedball) is a common practice.E,N,M 

! Smoking as a route of heroin administration has increased in the past several years.N Sources report no other

changes in method of use since spring

2002.

! Methadone treatment clients often

request sildenafil (Viagra®) because 

opiates tend to decrease sexual 

performance.M
SNAPSHOT: SAN FRANCISCO, CALIFORNIA

page 274 Pulse Check: January 2004

Who’s most likely to use marijuana?

Characteristic N

Age group (years) 18–30 

Gender 70% male 

Socioeconomic status Middle 

Residence Central city 

Referral source Criminal justice 

Level of education completed 2-year college 

Employment at intake Full time 

Source: NNon-methadone treatment respondent

! Non-methadone treatment clients for primary marijuana use are more likely than their other drug-using

counterparts to be adolescents or young adults.N 

! Marijuana is most often smoked in joints, blunts,

and pipes.E,N

! Sources report no changes in marijuana use or user

characteristics since spring 2002.

Who’s most likely to use crack cocaine?

Characteristic E N M

Age group (years) >30 >30 18–30 

Mean age (years) 32 40 NR 

Gender 60% male 70% male 60% male 

Race/ethnicity Black Black NR 

Socioeconomic status Low Low NR 

Residence Central city Central city NR 

Referral source N/A Individual NR 

Level of education completed N/A High school NR 

Employment at intake N/A Unemployed NR 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

Problem Change 

Decline in users’ perception of harm 

Increased THC potency of marijuana 

Increased polydrug use 

Increased progression to use of other drugs 

Decline in social disapproval (e.g., peers, parents, etc.)

Glamorization by entertainment industry 

Increased overall difficulty in treating the addiction 

Earlier initiation of marijuana use 

Promotion of marijuana as “medicine”

01 2 345

Extent complicated treatment

Not at all A lot 

Marijuana-using clients: To what extent have changes in the following problems complicated their 

treatment over the past 10 years?

NR

NR

NR

0

0

!""Non-methadone treatment

#" Methadone treatment respondent

! Crack users tend to be Black males

older than 30.E,N Sources report no

changes in crack use or user characteristics.

! Crack users new to non-methadone

treatment are more likely than the 

general crack-using population to be

female (70 versus 30 percent).N

! Sources report low use of powder

cocaine in San Francisco.E,N,M 

What they have to say...

! Increased court referrals involving

marijuana possession and sales

have had a positive effect of getting people into treatment earlier.N

! Marijuana-using clients who report

problems with being able to stop

using or with side effects have

increased over the past 10 years.N

! More dangerous marijuana 

combinations (especially marijuana

plus methamphetamine or ecstasy)

have increased over the past 10

years.N
SNAPSHOT: SAN FRANCISCO, CALIFORNIA

Pulse Check: January 2004 page 275

Who’s most likely to use methamphetamine?

Characteristic E N

Age group (years) 18–30 18–30 

Mean age (years) 27 NR 

Gender 60% male 75% male 

Race/ethnicity White White 

Socioeconomic status Low Middle 

Residence Central city Central city 

Referral source N/A Individual 

Level of education completed N/A 2-year college 

Employment at intake N/A Part time 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent

Reason

01 2 3 4 5

Extent contributed

Not at all Extremely

0

0

0

0

0

0

0

0 

0

0

More local production

Promotion of marijuana as “medicine” 

Increase in indoor farms 

Less emphasis by law enforcement and courts 

Decline in users’ perception of harm

Glamorization by news media 

Glamorization by entertainment industry 

Increased THC potency

Decline in price 

Decline in social disapproval (e.g., peers, parents, etc.)

Widespread marijuana availability and use over the past 10 years: To what extent have the following contributed?

What they have to say...

! Increase in indoor farms: Indoor farms have made it easier for people to conceal marijuana growth.L

! More local production, less emphasis by law enforcement and courts, and promotion of marijuana as “medicine”: The law

enforcement source believes that each of these problems has increased marijuana use and activity over the past 10 years

and that each is related to the introduction of Proposition 215 (“medical” marijuana legislation).L

! Decline in social disapproval: Unlike the majority of respondents in other Pulse Check cities, sources in San Francisco 

either believe that this decline has not had an impact or that it has not taken place at all.L,E

!"Law enforcement

#"Epidemiologic/ethnographic

respondent

! Most methamphetamine users are

young adult White males.E,N

! New methamphetamine nonmethadone treatment clients are more

likely to be female than the general

methamphetamine-using population

(50 versus 25 percent).N

! Methadone treatment clients who use

methamphetamine have similar 

characteristics to those who use heroin

only. That source reports some

increase in methamphetamine use.M
SNAPSHOT: SAN FRANCISCO, CALIFORNIA

page 276 Pulse Check: January 2004

How do users take methamphetamine?

Characteristic E N

Primary route of administration Injecting followed Injecting followed 

by oral use by smoking 

Other drugs taken NR Benzodiazepines 

Publicly or privately? Publicly Publicly and privately 

Alone or in groups? In groups Alone 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent

! The most common route of methamphetamine

administration in San Francisco is injecting, 

followed by smoking and oral use.E,N

! Methamphetamine clients new to treatment

are more likely than the general methamphetamine-using population to smoke the drug and

to take it in public and in groups.N That source

reports that new methamphetamine users

often start using the drug in nightclubs, but

often move to use alone and in private.

! The epidemiologic source notes that methamphetamine injection may be increasing.E

Who’s most likely to use ecstasy? 

Characteristic E N

Age group (years) 18–30 18–30 

Mean age (years) 22 NR 

Gender 55% male Split evenly 

Race/ethnicity White White 

Socioeconomic status Low and middle Middle 

Residence Central city Central city 

Level of education completed N/A 2-year college 

Employment at intake N/A Full time 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent

! Between spring and fall 2002, ecstasy use

decreased among methadone treatment

clients.M

! Among non-methadone treatment clients, all

ecstasy use is secondary or tertiary.N

! Ecstasy users tend to be White young adults

and evenly split between genders.E,N However,

the epidemiologic source notes that ecstasy

use in San Francisco spans social classes

and includes “street gang members as well

as upper class kids.” 

! Marijuana is often taken in combination with

ecstasy.E,N

! Respondents report no changes in ecstasy

use or user characteristics since spring 2002.

Who’s most likely to abuse OxyContin®?

Characteristic N M

Age group (years) >30 >18 

Gender 80% male 60% male 

Race/ethnicity White White 

Socioeconomic status Low and middle Low 

Residence Central city Central city and suburbs 

Sources: NNon-methadone treatment respondent; MMethadone treatment respondent

! Between spring and fall 2002, diverted

OxyContin® use among methadone treatment

admissions increased somewhat.M

! Treatment sources report that most

OxyContin® abusers take the drug orally and

do not use other drugs; however, the

methadone source states that OxyContin®

abusers often switch to heroin use. 
SNAPSHOT: SAN FRANCISCO, CALIFORNIA

Pulse Check: January 2004 page 277

WHERE ARE DRUGS USED AND

SOLD?

Most drugs (including heroin, crack,

marijuana, methamphetamine, 

ecstasy, and diverted OxyContin®)

are available in streets and open-air

markets located in the central city

areas of San Francisco.L,E

Heroin, crack, and marijuana are

also sold in the following locations:

! Inside carsL,E

! Crack houses/shooting galleriesL,E

! Private residencesE

! Playgrounds and parksE 

! Hotels/motelsL,E

! Around supermarketsL

! Public housing developmentsL,E

Drugs commonly sold at nightclubs

and bars, raves, concerts, and private

parties include marijuana, methamphetamine, and ecstasy.L,E

Additionally, marijuana and ecstasy

are often sold in or around schools

and college campuses.L,E Ecstasy sales

in public housing developments have

emerged in the past 6 months.L

Diverted OxyContin® sales occur

around public housing developments,

over the Internet, and inside cars.L

HOW DO ILLEGAL DRUGS GET FROM

SELLER TO BUYER?

To purchase heroin, crack, marijuana,

and ecstasy, buyers typically go to a

neighborhood known for drug sales,

locate a street dealer, and purchase

the drug hand to hand on the

street.L,E Typically dealers nod or say

a code phrase indicating that they are

selling drugs.L

To buy methamphetamine, buyers

typically contact dealers via cell

phones or the Internet to arrange a

meeting, at which the drug is

exchanged hand to hand.E

Internet communication and sales

between buyers and sellers of both

methamphetamine and ecstasy have

increased over the past 6 months.L,E

Diverted OxyContin® is also sold

over the Internet.

Who sells illegal drugs?

According to the law enforcement

source...

! Heroin, powder and crack

cocaine, and ecstasy sellers tend to

be 18–30-year-olds who are

organized, often into street gangs.

Dealers who sell primarily heroin

or crack often sell other drugs

(including marijuana and methamphetamine). Dealers who sell primarily ecstasy often sell methamphetamine and sildenafil as well. 

! Marijuana sellers may be organized

or independent; in HaightAshbury, most are independent

heroin addicts who sell marijuana

to support their heroin addiction.

! Sellers of methamphetamine and

diverted OxyContin® are independent young adults.

According to the epidemiologic

source...

Most drug dealers (heroin, crack,

marijuana, and ecstasy) are young

adults who operate independently.

They tend to sell only one type of

drug. Heroin and crack dealers are

somewhat likely to use their own

drugs, while marijuana and ecstasy

dealers are very likely to do so.

THE MARKET PERSPECTIVE

Which drug sellers are associated with which crimes?

Crime Heroin Powder Crack Marijuana Metham- Ecstasy Diverted

cocaine cocaine phetamine OxyContin®

Prostitution $ $

Gang-related activity $$ $ $ $ $ $

Violent criminal acts $$ $ $ $

Nonviolent criminal acts $

Domestic violence $ $

Drug-assisted rape $ $

Source: Law enforcement and epidemiologic/ethnographic respondents.

! Violent criminal acts associated with drug sales include

homicides, turf wars, and

assaults.L

! As in many cities where

methamphetamine is widely

available, criminal acts associated with methamphetamine

sales vary widely; in San

Francisco, sales are particularly

associated with sex work.L,E
SNAPSHOT: SAN FRANCISCO, CALIFORNIA

page 278 Pulse Check: January 2004

How pure are illegal drugs, and how much do they cost?

Drug Unit Purity Price

Mexican black One bag (0.1–0.25 g) 17% $10L

tar heroin

0.25 g NR $10–$20E 

1 g 17% $60L 

Crack One rock (0.1 g) 74% $6–$10L 

One rock NR $5–$20E

0.25 g 74% $25L

One packet, 10 rocks (1 g) $80L 

Powder cocaine One bindle (0.13–0.25 g) 64% $15–$25L

1 oz $400–$600L 

Marijuana Dime bag 1–6% THC $10L 

0.13 oz $60L

Methamphetamine 1 g 57–80% $130L 

0.13 oz $170L

0.06 oz $300L 

Ecstasy One tablet NR $10–$20L

Diverted OxyContin® 40-mg pill N/A $10L 

80-mg pill N/A $20L 

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic respondent

Between spring and fall 2002, the purity of

most drugs remained relatively stable.L,E The

epidemiologic source states that Mexican

black tar heroin purity increased slightly in

2002. 

Between spring and fall 2002, drug prices

remained relatively stable, with two exceptions:

! Heroin prices declined from $95–$100

per gram to $60 per gram.L

! Powder cocaine and crack prices

declined at ounce levels.L

New marketing and buying phenomena

include the following:

! Heroin dealers now sell cocaine and heroin packaged together for speedball use.N

! Crack users tend to pool their money to

buy the drug.N

Beyond cash: What else is accepted in exchange for drugs?

Heroin

Cash

Crack cocaine

Marijuana Methamphetamine

37%

Shoplifted

merchandise

Other stolen

merchandise

Property/

Merchandise

Drug given as gift

Other: Includes items accounting for 4 percent or less of transactions

for each of the five drugs, such as guns, other drugs, transporting the

drug, stealing the drug, food stamps, drug buying services, injecting

services, lookout services, and forged checks

Sex 88%

47%

41%

8%

15%

22%

9%

15%

3%

6%

8%

7%

27%

11%

11%

12%

5%

20%

Powder cocaine

66%

10%

7%

5%

Source: Mean of response ratings given by law enforcement, epidemiologic/

ethnographic, non-methadone treatment, and methadone treatment respondents; the epidemiologic/ethnographic source did not provide percentages

for cocaine exchanges; the methadone treatment source did not provide

information for methamphetamine exchanges.

! Cash remains the most common

means of exchange for illicit

drugs; however, it is much less

dominant in San Francisco than in

most other Pulse Check cities.

Other common modes of

exchange vary by drug.

! For the most part, the means of

exchange for drugs have remained

stable over the past 10 years, with

one exception: sex exchanged for

crack cocaine has decreased.E

! The epidemiologic source states

that begging or panhandling is the

single biggest supplier for cash to

buy heroin, crack, and methamphetamine.E

5%

7%

3%

2% 3%
SNAPSHOT: SAN FRANCISCO, CALIFORNIA

Pulse Check: January 2004 page 279

Community innovations and tools over the past 10 years:

How successful have they been?

01 2 3 4 5

Degree of success

Not at all Extremely successful

Increased use of task forces 

Crack house (nuisance abatement) laws 

Onsite lab tests 

Precursor laws

Drug user recognition education (DRE) for law enforcement

Sentencing changes

Drug courts 

Drug-free zone laws 

Prescription drug monitoring

Community innovation/tool What they have to say...

! Task forces: Increased cooperative

efforts between local, State, and

Federal offices over the past 10 years

have successfully combated illegal

drug activity.L In particular, local police

help in lab processing gives task

forces more time for narcotics investigations. Other task forces mentioned

include the Campaign Against Drug

Abuse (CADA) and Project Safe

Neighborhood. The law enforcement

source further suggests more task

force use for interdiction programs to

target the importation of drugs via

parcels, buses, and trains. High

Intensity Drug Trafficking Area (HITDA)

funding for radios, police cameras,

and other equipment and the

increased cooperation between local, State, and Federal agencies and the National Guard have been

directly responsible for large “crack sweeps.”L

! Drug courts: Pulse Check respondents rate drug court programs as very successful in combating

drug use and activity.L,E One limitation is the lack of treatment programs to which a judge can refer

offenders.E

! Onsite lab tests: The law enforcement source views onsite lab tests, including chemical field and

phosphine gas meter tests, as extremely helpful tools. 

! Crack house laws: The U.S. Department of Housing and Urban Development (HUD) and law enforcement practice of evicting drug users and sellers and closing crack houses for health violations, fire

noncompliance, and excessive garbage has proved extremely helpful in combating crack activity in

certain San Francisco neighborhoods.L

! Prescription drug monitoring program: The law enforcement source sees the prescription drug monitoring program in San Francisco as somewhat successful. He suggests increased manpower in the

diversion program and increased arrests of street sellers and buyers of diverted prescription drugs.L

SEPTEMBER 11 FOLLOWUP

With one exception, the San Francisco Pulse Check sources believe that the September 11 attacks and their aftermath

have not had any effects on the drug abuse problem. The non-methadone treatment respondent reports an increase in

admissions who are self-treating anxiety with benzodiazepines.

Source: Law enforcement respondent

THE CHANGING DRUG MARKET: THE LAST 10 YEARS
SNAPSHOT: SEATTLE, WASHINGTON

page 280 Pulse Check: January 2004

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

Three Pulse Check sourcesL,E,M believe the city’s overall drug problem has

remained stable; the non-methadone treatment source believes the drug

problem has grown somewhat worse. 

Some changes are reported:

! Task forces, particularly for methamphetamine, have been successful. A

decline in meth labs may be due to

precursor laws and law enforcement

efforts.L

! Drug-related incarceration and

recidivism have declined as a result

of the proliferation of drug courts.

! Heroin has replaced crack as the second most widely abused drug in the

city.E

! Crack use has increased among the

non-methadone treatment population, while powder cocaine use may

be decreasing.N

! Methamphetamine use continues to

increase.L,N Ice (high quality, smokable

methamphetamine), in particular, is

emerging.L

! Diverted OxyContin® (oxycodone

hydrochloride controlled-release)

activity has increased.L It is considered an emerging drug of abuse by

two sources.E,M

All four sources consider the city’s 

drug problem very serious, with marijuana cited as the most widely abused drug

by most sources. The drug related to the

most serious consequences varies by

source.

SEATTLE PRIMARY METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Total population:. . . 2,414,616

! Median age: . . . . . . 35.5 years

! Race (alone):

! White . . . . . . . . . . . . . 78.6 %

! Black. . . . . . . . . . . . . . . 4.4 %

! American Indian/

Alaska Native . . . . . . . . 1.0%

! Asian/Pacific Islander 9.9%

! Other race . . . . . . . . . . . 2.4% 

! Two or more races . . . . 3.9% 

! Hispanic (of any race):. . . 5.2%

! Unemployment rate: . . . . 3.2%

! Median household 

income: . . . . . . . . . . . $58,395

! Families below poverty level 

with children <18 years: 12%

Source: U.S. Census 2000* 

*The census data in this table are provided as a frame of reference for the information given by Pulse Check sources. When possible, the data given by the

law enforcement and epidemiologic/ethnographic sources reflect the metropolitan area.

Most widely abused drug:

MarijuanaL,E,N

HeroinM

No reported changes between spring

and fall 2002L,E,N,M

Second most widely abused drug:

CrackN,M

MethamphetamineL

HeroinE

Changes between spring and fall 2002:

Heroin replaced crack as the second

most widely abused drug.E

Drug related to the most serious

consequences:

HeroinE, M

MethamphetamineL

CrackN

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the second most

serious consequences:

HeroinL

CrackE

BenzodiazepinesM

No reported changes between spring

and fall 2002L,E,N,M 

New or emerging problems:

MethamphetamineL,N (ice)

Diverted OxyContin®E,M

Sources: LLaw enforcement, E

Epidemiologic/ethnographic, 

N

Non-methadone treatment, and

MMethadone treatment respondents

Note: These symbols appear throughout this

city profile to indicate type of respondent.

! Marijuana remains the most common

primary drug of abuse among nonmethadone clients, followed by crack

and methamphetamine. 

! Prescription pills remain the most

common secondary and tertiary drugs

of abuse among heroin users in the

methadone treatment program.

What are the primary drugs of abuse

among clients in a non-methadone

treatment program? (Fall 2002)

What drugs do clients in a methadone

program use?+ (Fall 2002)

Heroin

Crack cocaine

Marijuana

Methamphetamine

Source: Methadone treatment respondent 

+

Includes any use, whether as a primary, secondary, or tertiary drug; no clients reportedly

use powder cocaine; marijuana use is not

recorded.

Source: Non-methadone treatment respondent 

Heroin

Crack cocaine

Methamphetamine

Diverted OxyContin®

Benzodiazepines

Percent

0 20 40 60 80 100

64%

14% 5% 17%

99

17

(N=36)

(N=860) 15

12

10
SNAPSHOT: SEATTLE, WASHINGTON

Pulse Check: January 2004 page 281

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic respondent

Note: SA=South American (Colombian) heroin;

SWA=Southwest Asian heroin; SEA=Southeast

Asian heroin; and ice=highly pure methamphetamine in smokable form

Not

difficult

at all

Extremely

difficult

Undercover policeL UsersE

Heroin (in general and

Mexican black tar); methamphetamine (in general)

Crack; marijuana (all varieties); methamphetamine

(locally produced and Mexican)

Crack

Powder cocaine; diverted OxyContin®

Marijuana (in general)

Mexican black tar heroin

4

3

2

1

0

5

6

7

8

9

10

The heroin problem remained relatively stable between spring and fall

2002:

! Injectable Mexican black tar heroin remains the most available form

of the drug and is relatively easy

to purchase.L,E

! Heroin remains the drug related

to the most serious consequences

according to two sourcesE,N and

has replaced crack as the second

most widely abused drug according to one source.E

The two forms of the drug show

opposite trends:

! Crack is cited as the drug related

to the most serious consequences

by one source. That source reports

that the percentage of primary

crack users has increased between

fall and spring 2002.N

! Powder cocaine use remains low

and may be decreasing.N

Most sourcesL,E,N consider marijuana

the most widely used drug in the city.

It is easier for undercover officers to

purchase than in the past, especially

British Columbian marijuana (BC

bud), which comes from Canada.L

HEROIN

SA,SEA,SWA

SA

SA,SEA,SWA

Ice; ecstasy

Local commercial grade, hydroponic

marijuana, and BC bud; methamphetamine (in general and Mexican); ecstasy

Heroin (in general and Mexican brown);

sinsemilla; locally produced methamphetamine

Diverted OxyContin®

! Although ease-of-purchase ratings for

various drugs differ according to source,

marijuana is considered one of the easiest drugs to purchase.L,E

! Marijuana (in general and BC bud) is

considered less difficult for undercover

officers to purchase than in the past.L

Only three other sources in Pulse Check

cities report similar increases in BC bud

(Minneapolis/St. Paul,L St. Louis,E and

Portland, ORL

).

! Mexican black tar heroin is also considered relatively easy to purchase.L,E

! Ice (mostly imported from Canada) is

considered less difficult to purchase during these 6 months than during the previous 6 months.L,E

! Ecstasy and diverted OxyContin® are less

difficult for undercover officers to purchase than in the previous 6 months.L,E

MARIJUANA

METHAMPHETAMINE

Methamphetamine use and activity

have increased according to several

Pulse Check sources:

! The law enforcement source

believes that the drug is related to

the most serious consequences. 

! Two sources claim that methamphetamine—particularly ice—is

easier to purchase than in the

past.L,E Two sources consider

methamphetamine—particularly

ice—as increasing or emerging.L,N 

! Methamphetamine is related to

high-risk behaviors associated with

HIV/AIDS among males who have

sex with males.E

COCAINE
SNAPSHOT: SEATTLE, WASHINGTON

page 282 Pulse Check: January 2004

WHAT’S HAPPENING IN TREATMENT?

! The Pulse Check non-methadone

treatment respondent, whose 43-slot

program operates at nearly full

capacity, reports marijuana as the

primary drug of abuse among more

than half of that program’s clients

(see pie chart on the first page of this

chapter). Treatment percentages for

primary crack, methamphetamine,

and OxyContin® abusers increased

somewhat, and percentages for primary powder cocaine and ecstasy

users decreased somewhat between

spring and fall 2002.

! The methadone treatment respondent is with a facility operating at

nearly full capacity (860 of 875

treatment slots). Prescription pills

are commonly abused by clients in

the program (see bar chart on the

first page of this chapter).

! Methadone maintenance treatment is

available throughout the area. Public

treatment availability increased

between spring and fall 2002, but a

24-month waiting list is standard.

Private methadone treatment availability has remained relatively stable

between spring and fall 2002 and

appears to be underutilized.E

! The non-methadone treatment

respondent reports an increase in

clients with HIV/AIDS, most likely

due to a new referral source to

treatment: a nearby HIV/AIDS shelter. High-risk pregnancies among

clients in that program have

decreased recently, most likely due

to more prevention education.N

! Common comorbid disorders

among non-methadone treatment

clients include antisocial, conduct,

and mood disorders, all of which

have remained relatively stable

between spring and fall 2002.N

Who’s most likely to use heroin?

Characteristic E N M

Age group (years) >30 >30 >30

Gender Male Female Split evenly

Race/ethnicity White White White 

Socioeconomic status Low NR Low

Residence Central city NR Central city 

Referral source N/A NR Individual followed

by criminal justice

Level of education completed N/A NR High school 

Employment at intake N/A NR Unemployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! According to Pulse Check sources, heroin users tend to be older than 30,

White non-Hispanics who live in the central city and are of low socioeconomic

status. 

! Fewer heroin clients are employed in fall 2002 than during the previous

spring.M No other changes in heroin user characteristics are reported.E,N,M

THE USE PERSPECTIVE

! Diverted OxyContin®:

!"Two sources consider diverted

OxyContin® an emerging drug

of abuse.E,M

!"Both treatment sources report

an increasing percentage of

users since spring 2002.N,M

!"Injecting diverted OxyContin®

has increased between spring

and fall 2002, and deaths 

related to the drug have

increased dramatically.E

!"Diversion activity has increased

between spring and fall 2002,

but activity is still at a relatively

low level.L

! Phencyclidine (PCP):

!"PCP seizures and emergency

department visits related to

PCP increased between spring

and fall 2002.L

!"Possession of PCP is more commonly involved in arrests than

in the past.

OTHER DRUGS

Although its use and activity have leveled off in the past 6 months, ecstasy

is still considered an emerging drug of

abuse by Pulse Check sources.

! Ecstasy (methylenedioxymethamphetamine or MDMA) use is stable, but as reported in spring

2002, the drug is increasingly used

in streets and schools in addition

to raves and nightclubs. 

! Ecstasy continues to be related to

high-risk behaviors associated with

HIV/AIDS among men who have

sex with men.E

! Treatment clients who use ecstasy

continue to be few. Between spring

and fall 2002, use among clients

has decreased somewhat.N 

MDMA (ECSTASY)
SNAPSHOT: SEATTLE, WASHINGTON

Pulse Check: January 2004 page 283

Characteristics remain stable among the predominant

user groups. However, some

changes in general percentages and among users new

to treatment were reported:

! Primary crack use has

increased somewhat since

spring 2002.N

! According to the nonmethadone treatment

source, powder cocaine

use is low and has

decreased since spring

2002. However, according

to the epidemiologic

source, powder cocaine

use among users new to

treatment has increased,

and these users are

increasingly younger.

! Among non-methadone clients,

limited slot capacity, a common

barrier to treatment, has increased

within the last 6 months due to

cuts in State funding for treatment.

Lack of parental involvement with

youth in treatment is also a relatively

common, yet stable, problem within

the non-methadone treatment population. Lack of trained staff to

treat comorbidity has decreased as

a problem in the last 6 months

because staff are increasingly

attending training and workshops

to address comorbidity.N

! In the methadone treatment 

program, limited slot capacity

remains the most common barrier

to treatment. Lack of money for

transportation remains a problem

for private payees who are unemployed.M

WHO USES ILLICIT DRUGS?

The Pulse Check epidemiologic, 

non-methadone treatment, and

methadone treatment sources were

asked to describe the populations 

most likely to use heroin, cocaine,

marijuana, methamphetamine, ecstasy,

and diverted OxyContin®. They were

also asked to describe any emerging

user groups and to report on how the

drugs are used. As shown on the following pages, user characteristics vary

by drug. Further, because of the different perspective each brings, the three

sources sometimes describe quite different populations and use patterns for

each drug. For example, all methadone

clients are primary opiate users who

may use drugs other than opiates in a

secondary or tertiary manner.

Who’s most likely to use cocaine?

Crack cocaine Powder cocaine 

Characteristic E N M E

Age group (years) >30 >18 >18 >30 

Gender NR Male Split evenly NR

Race/ethnicity White White White White

Socioeconomic status Low Low Low Low 

Residence Central city Suburbs Central city Central city

Referral source N/A Criminal Individual followed N/A 

justice by criminal justice

Level of education 

completed N/A High school High school N/A

Employment at intake N/A Unemployed Unemployed N/A

Note: The characteristics cited by the methadone treatment source are for those who use heroin as a primary

drug and crack as a tertiary or secondary drug. No powder cocaine use was reported by the methadone 

treatment source. Very low powder cocaine use was reported by the non-methadone treatment source, and 

use characteristics were not reported.

Sources: E

Epidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone 

treatment respondent

How do users take heroin?

Characteristic E M

Primary route of administration Injecting Injecting 

Other drugs taken Powder cocaine Powder cocaine

(speedball) (speedball) 

Publicly or privately? Both Privately 

Alone or in groups? Both Alone

Note: Due to the low percentage of primary heroin users in the non-methadone treatment

program, that source did not provide responses to these questions.

Sources: EEpidemiologic/ethnographic respondent; MMethadone treatment respondent

! Use patterns appear stable between spring

and fall 2002. 

! Most heroin is injected. Injecting powder

cocaine in combination with heroin (speedball)

remains common.E,N
SNAPSHOT: SEATTLE, WASHINGTON

page 284 Pulse Check: January 2004

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

Respondents associate marijuana,

used either alone or with other drugs,

with the following consequences,

which remained stable between spring

and fall 2002:

!"Drug-related emergency room visitsE

!"Drug-related arrestsE,N,M

!"Short-term memory lossN,M

!"Deteriorating family/social

relationshipsN

!"Poor academic performanceN

!"School absenteeism or truancyN

!"Poor workplace performanceM

!"Unemployment ratesN

!"Workplace absenteeismM

Marijuana-using clients: To what

extent have changes in the following

problems complicated their treatment in the past 10 years?

The non-methadone treatment source

reports several problems that have

increased complications in treating

marijuana-using clients in the past 10

years: 

!"Increased severity of addiction

among clients

!"Increased THC potency of 

marijuana

!"Earlier initiation of marijuana use

!"Increased progression to use of

other drugs: The non-methadone

treatment source states that many

marijuana users seem to branch off

to prescription drug abuse (including OxyContin®) and methamphetamine use.

!"Decline in users’ perception of

harm

!"Decline in social disapproval 

(e.g., peers, parents, etc.) 

!"Glamorization by entertainment

industry

Who’s most likely to use marijuana?

Characteristic E N M

Age group (years) All 13–30 >18

Gender 70% male Male Male

Race/ethnicity White White White 

Socioeconomic status All Low Low

Residence All Suburbs Central city 

Referral source N/A Criminal justice (among adults); NR

School (among youth)

Level of education completed N/A Junior high and high school High school 

Employment at intake N/A Unemployed (among adults); NR

Full-time students (among youth)

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Marijuana users

tend to be White,

non-Hispanic males

of all age groups.

! Marijuana user

characteristics

have remained relatively stable

between spring

and fall 2002.E,N,M

Widespread marijuana availability and use over the past 10 years: 

To what extent have the following contributed?

Reason

0 123 45

Extent contributed

Not at all Extremely

Increase in indoor farms

Decline in users’ perception of harm

Decline in social disapproval

Promotion of marijuana as “medicine”

Increased THC potency

More local production

Glamorization by entertainment industry

Glamorization by news media

!""Law enforcement respondent

#""Epidemiologic/ethnographic respondent 

NR

NR

NR

NR

NR

NR

What they have to say...

The increase in indoor farms is the number-one contributor to marijuana use and activity.L

By contrast, sources in other Pulse Check cities tend to attribute somewhat lesser importance

to this change.
SNAPSHOT: SEATTLE, WASHINGTON

Pulse Check: January 2004 page 285

WHERE ARE DRUGS USED AND SOLD?

Streets and open-air markets where

buyers can purchase heroin, powder

and crack cocaine, marijuana, and

sometimes methamphetamine, still

exist in certain neighborhoods in the

central city. But the law enforcement

source states that they are relatively

confined and limited in number.

Other sales settings for heroin,

cocaine, marijuana, and methamphetamine include the following:L

!"Private residences

!"Public housing developments

!"College campuses (excluding crack)

!"Nightclubs and bars

!"Playgrounds and parks

!"Hotels and motels

!"Inside cars

Methamphetamine and marijuana 

are additionally sold around schools,

at raves, and at concerts. Crack is

additionally sold in crack houses.

Ecstasy is sold in private residences,

schools, nightclubs, and bars; on college campuses; and at private parties,

raves, and concerts.L

HOW DO DRUGS GET FROM SELLER

TO BUYER?

Other than obtaining drugs via openair markets, buyers can purchase

heroin and cocaine by setting up a

meeting with dealers via cell phone or

through a person who serves as a

“go-between” (an intermediary

between a dealer and a buyer).

Marijuana is exchanged similarly, but

the exchanges seem to be more interpersonal than for other drugs.L

Methamphetamine sales involve

acquaintance networks: buyers “must

know someone who knows someone”

to set up meetings for hand-to-hand

transactions, typically outside meth

labs.L Dealers communicate with buyers

via land line phones and face to face

and often also sell marijuana. Many

local manufacturers of methamphetamine make small batches of the drug

for themselves and for acquaintances.E

Similar to methamphetamine sales,

ecstasy sales tend to occur through

acquaintance networks, and the drug

is exchanged hand to hand.

Additionally, the sales are often venue

oriented: buyers often ask the person

at the door to a party or nightclub

about drug sales, and that person

directs a buyer to a dealer; furthermore, sometimes sellers simply

approach buyers at venues. Ecstasy

dealers often also sell gamma hydroxybutyrate (GHB), marijuana, and

sometimes methamphetamine. 

Diverted from doctors offices and

through prescription forgeries,

OxyContin® is often purchased 

illegally, with sellers and buyers communicating face to face and by cell

phones and land line phones.L

Who’s most likely to use methamphetamine?

Characteristic E N M

Age group (years) >18 >30 18–30

Gender Split evenly Male Split evenly

Race/ethnicity White White White 

Socioeconomic status Low Low Low

Residence All Suburbs Suburbs 

Referral source N/A Criminal justice Criminal justice

and individual

Level of education completed N/A Junior high High school 

Employment at intake N/A Unemployed Unemployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Methamphetamine users tend

to be White non-Hispanics of

low socioeconomic status who

live in the suburbs.N,M

! Smoking and injecting are the

most common routes of administration for methamphetamine

use. Smoking has increased

over the past several years.E

! No changes in characteristics

are reported.E,N,M

THE MARKET PERSPECTIVE
SNAPSHOT: SEATTLE, WASHINGTON

page 286 Pulse Check: January 2004

Beyond cash: What else is accepted in exchange for drugs?

Source: Mean of response ratings given by law enforcement and epidemiologic/ethnographic respondents. The epidemiologic/ethnographic respondent did not provide information for crack cocaine exchanges.

Heroin

Cash

Crack cocaine

Marijuana Methamphetamine

30%

Shoplifted merchandise

Other stolen merchandise

(e.g., electronic equipment)

Other: Mail and

identity theft

Property/merchandise Transporting 

the drug

Stealing the drug

Food stamps

Drug buying services Sex

100%

Powder cocaine

90%

5%

10%

10% 10%

10%

10%

10%

10%

50%

15%

15%

15%

5%

20%

10%

10% 10%

10%

10%

10%

10%

What they have to say...

! Cash remains the most common means of transactions.L

! However, compared with

other Pulse Check cities overall, other items and services

are more likely to be

exchanged for crack, heroin,

and methamphetamine.

! On the other hand, marijuana transactions appear to be

all cash—compared with

about 85 percent average

across all Pulse Check cities.

! The law enforcement source

explains that often methamphetamine users loot neighborhood mailboxes for paychecks and other forms of 

currency in order to buy

methamphetamine.L

WHO SELLS ILLEGAL DRUGS?

Heroin and cocaine sellers tend to

be organized, and two types of

street sellers exist: (1) go-between

addicts who act as liaisons between

buyers and the dealer who possesses

the drugs, and (2) the actual drug

dealers who possess the drugs.

Heroin and powder cocaine dealers

tend to be 18–30 years old, and

crack dealers tend to be

adolescents.L

Unlike heroin and cocaine dealers,

marijuana dealers are both independent and organized. A recent

influx of Southeast Asian gangs

based in Canada is involved in BC

bud sales in Seattle. These sellers are

more associated with violent criminal acts and street gang activity than

other marijuana sellers. They also

import ice from Canada for sale in

Seattle.L

Ecstasy dealers tend to be independent youth (13–18 years). Diverted

OxyContin® sellers are also independent, but they are more likely to

be older than 30 years.L 

10%

Which drug sellers are associated with

which crimes?

Crime H P Cr MJ Meth X

Gang- related

activity $ $$

Violent 

criminal acts: 

assaults $ $

Nonviolent

criminal acts: 

fraud and theft $ $$

No crimes 

associated $ $

BC bud sellers are more associated with violent

crime and gang action than other marijuana sellers.

Source: Law enforcement respondent

H=Heroin; P=Powder cocaine; Cr=Crack cocaine;

MJ=Marijuana; Meth=Methamphetamine; X=Ecstasy
SNAPSHOT: SEATTLE, WASHINGTON

Pulse Check: January 2004 page 287

THE MARKET PERSPECTIVE: A

10-YEAR VIEW

Drug marketing innovations and tools

over the past 10 years: To what degree

have they complicated efforts to detect

or disrupt drug activity in Seattle?

According to the law enforcement

source, dealers have used the following drug marketing innovations:

!"Increased communications via

Internet 

!"More organized networks 

!"Throwaway cell phones 

!"Polydrug dealers 

!"Expansion of drug sales beyond

the central city 

By contrast, disruption and detection

efforts have not been hampered by

increases or decreases in network

organization or the number of brand

names. Also, like in most other Pulse

Check cities, these efforts have not

been hampered by unique packaging.

SEPTEMBER 11 FOLLOWUP

None of the four Seattle Pulse Check

sources believes that the September

11 attacks and their aftermath have

had any long-term effects on the drug

abuse problem.

Community innovations and tools over the past 10 years: How successful

have they been?

NR

NR NR=Not reported

Drug courts 

Onsite lab tests

Increased use of task forces

Precursor laws

Crack house (nuisance abatement) laws

Drug-free zone laws

Prescription drug monitoring

!""Law enforcement respondent 

#""Epidemiologic/ethnographic respondent 

0 12 3 4 5

Degree of success

Not at all Extremely successful

! Task forces: Like in most other

Pulse Check cities, task forces,

particularly those for methamphetamine, have been successful in the Seattle area. Furthermore, a decline in local meth

labs may be due to stringent precursor laws and successful law

enforcement efforts.E

! Drug courts: The proliferation of

drug courts seems to be having

a positive effect on the community by reducing drug-related

incarceration and recidivism.L 

How pure are illegal drugs and how much do they cost?

Drug Unit Purity Price 

Mexican black tar heroin 1/10 g 14–58% $90–120 

1 oz $600–$1,300

Crack cocaine 1 g 40–85% $100

Powder cocaine 1 g 57–68% $80–$100

Mexican commercial grade marijuana 1 lb 2–3% $500–$700

Hydroponic marijuana 1 lb 12–18% $2,400–$3,200

BC bud 1 lb NR $2,800–$4,000

“Nazi method” methamphetamine 1 g 95% $20–$60

“Red phosphorus” methamphetamine 1 g 75% $20–$60

Ecstasy 150–250-mg pill NR $20–$30

Source: Law enforcement respondent

NR

! Between spring and fall 2002, drug purity and prices remained relatively stable.L

! Ecstasy adulterants are less toxic than they were in spring 2002. Dealers now substitute other pills for ecstasy and sell them as ecstasy. Ecstasy pills are cheaper at

raves ($10–$20 per pill) than they are in the community ($20–$30 per pill).L
SNAPSHOT: TAMPA/ST. PETERSBURG, FLORIDA

page 288 Pulse Check: January 2004

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

Three of the four Pulse Check sources believe the city’s overall drug problem has

remained stable since the previous reporting period,L,E,M while one believes the situation has worsened somewhat.N Specifically, several developments are reported:

! A Meth Squad has been introduced and has successfully seized many labs in a

nearby rural county that serves as the source for Tampa’s methamphetamine

supply.E Nevertheless, methamphetamine continues to be reported as an

emerging problem.L

! Community efforts are gearing up to combat another emerging problem:

diverted pharmaceuticals are becoming increasingly available on the street,

much more than a year or two ago, since pain management clinics began

opening up “right and left.”M Methadone, in particular, is increasingly

involved in emergency department episodes and deaths.

! Similar to reports in other cities (such as DenverE and Portland, ORL

), “triple

C” is what adolescents call dextromethorphan (found in the over-the-counter

product Coricidin HBP Cold and Cough®). The drug supposedly produces

effects similar to those of ecstasy when taken in large doses and is sometimes

combined with dimenhydrinate (found in the over-the-counter product

Dramamine®). A recent community alert, corroborated by law enforcement,

reports an increase in thefts of the product from groceries and pharmacies and

describes adolescents taking 20 to 43 tablets at a time.N Pharmacies are starting to display signs noting restriction of sales to one box per customer.M

Several longer term changes are reported:

! Crack was merely an emerging problem 5 years ago: now it has replaced

powder cocaine as the most widely abused drug.L

! Over the past 5 years, OxyContin®

abuse has replaced heroin as the

most widely abused drug among

clients in the Pulse Check source’s

methadone program.

! Because of increased training,

more treatment staff are aware of

comorbidity problems and how to

approach them.M

Three of the sources consider the

city’s drug problem very serious,L,E,M

and one describes it as “somewhat

serious.”M Because of the different

populations with whom they have

contact, the sources vary in their perception of which drugs are most

commonly abused and which have

the most serious consequences.

What drugs do clients in a methadone program usea

? (Fall 2002)

What are the primary drugs of abuse

among clients in a non-methadone

treatment program? (Fall 2002)

Heroin

Methamphetamine

Cocaine+

Marijuana

+The program doesn’t distinguish

between crack and powder cocaine, but

crack is the predominant form of

cocaine used.

Source: Non-methadone treatment

respondent

49%

2% 6%

43%

TAMPA/ST. PTERSBURG METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Total population:. . . 2,395,997

! Median age: . . . . . . 40.0 years 

! Race (alone):

! White . . . . . . . . . . . . . . 82.9%

! Black . . . . . . . . . . . . . . 10.2%

! American Indian/

Alaska Native . . . . . . . . 0.3%

! Asian/Pacific Islander 2.0%

! Other race . . . . . . . . . . . 2.7% 

! Two or more races . . . . 2.0% 

! Hispanic (of any race): 10.4% 

! Unemployment rate: . . . . 2.9% 

! Median household 

income: . . . . . . . . . . . $37,406

! Families below poverty level 

with children <18 years: 12.7% 

Source: U.S. Census 2000*

*The census data in this table are provided as a frame of reference for the information given by Pulse Check sources. Whenever possible, the data given by

the law enforcement and epidemiologic/ethnographic sources reflect the metropolitan area. 

Abused OxyContin® (oxycodone hydrochloride controlled-release)

Heroin

Marijuana

Benzodiazepines

Abused methadone

Other abused opiatesb

Crack

Methylenedioxymetham- phetamine (MDMA or ecstasy )

Powder cocaine

a

Includes any use, whether as a

primary, secondary, or tertiary

drug

b

Includes hydrocodone, morphine, and fentanyl patches

Source: Methadone treatment

respondent

(N=1,908)

0 20 40 60 80 100

Percentage 

(N=300)

20

15

4

30

30

30

30

46

70

! Ecstasy use among methadone clients, both

older and younger, has declined somewhat.M

! Treatment percentages in both programs

remained stable between spring and fall

2002.N,M
SNAPSHOT: TAMPA/ST. PETERSBURG, FLORIDA

Pulse Check: January 2004 page 289

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Sources: LLaw enforcement respondent; E

Epidemiologic/ethnographic

respondent

Note: SA=South American (Colombian)

heroin; SWA=Southwest Asian heroin;

SEA=Southeast Asian heroin; ice=highly

pure methamphetamine in smokable form

Not

difficult

at all

Undercover policeL UsersE

Crack, powder cocaine; marijuana (in general); ecstasy;

diverted OxyContin®

4

3

2

1

0

5

6

7

8

9

Local commercial marijuana

10

Locally produced methamphetamine

Methamphetamine (in general)

Mexican methamphetamine;

diverted OxyContin®

Ice

Crack

Marijuana (in general); ecstasy

Powder cocaine; alprazolam (Xanax®) 

Heroin (in general and Mexican

brown); hydroponic marijuana

Methamphetamine (in general,

and locally produced)

Sinsemilla

Mexican methamphetamine, ice

HEROIN

COCAINE

! No changes are reported in the

numbers or characteristics of users

between spring and fall 2002.

! While injecting is the primary

route of administration, smoking

has increased over the past 5

years.E Snorting, however, is the

most common route of administration in the Pulse Check source’s

non-methadone program,N and a

substantial number of methadone

patients snort heroin.M

! Since the last reporting period, the

number of crack users has

increased slightly, while the number of powder cocaine users has

declined slightly.E

! Treatment percentages, however,

remained stable, as did client

demographics and use patterns.N,M

Most widely abused drug:

MarijuanaE,N

CrackL

No reported changes between spring

and fall 2002L,E,N,M

Second most widely abused drug:

CrackE,N

MarijuanaL

HeroinM

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the most serious

consequences:

Cocaine (in general)L

CrackE

HeroinN

Diverted OxyContin®M

No reported changes between spring

and fall 2002L,E,N,M

Drug related to the second most

serious consequences:

HeroinL,M

Prescription pillsE

CrackN

No reported changes between spring

and fall 2002L,E,M,N

New or emerging problems:

MethamphetamineL

Prescription pills (especially diverted

alprazolam [Xanax®] and OxyContin®)

E

Dextromethorphan (in Coricidin HBP

Cough and Cold®) plus dimenhydrinate (in Dramamine®) N,M 

Diverted methadoneM

Sources: LLaw enforcement, EEpidemiologic/

ethnographic, NNon-methadone treatment,

and MMethadone treatment respondents 

Note: These symbols appear throughout this

city profile to indicate type of respondents.

! Tampa/St. Petersburg is one of six

Pulse Check areas where sources

believe diverted OxyContin® can be

obtained with no difficulty at all. (The

other five are BostonL

, DallasE, New

YorkL

, PittsburghE, and San

FranciscoL

).

! Undercover police find it less difficult

to obtain locally produced methamphetamine in fall 2002 than in the

previous spring.L

! Users find no change in difficulty of

obtaining drugs since the last reporting period.E

! Users and undercover police generally have a fairly similar degree of

difficulty in purchasing most drugs. 

Extremely

difficult

METHAMPHETAMINE

! The number of users is stable, as is

their ability to obtain drugs since

the last reporting period.E

! Undercover police find it less difficult to obtain locally produced

methamphetamine in fall 2002

than in the previous spring.L

MARIJUANA

! The percentages of primary, secondary, or tertiary marijuana use

remained stable in both treatment

programs between spring and fall

2002.N,M

! Respondents report no changes 

in the difficulty of users or undercover police to obtain the drug.L,E
SNAPSHOT: TAMPA/ST. PETERSBURG, FLORIDA

page 290 Pulse Check: January 2004

WHAT’S HAPPENING IN TREATMENT?

! Program descriptions, capacity,

and treatment availability: The

Pulse Check non-methadone treatment source is with a large facility

that includes several programs,

including outpatient, residential,

adolescent, criminal justice outpatient, and short-term treatment.

With an enrollment of 500, it is

operating below its capacity of

approximately 1,100. Located in

an affluent county, this particular

program has clients at the lower

end of the socioeconomic scale,

and Blacks are overrepresented.

Nearly half of the clients report

marijuana as their primary drug of

abuse, and more than 40 percent

report some form of cocaine (most

likely crack) as such (see pie chart

on the first page of this chapter).

The methadone treatment source

is with one of the many programs

operated under the same umbrella

as the non-methadone source.

Information provided for this 

issue of Pulse Check is based on

300 patients enrolled during the

last quarter of 2002. This program

is one of the few among those in

the other Pulse Check sites where

abused OxyContin® accounts for

more abuse than does heroin (see

bar graph on the first page of this

chapter).

Methadone maintenance treatment is available throughout the

area, particularly since the recent 

opening of the large program with

which both Pulse Check treatment

sources are affiliated. Treatment

capacity has remained stable

between spring and fall 2002.E

! Drug abuse consequences: Drug

overdoses have recently increased,

particularly those related to

methadone on the street. Methadone has unique properties which,

OTHER DRUGS

DIVERTED OXYCONTIN®

! Diverted pharmaceutical opiates

(in general): A subset of 35–40

percent of clients in the methadone

clinic are people who start out

with a chronic pain problem, go

to a pain management clinic to

receive pain medication, become

addicted to the medication, are

expelled from the chronic pain

program, and then seek help in

the methadone clinic. Those individuals often “go into business” by

presenting to a second pain management clinic to obtain additional drugs, which they sell.

! Benzodiazepines: A large increase

is reported in the abuse of benzodiazepines, particularly alprazolam. The diverted drug is commonly available on the street in

the form of “footballs” (30-day

supplies of 1-milligram blue pills).

Sometimes 2-milligram pills are

also sold as “bars.”E

! “Triple C”: An increase in overdoses involving a product containing dextromethorphan (Coricidin

HBP Cough and Cold®), which

used to be rare, is reported at the

juvenile facility associated with

the methadone clinic.M

MDMA (ECSTASY)

Two sources observe very different

populations: 

! One has been seeing increasingly

younger users over the past 5 years.E

! Another believes the people “outgrow it, mature out.”M Further, that

source perceives a decline in ecstasy

use even among younger people.

believe diverted OxyContin®

(known as “omego”N) can be

obtained with no difficulty at all.

(The other five are BostonL

,

DallasE

, New YorkL, PittsburghE,

and San FranciscoL

).

! Half of the clients in the methadone program abuse OxyContin®

as their primary drug, and 70 

percent report either primary, 

secondary, or tertiary abuse.

! Many OxyContin® abusers have

no history of drug use. They start

out with legitimate prescriptions

for pain, and become addicted. DIVERTED METHADONE

! The methadone treatment source

observes a large increase in

methadone-positive drug screens

on intake: 26 percent positive in

the last quarter of 2002—previously, positive findings were a rarity.M

! The users involved are coming

from pain management clinics

whose doctors started prescribing

methadone instead of OxyContin®

because of all the “bad press”

OxyContin® has received and

because methadone is cheaper and

more effective.M

! The respondent notes that “tons

are on the street” in a city that

never had a diversion problem

before pain clinics started advertising and writing prescriptions

“for anything you want.”M

! Emergency department episodes

and deaths involving methadone

have also increased.M

! Community efforts are starting to

deal with increased methadone

diversion and abuse. A proposed

first step is to send letters to doctors around the State, warning

them about the problem.M

THE USE PERSPECTIVE

! Tampa/St. Petersburg is one of six

Pulse Check areas where sources
SNAPSHOT: TAMPA/ST. PETERSBURG, FLORIDA

Pulse Check: January 2004 page 291

when used by opiate-naive people,

can have dangerous consequences.

Often even opiate-experienced people are methadone naive because

they don’t know exactly how they

will react.M The other treatment

source similarly reports an increase

in drug overdoses, attributing them

to more potent illegal drugs.N

Both treatment sources note an

increase in drug-related automobile accidents, most involving

young adolescents who “hang out”

with older teens or parents.N,M

Tuberculosis, while fairly rare, may

have increased slightly. Both treatment sources believe the increase

might be related to increased

homelessness.N,M

! Decreased barrier to treatment:

Because of increased training,

more people are aware of 

comorbidity problems and how to

approach them, thus decreasing

what had been a relatively common barrier to treatment.N,M

! Changes over the past 10 years:

More than any other change over

the past decade, the appearance of

MS Contin® (morphine sulfate)

and OxyContin® on the drug scene

has been the most complicating

factor in the community’s drug

abuse problem.N,M Other important

changes include the earlier first use

of more dangerous drugs,N,M the

normalization of drug use,N

increased court referrals to treatment,N and increased polydrug use.N

WHO USES ILLICIT DRUGS?

The Pulse Check epidemiologic, nonmethadone treatment, and methadone

treatment sources were asked to

describe the populations most likely

to use heroin, cocaine, marijuana,

methamphetamine, and ecstasy. They

were also asked to describe any

emerging user groups and to report

on how the drugs are used. As shown

on the following pages, user characteristics vary by drug. Further,

because of the different perspective

each brings, the three sources sometimes describe quite different populations and use patterns for each drug.

For example, all methadone clients

are primary opiate users who may use

drugs other than opiates in a secondary or tertiary manner.

How do users take heroin?

Characteristic E N M

Primary route of 

administration Injecting Snorting Injecting 

Other drugs taken NR NR Powder cocaine (speedballs)

Publicly or privately? Privately NR Privately 

Alone or in groups? In groups/ NR Both

among friends 

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! While injecting is the most common

primary route of administration,

smoking has increased over the past

5 years,E and a substantial number

of methadone patients snort heroin.M

! Snorting, however, is the most common route of administration among

the non-methadone clients.N

Who’s most likely to use heroin?

Characteristic E N M

Age group (years) 18–30 >30 >30 

Gender NR 69% female 65% male 

Race/ethnicity NR White White 

Socioeconomic status Low Middle Middle 

Residence Central city Suburbs Suburbs 

Referral source N/A Criminal justice Individual 

Level of education completed N/A High school High school 

Employment at intake N/A NR Full time

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment 

respondent; MMethadone treatment respondent

! Among first-time methadone admissions, approximately 15 percent report heroin as their primary

drug of abuse.M

! Atypical of non-methadone programs described in

most other Pulse Check sites, the majority of primary heroin abusers in this program are female.N

! Atypical of methadone programs described in most

other Pulse Check sites, only 19 percent of the

clients are primary heroin abusers— while about

half are primary OxyContin® abusers.

! No changes are reported in the numbers or characteristics of users between spring and fall 2002.
SNAPSHOT: TAMPA/ST. PETERSBURG, FLORIDA

page 292 Pulse Check: January 2004

Who’s most likely to use cocaine?

Crack cocaine Powder cocaine

Characteristic E N* M E M

Age group (years) >30 >30 >30 18–30 18–30

Mean age (years) 34 NR NR NR NR 

Gender 60% male 53% female NR Split evenly Split evenly

Race/ethnicity Black White White White White 

Socioeconomic status Middle Middle Low/middle Middle Low/middle 

Residence Central city Suburbs Suburbs Central city/Suburbs Suburbs

Referral source N/A Criminal justice Individual N/A Individual

Level of education completed N/A High school High school N/A High school

Employment at intake N/A NR Full time N/A Full time

*The program doesn’t distinguish between crack and powder cocaine, but crack is the predominant form of cocaine used.

Sources: E

Epidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Since the last reporting period, the number of crack users has increased slightly, while the number of powder cocaine users

has declined slightly.E

! Treatment percentages, however, remained stable, as did client demographics and use patterns.N,M

! Methadone clients combine powder cocaine with heroin (in speedballs), but they use crack without other drugs.M

Who’s most likely to use marijuana?

Characteristic E N M

Age group (years) 13–17, 18–30 13–17 18–30

Mean age (years) 23–24 NR NR 

Gender NR 62% male Split evenly

Race/ethnicity White, Black White White 

Socioeconomic status Low/middle Middle Low/middle

Residence All Suburbs Suburbs

Referral source N/A Criminal justice Individual 

Level of education N/A Junior high High school 

completed 

Employment at intake N/A NR Full time

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment

respondent; MMethadone treatment respondent

! Nearly half of the clients in the non-methadone treatment

program report marijuana as their primary drug of

abuse.N

! The percentages of primary, secondary, or tertiary marijuana use remained stable in both treatment programs

between spring and fall 2002.N,M

! Clients in both treatment programs generally smoke marijuana in joints,N,M although blunts are common in a related juvenile facility.M

! Joints and blunts are the most common delivery vehicles.

Younger, lower socioeconomic central city users tend to

use blunts. Suburban, middle-to-upper socioeconomic

users tend to use pipes.E

! Sources report no specific marijuana combinations. 

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

Marijuana, in combination with other

drugs, has recently been involved in

an increasing number of deaths and

emergency department episodes.E

It is also associated with the following

consequences, either alone or with

other drugs:

! Drug-related arrestsE,M

! Automobile accidentsE,N

! High-risk pregnanciesE,N

! Short-term memory lossE,M

! Deteriorating family and social

relationshipsE,M

! Poor academic performanceE,M

! School absenteeism or truancyE,M

! Dropping out of schoolE

! Poor workplace performanceE

! Workplace absenteeismE

! Unemployment ratesE
SNAPSHOT: TAMPA/ST. PETERSBURG, FLORIDA

Pulse Check: January 2004 page 293

Problem Change 

Earlier initiation of marijuana use 

Decline in social disapproval (e.g., peers, parents, etc.) 

Increased severity of addiction among clients 

Increased polydrug use 

Increased progression to use of other drugs 

Increased court referrals involving marijuana possession 

Increased court referrals involving marijuana sales 

Decline in users’ perception of harm 

Glamorization by entertainment industry 

Glamorization by news media 

Increased overall difficulty in treating the addiction 

Increased THC potency of marijuana 

01 2 3 4 5

Extent complicated treatment

Not at all Extremely

Marijuana-using clients: To what extent have changes in the following problems

complicated their treatment over the past 10 years?

!"Non-methadone treatment respondent

#"Methadone treatment respondent

What they have to say...

! The two treatment sources are

remarkably similar in their opinions about which changes have

most and least complicated the

treatment of marijuana users.

! Like many of their counterparts

in other Pulse Check cities, both

treatment sources attribute

importance to the earlier initiation of marijuana use. By contrast, Tampa/St. Petersburg

sources attribute somewhat

greater importance than

sources in most other Pulse

Check cities to increased court

referrals involving marijuana

possession.

! With regard to the decline in

social disapproval, one source

elaborates: “Parents are not as

concerned as they should be.”N

Reason

012 34 5

Extent contributed

Not at all Extremely

0

0

0

Decline in social disapproval (e.g., peers, parents, etc.)

Increase in indoor farms 

Decline in users’ perception of harm

Promotion of marijuana as “medicine” 

Widespread marijuana availability and use over the past 10 years: To what extent have the following contributed?

!"Law enforcement respondent

#"Epidemiologic/ethnographic respondent

What they have to say...

! Similar to the average opinion of their

counterparts in other Pulse Check

cities, the sources place the decline

in social disapproval of marijuana as

the most significant change over the

past 10 years.L,E

! As reported in many other Pulse

Check cities, prices have remained

stable, and thus have not contributed to increases in marijuana

use or availability.L

!"Law enforcement and court emphasis has remained stable over the 

past 10 years—unlike in many other

Pulse Check cities, where such

emphasis has declined.L

! Most marijuana continues to be

grown indoors.L

! Local production is at about the

same level as it was 10 years ago.L,E
SNAPSHOT: TAMPA/ST. PETERSBURG, FLORIDA

page 294 Pulse Check: January 2004

Who’s most likely to use ecstasy?

Characteristic E M

Age group (years) All groups 13–17, 18–30

Mean age (years) 22 NR

Gender Split evenly Split evenly

Race/ethnicity White White

Socioeconomic status Middle Low/middle

Residence All areas Suburbs

Referral source N/A Individual 

Level of education completed N/A Junior high

Employment at intake N/A Full time

Sources: EEpidemiologic/ethnographic respondent; MMethadone treatment respondent

WHO’S MOST LIKELY TO USE

METHAMPHETAMINE, AND HOW DO

THEY TAKE IT?

Methamphetamine users tend to be

WhiteE,N young adults (18–30 years)E

or older adults (older than 30).E,N They

are equally likely to be male or

female,E,N they are generally from middle socioeconomic backgrounds,E,N and

they live either in ruralE or suburbanN

areas. Primary methamphetamine

users account for only about 2 percent of clients in the non-methadone

program, and the methadone program

has no methamphetamine users. The

epidemiologic source reports a stable

number of users.

Clients in the non-methadone program generally take methamphetamine orally.N The epidemiologic

source, however, reports that injecting

is the most common primary route of

administration, followed by smoking

and snorting. The drug is generally

taken privately in small groups or

among friends, and it is sometimes

taken with marijuana or alprazolamE

.

WHO’S MOST LIKELY TO USE OTHER

DRUGS?

! Diverted OxyContin®: The many

methadone clients whose primary

drug of abuse is OxyContin® tend

to be male (about 65 percent),

White, and older than 30 years.

They tend to live in the suburbs,

come from both low and middle

socioeconomic backgrounds, and

are equally likely to snort or inject

the drug.M The epidemiologic

source agrees that users tend to be

White middle-socioeconomic suburbanites, but reports that abusers

tend to take the drug orally and

that they come from all age

groups, with an average age of

early twenties. Many of these people start out with legitimate prescriptions for pain, and then

become addicted. This source cites

an example of one young professional woman, with no history of

drug use, who took the drug as

prescribed after kidney surgery

and subsequently became

addicted.E

! Abused benzodiazepines:

Alprazolam abusers tend to be

WhiteE,N,M femalesE,N. The epidemiologic source observes more

younger abusers (17–25 years)

than do the non-methadone (older

than 30) and methadone (18–30

and older than 30) treatment

sources. Pills are sometimes consumed with alcohol.

! Other abused opiates: A stable

proportion of about 30 percent of

clients in the methadone program

abuse hydrocodone, morphine, or

fentanyl patches. They tend to be

White, suburban, low-to-middle

socioeconomic young adults and

older adults and are equally likely

to be male or female.M

! Ecstasy use is not recorded on intake to the non-methadone program.N

! Approximately 15 percent of clients in the methadone program use ecstasy.M

! Ecstasy users also take other club drugs,M powder cocaine,E and prescription

pills such as clonazepam (Klonopin®) and alprazolam.E

! Two sources observe very different populations. One has been seeing

increasingly younger users over the past 5 years.E Another believes the people “outgrow it [ecstasy], mature out.”M Further, that source perceives a

decline, even among younger people.
SNAPSHOT: TAMPA/ST. PETERSBURG, FLORIDA

Pulse Check: January 2004 page 295

WHO’S SELLING DRUGS, AND HOW? 

Most drugs are sold hand to hand at

meetings prearranged through an

intermediary. Cell phones are generally involved.L,E Additionally, mail

transactions are reported for

methamphetamine, OxyContin®

(both pills and “scripts”), and alprazolam (both pills and scripts).E

Dealers in Tampa/St. Petersburg tend

to sell more than one drug:L

! Heroin dealers also sell crack and

powder cocaine. 

! Crack dealers also sell powder,

cocaine, marijuana, and ecstasy. 

! Powder cocaine dealers also sell

crack, marijuana, and ecstasy, as

well as diverted pharmaceutical

drugs. 

! Marijuana dealers also sell crack,

powder cocaine, and diverted

pharmaceuticals. 

! Ecstasy dealers also sell diverted

pharmaceuticals.

According to the law enforcement

source, street-level sellers of heroin,

crack, powder cocaine, and marijuana

tend to be young adults (18–30 years)

who operate independently. Ecstasy

sellers also operate independently, but

they include adolescents as well as

young adults. Heroin sellers are somewhat likely to use their own drug;

crack, powder cocaine, marijuana, and

ecstasy sellers are very likely to do so.L

The epidemiologic source paints a

somewhat different picture. Crack

dealers are organized, and they are

generally older than 30. They are

involved in gang-related activity, violent criminal acts, nonviolent criminal acts such as theft, domestic violence, and drug-assisted rape.

Marijuana dealers do resemble the

other source’s description and are

involved in nonviolent criminal acts

such as theft and shoplifting. Ecstasy

dealers are reported as organized,

rather than independent, and they are

involved in nonviolent criminal acts

and drug-assisted rape.E

Methamphetamine sellers, unlike

other drug dealers, are part of out-oftown organizations. They tend to be

older than 30, are very likely to use

the drug, and also sell ecstasy.L,E They

are involved in prostitution and in

nonviolent criminal acts, such as theft

and burglary.E

Diverted OxyContin® is commonly

sold by individuals who obtain their

own prescriptions legitimately. They

tend to be older than 30, and they do

not sell other drugs.L They are

involved in nonviolent criminal acts

and in drug-assisted rape.E

Diverted alprazolam dealers generally

operate independently, are either

young adults or older adults, are

somewhat likely to use the drug, and

are involved in nonviolent crime and

drug-assisted rape.E

WHERE ARE DRUGS SOLD AND USED?

Heroin and crack markets are generally located in central city areas, powder

cocaine markets in both central city

and suburban areas, and methamphetamine markets mostly in suburban

areas. Marijuana and ecstasy sales are

equally distributed among all areas

(central city, suburban, and rural).L

Most illegal drugs (including heroin,

cocaine, marijuana, methamphetamine, and ecstasy) are sold in the following locations:L,E

! In streets and open-air markets

! Crack houses/shooting galleries

(excluding marijuana and ecstasy)

! Nightclubs and bars (excluding

heroin)

! Private residences

! Public housing developments

! Playgrounds and parks

! Private parties

! Hotels/motels

THE MARKET PERSPECTIVE

How much do drugs cost? 

Drug Unit Price

Heroin 1/4 g $20 

1 g $80

Powder cocaine 1 g $50

Crack cocaine 0.1–0.2 g $20

Marijuana 1/4 oz $40 

1 oz $1,100–$1,200

Ecstasy One tablet $12–$15 

Diverted Oxycontin® 40 mg $20

80 mg $40

Hydrocodone One tablet $3–$4

Source: Law enforcement respondent

No changes are reported in any

price or purity levels between

spring and fall 2002.
SNAPSHOT: TAMPA/ST. PETERSBURG, FLORIDA

page 296 Pulse Check: January 2004

Beyond cash: What else is accepted in exchange for drugs?

Heroin

Cash

Crack cocaine

Marijuana Methamphetamine

74%

Shoplifted merchandise

Other drugs

Other includes items accounting for 1

percent or less, such as food stamps

and drug transport (for heroin, crack,

and marijuana), as well as drug buying

services, injecting services, and lookout

services (for heroin and crack).

Other stolen merchandise 

(e.g., electronic equipment)

Property/Merchandise

Sex

87% 79%

71%

6%

5% 3%

5%

3%

6%

3%

5% 3%

5%

5%

2% 1%

1%

8%

2%

7%

4% 2%

5%

5%

7%

Powder cocaine

98%

Source: Mean of response ratings given by law enforcement, epidemiologic/ethnographic, non-methadone treatment, and methadone treatment respondents 

What they have to say...

! As in the vast majority of Pulse Check cities, most transactions are cash only, particularly in the case of powder cocaine.

! The practice of exchanging sex for drugs is less common in Tampa/St. Petersburg than in the majority of other Pulse Check cities.

! One source notes an increase, over the past decade, in the exchange of diverted prescription drugs—such as alprazolam and

OxyContin®—for illicit drugsE

. Such exchanges are particularly common for methamphetamineE and marijuanaM.

1%

1% 1%

! Around supermarkets

! Inside cars

Additional sales settings include the

following:E

! Around drug treatment clinics:

Heroin, crack, marijuana, and ecstasy

! In or around schools: Heroin, 

marijuana, and ecstasy

! Raves: Heroin, marijuana, methamphetamine, and ecstasy

! College campuses and concerts:

Powder cocaine, methamphetamine,

and ecstasy 

! Shopping malls: Marijuana,

methamphetamine, and ecstasy

Diverted OxyContin® is generally sold

in the suburbs, inside private residences.L

Most use settings mirror sales settings,

with the exceptions of playgrounds

and parks, around supermarkets, and

shopping malls.E
SNAPSHOT: TAMPA/ST. PETERSBURG, FLORIDA

Pulse Check: January 2004 page 297

Drug marketing innovations and tools over the past 10 years: To what degree have they complicated efforts to

detect or disrupt drug activity in Tampa/St. Petersburg?

01 23 45

Degree of complication

Not at all Extremely 

Throwaway cell phones 

Polydrug dealers

Relocation of sales settings within the community 

Increased communications via Internet 

Expansion of drug sales beyond the central city 

More organized networks 

Illicit marketing innovation/tool

!"Law enforcement respondent

#"Epidemiologic/ethnographic respondent

0

0

0

NR

NR

THE MARKET PERSPECTIVE: A 10-YEAR VIEW

Community innovations and tools over the past 10 years:

How successful have they been?

01 23 45

Degree of complication

Not at all Extremely 

Increased use of task forces

Drug user recognition education (DRE)

for law enforcement

Sentencing changes 

Drug courts

Onsite lab tests

Crack house (nuisance abatement) laws

Rescheduling of prescription drugs

Community innovation/tool

!"Law enforcement respondent

#"Epidemiologic/ethnographic respondent

NR

NR=Not reported

NR

NR

What they have to say...

! Task forces: A Meth Squad has been

introduced and has successfully seized

many labs in a nearby rural county that

serves as the source for Tampa’s

methamphetamine supply.E

! Sentencing changes: Minimum mandatory sentences and higher bail for trafficking have proven effective.L

! DRE: Tampa/St. Petersburg, along with

about half of the Pulse Check cities, has

a DRE program. As in those cities,

sources believe it successfully trains law

enforcement personnel to recognize drug

users.L,E

! Onsite lab tests: When a needle is found,

it can be tested immediately for methamphetamine, enabling quick identification

and rapid response.E

SEPTEMBER 11 FOLLOWUP

Except for a staff perception of decreased funding in the non-methadone

program,N the September 11 attacks and their aftermath have had no continuing aftereffects on the drug abuse situation in Tampa/St. Petersburg.

What they have to say...

! As in the vast majority of Pulse

Check cities, throwaway cell phones

have posed the greatest impediment

to detection and disruption efforts.L

! Most dealers have remained independent, so increased or decreased

network organization has not posed

as much of a challenge as in other

cities.L Moreover, even though

methamphetamine dealers, unlike

most other drug dealers, do work

within an organized structure, that

network has been disrupted by the

community’s Meth Squad.E

! Increased communications via the

Internet have posed a growing challenge especially among younger

users and with regard to gamma

hydroxybutyrate (GHB).
SNAPSHOT: WASHINGTON, DC

page 298 Pulse Check: January 2004

*The census data in this table are provided as a frame of reference for the information given by Pulse

Check sources. Whenever possible, the data given by the law enforcement and epidemiologic/ethnographic sources reflect the metropolitan area. 

THE BIG PICTURE: WHAT’S CHANGED? (SPRING 2002 

VS FALL 2002)

Three of four Pulse Check respondents consider the illegal drug problem very

serious,L,E,N and one considers it somewhat serious.M Three respondents consider

the problem as stable,L,E,M and one considers it somewhat worseN

.

Sources report several positive changes:

! After reports of increases in the last few Pulse Checks, abuse of OxyContin® (oxycodone hydrochloride controlled-release) declined, availability declined, and it has become more difficult for users to buy.E

! After increasing for the past few half-years, methylenedioxymethamphetamine (MDMA or ecstasy) use and

activity have leveled off, fewer raves

are being held, and ecstasy use among

non-methadone treatment admissions

has declined.E,N

! Although most facilities have waiting

lists, methadone treatment has

become more available.E

! Hepatitis C among methadone

clients declined due to more education and prevention.M

! Onsite lab tests (field tests) and the

increased use of task forces have

been highly successful in combating

the drug abuse problem in

Washington, DC.L

The use and sales of several drugs show

signs of increasing:

! After a 15-year lull, phencyclidine (PCP)

has returned to Washington, DC.E

Most widely abused drug:

MarijuanaL,E

CrackN

HeroinM

Changes between spring and fall 2002:

Heroin replaced benzodiazepines in the

methadone treatment program.M

Second most widely abused drug:

CrackL,E

MarijuanaN

BenzodiazepinesM

Changes between spring and fall 2002:

Benzodiazepines replaced crack in the

methadone treatment program.M

Drug related to the most serious

consequences:

HeroinE,N,M

CrackL

Changes between spring and fall 2002:

Heroin replaced crack.N

Drug related to the second most

serious consequences:

CrackE,N,M

HeroinL

Changes between spring and fall 2002:

Heroin replaced marijuana.L

New or emerging problems:

PCP

Methamphetamine and ecstasy use

and activity are increasing.L

Sources: LLaw enforcement, E

Epidemiologic/ethnographic, 

N

Non-methadone treatment, and MMethadone treatment respondents

Note: These symbols appear throughout this

city profile to indicate type of respondent.

What drugs do clients in a methadone

program use?+ (Fall 2002)

+

Includes any use, whether as a primary, secondary, or tertiary drug; the percentage for benzodiazepine abuse is “high” but not reported; the percentage for OxyContin® abuse was less than one;

the percentages for all other drugs were zero.

Heroin

Crack cocaine 

Percent who abuse the drug

0 20 40 60 80 100

WASHINGTON, DC, PRIMARY METROPOLITAN

STATISTICAL 

AREA PROFILE:

! Total population: . . . 4,923,153 

! Median age: . . . . . . 34.9 years 

! Race (alone):

! White: . . . . . . . . . . . . . 60.1%

! Black: . . . . . . . . . . . . . 26.0%

! American Indian/

Alaska Native: . . . . . . . 0.3%

! Asian/Pacific Islander: 6.8%

! Other race: . . . . . . . . . . 3.9%

! Two or more races: . . . . 2.9%

! Hispanic (of any race): 8.8% 

! Unemployment rate: . . . . 3.0% 

! Median household 

income: . . . . . . . . . . . . $62,216

! Families below poverty level 

with children <18 years: 7.2%

Source: U.S. Census 2000* 

Source: Methadone treatment respondent

! Heroin sales, availability, use, and treatment admissions have increased.L,E,N,M

! Five open-air markets, primarily for heroin, are new to the city since spring

2002.E

! Adolescent and young adult heroin sellers have increased and are associated

with more violence.L,E

! South American and Mexican brown heroin have become easier to buy.L

! Crack use increased, and unemployment among crack users increased.N

! Marijuana use, in general, increased.L, E

! Methamphetamine is becoming easier to purchase.L

(N=415)
SNAPSHOT: WASHINGTON, DC

Pulse Check: January 2004 page 299

Heroin (in general and SA); crack;

marijuana (in general, sinsemilla,

commercial grade); ecstasy; PCP

How difficult is it for undercover police and users to buy drugs? (Fall 2002)

Not

difficult

at all

0

1

2

3

Extremely

difficult

Undercover policeL UsersE

Diverted OxyContin®

Hydroponic marijuana

Ecstasy

SA

Mexican black tar heroin; 

BC bud; locally produced

methamphetamine 

7

8

9

10

HEROIN

PCP 4

5

Local commercial grade 

marijuana; methamphetamine

(in general, imported, and ice)

Mexican brown heroin 

Heroin sales, availability, use, and

treatment admissions are relatively

high and have increased:L,E,N,M

! Five open-air markets are new to

the city since fall 2002. Most of

these markets are primarily for

heroin sales and are run by adolescents (16–18 years).E

! Adolescent and young adult heroin sellers have increased, and more

violence is associated with these

younger dealers.L,E

! South American and Mexican

brown heroin have become easier

to buy.L

! Respondents agree that heroin (in

general and South American), crack

cocaine, and marijuana (in general,

commercial grade, and hydroponic)

are relatively easy to buy.L,E

! As in three other Pulse Check cities

(Boston, Cleveland, and Miami)

between spring and fall 2002,

diverted OxyContin® has become

more difficult for abusers to buy.E

! Respondents report that several

drugs are easier to buy since spring

2002:

- South American and Mexican brown

heroinL

- Hydroponic marijuanaL

- Methamphetamine (in general,

imported, and ice)L

- EcstasyL

- PCPL,E

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic respondent

Note: SA = South American (Colombian) heroin; SWA = Southwest Asian heroin; SEA =

Southeast Asian heroin; ice = highly pure methamphetamine in smokable form; and BC

bud = British Columbian marijuana.

Heroin (in general); crack; 

marijuana (in general and 

imported commercial grade)

Hydroponic marijuana

Powder cocaine; diverted

OxyContin®

6

COCAINE

! Crack use remains high and has

increased among non-methadone

treatment admissions.

! Powder cocaine use remains relatively low in the Washington, DC,

area. 

Marijuana use remains high and has

increased.

! Adults older than 30 are increasingly using the drug.E

! Hydroponic marijuana has

become easier to purchase.E

MARIJUANA

SEA, SWA, and Mexican 

heroin; powder cocaine 

METHAMPHETAMINE

! Methamphetamine activity and use

remain relatively low.

! One source, however, regards it as

an emerging drug that is becoming

more readily available.L
SNAPSHOT: WASHINGTON, DC

page 300 Pulse Check: January 2004

WHAT’S HAPPENING IN TREATMENT?

Treatment capacity

! The Pulse Check non-methadone

treatment respondent reports that

among the 300 clients in that program, crack is the most common

drug of abuse, followed by marijuana. That source further reports

increases in heroin and crack use

and a decline in ecstasy use among

treatment clients.N

! The methadone treatment respondent is with a facility that operates

at 90 percent capacity (415 of

460 slots filled) (see bar chart on

the first page of this chapter).

Beyond that specific facility, methadone maintenance treatment is

available throughout the area, but

programs (public and private)

have large waiting lists.E However,

methadone treatment is reportedly

more available during fall 2002

than it was during spring 2002.E

Barriers to treatment and consequences of drug use

! The most common barrier to

methadone treatment remains limited slot capacity.

! Another common barrier is the

inability of the methadone treatment program to test for OxyContin® abuse, which makes it difficult to know if a client abuses the

drug and what type of treatment is

appropriate.M

! The most common health-related

consequences of drug abuse

among methadone treatment

admissions remain HIV/AIDS and

hepatitis C; however, hepatitis C

has declined in the past 6 months

due to more education and prevention. Renal failure, most likely

related to alcohol abuse among

heroin addicts, increased between

spring and fall 2002.M

Increased complications for drug

treatment over the past 10 years

! The lack of housing opportunities

for people on methadone maintenance treatment makes recovery

difficult. Many transitional housing and “sober living” environments do not accept tenants who

are on methadone maintenance

treatment.M

! Other changes in drugs and drug

use over the past 10 years that

have made treatment more difficult include the following: the

declining cost of drugs (related

specifically to the low cost of

crack),N the earlier first use of

more dangerous drugs (related

specifically to PCP use),N the

spread of drug use among all age

groups (related specifically to the

use of marijuana blunts among

adolescents and young adults),N

and the lack of jobs and job

training opportunities for recovering clients.M

WHO USES ILLICIT DRUGS?

The Pulse Check epidemiologic, nonmethadone treatment, and

methadone treatment sources were

asked to describe the populations

most likely to use heroin, cocaine,

marijuana, methamphetamine, and

ecstasy. They were also asked to

describe any emerging user groups

and to report on how the drugs are

used. As shown on the following

pages, user characteristics vary by

drug. Further, because of the different perspective each brings, the

three sources sometimes describe

quite different populations and use

patterns for each drug. For example,

all methadone clients are primary

opiate users who may use drugs

other than opiates in a secondary or

tertiary manner. 

THE USE PERSPECTIVE

MDMA (ECSTASY)

! After increasing for the past few

half-years, ecstasy use and activity

have leveled off, fewer raves are

being held, and ecstasy use among

non-methadone treatment admissions has declined.E,N

! On the other hand, ecstasy is easier to purchase, is considered an

emerging drug by one source, and

street or open-air market sales

have increased.L

DIVERTED OXYCONTIN®

! After reports of increases in the

last few issues of Pulse Check,

OxyContin® abuse has declined. 

! Availability has declined, and it

has become more difficult for

users to buy, particularly around

methadone clinics, where it used

to be sold.E

PCP

Several reports show increased PCP

use and activity:

! PCP use has increased dramatically.E

! PCP-related arrests are up.L,E

! The drug is easier to buy.L,E

! The number of sellers has

increased.L

! Small, local PCP labs have

increased—unlike 15 years ago,

when the drug was popular in

Washington, DC, and most was

imported from outside the city.E
SNAPSHOT: WASHINGTON, DC

Pulse Check: January 2004 page 301

Who’s most likely to use heroin?

Characteristic E N M

Age group (years) >30 18–30 >30

Mean age (years) 35+ NR 46

Gender Male Split evenly 66% male

Race/ethnicity Black Black Black

Socioeconomic status Low Low Low

Residence Central city Central City Central city 

Referral source N/A Criminal justice, Individual

individual, alcohol/

drug abuse care

provider, employer

Level of education completed N/A High school High school 

Employment at intake N/A Part time Unemployed

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

How do users take heroin?

Characteristic E N M

Primary route of Injecting Snorting Injecting

administration

Other drugs taken Crack NR Benzodiazepines; 

(speedball) crack

Publicly or privately? Privately Privately Privately 

Alone or in groups? Alone In groups Alone

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Most heroin users in Washington, DC, inject the drug.E,M

! New heroin users tend to snort or inject the drug, and they do not take any other drugs.E

! Crack used in combination with heroin (speedball) remains a common practice.E,M

! Between spring and fall 2002, heroin combinations have changed: marijuana plus 

heroin used to be a common combination, but methadone treatment admissions have

switched to alcohol use with heroin.M

! Between spring and fall 2002, heroin

use increased among non-methadone

clients and new drug users.E,N

! Most heroin users are Black adults

older than 30 who are of low socioeconomic status.E,M

! New heroin users display different

characteristics than the general 

heroin-using population: they are

younger (18–30 years versus older

than 35), more likely to be White and

of higher socioeconomic status, and

more likely to reside in the suburbs.E
SNAPSHOT: WASHINGTON, DC

page 302 Pulse Check: January 2004

Who’s most likely to use marijuana?

Characteristic E N

Age group (years) 18–30 All

Gender Male Split evenly

Race/ethnicity Black Black

Socioeconomic status All Low

Residence Central city Central city

and suburbs

Referral source N/A Criminal justice, 

individual, alcohol/drug 

abuse care provider, employer

Level of education completed N/A Junior high 

Employment at intake N/A Part time

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone 

treatment respondent

! Marijuana use, in general, has

increased, and adults older than 30

years are increasingly using the drug.E

! As in many Pulse Check cities, marijuana user characteristics span a wide

range of ages and socioeconomic statuses.E,N

! New users are more likely than the

general marijuana-using population to

be adults older than 30 and of middle

socioeconomic status.E

! Marijuana is most often smoked in

blunts and joints.E,N

Who’s most likely to use cocaine?

Crack Powder cocaine 

Characteristic E N M N

Age group (years) 18–30 >18 >30 NR

Gender Female Split evenly Male Split evenly

Race/ethnicity Black White and Black Black Black

Socioeconomic Low Middle Low Middle 

status

Residence Central city Central city Central city Central city

Referral source N/A Criminal justice, individual, Individual Criminal justice, individual,

and other alcohol/drug alcohol/drug abuse care

abuse care provider, employer provider, employer

Level of education N/A High school NR High school

completed

Employment at intake N/A Part time NR Part time

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent; MMethadone treatment respondent

! Among non-methadone treatment admissions, crack use increased between spring and fall 2002. Unemployment

among crack users also increased.N

! After methadone clients who use crack undergo treatment, they stop using crack with heroin (speedball) and smoke

crack alone.M

! Powder cocaine use is relatively low in Washington, DC.E,N,M Sources report no changes in user characteristics. 
SNAPSHOT: WASHINGTON, DC

Pulse Check: January 2004 page 303

WHAT ARE THE NEGATIVE CONSEQUENCES OF MARIJUANA USE?

Marijuana, used either alone or with

other drugs, is associated with the

following consequences, which

remained stable between spring and

fall 2002:

! Drug-related deathsN

! Drug-related arrestsE,N

! Automobile accidentsN

! High-risk pregnanciesN

! Short-term memory lossN

! Deteriorating family and social

relationshipsN

! Poor academic performanceN

! School absenteeism, truancy, or

dropping out of schoolN

! Poor workplace performanceN

! Workplace absenteeismN

SEVERAL CHANGES OVER THE PAST

10 YEARS HAVE GREATLY COMPLICATED TREATMENT FOR MARIJUANA-USING CLIENTS:N

! Increased severity of addiction

among clients

! Increased overall difficulty in

treating the addiction

! Earlier initiation of marijuana use

! Decline in users’ perception of

harm

! Decline in social disapproval

! Glamorization by the entertainment industry

! Increased court referral involving

marijuana possession and sales 

WHO’S MOST LIKELY TO USE

METHAMPHETAMINE?

Methamphetamine use is low in

Washington, DC, and no changes in

user characteristics are reported.E,N,M

! After increasing for the past few half-years, ecstasy use and activity leveled off

between spring and fall 2002 and are now fairly stable. The rave scene has

also “quieted down.”E

! Among non-methadone treatment admissions, ecstasy use decreased.N

! Ecstasy users tend to be young adults of middle to high socioeconomic status

who reside in the central city.N,E

! Respondents report no changes in user or use demographics since spring 2002.

OTHER DRUGS

! Diverted OxyContin®: Most

OxyContin® abusers are heroin

addicts who take OxyContin® as

a heroin substitute.E They tend to

be older than 30, male, White

and Black, of low socioeconomic

status, and they inject the drug.

OxyContin® use has decreased

dramatically between spring and

fall 2002.

! PCP: PCP use has increased dramatically between spring and fall

2002. Most users are 13–30 years

old, male, Black, of low to middle

socioeconomic status, and live in

the central city. Arrests are up for

PCP, which is sold as a liquid in

vials. Users dip menthol cigarettes

or cigars in the liquid and smoke

the cigarette or cigar, known as

“big dipper.”E

! Alprazolam (Xanax®): Methadone

treatment clients often use benzodiazepines sequentially with heroin and alcohol.M

Who’s most likely to use ecstasy?

Characteristic E N

Age group (years) 18–30 18–30

Gender Male Split evenly

Race/ethnicity White Black

Socioeconomic status Middle and Middle

high

Residence Central city Central city

Referral source N/A Criminal justice 

Level of education completed N/A High school 

Employment at intake N/A Full time

Sources: EEpidemiologic/ethnographic respondent; NNon-methadone treatment respondent
SNAPSHOT: WASHINGTON, DC

page 304 Pulse Check: January 2004

WHERE ARE DRUGS USED AND

SOLD?

Most drugs are used and sold in the

central city, and most (heroin, crack

and powder cocaine, marijuana, ecstasy, diverted OxyContin®, and PCP) are

sold at open-air markets and on street

corners. The law enforcement source

estimates there are 50 open-air markets in Washington, DC. The epidemiologic respondent reports five new

open-air markets in the city since

spring 2002. Most of these markets

are for heroin sales in particular and

are run by adolescents (16–18 years).E

Besides open-air markets, heroin is

also sold at the following locations:

! Inside private residencesL

! Around public housing

developmentsL,E

! SchoolsL

! Drug treatment clinicsL,E

Crack is sold in similar locations,

including the following:

! Crack housesL,E

! Inside private residencesL

! Public housing developmentsL,E

! SchoolsL

! Playgrounds and parksL,E

! Inside carsL,E

Powder cocaine, which is not very

available in Washington, DC, is sold

in nightclubs and bars.L

Marijuana is sold at a wide variety of

locations:

! Private residencesL,E

! Public housing developmentsL,E

! SchoolsL,E

! College campusesL

! Nightclubs and barsL

! Playgrounds and parksL,E

! Private partiesL,E

! Raves and concertsL

! Inside carsL

Most methamphetamine sales are

confined to private residences, nightclubs, and bars.L

Ecstasy sales occur in private residences,E nightclubs and bars,L,E and

raves.L,E However, the number of raves

has leveled off since spring 2002.E

In addition to open-air market sales,

OxyContin® (most of which is diverted from pharmacies outside the city)

is sold around drug treatment clinics.

PCP sales are out in the open and

nearly all occur on the street.L

HOW DO ILLEGAL DRUGS GET FROM

SELLER TO BUYER?

Typically, heroin and crack buyers

search for open-air markets and buy

the drugs hand to hand. Drugs sold

with heroin include diverted

OxyContin®, methadone, other prescription opiates, and sometimes

crack. Dealers who sell primarily

crack tend to sell no other drugs.L

Marijuana is also sold out in the

open, often on street corners. Dealers

approach buyers for hand-to-hand

exchanges of the drug.L,E Additionally,

buyers may call marijuana dealers to

arrange a meeting for exchanging the

drug.E

Most ecstasy sales are venue oriented

(in nightclubs or raves). Buyers

approach known dealers or are

directed to dealers by acquaintances

at these venues.L,E Some ecstasy is sold

similarly to heroin (in open-air markets), and these types of ecstasy sales

increased between spring and fall

2002.L Other drugs sold by ecstasy

dealers include gamma hydroxybutyrate (GHB) and lysergic acid diethylamide (LSD).

WHO SELLS ILLEGAL DRUGS?

Sellers of most drugs in Washington,

DC, are independent young adults

(18–30 years) and adults (>30 years).

Crack sellers tend to be more organized (typically into loose neighborhood groups, known as “crews”) than

their other drug counterparts.L,E

Older heroin dealers are likely to be

heroin addicts, and most diverted

OxyContin® dealers tend to be prescription drug or heroin addicts.E

Respondents report several changes

in sales groups between spring and

fall 2002:

! Young adult heroin sellers have

increased, and more violence is

associated with these younger

dealers.L,E

! Young adult Blacks (as opposed to

Whites) are increasingly selling

ecstasy.L Furthermore, nightclub

owners, bartenders, or bouncers

tend to know ecstasy dealers and

allow them to sell the drug in their

establishments.E

! The number of PCP dealers has

increased.L,E Most dealers manufacture the PCP in their own small,

local labs.E

BEYOND CASH: WHAT ELSE IS

ACCEPTED IN EXCHANGE FOR DRUGS?

The law enforcement source states

that over the last 10 years, 99 percent of transactions for all drugs

have used cash. Property and merchandise exchange accounts for the

other 1 percent.L

THE MARKET PERSPECTIVE
SNAPSHOT: WASHINGTON, DC

Pulse Check: January 2004 page 305

How pure are illegal drugs and much do they cost?

Drug Unit Purity Price

South American heroin 1 mg (highly adulterated) 23% $1.05E

Dime bag (50–75 mg) 10–15% $10L

1 g 60–70% $120–$140L

1 g (highly adulterated) 23% $120–$150E

Crack cocaine One rock NR $10E

Dime bag (75 mg) 30–60% $10L

1 g 30–60% $100L

Powder cocaine Dime bag (100–150 mg) 30% $10L,E

1 g 30–60% $50–$100L,E

Marijuana (commercial grade) One bag (three joints) NR $5–$10E

One blunt NR $10–$20E

One bag (750 mg) NR $20L

Marijuana (hydroponic) 1 oz NR $480E

Methamphetamine (powder or ice) 1 g NR $140L

Ecstasy One pill NR $18–$35L,E

Diverted OxyContin® 20-mg pill N/A $30–$40L

40-mg pill N/A $40–$80L,E

PCP (liquid) One vial NR $20–$50E

One dipped cigarette NR $25L

1 oz NR $350–$500L

Sources: LLaw enforcement respondent; EEpidemiologic/ethnographic respondent

! South American

(Colombian) heroin is sold

in two forms in Washington, DC: highly adulterated

(“scramble” at about 23

percent pure) and unadulterated (“bone” at 40–80

percent pure).E

! PCP is typically sold in vials

(referred to as “dippers”)

with ounces of marijuana.

Menthol cigarettes dipped

in PCP are also sold.L

! Between spring and fall

2002, drug purity and

prices remained stable

with one exception: diverted OxyContin® prices

declined.E

Which drug sellers are associated with which crimes?

Crime Heroin Crack Powder Marijuana Metham- Ecstasy PCP

cocaine phetamine 

Prostitution $

Gang-related activity $ $

Violent criminal acts $$ $ $

Nonviolent criminal acts $$ $

No crimes associated $ $

Sources: Law enforcement respondent; epidemiologic/ethnographic respondent

COMMUNITY INNOVATIONS AND TOOLS OVER THE PAST 10

YEARS: HOW SUCCESSFUL HAVE THEY BEEN?

The law enforcement respondent rates two law enforcement tools as highly successful in combating the drug abuse

problem in Washington, DC: onsite lab tests (field tests)

and the increased use of task forces. The newest task force

is a homicide-narcotics task force that has already been

quite successful.L

SEPTEMBER 11 FOLLOWUP

None of the four Pulse Check respondents in Washington,

DC, believes that the September 11 attacks and their aftermath have had any long-term effects on the drug abuse

problem. The law enforcement source states that although

drug dealers continue to avoid airplanes for transporting

drugs into Washington, DC, they find other ways to import

drugs, and the drug supply is stable. 

! Heroin and crack cocaine sellers

are involved in a wide variety of

crimes, including gang-related

crimes, assaults, petty theft, and

larceny.L,E

! Violent crimes associated with

PCP sales increased between

spring and fall 2002.L

! Diverted OxyContin® is not generally associated with 

criminal activity.
page 306 Pulse Check: January 2004

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APPENDICES

Pulse Check: January 2004 page 307

APPENDICES

PULSE CHECK
APPENDIX I: METHODOLOGY

page 308 Pulse Check: January 2004

APPENDIX 1: METHODOLOGY

How were the sites selected? (See map

in the Introduction) A total of 25 sites

were studied for this issue of Pulse

Check, to correspond with ONDCP’s

current 25-Cities Initiative, which

includes the largest cities within

America’s 25 most populous metropolitan areas. Though drug use has

harmed all cities, America’s largest

cities have been particularly hard hit.

These cities include the following 12,

which have been reported on in the

past four issues of Pulse Check:

Baltimore, MD*

Boston, MA

Chicago, IL

Denver, CO

Detroit, MI

Miami, FL

Los Angeles, CA

New York, NY

Philadelphia, PA

St. Louis, MO

Seattle, WA

Washington, DC

They also include the following 13

newly added cities:

Atlanta, GA

Cincinnati, OH

Cleveland, OH

Dallas, TX

Houston, TX

Minneapolis/St. Paul, MN

Phoenix, AZ

San Diego, CA

San Francisco, CA

Pittsburgh, PA

Portland, OR

Sacramento, CA

Tampa/St. Petersburg, FL

How do the 25 sites vary? While these

25 sites were purposely selected, they

nevertheless represent a broad cross-section of geographic regions and demographic characteristics, as highlighted in

Appendix 2. For example, their unemployment rates range from a 2.5 percent

low in San Francisco to a 6.2 percent

high in Chicago and Philadelphia. Their

poverty levels (for persons younger than

18) range from 6.5 percent in 

Minneapolis/St. Paul to 23.3 percent in

New York. The racial/ethnic breakdowns in the 25 sites further exemplify

their diversity: White representation

ranges from 48.7 percent in Los Angeles

and 48.8 percent in New York to 89.5

percent in Pittsburgh; Black representation ranges from 4.4 percent in Seattle

to 29.6 percent in Atlanta; and Hispanic

(of any race) representation ranges from

less than 1 percent in Pittsburgh to 57.3

percent in Denver.

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 25 sites: an ethnographer or epidemiologist, a law

enforcement official, a non-methadone

treatment provider, and a methadone

treatment provider. As in the existing 12

Pulse Check sites, ethnographers and

epidemiologists in the 13 new sites were

recruited based on several possible criteria: past participation in the Pulse Check

program; membership in the National

Institute on Drug Abuse (NIDA)

Community Epidemiology Work Group

(CEWG); research activities in local universities; or service in local community

programs. We recruited law enforcement officials—again as in the past—by

contacting local police department narcotic units, Drug Enforcement

Administration (DEA) local offices, and

High Intensity Drug Trafficking Areas

(HIDTA) directors. 

To identify knowledgeable treatment

sources, we consulted with experts in

the field in the 13 newly added sites.

This purposeful means of selecting

treatment sources has been part of the

Pulse Check methodology since the

January–June 2001 issue. Some of the

treatment sources in the 12 existing sites

had been selected previously via a random selection methodology (described

in the Mid-Year 2000 issue methodology

appendix). Those sources were retained

in order to preserve continuity. 

All sources from the 13 new sites were

identified and recruited during March

through May 2003, and telephone discussions were conducted with them

throughout that period. This wave of

identification, recruitment, and discussion followed a first wave of discussions, held December 2002 through

January 2002, with sources in the 12

existing sites.

Altogether, we have identified and

recruited 99 of the potential 100

sources in the 25 Pulse Check sites: one

treatment source could not be identified

(Portland, OR, non-methadone). For

this Pulse Check issue, we successfully

obtained information from 97 of those

99 sources: a response rate of 98 percent. Two participants were unavailable

for this round of discussions: the

Cincinnati law enforcement official, and

the Miami methadone provider.

What kind of data were collected, and

how? For each of the 97 responding

sources, we conducted a single telephone discussion lasting about 1 hour.

We asked sources to explore with us

their perceptions of any change in the

drug abuse situation between spring and

fall 2002. We discussed a broad range of

topic areas with these individuals, as

delineated in Appendix 4. Not surprisingly, ethnographic and epidemiologic

sources were 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.

Many 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, and other local market activities;

they were not asked to discuss user

*Baltimore has been a Pulse Check site in the last three issues groups and characteristics.
APPENDICES 2: POPULATION DEMOGRAPHICS

Pulse Check: January 2004 page 309

Race percent Percent

American Percent Unem- Median persons

Pulse Check Median Indian/ Asian Two Hispanic ploy- house- under 18

Sites Total age Alaska Pacific or (any ment hold below povpopulation (Years) White Black Native Islander Other more race) rate rate erty level

Boston, MA PMSA 3,406,829 36.3 82.5 7.0 0.2 4.9 3.0 2.4 5.9 2.9 $55,183 8.6

New York, NY PMSA 9,314,235 34.6 48.8 24.6 0.5 9.2 12.2 4.6 25.1 5.1 $41,053 23.3

Philadelphia, PA PMSA 5,100,931 36.4 72.1 20.1 0.2 3.4 2.5 1.6 5.1 6.2 $47,536 14.4

Pittsburgh, PA MSA 2,358,695 40.0 89.5 8.1 0.1 1.1 0.3 0.9 0.7 2.6 $37,467 12.7

Atlanta, GA PMSA 4,112,198 32.9 64.2 29.6 0.7 3.8 3.6 1.7 6.5 3.5 $51,948 11.8

Baltimore, MD PMSA 2,552,994 36.6 67.3 27.4 0.3 2.7 0.7 1.5 2.0 3.3 $49,938 10.3

Dallas, TX PMSA 3,519,176 31.8 67.2 15.1 0.6 4.1 10.7 2.4 23.0 3.4 $55,854 11.6

Houston, TX PMSA 4,177,646 31.6 61.1 17.5 0.4 5.3 12.9 2.8 29.9 4.1 $44,665 14.8

Miami, FL PMSA 2,109,282 34.1 79.4 5.5 0.2 1.4 4.6 3.8 57.3 5.0 $35,966 19.3

Tampa/St. Petersburg, FL MSA 2,395,997 40.0 82.9 10.2 0.3 2.0 2.7 2.0 10.4 2.9 $37,406 12.7

Washington, DC PMSA 4,923,153 34.9 60.1 26.0 0.3 5.8 3.8 2.9 8.8 3.0 $62,216 7.2

Chicago, IL PMSA 8,272,768 33.7 65.8 18.9 0.3 4.6 8.2 2.3 17.1 6.2 $51,680 11.4

Cleveland, OH PMSA 2,250,871 37.3 79.6 18.5 0.2 1.4 1.4 1.6 3.3 3.4 $42,089 13.1

Cincinnati, OH PMSA 1,646,395 35.1 84.1 13.0 0.2 1.2 0.4 1.1 1.1 2.9 $44,248 11.1

Detroit, MI PMSA 4,441,551 35.5 71.2 22.9 0.3 2.3 1.1 2.1 2.9 5.9 $49,175 14.8

Minneapolis/

St. Paul, MN MSA 2,968,806 34.2 86.1 5.3 0.7 4.1 1.6 2.1 3.3 3.5 $54,304 6.5

St. Louis, MO MSA 2,603,607 36.0 78.3 18.3 0.2 1.4 0.5 1.2 1.5 3.7 $44,437 11.2

Denver, CO PMSA 2,109,282 34.1 79.4 5.5 0.2 1.4 4.6 3.8 57.3 5.0 $35,966 19.3

Los Angeles, CA PMSA 9,519,338 32.0 48.7 9.8 0.8 12.2 23.5 4.9 44.6 5.0 $42,189 19.9

Phoenix, AZ MSA 3,251,876 33.2 77.0 3.7 2.2 2.2 12.1 2.9 25.1 3.1 $44,572 12.7

Portland, OR MSA 1,918,009 34.8 84.5 2.7 0.9 5.4 3.8 3.3 7.5 3.9 $47,007 9.7

Sacramento, CA PMSA 1,628,197 35.1 70.2 7.7 1.1 9.4 6.5 5.2 14.4 3.9 $46,602 13.1

San Diego, CA MSA 2,813,833 33.2 66.5 5.7 0.9 9.4 12.8 4.7 26.7 3.6 $47,067 13.3

San Francisco, CA PMSA 1,731,183 37.3 58.6 5.3 0.4 23.5 7.7 4.5 16.8 2.5 $63,297 7.6

Seattle, WA PMSA 2,414,616 35.5 78.6 4.4 1.0 9.9 2.4 3.9 5.2 3.2 $58,395 12

Source: 2000 U.S. Census, 2000 data

Note: The census data in this table are provided as a frame of reference for the information given by Pulse Check sources. Whenever possible, the data given

by the law enforcement and epidemiologic/ethnographic sources reflect the metropolitan areas. West Midwest South Northeast

APPENDIX 2: POPULATION DEMOGRAPHICS IN THE 25 PULSE CHECK SITES
APPENDIX 3: PULSE CHECK SOURCES

page 310 Pulse Check: January 2004

Pulse Check Site Epidemiology/Ethnography Law Enforcement 

Atlanta, GA Tara McDonald and Miriam Boeri Sergeant Asa Walker

Georgia State University Atlanta Police Department

Department of Sociology

Baltimore, MD James Peterson Robert J. Penland

Organization prefers anonymity Washington-Baltimore HIDTA

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

Harvard University Boston Police Department

Department of the History of Science Drug Control Division

Chicago, IL Larry Ouellet, PhD Individual prefers anonymity

EPI/BIO COIP Chicago Police Department, Organized Crime Division,

School of Public Health Narcotic and Gang Investigations Section

Cincinnati, OH Tim Lawrence Nonrespondent

Hamilton Country Alcohol and Drug Board

Cleveland, OH Individual prefers anonymity Individual prefers anonymity

University of Akron Ohio HIDTA

Institute for Health and Social Policy

Dallas, TX James Rucker, BA, LCDC Robert Evans

Greater Dallas Council of Alcohol Dallas Drug Enforcement Administration 

and Drug Abuse

Denver, CO Bruce D. Mendelson, MPA Curt Williams and Rob McGregor

Colorado Department of Human Services Denver Police Department

Alcohol and Drug Abuse Division Fugitive Location and Apprehension Group

Detroit, MI Richard F. Calkins Individual prefers anonymity

Michigan Department of Community Health Southeast Michigan HIDTA

Division of Quality Management and Planning

Houston, TX Ann Robison, PhD James Prendergast

Montrose Counseling Center DEA Houston Field Division 

Los Angeles, CA Beth Finnerty, MPH Eric Lillo

University of California, Los Angeles Los Angeles Police Department

Integrated Substance Abuse Programs (ISAP) 

Miami, FL James N. Hall Eladio Paez 

Up Front Drug Information Center City of Miami Police Department

Minneapolis/St. Paul, MN Carol L. Falkowski Lieutenant Daniel Grout 

Hazelden Foundation Minneapolis Police Narcotics Unit 

New York, NY John A. Galea, MA Individual prefers anonymity

New York State Office of Alcoholism Drug Enforcement Administration

and Substance Abuse Services Street Studies Unit New York Division Unified Intelligence (S-13)

Philadelphia, PA Samuel J. Cutler Individual prefers anonymity

Behavioral Health System Coordinating Office Drug Enforcement Administration

for Drug and Alcohol Abuse Programs Philadelphia Field Division Divisional Intelligence Group

Phoenix, AZ Ilene L. Dode, PhD Individual prefers anonymity

EMPACT—Suicide Prevention Center, Inc. Phoenix Police Department

Pittsburgh, PA Michael T. Flaherty, PhD and Janice Pringle, PhD Prefers Anonymity

Institute for Research, Education,

and Training in Addictions (IRETA)

Portland, OR Bret Fuller , PhD Chuck Karl and Ken Reuben 

Department of Public Health & Preventive Medicine Oregon HIDTA

Oregon Health & Science University

Sacramento, CA Sharon DiPirro-Beard, MFT, RD Lieutenant Bob Lozito

County of Sacramento Department of Health Sacramento County Sheriff’s Department

and Human Services Alcohol and Drug Services Division

San Diego, CA Prefers Anonymity Rick Ellington

Drug Enforcement Administration, Team II

San Francisco, CA Prefers Anonymity Craig Buehler

California State Narcotics

Seattle, WA Caleb Banta-Green Steve Freng

Alcohol and Drug Abuse Institute Maine Drug Enforcement Administration

at the University of Washington

St. Louis, MO James M. Topolski, PhD Detective Leo Rice

Missouri Institute of Mental Health St. Louis Police Department, Narcotics Division

Tampa/St. Petersburg, FL Carrie Elk, PhD Sergeant Dale Carnell

Institute for the Prevention and Pinellas County Sheriff’s Office

Prosecution of Drug Facilitated Rape

Washington, DC Jerry Brown Sergeant John Brennan

Department of Health Washington, D.C., Police Department

HIV/AIDS Administration Major Narcotics
APPENDIX 3: PULSE CHECK SOURCES

Pulse Check: January 2004 page 311

Pulse Check Site Non-Methadone Treatment Methadone Treatment 

Atlanta Onaje Salim, MA, LAPC, MAC Ned Etherington, and 

Fulton County ADTC Cathy Etherington

Alliance Recovery Center

Baltimore, MD Adrienne Britton-Robinson, BA, CAC, and Cindy Shaw-Wilson, LCADC

George Larry, MA Institute for Behavior Resources (IBR Reach)

Total Health Care

Boston, MA Judy McDonough Lawrence O’Toole

Gavin House Habit Management 

Chicago, IL Dan Lustig Individual prefers anonymity

Hay Market Center Cornell Interventions

Cincinnati, OH Pam McClain Individual prefers anonymity

Talbert House Central Community Health Board 

Cleveland, OH Individual prefers anonymity Ron Winbush and Dr. Deborah Watson

Cleveland Clinic Alcohol and Community Action Against Addiction (CAAA) 

Drug Recovery Center

Dallas, TX Doug Denton Individual prefers anonymity

Homeward Bound, Inc. West Texas Counseling and 

Rehabilitation Program of Dallas

Denver, CO Tim McCarthy Pamela J. Manuele, RN, BSN, ANPC, CCJS

Arapahoe House Comprehensive Addiction Treatment Services

Detroit, MI Peter Mason Octavius Sapp, CAC

Renaissance West Community Health Services City of Detroit, Department of Human Services

Drug Treatment Program

Houston, TX Pamela Sampson, MS Steven V. Tapscott, MA

Riverside General Hospital, Administration Texas Treatment Center 

Los Angeles, CA Peter deGyarfas Individual prefers anonymity

Substance Abuse Treatment Program Aegis Medical System 

Division of Adolescent Medicine 

Children’s Hospital of Los Angeles 

Miami, FL Joseph A. Martinez, JD and Michael Miller, PhD Nonrespondent

The Village South, Inc. 

Addiction Treatment Center 

Minneapolis/St. Paul, MN Michael Milligan and Michael Kenney Greg Carlson

Boys Totem Town Hennepin Faculty Associates

New York, NY Prefers anonymity Individual prefers anonymity

Lower Eastside Service Center

Philadelphia, PA Chris Sweeney Sari Trachtenberg 

Northeast Treatment NARP 

Thomas Jefferson University

Division of Substance Abuse

Phoenix, AZ Dale Rinard and Penny Free Burke Chuck Neff 

TERROS Valle del Sol 

Pittsburgh, PA Kenneth Ramsey, PhD Marlene Burks 

Gateway Rehabilitation Center Tadiso Inc

Portland, OR Source not Identified Tim Hartnett

CODA

Sacramento, Ca Trisha Stanionis John McCarthy, MD

The Effort, Inc. Bi-Valley Medical Clinic

San Diego, CA Roxy Walnum Kathy Goyette 

East County Center for Change San Diego Health Alliance

San Francisco, CA Greg Hayner, PharmD Laurene Spencer, MD

Haight-Ashbury Free Clinics, Inc. BAART-Geary Street Clinic

Seattle, WA Ramona Graham Victoria Evans

Center for Human Services Therapeutic Health Services 

St. Louis, MO Mike Morrison Cheryl Gardine

Bridgeway Counseling DART 

Tampa/St. Petersburg, FL Mark Vargo, PhD Andre Benson, MD

Operation PAR, Research Department Operation Par

Washington, D.C. James Shepard LaTonya Sullivan

Organization prefers anonymity Organization prefers anonymity
APPENDIX 4: DISCUSSION AREAS

page 312 Pulse Check: January 2004

APPENDIX 4: DISCUSSION AREAS BY SOURCE TYPE*

Topic L E M N

SPECIAL SECTION. LOCAL DRUG MARKETS: A DECADE OF CHANGE 

During the last reporting period, among street-level transactions involving each listed drug,**what percentage involved 

exchanging any of the following items: cash, property/merchandise, shoplifted merchandise, other stolen merchandise, 

sex, guns, other drugs, transporting drugs, stealing the drug, food stamps, drug buying services, injecting services, lookout

services, other? ! !!!

Have there been any changes in any of these specific types of transactions over the past 10 years? ! !!!

Over the past 10 years, to what degree have specific illicit marketing innovations or tools complicated efforts to 

detect or disrupt drug activity in your community? ! !

Over the past 10 years, to what degree have specific changes in the drug market and in the nature of drug users 

made your community's drug abuse problem more complex? ! !

Over the past 10 years, has your community tried any specific innovations, changes, or tools to address increased 

complexities of drug markets? ! !

Over the past 10 years, to what extent have specific changes contributed to the widespread availability and use of 

marijuana? ! !

Over the past 10 years, to what extent have changes in specific problems complicated the treatment of marijuanausing clients, particularly youth? ! !

What continuing effects, if any, have the September 11 attacks and their aftermath had on the drug abuse problem? ! !!!

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

During the current and last reporting periods, what was the most commonly abused drug in your community? 

Second most commonly abused drug? What drug was related to the most serious consequences? 

Second most serious consequences? Is any new problem drug appearing in your community? ! !!!

THE DRUG**

How difficult is it for undercover officers/users to buy drugs (and various forms of each drug)?*** ! !

Has it become more difficult, less difficult, or the same, to buy drugs since the last reporting period? ! !

During this reporting period, has there been a time when undercover officers/buyers could not buy drugs? ! !

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 each 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 remained stable? ! !

What is the source for your price, purity, and adulterant information? ! !

How is the drug locally manufactured, processed, diverted, or grown? ! !

Have there been any changes in the local manufacturing process since the last reporting period? ! !

THE MARKET PERSPECTIVE**

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 type of other crimes are sellers involved? ! !

Have there been any changes in seller characteristics since the last reporting period? ! !

Are there any new seller groups this reporting period? ! !

What is the geographical area where most street-level sales of each drug occur? ! !

Where is each drug sold? ! !

How does each drug get from seller to buyer? ! !

How do dealers communicate with buyers, suppliers, and other dealers? ! !

Are other drugs sold by this type of dealer? If yes, please list the drugs. ! !

Have any of the drug scene characteristics changed since the last reporting period? If yes, please describe. ! !

THE USERS PERSPECTIVE: Predominant characteristics** 

How did the number of users change since the last reporting period? !

What are the total number and percentage of primary users for this drug? All use 

(including primary, secondary, and tertiary)? ! !

Have these percentages or numbers changed since the last reporting period? ! !

What percentage of the drug clients are return clients for that drug? ! !

What percentage of the drug clients are return clients for any drug? ! !

What is the predominant age range of the drug users? Mean age? Has either of these changed since 

the last reporting period? !! !
APPENDIX 4: DISCUSSION AREAS

Pulse Check: January 2004 page 313

THE USERS PERSPECTIVE: Predominant characteristics** (continued)

What is the predominant gender (provide percentages if possible), 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, and has it changed since the last reporting period? !! !

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? Have there been any changes? !! !

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 predominant employment status, and has it changed since the last reporting period? ! !

What are the common negative consequences of marijuana use (asked for marijuana only)? !! !

THE USERS: New/emerging 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. !

What are the total number and percentage of users new to treatment? Have these numbers or percentages changed 

since the last reporting period? ! !

How did the number of users new to treatment change since the last reporting period? If increased, repeat all 

questions under "the users: predominant characteristics" for the new-to-treatment 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? !

DRUG ABUSE RELATED CONSEQUENCES, COMORBIDITY, AND BARRIERS TO TREATMENT

How common are specific drug-related consequences among clients in your program? Have these drug-related 

consequences increased, decreased, or remained stable since the last reporting period? ! !

How common are specific psychiatric comorbid diagnoses in your program? Have these comorbid disorders 

increased, decreased, or remained stable since the last reporting period? ! !

How common are specific barriers to treatment? Have these barriers to treatment increased, decreased, or remained 

stable since the last reporting period? ! !

TREATMENT BACKGROUND

How do you define program capacity? ! !

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, EEpidemiologic/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 cocaine, powder cocaine, marijuana, methamphetamine, ecstasy, diverted OxyContin®,

and any other drugs (specify) for each of the discussion areas.

***Law enforcement sources were asked about undercover officers' ability to buy drugs; epidemiologic/ethnographic sources were 

asked about users' ability to buy drugs.

L E M N
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NCJ 201398