PULSE CHECK PULSE CHECK

Trends in Drug Abuse

January–June 2002 Reporting Period

Executive Office of the President

Office of National Drug Control Policy

November 2002

Special Topic:

A Look At Local Drug Markets

Trends in Drug Abuse

January–June 2002 Reporting Period

Executive Office of the President

Office of National Drug Control Policy

November 2002

Special Topic:

A Look At Local Drug Markets
PULSE CHECK

Trends in Drug Abuse

November 2002

Executive Office of the President

Office of National Drug Control Policy

Washington, DC 20503

NCJ 197242
ACKNOWLEDGEMENTS

ACKNOWLEDGEMENTS

The Office of National Drug Control Policy (ONDCP) acknowledges the contributions made by the 78 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: November 2002 page iii

CONTENTS

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

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

Special Topic: A Look at Local Drug Markets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Drug Treatment Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Heroin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

Crack Cocaine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

Powder Cocaine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

Marijuana . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

Methamphetamine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

Diverted Synthetic Opioids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

Ecstasy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

Other Drugs of Concern . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77

Appendix 1: Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

Appendix 2: Population Demographics in the 20 Pulse Check Sites . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81

Appendix 3: National-Level Data Sources Available in the 20 Pulse Check Sites . . . . . . . . . . . . . . . . . . 81

Appendix 4: Pulse Check Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82

Appendix 5: Discussion Areas by Source Type. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84

EXHIBITS

Highlights

Exhibit 1. How serious is the perceived drug problem in the 20 Pulse Check communities (spring 2002)? . . . . . . . . . .1

Exhibit 2. How has the perceived drug problem changed (fall 2001 vs spring 2002)? . . . . . . . . . . . . . . . . . . . . . . . . .1

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

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

Exhibit 5. How has the preceived drug problem changed (fall 2001 vs spring 2002)? . . . . . . . . . . . . . . . . . . . . . . . . .3

Exhibit 6. What new problems have emerged or intensified during spring 2002? . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

Exhibit 7. In what crimes, besides drug sales, are illict drug sellers involved across Pulse Check cities? . . . . . . . . . . . . .5

Exhibit 8. How likely are sellers to use their own drugs across Pulse Check cities, by drug? . . . . . . . . . . . . . . . . . . . . .6
CONTENTS

page iv Pulse Check: November 2002

Special Topic: A Look at Local Drug Markets

Exhibit 1. How difficult is it for undercover police and users to buy drugs? (Averages, 0–10 scale) . . . . . . . . . . . . . . . 9

Exhibit 2. How difficult is it for undercover police and users to buy specific drugs across the 

20 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 

Exhibit 3. How difficult is it to buy heroin? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 

Exhibit 4. How difficult is it to buy methamphetamine? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12 

Exhibit 5. How do dealers and buyers communicate? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 

Exhibit 6. What else, besides cash, is exchanged for drugs? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14 

Drug Treatment Issues

Exhibit 1. How has illicit drug abuse impacted the health of users? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Exhibit 2. What are the barriers to drug treatment in different Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . .22 

Heroin

Exhibit 1. How available is heroin across the 20 Pulse Check cities (spring 2002)? . . . . . . . . . . . . . . . . . . . . . . . . . .25 

Exhibit 2. How has overall heroin availability changed (fall 2001 vs spring 2002)? . . . . . . . . . . . . . . . . . . . . . . . . . .26 

Exhibit 3. Which heroin varieties have changed in availability (fall 2001 vs spring 2002)? . . . . . . . . . . . . . . . . . . . . .26 

Exhibit 4. What are the prices and purtiy levels of different types of heroin in 19 Pulse Check cities? . . . . . . . . . . . .27 

Exhibit 5. How is heroin referred to, and what types of heroin predominate, in the four regions of the country? . . . 28

Exhibit 6. How are street-level heroin sellers organized across the 20 Pulse Check cities (spring 2002)? . . . . . . . . . . .29 

Exhibit 7. What other drugs do heroin dealers sell? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31 

Exhibit 8. Which non-methadone treatment programs in Pulse Check cities have substantial percentages of clients

reporting heroin as their primary drug of abuse? How have those percentages changed 

(fall 2001 vs spring 2002)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Exhibit 9. How do users administer heroin? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

Crack Cocaine

Exhibit 1. How available is crack cocaine across the 20 Pulse Check cities (spring 2002)? . . . . . . . . . . . . . . . . . . . . .35

Exhibit 2. How has crack cocaine availability changed (fall 2001 vs spring 2002)? . . . . . . . . . . . . . . . . . . . . . . . . . .36

Exhibit 3. What are crack cocaine price levels in 19 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37

Exhibit 4. How is crack cocaine referred to in the four regions of the country? . . . . . . . . . . . . . . . . . . . . . . . . . . . .38

Exhibit 5. Which non-methadone treatment programs in Pulse Check cities have substanital percentages of 

clients reporting crack or powder cocaine as their primary drug of abuse? How have these percentages

changed (fall 2001 vs spring 2002)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39

Exhibit 6. Which genders are the predominant users of specific drugs in the Pulse Check cities? . . . . . . . . . . . . . . . .40

Powder Cocaine

Exhibit 1. How available is powder cocaine across the 20 Pulse Check cities (spring 2002)? . . . . . . . . . . . . . . . . . . .43

Exhibit 2. How has powder cocaine availability changed (fall 2001 vs spring 2002)? . . . . . . . . . . . . . . . . . . . . . . . .43

Exhibit 3. What are the prices and purity levels of powder cocaine in 18 Pulse Check cities? . . . . . . . . . . . . . . . . . . .44

Exhibit 4. How is powder cocaine referred to in the four regions of the country? . . . . . . . . . . . . . . . . . . . . . . . . . . .45

Exhibit 5. How has the number of powder cocaine users changed (fall 2001 vs spring 2002)? . . . . . . . . . . . . . . . . . .46
CONTENTS

Pulse Check: November 2002 page v

Marijuana

Exhibit 1. How available is marijuana across the 20 Pulse Check cities (spring 2002)? . . . . . . . . . . . . . . . . . . . . . . . .49

Exhibit 2. How has marijuana availability changed (fall 2001 vs spring 2002)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

Exhibit 3. Which marijuana varieties have changed in availability (fall 2001 vs spring 2002)? . . . . . . . . . . . . . . . . . .50

Exhibit 4. How much does marijuana cost in 19 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51

Exhibit 5. How is marijuana referred to in the four regions of the country? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52

Exhibit 6. Which non-methadone treatment programs in Pulse Check sites have substantial

percentages of clients reporting marijuana as their primary drug of abuse? How have those

percentages changed (fall 2001 vs spring 2002)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53

Exhibit 7. How are different drug users referred to treatment? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53

Exhibit 8. Who is most likely to use marijuana? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54

Exhibit 9. Where are drug users most likely to reside? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54

Exhibit 10. What adverse consequences do substantial percentages of Pulse Check sources attribute to the 

use of marijuana, either alone or in combination with other drugs? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56

Methamphetamine

Exhibit 1. How available is methamphetamine across the 20 Pulse Check cities (spring 2002)? . . . . . . . . . . . . . . . . .57

Exhibit 2. How has methamphetamine availability changed (fall 2001 vs spring 2002)? . . . . . . . . . . . . . . . . . . . . . .57

Exhibit 3. How much does methamphetamine cost in 13 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59

Exhibit 4. How is methamphetamine referred to in the four regions of the country? . . . . . . . . . . . . . . . . . . . . . . . . .61

Exhibit 5. Which treatment programs in Pulse Check sites have substantial percentages of clients reporting

methamphetamine use? How have those percentages changed (fall 2001 vs spring 2002)? . . . . . . . . . . . . .62

Diverted Synthetic Opioids

Exhibit 1. Where is OxyContin® diversion and abuse emerging across the 20 Pulse Check cities? . . . . . . . . . . . . . . .65

Exhibit 2. How available is diverted OxyContin® across the 20 Pulse Check cities (spring 2002)? . . . . . . . . . . . . . . .66

Exhibit 3. How has diverted OxyContin® availability changed (fall 2001 vs spring 2002)? . . . . . . . . . . . . . . . . . . . .66

Exhibit 4. Which treatment programs in Pulse Check sites have substantial percentages of clients reporting 

OxyContin® as their primary drug of abuse? How have those percentages changed 

(fall 2001 vs spring 2002)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .69

Ecstasy

Exhibit 1. Where is ecstasy emerging across the 20 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71

Exhibit 2. How available is ecstasy, and how has availability changed, across the 20 Pulse Check

cities (fall 2001 vs spring 2002)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71

Exhibit 3. How is ecstasy referred to and marketed across the 20 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . .72

Exhibit 4. How much does a pill (one dose) of ecstasy cost in the 20 Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . .73

Other Drugs of Concern

What are some street prices of other drugs of concern? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .78
page vi Pulse Check: Nobember 2002

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HIGHLIGHTS

Pulse Check: November 2002 page 1

! Marijuana is the illicit drug most

easily purchased by both users 

and undercover police, followed

by crack.

! Users find it a bit more difficult

than undercover police to purchase powder cocaine.

! Heroin is also relatively easy to

purchase on the street. Undercover

police generally find it slightly

more difficult to purchase than

crack or powder cocaine. Users,

on average, purchase heroin with

more difficulty than crack but with

less difficulty than powder cocaine.

Exhibit 2.

How has the perceived drug

problem changed (fall 2001 vs

spring 2002)?

Sources: Law enforcement, epidemiologic/

ethnographic, and treatment respondents

Somewhat

Worse

Much

Worse

Less

Serious

Percent (N=78)

Same

100

90

80

70

60

50

40

30

20

10

0

Exhibit 1.

How serious is the perceived drug

problem in the 20 Pulse Check

communities (spring 2002)?

Sources: Law enforcement, epidemiologic/

ethnographic, and treatment respondents

Somewhat

Serious Very

Serious

Percent (N=78)

100

90

80

70

60

50

40

30

20

10

0

This report is based on discussions with 78 epidemiologists, ethnographers, law enforcement officials, and methadone and

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

between late June and early August 2002, reveal that overall, when comparing spring 2002 with the previous fall period,

the majority of Pulse Check sources believe their communities’ drug abuse problem to be very serious but stable, although a

substantial percentage believe the situation to be somewhat worse. (Exhibits 1 and 2)

PULSE CHECK HIGHLIGHTS✛

The illicit drug situation is characterized by several key features:

➤ Heroin continues to surpass crack as the drug associated with the most

serious consequences, as perceived by 31 sources in 15 cities, particularly

in the Northeast and Midwest. (Exhibits 3 and 4)

➤ Crack remains a serious problem, according to 21 sources in 14 cities, 

particularly in the South. One source in Memphis suggests that crack has

overtaken marijuana as the most commonly abused drug. (Exhibits 3, 4,

and 5)

➤ Marijuana remains the most widely abused illicit drug, as reported by 34

sources in 17 cities. (Exhibits 3 and 4)

➤ Methamphetamine is reported as an emerging or intensifying problem in

10 cities. (Exhibit 6) Furthermore, sources in eight cities, particularly in

the West, consider it the drug contributing to the most serious consequences. (Exhibits 3 and 4)

➤ Some signs indicate that diversion of OxyContin® (oxycodone hydrochloride controlled-released) might have peaked during the last reporting

period. However, it continues to be reported as an emerging problem by

sources in 14 Pulse Check cities. (Exhibit 6)

➤ Ecstasy (methylenedioxymethamphetamine or MDMA) continues to

emerge or intensify as a problem in all but five Pulse Check cities: in

Detroit, Miami, New Orleans, New York, and Portland (ME), it has now

either leveled off or has become an established drug of abuse. (Exhibit 6)

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

Law enforcement respondent, EEpidemiologic/ethnographic

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

HIGHLIGHTS FROM THE SPECIAL TOPIC SECTION: A LOOK AT LOCAL

DRUG MARKETS
HIGHLIGHTS

page 2 Pulse Check: November 2002

! Of the five drugs discussed, methamphetamine is the most difficult

to purchase overall. It is easiest to 

purchase the drug in Honolulu,

Los Angeles, Memphis, and 

Sioux Falls.

! Only a few sources report that

users or undercover police had 

a hard time buying drugs at 

any specific times during this

reporting period.

! Drug markets in several Pulse

Check cities appear more active

when users receive paychecks or

Government checks, on or before

weekends and holidays, when

police presence is low, and when

supply is up.

! Beepers and cell phones are the

most common means of communication between dealers and their

buyers, suppliers, and fellow 

dealers.

! Motor vehicles, usually personal

cars, are the most frequently mentioned means of moving drugs.

! Dealers generally accept mostly

cash in payment for drugs. They

do, however, occasionally accept

other modes of payment, such as

sex, property or merchandise,

other drugs, drug transport, and

other items or services.

! Dealers dispose of cash from 

drug sales in many ways, including money laundering in various

forms, “re-upping” supplies,

spending on entertainment, 

and passing money up the 

supply ladder.

! An intense and visible police presence is, by far, the most effective,

albeit short-term, deterrent to

street drug buys.

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

cities, by type of source?

Drug Most commonly abused?* Most serious consequences?

LE N L E NM

Boston, MA MJ MJ H HCl Crack H H

New York, NY MJ MJ Crack H Crack Crack Crack

Philadelphia, PA MJ MJ H H H Crack H

Portland, ME H MJ H H H H H

Baltimore, MD MJ H H Crack H H Benzos

Columbia, SC Crack MJ MJ Crack Crack MJ H

El Paso, TX MJ MJ Cocaine H Crack H Cocaine

Memphis, TN Meth Crack Crack Meth Crack Crack Benzos

Miami, FL Crack MJ Crack Oxy HCl + Crack Benzos

Crack

New Orleans, LA Crack H Crack H Crack Crack NR

Washington, DC MJ MJ Crack Crack H H H

Chicago, IL Crack MJ MJ Crack H H H

Detroit, MI MJ MJ Crack H H Crack H

Sioux Falls, SD MJ MJ MJ Meth Meth MJ NR

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

Billings, MT Meth MJ MJ Meth Meth Meth Meth

Denver, CO MJ MJ Meth Meth HCl Meth H

Honolulu, HI Meth Meth Meth Meth Meth Meth Benzos

Los Angeles, CA Crack MJ MJ Crack H Meth H

Seattle, WA MJ MJ MJ Meth H MJ H

*Methadone treatment sources are excluded from this count. 

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

methadone treatment respondents

NR = Not reported Northeast South West Midwest

Exhibit 4. What are the most serious drug problems in the 20 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 7 5 31 15

Crack 12 9 21 14

Powder cocaine 1 1 3 3

Marijuana 34 17 3 3

Methamphetamine 6 4 15 8

Diverted OxyContin® 00 11

Benzodiazepines 0 0 4 4

*Methadone treatment sources are excluded from this count. 

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

methadone treatment respondents
HIGHLIGHTS

Pulse Check: November 2002 page 3

HIGHLIGHTS OF TREATMENT

ISSUES

Epidemiologic/ethnographic and

treatment sources discuss various

treatment issues, such as methadone

maintenance capacity, treatment referral sources, adverse health consequences, barriers to treatment, and

diagnoses of psychiatric comorbidity:

! Since the last Pulse Check, public

methadone maintenance capacity

has decreased somewhat in

Chicago. Private capacity, however,

has increased in Memphis, Miami,

New Orleans, and Portland (ME),

although waiting lists are reported

by six sources.

! Drug users, particularly those who

use marijuana or crack, are predominantly referred to treatment

through courts or the criminal justice system. Referral sources have

remained generally stable since the

last reporting period.

! The impact of drug use on AIDS

and HIV seems to have stabilized

in the majority of treatment programs. Reported hepatitis C cases,

however, continue to increase,

usually because of increased

screening and awareness.

! The most reported barriers to drug

treatment (in descending order) are

limited slot capacity, lack of trained

staff to treat comorbid mental

health disorders, and violent

behavior among presenting clients.

! Mood and conduct disorders are

the most commonly reported mental health diagnoses among drug

treatment clients, according to

treatment respondents.

HIGHLIGHTS BY SPECIFIC ILLICIT

DRUG

The 78 discussions also yielded key

findings about heroin, crack, powder

cocaine, marijuana, methamphetamine, synthetic opioids, ecstasy, and

GHB (gamma hydroxybutyrate).

HEROIN

! Heroin availability remains generally stable. Only six increases are

reported (in BostonE

, Columbia

[SC]E

, DenverL, MemphisL, MiamiE,

and Portland [ME]L,E) and one

decline (in PhiladelphiaL

). Highpurity snortable South American

(Colombian) white heroin remains

the most common variety, especially

in the Northeast.

! Sources report declining prices,

especially for larger quantities of

heroin, in six cities in the

Northeast and West.

! Brand names still proliferate in the

Northeast and South, but they are

becoming less common in several

cities, such as Boston and Philadelphia. Possibly, dealers fear that

labels and brand names make them

vulnerable to law enforcement.

! Local drug market structures vary

from city to city, but they are generally stable, with a few exceptions. For example, sales in Boston

continue to decentralize, as users

increasingly support their habits by

selling heroin; by contrast, in nearby Portland, independent locals are

increasingly working together.

! A younger cohort of heroin users

is reported in Boston, Miami, 

New Orleans, Portland, St. Louis,

Seattle, and Washington, DC.

By contrast, aging heroin-using

populations are reported in El

Paso, Philadelphia, and St. Louis.

! Users of diverted OxyContin® in

Portland are switching to heroin,

which is now easier to obtain.

! The number of heroin clients has

increased in non-methadone programs in nine Pulse Check cities.

! Snorting has increased in seven

nonwestern cities. Injecting, however, has reportedly increased in

BostonE and PortlandE,N, resulting

in new hepatitis C cases among

young adults. 

Exhibit 5. How has the perceived drug problem changed (fall 2001 vs spring 2002)?

Denver, COL

Honolulu, HIM

Memphis, TNL

Miami, FLE

Portland, MEL,E

Seattle, WAN

Washington, DCN

Powder cocaine 

Heroin

Marijuana 

Heroin 

Pharmaceutical opiates

Cocaine

Crack

Methamphetamine 

Benzodiazepines

Methamphetamine 

Cocaine + narcotics

Heroin 

Marijuana 

Heroin

Memphis, TNE

El Paso, TXM

Honolulu, HIL

New Orleans, LAE

Portland, MEL

Washington, DCM

Washington, DCL

Marijuana

Cocaine 

Marijuana 

Crack 

Marijuana 

Heroin 

Crack

Crack

Heroin

Methamphetamine

Heroin

Heroin

Benzodiazepines

Marijuana

Where has “the most commonly abused drug” 

changed?

City/Source Fall 2001 Spring 2002

Where has the drug with “the most serious 

consequences” changed?

City/Source Fall 2001 Spring 2002
HIGHLIGHTS

page 4 Pulse Check: November 2002

CRACK COCAINE

! Availability remains generally wide

and stable. Declines are perceived

in four cities (BostonL,E, HonoluluE,

PhiladelphiaL, and SeattleE), and

increases are perceived in another

four (BillingsL, MemphisE, New

YorkE, and Sioux FallsL).

! Crack tends to be processed locally

(from powder cocaine), either by

local distributors or users, because

Federal guidelines for distributing

crack are stricter than for powder.

! Overall, street-level crack sellers

are equally likely to operate independently than as part of organized sales structures—unlike sellers

of other illicit drugs, who are

more likely to operate independently.

! Only a few changes are reported in

market techniques and locations.

For example, in Boston, sales 

continue to be more “underground” than before, with more

beeper and cell phone use. In

Philadelphia, sales are similarly

moving indoors, while outdoor

markets are constantly relocating

to evade law enforcement.

! Crack sales are associated with

prostitution, gang-related crime,

and violent crime more often than

other drug sales. (Exhibit 7)

! Crack users tend to be predominantly young adults (18–30 years),

but adolescent users are increasing

in Billings, Los Angeles, and 

Sioux Falls.

POWDER COCAINE

! Availability remains generally wide

and stable, with declines in two

cities (HonoluluE and PhiladelphiaL

)

and increases in four (MemphisL

,

New YorkE

, Portland [ME]L, and 

Sioux FallsE

).

! Powder cocaine sellers are predominantly young adults (18– 

30 years), but adolescents also 

sell the drug in ChicagoE and 

Los AngelesL,E.

! Powder cocaine sellers are more

likely to use their own drug than

heroin or crack sellers (Exhibit 8).

! Unlike heroin and crack markets,

which are located primarily in central city areas, powder cocaine

markets are more evenly distributed among geographic areas. 

! Indoor and outdoor sales are

equally common in the majority 

of cities. Frequent settings include

nightclubs, bars, raves, and concerts.

! In Portland, sellers are increasingly

organized and are selling greater

quantities of powder cocaine.

Elsewhere, the market appears 

relatively stable.

! The number of powder cocaine

users in treatment increased

according to seven sources (in

ChicagoN, Columbia [SC]N,

DenverE

, Hono-luluN, MiamiE, 

and Sioux FallsE,N) and declined

according to four (in ColumbiaE

,

DenverN,M, and PortlandN).

Exhibit 6. What new problems have emerged or intensified during spring 2002?

Baltimore, MDM

Billings, MTN

Boston, MAL

Chicago, ILL

Columbia, SCL

Denver, COL,E

El Paso, TXE

Honolulu, HIN

Los Angeles, CAL,E,N

Memphis, TNN

Philadelphia, PAE,M

St. Louis, MOE

Seattle, WAL

Sioux Falls, SDL

Washington, DCL

Baltimore, MDL

Billings, MTN

Boston, MAL,E,M,N

Columbia, SCE,N

Denver, COM

El Paso, TXM

Honolulu, HIE,M,N

Memphis, TNL

New Orleans, LAL,E

New York, NYM

Philadelphia, PAE,M,N

St. Louis, MON

Seattle, WAL,E,M,N

Washington, DCE

Columbia, SCL

Denver, COE

Detroit, MIE

El Paso, TXN

Memphis, TNE

Miami, FLE

New York, NYL

St. Louis, MOL,E

Seattle, WAL,N

Sioux Falls, SDE

Benzodiazepines: Boston, MAE

Clonidine (Catapres®): Baltimore, MDM

Cocaine: Portland, MEM

Diverted methadone: Portland, MEL,E,N

DXM (dextromethorphan): Denver,COE

GHB: Denver, COE; Los Angeles, CAE

Ketamine: Denver, COE; El Paso, TXE’;

New Orleans, LAL

; Sioux Falls, SDL

Khat*: Boston, MAL

Other opiates: Billings, MTN

Boston, MAE

Columbia, SCE

Denver, COE

PCP: Philadelphia, PAE

Washington, DCM

Powder Cocaine: Sioux Falls, SDE,N

Other Emerging Drug Problems

*Khat is a natural stimulant from the Catha Edulis plant, found in a flowering evergreen tree or large shrub from East Africa and Southern Arabia. Its

leaves contain psychoactive ingredients structurally and chemically similar to d-amphetamine.

Ecstasy/Club Drugs OxyContin® Methamphetamine
HIGHLIGHTS

Pulse Check: November 2002 page 5

! Preadolescent and adolescent powder cocaine users in the Sioux

FallsN program have increased

since the last reporting period.

! Injecting has increased in El Paso

and Sioux Falls. It is a common

route of administration when powder cocaine is used in combination

with heroin. Snorting, however,

remains the predominant route of

administration across sites.

MARIJUANA

! Honolulu, Memphis, and New

Orleans are the only three cities

where no Pulse Check source

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

! Non-methadone treatment sources

in Columbia (SC), Seattle, and

Sioux Falls consider marijuana the

drug that contributes to the most

serious consequences.

! Availability remains wide and generally stable. A few increases are

reported in availability of indoorgrown hydroponic marijuana.

British Columbian marijuana (“BC

bud”) availability has increased in

five cities, mostly in the West.

! Marijuana wraps, often sold in

several colors and flavors, are

becoming increasingly common, as

reported in El Paso, Miami,

Philadelphia, and Washington, DC.

Sometimes, as in El Paso, they are

specifically marketed toward

young girls.

! Marijuana sellers are very likely to

use their own drug, much more so

than sellers of other drugs.

(Exhibit 8)

! Marijuana users are more likely to

reside in all locations (central city,

suburban, and rural areas) than

users of other drugs.

! The age of marijuana users has

been declining in several cities,

including Boston, Columbia,

Honolulu, Los Angeles, Memphis,

and Sioux Falls.

! More than half of responding epidemiologic/ethnographic and treatment sources name arrests as an

adverse consequence of marijuana

use. More than one-third name

poor academic performance, deteriorating family or social relationships, poor workplace performance, school absenteeism or truancy, and short-term memory loss (in

descending order of frequency).

METHAMPHETAMINE

! Methamphetamine has replaced

powder cocaine as the drug contributing to the most serious drug

consequences in DenverL

. It has

replaced marijuana as such in

MemphisE.

! The majority of sources report 

stable availability, but sources in

12 cities believe availability has

increased since the last reporting

period. 

! The number of small, local methamphetamine labs has increased in

nine Pulse Check cities: Boston,

Chicago, Denver, Detroit, Los

Angeles, Miami, Portland (ME), St.

Louis, and Sioux Falls. Nevertheless, availability levels remain low

in many of these cities.

! Methamphetamine sellers are more

likely to be involved in domestic

violence than sellers of other drugs,

according to law enforcement and

epidemiologic/ethnographic respondents. (Exhibit 7)

! Methamphetamine markets and

use have been spreading within

communities: sometimes from the

city toward rural areas, as in

Denver, Memphis, Seattle, and

Sioux Falls; sometimes from rural

toward city areas, as in Chicago,

Los Angeles, Miami, parts of New

York, and St. Louis.

Exhibit 7.

In what crimes, besides drug sales, are illicit drug sellers involved across

Pulse Check cities?

Sources: Law enforcement and epidemiologic/ethnographic respondents

Marijuana

Methamphetamine

Powder cocaine

Heroin

Crack

Prostitution

(N=52) Gangrelated

crimes

(N=67)

Violent

crimes

(N=86)

Nonviolent

crimes

(N=91)

Domestic

violence

(N=36)

Percent

100

90

80

70

60

50

40

30

20

10

0
HIGHLIGHTS

page 6 Pulse Check: November 2002

DIVERTED SYNTHETIC OPIOIDS

! Availability of diverted OxyContin® has remained stable

according to half of the Pulse

Check sources, particularly in the

Midwest. Increases, however, are

still reported in 10 cities, while

declines are reported in 4.

! In Philadelphia and Portland (ME),

declines in some aspects of the

diverted OxyContin® problem 

are attributed to a combination of

legislation, arrests, education, press

coverage, and changed prescription policies.

! Despite declining or stabilizing

availability, adverse consequences

are still increasing in Philadelphia

(in mortality and emergency

department episodes) and Portland

(in people initiating use).

! In Boston, pharmacy robberies

involving OxyContin® continue to

increase, and sales of the diverted

drug appear more organized than

in the past.

! Diverted OxyContin® is sold by a

wide range of individuals, mostly

independent—from elderly “pill

ladies” in Columbia (SC) to “bad”

doctors and pharmacists in Seattle

to addicts as well as armed criminals in Boston.

! Since the last reporting period,

among treatment programs where

abuse of diverted OxyContin® is

reported, the number of users 

has increased substantially in 3,

increased somewhat in 16, and

remained stable in 10 Pulse 

Check cites.

! Abusers of OxyContin® reside

predominantly in central city areas

according to sources in half of the

Pulse Check cities, dispelling the

myth of “hillbilly heroin.”

ECSTASY (methylenedioxymethamphetamine or MDMA)

! About half of the respondents

report that ecstasy availability has

increased. Approximately half

report that it has remained stable,

often at elevated levels.

! Fewer sources report adulterated

ecstasy than in the last Pulse

Check. However, fraudulent substitutions (such as hormone replacement pills) have been confiscated

in some cities (such as Detroit, St.

Louis, and Seattle).

! Nearly all respondents believe that

sellers are very likely or somewhat

likely to use their own ecstasy.

(Exhibit 8)

! The ecstasy market continues to

move to the street—beyond the

rave, concert, and club scene—

unlike markets for drugs like heroin

and cocaine, which are increasingly

moving indoors in some cities. 

! Younger students are using ecstasy

in some cities (such as Baltimore

and Boston). 

! While users tend to be middle

socioeconomic Whites, increasing

use is reported among some

minorities and lower socioeconomic groups (in Memphis, New

York, St. Louis, and Sioux Falls).

GHB (gamma hydroxybutyrate)

! GHB is mentioned as an emerging

problem in Denver and Los Angeles.

! Wide availability is reported in

Denver, Los Angeles, Miami, and

New Orleans. Availability has

increased in Los AngelesL,E,

MemphisL, and Sioux FallsL. It has

declined in MiamiE and St. LouisL,E.

KETAMINE (“Special K”)

! Ketamine is reported as an emerging or intensifying drug problem in

Denver, El Paso, New Orleans, and

Sioux Falls. It is increasingly available in Memphis. 

! The drug is sometimes associated

with the club or rave scene.

Exhibit 8.

How likely are sellers to use their own drugs across Pulse Check cities,

by drug?

Sources: Law enforcement and epidemiologic/ethnographic respondents

Very likely

to use

Somewhat

likely to use

Not very

likely to use

No use

Heroin

(N=33)

Crack 

(N=32)

Powder cocaine

(N=30)

Marijana

(N=34)

Methamphetamine 

(N=25)

Ecstasy 

(N=30)

36%

74%

34% 33%

52% 57%
INTRODUCTION

Pulse Check: November 2002 page 7

INTRODUCTION

Since 1992, the Office of National

Drug Control Policy (ONDCP) has

published the Pulse Check, a source

for timely information on drug abuse

and drug markets. The report aims to

describe chronic drug users, emerging

drugs, new routes of administration,

varying use patterns, changing

demand for treatment, drug-related

criminal activity, drug markets, and

shifts in supply and distribution patterns. Pulse

Check regularly addresses four drugs of serious

concern: heroin, crack

cocaine/powder cocaine,

marijuana, and methamphetamine. Additionally,

due to their spread

across the country, Pulse

Check continues to

monitor the problems of

“ecstasy” (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 Household

Survey on Drug Abuse and other

national data sources report findings

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

to describe the age, ethnicity, and

gender of illegal drug users and those

who sell drugs and any changes in

these characteristics. The information

provided to Pulse Check reflects the

observations of the sources, and their

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

the drug problem. The intent of the

Pulse Check has been and continues

to be merely to describe patterns in

illicit drug use and illicit drug markets

that are emerging in local communities.

Use and Interpretation of Pulse

Check Information

By contacting professionals from three

different disciplines—ethnography/

epidemiology, law enforcement, and

treatment—a rich picture of the

changing drug abuse situation emerges.

Though this approach offers substantial strengths in timeliness and depth,

Pulse Check is not intended as a 

quantitative measure of the prevalence

of drug abuse or its consequences. Any

interpretation or conclusion drawn

from Pulse Check must be viewed 

carefully and in conjunction with other

more quantifiable direct and indirect

measures of the drug abuse problem.

More specifically, several of the 

limitations of Pulse Check are briefly

discussed below.

Pulse Check focuses on the drug abuse

situation in 20 specific sites throughout the Nation. Though considerable

effort was made to select sites across a

broad range of geographic areas,

including Census regions and divisions,

urban and rural States, racial/ethnic

coverage, and High Intensity Drug

Trafficking Areas, Pulse

Check cannot be

viewed as a national

study, and information

cannot be reasonably

aggregated up to a

national level.

Of the 80 sources

identified and recruited across the three disciplines, 78 provided

information for this

Pulse Check issue.

The information presented in this report is

based solely on the

observations and perceptions of those

78 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 78.

Any contradictory reports within an

individual site are not necessarily a

The 20 Pulse Check Sites
INTRODUCTION

page 8 Pulse Check: November 2002

Pulse Check limitation. Just as the site

sampling methodology was designed

to reflect the country’s geographic

and population diversity, recruiting

four sources per site was incorporated

into the design to reflect diversity

within each 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 20 sites—

one from a methadone program, and

one from a non-methadone program.

Taken together, all four sources at

each site provide a richer picture of

the drug problem’s nature. 

Current Sources and Reporting

Periods

The current report includes information gathered during June 17 through

August 5, 2002, from telephone conversations with 78 sources, representing 20 sites across the various regions

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

abuse situation as it was during the

spring months of 2002 and in comparison to a period 6 months earlier,

during fall 2001.

The law enforcement sources who

provided information include 20 

narcotics officers from local police

departments, field office agents of the

Drug Enforcement Administration

(DEA), and representatives of High

Intensity Drug Trafficking Areas

(HIDTAs). 

The epidemiologists and ethnographers are 20 researchers associated

either with local health departments,

university-based research groups, or

other community health organizations. Some of those 20 individuals

are qualitative researchers who

employ ethnographic techniques to

obtain observational data directly 

from the drug user’s world; others

are epidemiologists who access both

qualitative and quantitative data. 

The treatment sources are 38 providers

from 21 non-methadone programs and

17 methadone programs across the 20

sites. Those providers include two 

non-methadone sources each from

Billings because that city does not have

a methadone program. They do not

include another two individuals who

were unable to participate in this

round of discussions: the methadone

treatment source from New Orleans;

and one of the two non-methadone

treatment sources from Sioux Falls

(where, as in Billings, there are no

methadone programs).

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. 
SPECIAL TOPIC: A LOOK AT LOCAL DRUG MARKETS

Pulse Check: November 2002 page 9

Local drug markets, like any economic

markets, are subject to a wide variety

of influences. Thus, in order to disrupt street-level drug markets within

local communities, it is necessary to

understand how they operate.

As key informants and opinion leaders

in their communities, Pulse Check

sources are well positioned to describe

drug market activity, pinpoint its 

vulnerabilities, and suggest ways to

disrupt it. Therefore, during our routine semiannual telephone discussions

conducted June 17 through August 5,

2002, we asked Pulse Check’s 20 law

enforcement and 20 epidemiologic/

ethnographic sources a series of 

market-related questions relevant to

their specific areas of expertise. 

Questions included the following:

How difficult is it to buy drugs?

When do local drug markets seem

most active? When do they slow

down? How do street-level dealers

communicate with each other, with

their suppliers, and with their buyers?

How do dealers transport drugs to

their selling locations? What else,

besides cash, do dealers accept in

exchange for drugs? What happens 

to cash collected by street dealers?

What deters street drug buys? How

do targeted law enforcement or 

legislative policy directives impact

communities’ drug problems? How

can local drug market activity be 

disrupted? What challenges face law

enforcement efforts? 

In responding, the law enforcement

sources provided information and

opinions from the undercover police

officer’s point of view, while the 

epidemiologic/ethnographic sources

described market activity from the

user’s perspective. 

How difficult is it to buy drugs?

(Exhibits 1–4) Marijuana is the most

easily purchased illicit drug, both for

undercover police and users: on 

average, on a 0–10 scale (with 0 being

“not difficult at all” and 10 being

“extremely difficult”), the 40 law

enforcement and epidemiologic/

ethnographic sources rate it at less

than 1. Specifically, undercover police

find it not difficult at all to purchase

marijuana in 9 sites and fairly easy to

purchase in another 10 sites. Only in

Philadelphia, where police do not

make undercover marijuana buys,

does the law enforcement source

report, anecdotally, that it is moderately difficult to purchase marijuana.

Similarly, according to epidemiologic/

ethnographic sources, users find it

not difficult at all to purchase marijuana in half of the sites and fairly

easy to do so in the other half.

Crack is the second most easily purchased illicit drug at the street level.

According to undercover police, it is

easily obtained in Columbia (SC),

Denver, Los Angeles, New York, St.

Louis, and Washington, DC. Users 

can obtain crack easily in Baltimore,

Memphis, New Orleans, New York,

Philadelphia, and Washington, DC. At

the other extreme, it is most difficult to

purchase crack in Billings (for users)

and Sioux Falls (for undercover police).

Powder cocaine is easily purchased by

undercover police in the same six

sites as crack. By contrast, it is relatively difficult to purchase street-level

powder cocaine in Philadelphia and

Detroit. Users find it a bit more 

difficult than undercover police to

purchase powder cocaine, particularly

in Billings and Washington, DC.

Heroin is also relatively easy to 

purchase on the street, but slightly

more difficult than crack or powder

cocaine, according to law enforcement sources. Undercover purchases

are not difficult at all in five sites,

while, by contrast, it is difficult to

purchase heroin undercover in

Billings and Philadelphia and 

extremely difficult in Sioux Falls. The

difficulty in purchasing drugs in

Philadelphia results from that city’s

recent Operation Safe Streets, which

has disrupted the more than 200

open-air drug markets. Users, on

average, purchase heroin with more

difficulty than crack, but with less 

difficulty than powder cocaine.

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

Law enforcement respondent, EEpidemiologic/ethnographic

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

Exhibit 1.

How difficult is it for undercover

police and users to buy drugs?

(Averages, 0–10 scale) Extremely difficult Not difficult at all

Marijuana

Mean

Crack Powder

Cocaine

Heroin Meth

10

9

8

7

6

5

4

3

2

1

0

UsersE (N=20)

Undercover policeL (N=20)

A LOOK AT LOCAL DRUG MARKETS✛

Source: Law enforcement (L) and 

epidemiologic/ethnographic (E) respondents
SPECIAL TOPIC: A LOOK AT LOCAL DRUG MARKETS

page 10 Pulse Check: November 2002

Of the five drugs discussed, methamphetamine is the most difficult to 

purchase and has the most variability

across the 20 sites. Every degree of

difficulty (from 0 through 10) is

reported. At the two extremes, it is

easiest to purchase methamphetamine

in Honolulu, Los Angeles, Memphis,

and Sioux Falls, and it is most difficult

to purchase it in Boston and Chicago.

Is there any particular day,

week, or month that local drug

markets seem more active? Four

themes emerge in discussions about

time-related increases in market activity: personal income, weekends and

holidays, police presence, and supply. 

" When personal income goes up:

Law enforcement sources in seven

sites—Billings, Columbia (SC), 

Memphis, New Orleans, Philadelphia, Seattle, and Washington,

DC—note that market activity

appears to increase at times of the

month when people get paychecks

or Government checks, usually

around the 1st of the month, 

sometimes also around the 15th.

The Memphis source also notes an

increase around tax refund time.

Similar observations are made by

epidemiologic/ethnographic sources

in eight sites: Baltimore, Chicago,

Columbia, Denver, El Paso, Los

Angeles, Memphis, and New

Orleans. The El Paso source adds

that more people enter detox

toward the end of the month to tide

them over until more money

becomes available at the beginning

of the month and they can once

again buy their drugs of choice.

" On or before weekends and 

holidays: The Philadelphia law

enforcement source notes that 

markets appear more active on

Thursdays, Fridays, and Saturdays;

conversely, they are less active on

religious holidays. Similarly, in

Sioux Falls, markets appear more

active on weekends. In Miami too,

dealers sell on the street from

Thursday through Sunday, noon till

midnight. Individual dealers work

8-hour shifts during that time, with

“new guys” getting the late night

shift. Additionally, wholesale

cocaine sales tend to slow down in

Miami from late November to late

January, as distributors stock up so

that their inventory carries them

through the holidays. (This pattern, also reported in the last Pulse

Check, persisted this year, even

after September 11.) In Seattle,

where heroin and crack are less

available in the suburbs than in

downtown areas, market activity

increases on Fridays, when outsiders come into town for their

weekend supply of those two

drugs. Powder cocaine, marijuana,

and methamphetamine, however,

are available in the suburbs.

" Weekend or holiday increases are

also noted by epidemiologic/

ethnographic sources in several

sites. The Columbia, Denver, and

St. Louis sources associate

increased activity on weekends

with recreational drug use; the St.

Louis and Los Angeles sources

associate it with Friday paydays;

and the New York source notes

that outpatients in treatment take

their medications home on weekends. In Washington, DC, heroin

dealers do not sell on Sundays, but

then they run “specials” on

Exhibit 2. 

How difficult is it for undercover police (UP) and users (U) to buy specific drugs across the 20 Pulse Check cities?* 

City Heroin Crack Powder cocaine Marijuana Meth

UPL UE UPL UE UPL UE UPL UE UPL UE

Boston, MA 1 3 2 2 1 3 2 1 4 10

New York, NY 0 0 0 0 0 1 0 0 5 9

Philadelphia, PA 0/9** 1 0/6** 0 0/7** 7 4.5 1 7 9

Portland, ME 6 3 5 7 4 7 1 1 9 7

Baltimore, MD 4 0 2 0 2 0 1 0 8 NR

Columbia, SC 4 7 0 4 0 4 0 2 8 6

El Paso, TX 2 2 4 1 2 1 2 1 4 3

Memphis, TN 2 3 1 0 1 1 1 0 1 0

Miami, FL 1 2 1 1 1 0 1 0 9 5

New Orleans, LA 7 0 2 0 2 3 1 0 8 7

Washington, DC 0 0 0 0 0 10 0 0 5 NR

Chicago, IL 1 1 1 1 3 3 1 1 10 9

Detroit, MI 2 5 1 2 8 3 0 2 6 5

Sioux Falls, SD 10 8 9 8 5 7 2 0 2 0

St. Louis, MO 0 3 0 2 0 4 0 1 3 3

Billings, MT 9 10 5 10 4 10 0 1 0 3

Denver, CO 0 2 0 4 0 1 0 0 1 2

Honolulu, HI 4 5 1 4 2 7 0 0 0 2

Los Angeles, CA 0 2 0 2 0 6 0 0 0 2

Seattle, WA 4 1 4 1 3 1 2 1 4 1

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

*0–10 scale: 0 = not difficult at all; 10 = extremely difficult

**In Philadelphia, “0” ratings are wholesale, higher ratings are retail. Northeast South West Midwest
SPECIAL TOPIC: A LOOK AT LOCAL DRUG MARKETS

Pulse Check: November 2002 page 11

Monday, when users crave the

drug. The Detroit source notes

increased drug use during election

times, possibly because some users

are in a celebratory mode. In

Philadelphia, by contrast, it is more

difficult to get drugs, especially

marijuana, on election and primary

days, and 2 days beforehand,

because of increased police presence.

" When police presence is low: The

New York law enforcement source

notes that market activity increases

when police presence is low, as was

the case after September 11. Conversely, the Baltimore ethnographic

source notes that people avoid 

buying on the street on known law

enforcement “target days.”

" When supply is up: In Billings,

markets are more active when 

sellers get their drug shipments.

During this reporting period, has

there been a time when users

could not buy specific drugs?

Only a handful of sources report that

users had a hard time buying drugs at

any specific time:

" Boston, MAE

: The heroin supply

temporarily dried up in early 

winter, around January. Some users

speculated about possible relationship with the September 11 attacks.

This slight drought, however, was

followed by an increase in demand

and an upsurge in the sale of

weighed gram-sized rocks of heroin.

" Columbia, SCL

: Methamphetamine

was temporarily unavailable following the arrest of a clubgoing seller.

By the following weekend, a new

dealer had taken over.

" Denver, COL

: Following any big

bust, sellers tend to go underground briefly.

" Miami, FLL

: While no slowdown 

is reported during this period,

wholesale drug sales in Miami 

generally slow down during the

holiday season from late November

through late January. Dealers fill

up their inventories before the holidays, then sell from their inventories. Supply is also disrupted whenever a hurricane hits.

" St. Louis, MOE

: A few recent

seizures of “mom-and-pop” methamphetamine labs made it more

difficult for small circles of buyers

to get the drug. Methamphetamine

is still relatively new within that

city, as opposed to the surrounding

rural areas where it is more established, so any arrest or seizure creates a lull until new contacts are

made or new labs are set up.

Exhibit 3.

How difficult is it to buy heroin?

0

1

2

3

4

5

6

7

8

9

10

Baltimore, New Orleans, New York,

Washington, DC

Chicago, Philadelphia, Seattle

Denver, El Paso, Los Angeles, Miami

Boston, Memphis, Portland (ME), 

St. Louis

Undercover policeL UsersE

Detroit, Honolulu

Columbia (SC)

Sioux Falls

Billings

Denver, Los Angeles, New York,

Philadelphia (wholesale), St. Louis,

Washington, DC

Boston, Chicago, Miami

Detroit, El Paso, Memphis

Baltimore, Columbia (SC), Honolulu,

Seattle

Portland (ME)

New Orleans

Billings, Philadelphia (retail)

Sioux Falls

Not

difficult

at all

Extremely

difficult

Source: Law enforcement (L) and epidemiologic/ethnographic (E) respondents
SPECIAL TOPIC: A LOOK AT LOCAL DRUG MARKETS

page 12 Pulse Check: November 2002

" Philadelphia, PAL

: Law enforcement reports that Operation Safe

Streets has made it more difficult

for users to obtain drugs. 

" Portland, MEL

: Occasionally, when

the source’s supply is out, buyers

cannot find any crack. These

episodes run in streaks.

" Sioux Falls, SDL

: Crack and 

powder cocaine are periodically

unavailable.

How do street-level dealers 

communicate? (Exhibit 5) Law

enforcement sources report beepers

and cell phones as the most common

means of communication between

dealers and their buyers, suppliers,

and fellow dealers. Regular telephones (mentioned in seven sites) are

less common than cell phones: they

are mentioned more often in dealerto-dealer communications rather than

in dealer-supplier or dealer-buyer 

contexts, and they are sometimes

used in rural areas, such as parts of

Portland (ME), where cell phones

don’t always work. Phone cards are

used at all market levels in Miami.

Some New York dealers use the

Internet to communicate with 

fellow dealers, while Miami dealers

use the Internet for both dealer-todealer and dealer-to-supplier communications, and Memphis dealers use it

to communicate with buyers. Walkietalkies are used among dealers in

Memphis. Hand signals are sometimes used in areas with open street

markets, such as Baltimore and

Philadelphia. Word of mouth is mentioned in Chicago (dealer-to-buyer),

Los Angeles (dealer-to-dealer and

dealer-to-buyer), Memphis (dealer-todealer and dealer-to-supplier), New

Orleans (dealer-to-buyer), and New

York (dealer-to-dealer). 

Dealers meet face-to-face with other

dealers in Chicago, New Orleans, and

Washington, DC; with their suppliers

in Chicago, Denver, and Memphis;

with their buyers in Baltimore,

Columbia, Detroit, Honolulu,

Memphis, New York, Phildelphia, St.

Louis, Seattle, and Washington, DC;

and to supplement electronic communication at all levels in Philadelphia.

Face-to-face contact between dealers

and buyers sometimes occurs at prearranged meetings sites (as in Detroit

and Memphis) or at well-known street

locations (as in Columbia, New York,

and Washington, DC). In New York,

suppliers contact dealers, but dealers

generally do not contact suppliers. 

How do dealers transport drugs

to their selling locations? Motor

vehicles, usually personal cars, are the

most frequently mentioned means of

moving drugs, according to the vast

Exhibit 4.

How difficult is it to buy methamphetamine?

0

1

2

3

4

5

6

7

8

9

10

Not

difficult

at all

Extremely

difficult

Undercover policeL UsersE

Honolulu, Los Angeles

Memphis, Denver

Sioux Falls

St. Louis

Boston, El Paso, Seattle

New York, Washington, DC

Philadelphia

Baltimore, Columbia (SC), New Orleans

Detroit

Miami, Portland (ME)

Chicago

Memphis, Sioux Falls

Seattle

Billings, El Paso, St. Louis

Denver, Honolulu, Los Angeles

Detroit, Miami

Columbia (SC)

New Orleans, Portland (ME)

Boston

Chicago, New York, Philadephia

Source: Law enforcement (L) and epidemiologic/ethnographic (E) respondents
SPECIAL TOPIC: A LOOK AT LOCAL DRUG MARKETS

Pulse Check: November 2002 page 13

majority of law enforcement sources.

Other vehicles mentioned include

planes (Seattle), rental cars (Portland,

ME), taxi cabs (Columbia, SC),

motorcycles (Philadelphia), trucks

(Memphis, Philadelphia), coach bus

(Billings), bikes (Honolulu and

Philadelphia), and “trapped vehicles”

(vehicles with secret compartments)

(Philadelphia). Some dealers carry

their drugs on their persons, as in

Baltimore, El Paso, Chicago, and

Sioux Falls. Foot traffic is mentioned

in Chicago, Los Angeles, Philadelphia,

and Seattle. Goverment and private

shipping and express mail services are

mentioned in Memphis. Dealers in

some cities, such as Columbia, sometimes use a third party, such as a girl

friend who is not actively involved in

selling, to transport their drugs.

What else, besides cash, do

dealers accept in exchange for

drugs? (Exhibit 6) Dealers in 16 

of the 20 Pulse Check cities accept

mostly cash in payment for drugs.

Occasionally they accept other modes

of payment, such as sex, property or

merchandise, other drugs, drug transport, and other items or services.

Such alternative payment modes are

even more common than cash in 

four cities: Columbia (SC), El Paso,

Honolulu, and Memphis.

Sex is sometimes traded for drugs in

all 20 sites, and property or merchandise is sometimes accepted as payment

in nearly every site. Specified items

include fenced goods (in Denver,

Philadelphia, and Seattle), stolen

property (in Portland [ME] and Los

Angeles), jewelry and audio equipment (in Philadelphia), shoplifted

merchandise or groceries (in El Paso

and Miami), precursor chemicals (in

Denver, in exchange for methamphetamine), and vehicles (in Memphis).

Guns are mentioned in Baltimore and

Philadelphia, and Food Stamps are

mentioned in New Orleans and

Seattle. In El Paso, users often get

their drugs in exchange for bikes,

toys, other children’s holiday gifts

(including those donated by charitable organizations), and even holiday

turkeys. In nine cities, mostly in the

South and West, specific drugs are

sometimes traded for other drugs. 

Users in half of the cities sometimes

transport other drugs in exchange for

their own drugs. For example, “ponying” is common in El Paso, where

users act as mules, bringing drugs

from Mexico and keeping a portion

of the drugs for themselves.

Similarly, in Washington, DC, some

users work for their dealer, selling

drugs in exchange for their own

drugs. In Portland (ME), heroin users

support their habits by buying more

heroin in nearby Massachusetts areas

and then selling it locally. Sometimes

users steal their drugs, as reported in

seven sites, including Portland, where

OxyContin® is sometimes obtained

via pharmacy break-ins. 

Services are occasionally exchanged

for drugs. For example, in Chicago

and Detroit, drug “shoppers” get to

keep a portion of the drugs they buy

for other users. Also in Detroit in

exchange for drugs, some people (“hitters”) inject other users with hard-tofind veins, and some act as “lookouts.”

What happens to the cash 

collected by street dealers? Law

enforcement sources report a wide

range of cash-related activities—from

sophisticated money laundering 

operations down to dealers simply

“spending it” (as in Billings)—depending on the city and the dealer level. 

Money laundering is mentioned in

Boston, Memphis, Miami, and

Exhibit 5. 

How do dealers and buyers communicate?

Buyers

Dealers

Face-to-face Baltimore, Columbia (SC), Detroit, Honolulu, Memphis,

New York, Philadelphia, St. Louis, Seattle, Washington, DC 

Cell phones/Pagers Boston, Columbia, Denver, Detroit, El Paso, Los Angeles,

Miami, Philadelphia, Seattle 

Telephone Baltimore, Denver, Honolulu, Portland (ME), St. Louis 

Word of mouth Chicago, Los Angeles, New Orleans 

Couriers Philadelphia 

Hand signals Philadelphia 

Internet Memphis 

Phone cards Miami

Sources: Law enforcement respondents
SPECIAL TOPIC: A LOOK AT LOCAL DRUG MARKETS

page 14 Pulse Check: November 2002

Portland (ME). Miami is a particular

attraction because it is a tremendous

financial center, with many international banks, and because it is a vacation spot where dealers can combine

business with pleasure. Several techniques are used in that city: (1) a black

market peso exchange—dealers use

street drug money to purchase 

computers, appliances, and other

electronics from small businesses

around the airport area, then they

export the items to Colombia, where

a black market shopping center sells

them to the public; (2) wire transfers

and moneygrams; (3) rental cars used

for driving cash to Mexican border

areas in Texas or California; (4) 

off-shore banking; and (5) ATM

transactions—cash is deposited at

local locations and withdrawn from

machines in Colombia.

In Boston, some Dominicans launder

money through small storefront 

businesses. In nearby Portland, one

person was recently indicted on 170

counts of laundering money acquired

from selling marijuana. Most drug

money in that city, however, goes to

support the individual sellers’ habits

or else to “re-up” their supplies

acquired on trips to nearby areas,

such as Lawrence and Lowell (MA),

parts of New Hampshire, and New

York City.

As in Portland, street dealers in other

cities often use their cash to pay off

their suppliers or re-up their supplies,

thus perpetuating the cycle. Any leftover cash becomes profit, often used

for entertainment, as reported in St.

Louis. The Baltimore sellers hold

onto the cash for a while until they

have an amount substantial enough to

take to their suppliers. The Columbia

sellers transfer cash to their suppliers

(who are located in Texas or California

if they supply marijuana) using several techniques: they wire the money;

they use air and train travelers; or they

send express-mail packages of items

filled with cash (such as shoes).

Express mail services are also used by

higher level dealers in Sioux Falls.

Within many cities, money is passed

from one dealer level to the next one

up via several techniques. In Philadelphia, for example, cash passes

from buyer to “case worker” to

“manager” to higher leader via 

cars, hand-to-hand exchange, bikes,

motorcycles, or dropoffs at safe locations. Higher level dealers then use

the money to buy real estate, buy

Exhibit 6. 

What else, besides cash, is exchanged for drugs?

Mostly Property/ Sex Other Transport Steal the Other

Regions cash Merchandise drugs drugs drug

Boston, MA $ $$

New York, NY $ $ $$ $ $

Philadelphia, PA $ $$ Guns

Portland, ME $ $$ $ $

Baltimore, MD $ $$ $ Guns

Columbia, SC $

El Paso, TX $ $$ $ $ Charity gifts; shoplifted merchandise

Memphis, TN $ $$ $ $

Miami, FL $ $ $$ Stolen/shoplifted merchandise/groceries

New Orleans, LA $ $ $$ $ Food Stamps

Washington, DC $ $$ $

Chicago, IL $ $ Drug buying services

Detroit, MI $ $ $$ $ “hit” other user’s vein; 

buy/lookout for other users

Sioux Falls, SD $ $$

St. Louis, MO $ $$ $ $

Billings, MT $ $$

Denver, CO $ $$ $ $ Precursors

Honolulu, HI $ $$

Los Angeles, CA $ $ $$

Seattle, WA $ $ $$ $ Food Stamps

West Midwest South Northeast

Source: Law enforcement (L) and epidemiologic/ethnographic (E) respondents
cars, or make wire transfers and bank

deposits. In El Paso, cash from heroin

sales works its way from the buyer

through the various levels and eventually to Mexico via body carriers

and vehicles and, recently, with purchases of money orders. In Seattle,

money moves almost immediately,

within a small geographic area, to the

next tier of suppliers, usually carried

on someone’s person or by car or

bus. Multi-tiered passing of drug

money is also mentioned in Chicago,

Memphis, and New Orleans.

What deters street drug buys?

An intense and visible police presence

is, by far, the most effective, albeit

short-term, deterrent, according to

law enforcement and epidemiologic/

ethnographic sources. The other 

most commonly reported deterrents

are other police interventions (such 

as anti-terrorist activities), media 

coverage, overdoses, supply or

demand changes, neighborhood

changes, and legislative/sentencing

changes.

Several sources suggest additional

deterrent measures that might be

effective in their communities’ 

future efforts:

" Baltimore, MDL

: Knock down

abandoned buildings. 

" Chicago, ILE

: Find legitmate jobs

for people who sell drugs.

" Los Angeles, CAE

: Make large

local-level busts to force dealers

indoors or stay low key.

" Memphis, TNE

: Increase media

coverage of drug-related crime 

to make more people afraid to 

buy drugs.

" Portland, MEL

: Use the existing

joint task force, which includes

nearby Lawrence and Lowell,

Massachusetts, to increasingly 

target suppliers from those areas.

" St. Louis, MOE

: Target prevention

efforts toward specific drugs, specific populations, and specific geographic areas.

" Sioux Falls, SDL

: Give classes on

methamphetamine lab detection to

different community groups; try to

get a precursor law that parallels

the Federal law.

How have recent targeted law

enforcement or legislative policy

directives or initiatives impacted

on communities’ drug problems?

Law enforcement and epidemiologic/

ethnographic sources report a range

of recent initiatives, particularly those

involving new precursor laws and

other efforts targeting methamphetamine. Other widely reported efforts

include targeting diverted

OxyContin®, rescheduling other

drugs, enacting stricter sentencing

guidelines, and diverting offenders

into treatment.

How can local drug market 

activity be disrupted in the

future? Pulse Check law enforcement

sources suggest a wide range of possible strategies. While these individual

opinions do not reflect the views of

any government entity, they might be

of interest to decisionmakers and 

policymakers at the local, State, and

Federal levels. 

" Alter courts’ focus to emphasize

dealers, not users (for example,

expand drug courts and in-custody

treatment opportunities).

" Identify new legal drugs with abuse

potential, and place them on the

controlled list within 6 months.

This strategy works better at the

Federal level, where sanctions tend

to be more punitive, than at the

State level.

" Target out-of-State suppliers,

because arresting local suppliers

and dealers has a short-term effect.

" Map drug calls-for-service to help

pinpoint locations for law enforcement activities.

" Increase community involvement.

" Enact more precursor laws at the

Federal and State levels.

" Adopt stricter mandates and 

penalties for smaller drug dealers.

" Tax convicted drug dealers.

" Change local nuisance abatement

laws to require more convictions

over longer time periods.

" Strengthen existing laws to ensure

that dealers are not released on

technicalities.

SPECIAL TOPIC: A LOOK AT LOCAL DRUG MARKETS

Pulse Check: November 2002 page 15

Dealers dispose of cash from drug

sales in many ways, according to

law enforcement sources in many

Pulse Check cities...

➤ Money laundering: Boston,

Memphis, Miami, Portland (ME)

➤ “Re-upping” supplies: Baltimore,

Columbia (SC), Honolulu, Los

Angeles, Portland (ME), Sioux Falls,

and St. Louis

➤ Entertainment: St. Louis

➤ Passing money up the supply ladder:

Chicago, El Paso, Memphis, New

Orleans, Philadelphia, and Seattle
SPECIAL TOPIC: A LOOK AT LOCAL DRUG MARKETS

page 16 Pulse Check: November 2002

Recent deterrents in specific Pulse Check communities...

An intense and visible police

presence is, by far, the most effective, albeit short-term, deterrent,

according to sources in 12 cities:

Such a presence usually involves 

uniformed police or marked units.

For example:

Other police interventions:

Other types of police interventions, such as the following, 

have had deterrent effects in 

some cities.

Media coverage: 

Deterrent effects have been 

noted after the following.

➤ New York, NYL: When police presence declines, drug activity increases, as was the case 

immediately after September 11. 

➤ Philadelphia, PAL,E: The recent Operation Safe Streets project to deter drug market activities has

placed uniformed police at more than 200 open-air corners. The effort has already had an

impact—a decrease in outdoor drug sales and fewer potential buyers coming from Delaware,

South New Jersey, and suburban Philadelphia areas. Sources report it is now easier to obtain

larger wholesale-level quantities than smaller quantities. 

➤ St. Louis, MOL,E: Police periodically target low-level dealers and arrest them all at the same

time—a recent sweep, for example, focused on methamphetamine. 

➤ Seattle, WAL,E: Such saturation takes two forms: in one organized semiannual interjurisdictional

effort to disrupt the illegal drug market, a large number of uniformed police move into areas

known for illegal drug activity; in a more episodic, spontaneous response to local merchants’

complaints, an increased police presence is used to displace buyers and sellers, causing specific

drug sales activities to be curtailed, at least temporarily. 

➤ Baltimore, MDL

; Billings, MTE; Los Angeles, CAL; and El Paso, TXL: Undercover operations

➤ Columbia, SCL

: An ongoing community-based operation involving an undercover officer

assigned to make buys for a 1-month period, then arrest and issue sealed indictments to 

15–20 sellers at a time

➤ El Paso, TXL

: An undercover rave operation in December that stopped the spread of raves 

from New Mexico

➤ Memphis, TNL

: Large sting operations; interdiction of outgoing parcels; increased intelligence

on traffickers; anti-terrorist and money laundering operations and drug distribution operations

➤ Miami, FLE

: A Federal and State coordinated effort to “clean up” cargo smuggling on the Miami

River (While successful, it has also dispersed that type of trafficking to other small ports).

➤ New Orleans, LAL

: Reverse stings 

➤ St. Louis, MOE

: Increased surveillance activity along Highway 44 (main connection to Mexico) 

➤ Boston, MAL

: Names of actual buyers and sellers published in newspapers

➤ Memphis, TNE

: Media coverage of drug-related shootings (some involving young children) and

methamphetamine lab seizures

➤ Miami, FLE

: News stories about crack-sales-related violence 

➤ Portland, MEL

: A series of special articles on heroin, publicity about major arrests, and stories

about recent methadone overdoses 

➤ Philadelphia, PAL

: Press stories about arrests

➤ Sioux Falls, SDL

: Media publicity of recent drug busts 

BaltimoreL,E

BostonL,E

ChicagoL

DenverE

DetroitL,E

El PasoL,E

MemphisL

New OrleansL,E

New YorkL,E

PhiladelphiaL,E

St. LouisL,E

SeattleL,E
SPECIAL TOPIC: A LOOK AT LOCAL DRUG MARKETS

Pulse Check: November 2002 page 17

Recent deterrents in specific Pulse Check communities (continued)...

A rash of overdoses: 

The “scare” effects of recent 

overdose outbreaks are reported

in several cities.

Supply/demand changes:

Availability, price, and cash 

flow have had deterrent 

effects in some cities.

Neighborhood changes:

Overt drug activity has declined

in some cities following changes

in the physical environment. 

Anti-terrorist activities:

Drug-deterrent side effects 

are sometimes noted.

Other deterrents:

➤ Boston, MAL

: Increases in overdoses have been a deterrent.

➤ Columbia, SCE

: A recent increase in overdoses and overdose deaths, resulting from heroin being

mixed with pure fentanyl, slowed down heroin purchases for a period of time. 

➤ El Paso, TXE

: Six heroin overdoses during the Mardi Gras season frightened some users into

switching to other drugs or buying from other dealers. 

➤ Portland, MEL,E: Heroin purchases slowed down following a dramatic increase in overdoses

among the newer OxyContin® addicts who were switching to heroin. (These addicts had not

built up the tolerance of old-time users, and they lacked an understanding about unpredictable

heroin purity.) 

➤ St. Louis, MOE

: GHB is now rarely reported since a series of deaths 2 years ago.

➤ Baltimore, MDE

: Lack of availability

➤ Columbia, SCE

: Periodic increases in marijuana prices

➤ New Orleans, LAE

: Buyers’ periodic lack of cash

➤ St. Louis, MOE

: Price increases

➤ Boston, MAE

: Revitalization of neighborhoods, with businesses coming in, economic prosperity,

and improved appearance

➤ Boston, MAL

: Neighborhoods known to be strict 

➤ Chicago, ILE

: Gentrification of neighborhoods 

➤ Miami, FLL

: Nuisance abatement laws in nearby Ft. Lauderdale make property owners 

responsible for criminal activity. These laws are part of their city revitalization program, 

which approaches crime prevention through environmental design.

➤ El Paso, TXL,E: Shutting down bridges, checking cars, and heavy border patrols after September

11 had an immediate but short-lived effect on drug sales and trafficking.

➤ Los Angeles, CAE

: Narcotics officers have been deployed to anti-terrorism efforts since

September 11.

➤ Portland, MEE

: The Canadian border has been tightened up since September 11.

➤ Memphis, TNL

: In looking for terrorist activities, police are stumbling on drug operations.

➤ Washington, DCL,E: Tightened security since September 11 has also helped catch drug 

traffickers and dealers. On the other hand, dealers might be more brazen because they perceive

that police have been diverted to anti-terrorism efforts. 

➤ Baltimore, MDL

: Using video cameras; changing two-way streets into one-way streets in order to

make it more difficult to get to normal dealing locations 
" Conduct street corner conspiracy

investigations: have undercover officers make buys at one location from

several people on several occasions;

“follow the money” from runners

to liaisons, to higher-ups, to money

collectors, and so forth; charge all

parties, not just those in possession;

once the number of street dealers is

depleted at a location, have other

city and community agencies “clean

up” the area; maintain an increased

police presence.

" Continue public education activities, such as press releases and

other efforts to increase media

attention.

" Maintain a proactive approach to

enforcement at the local level, 

similar to national-level agencies

like the DEA or HIDTA.

" Expand drug courts and in-custody

treatment.

The 20 Pulse Check epidemiologic/

ethnographic sources were asked what

gaps or challenges, if any, they perceive in their specific communities’

current law enforcement efforts. These

individuals offered several recommendations, including the following:

SPECIAL TOPIC: A LOOK AT LOCAL DRUG MARKETS

page 18 Pulse Check: November 2002

Recent initiatives have had impact in many Pulse Check cities...

New precursor laws and 

other efforts targeting 

methamphetamine:

Stricter sentencing: 

➤ Billings, MTE

: The area was recently designated as a methamphetamine high traffic area, enabling law

enforcement to receive more funding.

➤ Boston, MAE

: The precursor law has changed.

➤ Denver, COE

: Since a recent precursor law change, an offender can be arrested for only one or more

precursors and does not have to be cooking them. 

➤ Detroit, MIE

: A methamphetamine task force was recently formed.

➤ Los Angeles, CAE

: A new system targeting methamphetamine precursors limits the number of overthe-counter purchases and alerts the DEA to large-quantity purchases. Also, law enforcement efforts

targeting farm robberies are aimed at methamphetamine manufacturers who rob fertilizer supplies

from farms.

➤ St. Louis, MOE

: Many efforts against precursor chemicals (not particularly new), such as laws and

training of pharmacy staff about bulk purchases of cold medicines, have made it more 

difficult for people to cook methamphetamine, especially in rural areas.

➤ Seattle, WAE

: A methamphetamine task force has raised citizen awareness about sights and 

smells that help locate labs in their own neighborhoods.

➤ Seattle, WAL

: New methamphetamine precursor legislation, passed during the January–April 

statewide session, has increased the number of prohibited or restricted precursors.

➤ Sioux Falls, SDE

: A methamphetamine awareness campaign includes community education. 

The recent increase in lab seizures may be due to the community’s heightened awareness about what

to look for. 

➤ Boston, MAE

: GHB has become a scheduled drug.

➤ Denver, COE

: GHB has recently become a Schedule I drug.

➤ Detroit, MIL,E: Ecstasy is now a Schedule I drug, with increased penalties for possession with 

intent to deliver. 
SPECIAL TOPIC: A LOOK AT LOCAL DRUG MARKETS

Pulse Check: November 2002 page 19

Recent initiatives have had impact in many Pulse Check cities (continued)...

Efforts targeting diverted

OxyContin®: 

Rescheduling of drugs: 

Diversion to treatment: 

Other community efforts: 

➤ Columbia, SCE

: During a 4-month period while legislation removed OxyContin® from the Medicaid

extension list, the number of clients abusing that drug declined. However, when the policy was

rescinded or relaxed, the number rebounded and then surpassed earlier numbers.

➤ Philadelphia, PAL

: Government rescheduling of diverted OxyContin®, and punitive action such as

sentencing the infamous “Dr. Oxy” to 30 years in jail, have stopped the momentum.

➤ Portland, MEL,E: Numerous efforts regarding diverted OxyContin®, such as changes in prescription

policies and educating prescribers, have caused declines since last year in the number of prescriptions

and in the size of pharmacy stock. Consequently, availability of the diverted drug is down and prices

are up. However, while these measures have affected buys, they have not affected use: some newer

users have been switching to heroin. 

➤ Detroit, MIL,E: Harsher sentences for trafficking large amounts of crack (more than 650 grams) has

helped jail big dealers for life; however, now most traffickers avoid this law by dealing with smaller

quantities. 

➤ Miami, FLL

: Stricter sentencing guidelines about 3 years ago resulted in the disappearance of 

flunitrazepam (Rohypnol) and the decline in dealers using firearms. A Weed and Seed program has

lowered prosecution criteria to 5 grams, allowing prosecution of habitual drug dealers and preventing

small dealers from falling through the cracks.

➤ Honolulu, HIE

: A recent State Senate bill calls for diverting nonviolent first-time drug offenders into

treatment. Not enough treatment slots, however, are available to do so.

➤ Los Angeles, CAE

: Data regarding the impact of Proposition 36, which diverts nonviolent offenders

from incarceration to treatment, will be analyzed after the county’s different data systems are 

linked up. 

➤ Memphis, TNE

: A new alcohol and other drugs program for misdemeanor drug charges is expected

to have a dramatic impact. 

➤ Los Angeles, CAE

: The Los Angeles Police Department’s Narcotic Hotline and the Mayor’s “We Tip”

program provide for confidential reporting of drug activity in specific communities.

➤ Portland, MEE

: Methadone clinics are now open 7 days a week. Previously, when clinics had been

closed on Sundays, some clients who got extra doses on Saturday ended up selling them. 

" Continue joint cooperation among

various law enforcement and 

public health entities.

" Increase funding, staffing, and

resources for various activities,

such as: sustained police patrols;

targeted efforts for prevention,

education, and outreach; comprehensive data monitoring efforts;

and research on trends, services,

and policy.

" Simultaneously address the 

interrelated issues of illegal drugs

and terrorism.

" Address treatment issues in 

conjunction with law enforcement

efforts.

" Deal with problems unique to 

individual communities’ geographic

location, economic situation, and

legislative policies.

" Pay more attention to diversion

and illicit sales of prescription

products.
SPECIAL TOPIC: A LOOK AT LOCAL DRUG MARKETS

page 20 Pulse Check: November 2002

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DRUG TREATMENT ISSUES

Pulse Check: November 2002 page 21

DRUG TREATMENT ISSUES

How available is methadone

treatment in Pulse Check communities? Methadone maintenance

is still not available in Billings or

Sioux Falls. As reported in the past

two Pulse Check issues, about half of

the epidemiologic/ethnographic

sources in the remaining cities—

mainly in the South—consider

methadone to be available in selected

areas only, while the other half consider it available throughout their

areas. Four sources (in Baltimore, Los

Angeles, Seattle, and Washington, DC)

report that methadone maintenance is

somewhat more available since the

last Pulse Check. 

Five epidemiologic/ethnographic

respondents report adequate capacity

of public methadone maintenance,

while seven (in Baltimore, Chicago,

Detroit, El Paso, Honolulu, St. Louis,

and Seattle) report having waiting

periods of 1–12 months. Since the

last Pulse Check, public methadone

maintenance capacity has decreased

somewhat in Chicago. Private capacity,

however, has increased in four cities

(Memphis, Miami, New Orleans, and

Portland [ME]), although waiting lists

are reported by six sources.

How has drug abuse impacted

the health of clients in treatment? (Exhibit 1) Since the last Pulse

Check reporting period, the impact of

drug use on AIDS and HIV status

seems to have stabilized in the majority of methadone and non-methadone

programs, except as listed in exhibit 1.

By contrast, reported cases of hepatitis C continue to increase among drug

users in programs across the Nation,

nearly always because of increased

screening and awareness. High-risk

pregnancies, drug-related auto 

Exhibit 1. 

How has illicit drug use impacted the health of users? 

City/Source Adverse Comments

Conequence

Baltimore, MDN

Billings, MTN

Philadelphia, PAM

Seattle, WAM Increased particularly among Blacks and those who inject 

Washington, DCN Mostly due to unprotected sex and prostitution among 

drug users 

Columbia, SCM

Portland, MEN Heroin increased in potency so injection declined. 

Baltimore, MDM,N Unsafe sex, sharing needles

Billings, MTN Sharing needles

Boston, MAN More testing; 85 percent of patients are positive 

Chicago, ILM More testing; about 75 percent of clients are positive 

Denver, COM,N More testing; 70 percent of clients are positiveM; many clients

were originally diagnosed with hepatitis B, but have been

retested with more sensitive tests that indicate hepatitis C 

El Paso, TXN Increases in injecting

Los Angeles, CAM More testing has resulted in higher reported rates of hepatits C 

Miami, FLM More testing has resulted in higher reported rates of hepatits C 

Philadelphia, PAN More testing has resulted in higher reported rates of hepatits C

Portland, MEM,N More testing has resulted in higher reported rates of hepatits C

St. Louis, MOM,N More testing; large problem, especially among people 

older than 40

Seattle, WAN

Washington, DCM

Memphis, TNM

Billings, MTN

Columbia, SCM

Washington, DC

Billings, MTN

El Paso, TXM Clients are having unsafe sex and contracting STDs. 

Los Angeles, CAM

Seattle, WAN

St. Louis, MOM More women are presenting at hospitals.

Washington, DCN Increasing, especially among young adults

Columbia, SCM

Billings, MTN Related to prescription opiates, especially OxyContin® and

methamphetamine; stronger methamphetamine now

available and causing ODs

Columbia, SCN,M Increases in drug combinations, especially alcohol and

prescription pills, such as alprazolam (Xanax®) or 

hydrocodone (Vicodin®)

Philadelphia, PAN Higher quality of heroin available

Portland, MEM,N Increases in the combination of drugs including heroin, 

crack, and benzodiazepines

St. Louis, MOM

Philadelphia, PAM

Baltimore, MDN Related to crack and nicotine use 

Boston, MA 

Columbia, SCM

Memphis, TNM

St. Louis, MOM

HIIV/AIDS Hepatitis C Overdoses High-Risk Pregnancies Auto Accidents Tuberculosis (TB)

Sources: Methadone and non-methadone treatment providers
accidents, and overdoses (usually

involving a combination of drugs)

increased in several cities, but most

levels remain stable. Tuberculosis 

(TB) has decreased in four cities 

and increased only in Baltimore.

What barriers face drug treatment in Pulse Check cities?

(Exhibit 2) Methadone and nonmethadone treatment programs across

the country report many barriers to

drug treatment. The most commonly

mentioned barriers are limited slot

capacity (a situation often caused by

lack of funding), lack of trained staff

to treat comorbid mental health disorders, and violent behavior among

presenting clients. Several sources (in

Chicago, Honolulu, Los Angeles,

Portland [ME], St. Louis, and Seattle)

report that funding has recently been

cut, which has decreased slot capacities and increased waiting lists. Other

common barriers to treatment include

lack of transportation for potential

clients and difficulty recruiting

trained staff. Many programs cannot

treat clients younger than 18 years,

but these clients are often referred to

programs designed especially for adolescents. 

Have diagnoses of psychiatric

comorbidity been shifting in

treatment programs? Mood 

and conduct disorders are the most

commonly reported mental health

diagnoses among drug treatment

clients, according to Pulse Check

respondents. These types of diagnoses

are generally stable, but increased levels or stable-at-high levels are reported in several cities:

DRUG TREATMENT ISSUES

page 22 Pulse Check: November 2002

Exhibit 2.

What are the barriers to drug treatment in different Pulse Check cities?

Baltimore, MD !!! The program has 56 vacant slots but 545 Difficulty recruiting trained staff due to

on the waiting list. It is difficult to compete change in the certification processM; lack of

with private treatment programs’ salaries comprehensive servicesM; lack of transportfor trained staffM. ation or money for transportationN

Billings, MT !!! This program lacks licensed addiction 

counselorsN. Disruptive behavior disorders,

especially among younger clients, seem

to be increasing and problematicN.

Boston, MA ! ! This program turns away about 25 potential Difficulty recruiting trained staffM ; lack of 

clients plus 3 drug treatment requests from recovery homes in the Boston areaN

jails per weekN.

Chicago, IL !!! The Illinois Department of Public Aid is Lack of transportation or money for 

cutting transportation by 75 percentM. transportationM,N; lack of medical doctorsM;

Violence occurs if one particular gang is gang affiliation among clientsN

overrepresented within the program.N

Columbia, SC ! ! These programs are hiring more staff within 

the next 6 months, so slot capacity should 

become more adequateM,N. 

Denver, CO ! ! Demand outweighs resources for this 

program, and the funding is perceived as

inadequateN. Treatment programs seem to 

have either substance abuse or mental 

health treatment services, but there is 

not enough overlapN.

Detroit, MI ! Lack of trained staffM

El Paso, TX ! ! More money and staff are needed to help 

with more clientsM.

Lack of

Limited trained

slot staff to Violent

capacity/ treat behavior Comments Other barriers

Waiting comorbid among City list clients clients
DRUG TREATMENT ISSUES

Pulse Check: November 2002 page 23

" Billings, MTN: Recent increases in

several diagnoses—including conduct disorder, psychosis, mood disorder, and suicidal thoughts and

attempts—reflect the overall increase

in the use of illegal drugs.

" Columbia, SCM: An increase in conduct disorders has resulted from

clients unhappy about being held

accountable for positive urinalyses.

" El Paso, TXN: An increase in conduct disorders among the younger

age group reflects improved diagnostic capabilities. An increase in

suicidal ideations is also noted.

" Memphis, TNN: Comorbidity is 

stable at high levels, reflecting a

major need for the community’s jail

system to triage with the mental

health system. Prisoners often

receive medication, such as antipsychotics, antidepressants, and mood

stabilizers, while in jail. Often,

however, they are released—

sometimes at 2:00 or 3:00 a.m.—

without discharge medications.

Within a week, these individuals

start decompensating. Some use

cocaine or marijuana to stabilize

their moods. Some end up in 

Exhibit 2. (continued)

What are the barriers to drug treatment in different Pulse Check cities? 

Honolulu, HI !!! Funding is low and has been cut Lack of fundingM

recently due to a poor economyN. 

Violent behavior among presenting 

clients is methamphetamine relatedN.

Los Angeles, CA ! ! Funding has been cut recentlyN. Lack of funding, especially among 

Comorbid disorders have been low-income adultsM; lack of English 

increasingN. language skills among students and parentsN

Memphis, TN ! Lack of resources for drugs that don't 

require medical detox (especially 

marijuana and crack)N

Miami, FL ! ! Funding is lowN. Lack of in-home treatment resourcesN; lack

of services to treat families as a wholeN

New Orleans, LA ! !

New York, NY !!! This program reports difficulty in hiring Clients unable to payM; lack of child 

trained staffM. Many violent clients are care for clientsM

mandated by the courts to participate in 

anger management coursesN.

Philadelphia, PA !!! This program employs one psychiatrist Low reimbursement ratesM

with limited time per week, so they refer

psychosis patients to mental health 

facilities that may lack expertise in 

substance addictionN.

Portland, ME ! ! This program reports chronic waiting listsN. 

The barrier of lack of trained staff to treat 

comorbid disorders is improvingN. 

St. Louis, MO ! ! Many State-funded detox services were Lack of State fundingN; lack of safe,

cut recentlyN. healthy, affordable, drug-free housingN

Seattle, WA ! One hundred people are currently wait- Lack of mental health services in the 

listed, and public subsidy slots have been countyM; lack of inpatient careM

filled since the beginning of yearM. In the 

last 6 months, capacity has been halved

due to funding cutsN.

Sioux Falls, SD ! Lack of fundingN; families not following 

recommendationsN

Washington, DC !

Lack of

Limited trained

slot staff to Violent

capacity/ treat behavior Comments Other barriers

Waiting comorbid among

City list clients clients
DRUG TREATMENT ISSUES

page 24 Pulse Check: November 2002

emergency departments and are

subsequently referred to treatment.

" St. Louis, MOM: Treatment staff are

more aware of dual diagnoses than

in the past and are working more

closely with mental health centers.

They are therefore increasingly

diagnosing conduct disorders,

mood disorders, and suicidal

thoughts and attempts.

" St. Louis, MON: The recent opening of an adolescent drug treatment

program has led to an increase in

diagnoses of conduct disorders.

Additionally, large funding cuts in

the private sector have led to more

people with drug-related psychosis,

schizophrenia, depression, and

bipolar disorders being referred to

this program.

" Seattle, WAM: An apparent increase

in comorbidity diagnosis numbers

actually reflects an increase in 

ancillary services.
HEROIN

Pulse Check: November 2002 page 25

HEROIN✛

Only seven sources in five cities

(Boston, Philadelphia, Portland [ME]

in the Northeast and Baltimore and

New Orleans in the South) consider

heroin the most commonly used drug

(methadone treatment sources are

excluded from that count because

heroin is nearly always the most commonly used drug in those programs).

However, heroin, more than any

other drug, contributes to the most

serious consequences—that is, medically, legally, societally, or otherwise—according to 31 sources in 15

cities: all four cities in the Northeast;

Baltimore, Columbia (SC), El Paso,

New Orleans, and Washington, DC,

in the South; Chicago, Detroit, and

St. Louis in the Midwest; and Denver,

Los Angeles, and Seattle in the West.

Compared with the last Pulse Check

reporting period, the non-methadone

treatment source in Washington, DC,

believes that heroin has replaced

crack as the drug contributing to the

most serious consequences, and two

sources in Portland believe that 

heroin has replaced pharmaceutical

opiates and diverted OxyContin®

(oxycodone hydrochloride controlledrelease) as the drug with the most

serious consequences. Similarly, heroin has replaced cocaine as the most

commonly used drug according to

sources in two southern cities: El

Paso and New Orleans. According to

the law enforcement source in

Portland, it has replaced marijuana as

the most commonly used drug.

HEROIN: THE DRUG

How available is heroin—in its

various forms—across the 

country? (Exhibits 1, 2, and 3)

More than half (23) of the 40 

Pulse Check law enforcement and 

epidemiologic/ethnographic sources

consider heroin widely available in

their communities. Sources in the

Northeast and South continue to

report wider heroin availability than

their counterparts in the Midwest and

West. Only four sources in two cities

(Billings and Sioux Falls) consider

heroin not or not very available.

As reported in the last several issues

of Pulse Check, high-purity snortable

South American (Colombian) white

heroin is the most common type,

especially in the Northeast. Mexican

black tar, a lower purity, injectable

heroin, follows as the most common

type and is widely available in most

western Pulse Check cities. Southwest

Asian heroin is the least available of

the types of heroin and is considered

widely available only in Chicago and

New Orleans. Southeast Asian heroin

is considered widely available only in

New Orleans, Portland (ME), and

Washington, DC.

Exhibit 1.

How available is heroin across the 20 Pulse Check cities (spring 2002)?

HEROIN

Seattle

Sioux

Falls

Memphis Columbia

New York City

Boston

Washington, DC

Portland

El Paso

Los

Angeles

Honolulu

Philadelphia

Miami

Detroit

Chicago

Baltimore

New

Orleans

Seattle

Sioux

Falls

Memphis Columbia

New York City

Boston

Washington, DC

Portland

Denver

El Paso

Los

Angeles

Honolulu

Philadelphia

Miami

Detroit

Chicago

Baltimore

New

Orleans

Billings

St.

Louis

Denver St. Louis

Billings

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

Widely Somewhat Not Very Not

Available Available Available Available

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

Law enforcement respondent, EEpidemiologic/ethnographic

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

According to law enforcement sources (N=20)...
Heroin availability remained stable

between fall 2001 and spring 2002,

according to the majority of law

enforcement and epidemiologic/

ethnographic sources. In Philadelphia,

availability declined, according to the

law enforcement source; however,

availability reportedly increased in six

sites across the country. Similarly, 

the various forms of heroin remain

generally stable in availability, with

exceptions listed in Exhibit 3. 

How pure is heroin across the

country? (Exhibit 4) Similar to

reports in the last Pulse Check,

according to law enforcement and

epidemiologic/ethnographic sources,

street-level South American heroin

ranges from 40 to 95 percent, with

both extremes reported in Philadelphia. Also, as reported in the last

Pulse Check, street-level Mexican

black tar heroin ranges in purity from

8 percent in Denver to 70 percent in

Billings. Purity levels remained stable

in most Pulse Check cities with a few

exceptions: they increased in two

northeastern cities (New YorkE and

Portland [ME]L,E), and they declined

in BaltimoreE and Los AngelesE.

A wide range of heroin adulterants

(especially lactose-based additives and

baby laxatives) continues to be

reported by law enforcement, 

epidemiologic/ethnographic, and

treatment sources, particularly in the

Northeast and South. Quinine is a

new adulterant (used to increase 

the heroin “rush”) since fall 2001

according to sources in several cities,

including Detroit, Portland, and

Washington, DC. Other adulterants

reported as new this reporting period

include cocaine in Portland, “Golden

Seal” and milk thistle (additives found

at health food stores) in St. Louis,

and meat tenderizer and flour in

Washington, DC. 

What are street-level heroin

prices across the country?

(Exhibit 4) As reported during the

last two reporting periods, one dose

(0.1 gram) sells for as little as $4 for

South American heroin in Boston to

as much as $120 for Mexican black

tar in Seattle. Sources report declining prices, especially for larger quantities of the drug, in six cities in the

Northeast and West: BaltimoreE (for

HEROIN

page 26 Pulse Check: November 2002

Exhibit 3.

Which heroin varieties have

changed in availability (fall 2001

vs spring 2002)?

Colombian

Boston, MAE

Chicago, ILL,E

Miami, FLE

Portland, MEL

Mexican black tar

Denver, COL

Los Angeles, CAL

Memphis, TNL

New York, NYL

Mexican brown tar

Denver, COL

Los Angeles, CAL

Memphis, TNL

Miami, FLE

Southeast Asian

Detroit, MIE

Memphis, TNL

Portland, MEE

Southwest Asian

Baltimore, MDL

Chicago, ILE

Detroit, MIE

New York, NYL

Portland, MEL

Colombian

Philadelphia, PAL

Mexican black tar

New York, NYE

Mexican brown tar

New York, NYE

Southeast Asian

Chicago, ILE

New York, NYE

Southwest Asian

New York, NYE

Exhibit 2.

How has overall heroin availability changed (fall 2001 vs

spring 2002)?

Boston, MA E

Columbia, SCE

Denver, COL

Memphis, TNL

Miami, FLE

Portland, MEL,E

Baltimore, MDL,E

Billings, MTL,E

Boston, MAL

Chicago, ILL,E

Columbia, SCL

Denver, COE

Detroit, MIL,E

El Paso, TXL,E

Honolulu, HIL,E

Los Angeles, CAL,E

Memphis, TNE

Miami, FLL

New Orleans, LAL,E

New York, NYL,E

Philadelphia, PAE

St. Louis, MOL,E

Seattle, WAL,E

Sioux Falls, SDL,E

Washington, DCL,E

Philadelphia, PAL
HEROIN

Pulse Check: November 2002 page 27

gram quantities), BostonE, HonoluluE

(for larger quantities), Los AngelesL,E,

MiamiL (for ounce quantities), and

Portland (ME)L,E. High-end prices

increased according to the epidemiologic source in Detroit.

How is heroin referred to across

the country, and how are brand

names and packaging used as

marketing tools? (Exhibit 5) As

reported in the last Pulse Check,

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

and are rarer in the Midwest and the

West. Slang terms often refer to the

heroin packaging: for example

“brown bag” refers to the packaging

in Memphis and “joint” refers to one

plastic bag of heroin in Washington,

DC. Often the slang term alludes to

Exhibit 4.

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

MOST COMMON STREET UNIT 1 GRAM

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

Baltimore, MDL,E pill, "10 bag," NR down $10 NR $100–$150

capsule down

Boston, MAL "bundle" 0.1 g ≥80% $4–$6 NR NR

Miami, FLL NR 1 oz NR $2,100/down NR NR

New York, NYE "bag" 0.1 g 70%/up $10 ≥70%/up $90–$100

New York, NYL "bag" NR 80–90% $10–$14 80–90% $60–$74

NR 1 oz 80–90% $2,000

Philadelphia, PAE "hit" NR 71% $10 NR NR

Philadelphia, PAL "bag" 0.3 g 40–95% $10–$20 70–75% $75–$300

"bundle" 10–13 bags 40% $100

Portland, MEL "bag" 0.1 g ≥70–75%/up $20–$25/down NR NR

Billings, MTL "bundle" 1 g 50–70% $260 50–70% $260

Denver, COE NR 1 oz 40% $2,000–$3,000 8–64% $100–$150

El Paso, TXE "dime," "deime" 2–3 person hit NR $2.50–$3 NR NR

El Paso, TXL NR 0.1 g NR $20 NR NR

Honolulu, HIE "paper" 0.25 g 25% $50–$75 25% $150–$200 

down

Honolulu, HIL "bundle" 0.1 g NR $50–$75 NR $150–$300

Los Angeles, CAE "Mexican ounce" 25 g down $600–$700/down 16–18%/down $90–$100

Los Angeles, CAL "balloon" 0.1 g NR $20/down NR NR

Memphis, TNE vial NR NR $25–$30 NR $100

Memphis, TNL NR 0.1 g NR $50 NR $400–$450

Seattle, WAE NR NR NR NR 15–25% $40–$65

Seattle, WAL NR 0.1 g 14–58% $90–$120 NR NR

Chicago, ILE "dime bag" NR NR $10 NR $50–$300

Chicago, ILL "hit" 0.2 g NR $20 NR $150

Columbia, SCL "bundle" 2 g NR $225 NR $125–$130

Detroit, MIE "hit" NR 20–70% $10 NR NR

"bundle" 10–12 hits 20–70% $100–$200

Detroit, MIL "dime" 0.1 g NR $10 NR $100–$150

New Orleans, LAE NR NR NR NR NR $300–$600

New Orleans, LAL "foil," "hit" 0.5 g 7% $20–$25 NR NR

St. Louis, MOE NR 1 g NR $100 NR $100

Washington, DCE "bone" (unadulterated) NR 40–80% NR NR NR

"bag" (white) NR NR $8, $10, and $20 23% $120–$150

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

Sources: Law enforcement and epidemiologic/ethnographic respondents

*Respondents in Sioux Falls did not provide this information. **Changes since fall 2001 are noted as "up" or "down."

NR=not reported South American white Mexican black tar or brown Unspecified type
HEROIN

page 28 Pulse Check: November 2002

the type of heroin sold: “tar,”

“black,” and “negra” (referring to

Mexican black tar heroin) are common slang terms in the South and

West, and “china” or “china white”

(referring to Southeast Asian powder

heroin) are common slang terms

reported in Billings, Chicago,

Honolulu, Los Angeles, and Memphis.

Dealers use brand names as marketing

devices so that buyers can recognize

heroin quality and return to that particular dealer for future sales. Brand

names tend to change often, especially if buyers recognize a particular

brand as low quality or if a dealer

suspects that law enforcement personnel are able to connect a heroin

brand to a dealer. During this reporting period, 7 new brand names were

reported in the Northeast (compared

with 18 new ones last reporting period just in Philadelphia) and 5 in the

South. Although brand names are still

common in the Northeast and South,

they are becoming less common in

several cities, including Boston, where

dealers fear that labels and brand

names may make them vulnerable to

law enforcement, and in Philadelphia. 

Heroin packaging continues to vary

widely in most Pulse Check cities,

with the most common packaging

continuing to be plastic, cellophane,

glassine, or coin bags, often the zipper type. Other common packaging

includes balloons and “bindles,” in

which the heroin is folded, often

made of foil, paper bags, plastic

wrap, wax paper, magazine pages, or

lottery tickets. 

Brands can also be identified by the

color of the bag in which heroin is

sold (as in Boston, Portland [ME],

and Washington, DC) or the color of

the balloon in which it is sold (as in

Memphis). According to the law

enforcement source in Chicago, dealers are no longer inserting popcorn

kernels or colored pieces of candy

into the plastic heroin-filled bags to

identify dealers.

Less common packaging includes 

condoms in New York; capsules, gel

caps, and small glass vials in Baltimore;

vials in Memphis; pellets in New

Orleans; “seal-a-meals” (heat-sealed

plastic bags) in Portland, and brown

packing tape inside of duct tape in St.

Louis. In El Paso, heroin is wrapped

in foil inside a balloon so that dealers

can put it in their cheeks or swallow

it if they deem it necessary. In

Detroit, the variety of heroin 

packaging has widened since the last

reporting period. In Boston, since the

last reporting period, packaging has

moved toward grams and fractions of

grams and away from $10 bags, bundles, and bricks. Because the “grams”

are not weighed and are in rock form

Exhibit 5. 

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

WEST

Smack, dope, chiva,

boy, black, stuff,

horse, junk, skag,

goat, bindle, down,

girl, dujra

H, horse, hayron,

dope, boy, smack,

junk, stuff, blow,

raw, cap, buttons,

snotty, getting

snotty

H, big H, horse, dope, smack, junk, product, boy,

brother, bags, packets, dimes, dees, diesel, downtown, manteca (=lard), pabajomud, mud

103.9, 747, 8-ball, 911, alien figure, allen iverson,

bad habit, bart simpson, batboy, big mac, bingo, body

bag, bomb, bull dog, bumble bee, cobra, cold water,

colt 45, creeper power, DOA, demolition, devil, devil's

advocate, diesel dmx, DINOSAUR, doo-wop, double

nut, dracula, eagle, fatal, fingers, ghost, godfather,

happy face, holyfield, homicide, hot water, i'll be

back, it's hot, k & a, knock out, land rover, legend,

lexus, life, life after death, lucifer, maggie 2, magnum

357, marijuana leaf, mike tyson, monkey business,

MONICA LEWINSKI, mvp, nautica, nike, no joke,

NO MONEY, number one, old navy, one and done,

one hundred percent, one life, one way, opium, pac

man, pain killer, playboy, playing cards, polo, poison,

purple haze, red devil, RED HOT, river, rush, samurai, scorpio, scorpion, SPADES, suicide, super a, super

buick, super hot, super nautica, thumbs up, timberland, titanic, tnt, tomahawk, tommy hilfiger, too

strong, TOP DOG, toyota, trinidad, unicorn, ups,

usa, viper, wcw, white control, white house

MIDWEST NORTHEAST

SOUTH

Mostly

Mexican

black tar

available

Mostly

Colombian

white

available

Heroin

type varies

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

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

H, big H, heron, ron, horse, boy, he, smack, dope, stuff, doogie, doozy, diesel, tammy, manteca,

foil, papers, brown bag, brown, chiva (=goat), train, old garbage, dog food, s**t, carga, joint, billie,

negra (Mexican black tar), negro, scramble (low purity), bone (high purity), raw (very high purity)

10 PACK, 747, big doodig, BIN LADEN, HOLY TERROR, jerry springer, murder one, no limit, pink

hearts, playboy, pluto, skull and crossbones, white dragon
HEROIN

Pulse Check: November 2002 page 29

(“eggs”), this marketing technique

enables the dealers to convince the

buyer that they are getting more

heroin for their money. 

HEROIN: THE MARKET

Who sells heroin? (Exhibit 6)

Heroin sellers are more likely to be

independent than organized, especially

in the West and South, according to

law enforcement sources. Epidemiologic/ethnographic sources are more

likely to report organized sales structures than their law enforcement

counterparts, and law enforcement

sources more often report both independent and organized structures in a

particular city than their epidemiologic/ethnographic counterparts. 

The intricacies and varieties of heroin

sales organizations in many Pulse

Check cities underscore the challenges

in disrupting local markets:

" Baltimore, MDE

: Most heroin 

sellers are highly organized because

“to survive on the street you need

someone to cover your back.”

" Denver, COE

: Heroin sellers participate in polydrug distribution within

small autonomous street cells.

" Memphis, TNE

: Heroin sellers are

highly organized on an international

level.

" Miami, FLE

: The organization of

heroin sellers often depends on the

location of the market. Heroin sellers in the streets tend to be independent, but when selling in the

clubs, they tend to be organized in

groups.

" Philadelphia, PAL

: Although heroin

dealers are mostly independent,

some small organized groups work

together for specific transactions,

then separate, and then reform.

" Portland, MEL

: Heroin sellers fall

into two groups: independent and

organized. Several organized

groups travel to Lowell (in nearby

Massachusetts) in cars, split into

smaller groups as they return, and

expand the number of people who

distribute the drug after they return

to Portland.

" Seattle, WAL

: Heroin dealers fall

into two types of structures: (1)

street gangs and (2) loosely organized structures in which a “gobetween” (a heroin addict who is a

liaison between the buyer and the

driver) and the driver (the person

in the car who has the heroin)

work together.

Exhibit 6.

How are street-level heroin sellers organized across the 20 Pulse Check

cities (spring 2002)?

Seattle

Sioux

Falls

Memphis Columbia

New York City

Boston

Washington, DC

Portland

El Paso

Los

Angeles

Honolulu

Philadelphia

Miami

Detroit

Chicago

Baltimore

New

Orleans**

Seattle

Sioux

Falls

Memphis Columbia

New York City

Boston

Washington, DC

Portland

Denver

El Paso

Los

Angeles

Honolulu

Philadelphia

Miami

Detroit

Chicago

Baltimore

New

Orleans

Billings

Billings

St. Louis

Denver St. Louis

According to epidemiologic/ethnographic sources (N=15)*...

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

Independent Organized Both Independent and Organized

* The law enforcement source in Sioux Falls did not respond. The epidemiologic/

ethnographic sources in Billings, Columbia (SC), Philadelphia, Seattle, and Sioux Falls did not

respond. 

** This source defined the level of organization as “very loose.”
HEROIN

page 30 Pulse Check: November 2002

Law enforcement and epidemiologic/

ethnographic sources continue to

report young adults (18–30 years) 

as the most common age group of

heroin sellers, but adolescents are

sometimes reported. Epidemiologic

sources report adolescents more often

than do law enforcement sources, and

law enforcement sources report older

adults (30 years and older) more

often than their epidemiologic 

counterparts. 

Only a few law enforcement and 

epidemiologic sources report any new

seller groups or structural changes

this semester in Pulse Check cities: 

" Baltimore, MDL

, and Washington,

DCE: Heroin sellers are reportedly

younger than they were during the

last reporting period. 

" Boston, MAE

: Sellers are more

independent, and sales continue to

decentralize. Nearly all sellers now

use beepers and cell phones, and

many users support their heroin

habits by selling the drug.

" Portland, MEL

: The organizational

structure of heroin dealers is new

this reporting period. In the past,

dealers were independent locals,

but they are increasingly working

together. 

According to law enforcement and

epidemiologic/ethnographic respondents, heroin sellers often use the

drug, with 36 percent of respondents

reporting them as very likely to use

the drug, and 30 percent reporting

them as somewhat likely to use the

drug. In this respect, they resemble

crack and powder cocaine dealers, but

differ from marijuana, methamphetamine, and ecstasy dealers, who are

even more likely to use the drug that

they sell (see Highlights Exhibit 8).

How is street-level heroin marketed? Although open-air heroin

markets continue to operate in several

cities (Chicago, Detroit, Denver,

Honolulu, Seattle, and Washington,

DC), “underground” sales are common, requiring a wide range of law

enforcement strategies to disrupt

markets. Dealers commonly employ

counterstrategies such as using beepers or cell phones to arrange meetings

for the exchange of the drug with

buyers (as reported in BostonL

, HonoluluL

, Portland [ME]L, MemphisL, Los

AngelesL

, SeattleL, and St. LouisE,L)

and creating multitiered marketing

structures (as reported in BaltimoreL,

ChicagoL, and DetroitL). Examples of

how heroin markets vary from city to

city include:

" Baltimore, MDL

: A multilayered

heroin market, involving a “touter,”

“runner,” and “dealer,” is used

because sellers will not sell to anyone they don’t know. The touter

stands on the street advertising the

drug and exchanges money for

heroin with the buyer; the runner 

is the liaison between the touter

and the dealer; and the dealer supplies the heroin.

" Boston, MAL

: Heroin sellers create

a small list of customers to whom

they will sell the drug. When 

contacted by a customer, the seller

delivers the drug to a common meeting place or the customer’s house. 

" Chicago, ILL

: Heroin is sold 

discreetly inside, with several layers

of people selling the drug. For

example, on one floor of a house

or building a buyer requests heroin,

on the next floor the buyer pays for

the drug requested, on the next

floor someone tells the buyer where

to go to obtain the drug, and finally the buyer goes to that location to

obtain the drug.

" Columbia, SCL

: A contact will

direct heroin buyers to a house 

or around a supermarket. When a

buyer’s car arrives at that place, a

dealer will approach him/her for 

a sale.

" El Paso, TXL

: Most sales occur

indoors after a buyer has been

introduced to a seller through a

common acquaintance. 

" Philadelphia, PAL

: In certain neighborhoods, customers will drive by,

roll down the car window, and buy

the drug.

" St. Louis, MOE,L: Buyers must place

their “orders” for drugs to the dealer, and then the drug is exchanged

hand-to-hand.

What other drugs do heroin 

dealers sell? (Exhibit 7) Heroin

dealers continue to sell additional

drugs in all Pulse Check cities, except

for Billings, New York, and

Philadelphia, where heroin is sold by

itself. Additional drugs most often

reported as sold with heroin are crack

and powder cocaine. No changes are

reported since fall 2001.

What types of crimes are related

to heroin sales? Nonviolent and

violent crimes are equally involved in

heroin sales, according to 20 law

enforcement and epidemiologic/

ethnographic sources. Common violent crimes include assaults with

weapons in New York, Portland

(ME), St. Louis, and Washington,

DC; gun sales in Philadelphia; rape in

Memphis; and homicides in Portland.

Reported nonviolent crimes include

burglary in Detroit, Memphis, New

York, and St. Louis; petty theft and

shoplifting in Boston, Memphis,
HEROIN

Pulse Check: November 2002 page 31

Philadelphia, Portland, and Washington, DC; petty embezzling in Boston;

forgery in Portland; and money laundering in Miami. The epidemiologic

source in Portland notes that violence

related to heroin sales has increased

since the last reporting period.

Prostitution, especially on the part of

the users, is reported by 18 law

enforcement and epidemiologic/

ethnographic sources in all regions of

the Nation, and gang-related activities

are reported by 15 law enforcement

and epidemiologic/ethnographic

sources in all the regions. According

to the law enforcement source in

Denver, gang-related activity has

increased since the last Pulse Check

reporting period.

Where are heroin markets 

located? Law enforcement and 

epidemiologic/ethnographic sources

continue to agree that most heroin

markets are located in central city

areas. Additionally, suburban areas

are mentioned in Denver, Miami, and

St. Louis, and “all areas” are reported

in El Paso, Memphis, Miami, New

Orleans, New York, and Portland

(ME). According to the law enforcement source in Denver, the market

continues to shift geographically from

central city areas to the suburbs. 

Heroin markets continue to be 

located in open-air markets on streets

or on street corners according to law

enforcement sources in every city

except for Sioux Falls, where heroin

is rarely available. The next most

common market settings continue to

be around public housing developments and inside private residences

(as reported in 16 cities each). Crack

houses are reported market settings in

10 cities across all 4 regions. Heroin

is also commonly sold inside cars, as

reported in 10 cities located in the

Northeast, South, and West. Parks,

nightclubs and bars, junior high and

high schools, private parties, hotels

and motels, and areas around drug

treatment clinics continue to be mentioned as common heroin market

locations in various cities. 

The heroin market has expanded to

include new locations in several cities

since the last Pulse Check reporting

period:

" Denver, COL

: New locations for

heroin markets include junior high

and high schools and private parties. 

" New Orleans, LAL

: Heroin markets

used to be only around housing

projects, but now they can be

found in a wide variety of locations.

" Philadelphia, PAL

: Heroin sales are

beginning to move indoors or to

other street corners to avoid law

enforcement.

" Portland, MEL

: Heroin sales have

begun to take place around treatment clinics and inside hotels or

motels.

" Washington, DCL

: Since the last

Pulse Check, five new open-air 

markets for heroin in particular

have been opened, typically by

dealers 16–18 years old.

HEROIN: THE USERS

How many heroin users are in

treatment? (Exhibit 8) As would be

expected, heroin is the primary drug

of abuse among methadone treatment

clients in nearly all Pulse Check cities.

In Memphis, however, pharmaceutical opiates and benzodiazepines are

the primary problems. Among nonmethadone treatment clients in Pulse

Check cities, primary heroin users

range from a small percentage of

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

Boston, MA #

New York, NY ### Ecstasy

Philadelphia, PA #

Portland, ME OxyContin® and other

pharmaceutical opiates

Baltimore, MD ###

Columbia, SC #

El Paso, TX ### Rohypnol (flunitrazepam)

Memphis, TN ### Pharmaceutical opiates

Miami, FL # # Ecstasy

New Orleans, LA #

Washington, DC # #

Chicago, IL # #

Detroit, MI #

St. Louis, MO ###

Billings, MT #

Denver, CO ### Methamphetamine

Honolulu, HI Varies widely

Los Angeles, CA # #

Seattle, WA ### Benzodiazepines

Powder Mari- No other

City Crack Cocaine juana Other drug sold

Northeast Midwest West South

Sources: Law enforcement and epidemiologic/ethnographic respondents

*Respondents in Sioux Falls did not provide this information. 
HEROIN

page 32 Pulse Check: November 2002

clients (0–5 percent) in places such 

as Billings, Columbia (SC), Detroit,

Honolulu, Los Angeles, Memphis,

New York, and Sioux Falls to a high

of 75 percent of treatment clients in

Baltimore.

Since the last reporting period, 

several non-methadone treatment

programs in Pulse Check cities

(Billings, Boston, Chicago, Portland

[ME], Seattle, and Washington, DC)

have reported increases in the 

number of heroin clients. 

The Portland epidemiologic source

notes that heroin use has increased,

probably because OxyContin®

abusers are switching to heroin,

which is easier to obtain. Increases

are also reported in three nonmethadone treatment programs

where the heroin population is small:

Columbia (SC), Memphis, and New

York. A decrease in heroin clients is

mentioned by the non-methadone

treatment source in Baltimore.

Methadone treatment sources report

stable numbers and proportions of

heroin clients since the last reporting

period, except in Honolulu, where

they decreased. 

How do heroin clients wind 

up in treatment? According to nonmethadone treatment sources, heroin

clients are most likely to be referred to

treatment by the criminal justice system. By contrast, methadone treatment

sources report self-referrals (19 sources)

as the most common type of referral,

followed by referrals from the criminal

justice system (8 sources). Mostly

because drug courts are increasingly

established in many Pulse Check cities,

more heroin clients are being referred

to methadone and non-methadone

treatment by the criminal justice 

system, including those in BaltimoreM,

BillingsN, New YorkM, and SeattleM.

Who uses heroin? As reported in

previous Pulse Checks, heroin users

tend to be White males, older than 30,

of low socioeconomic position, who

live in central city areas. However,

demographics vary from city to city.

For example, although adults (older

than 30) predominate according to

most sources, young adults (18–25

years) predominate according to

sources in eight cities (Columbia [SC]M,

DenverN, MiamiE, PhiladelphiaE,N,

Portland [ME]N, Sioux FallsE, St.

LouisN, and Washington, DCN), while

adolescents predominate as heroin

clients according to two sources (in

ColumbiaN and DenverM). Mean ages

range from 25 (PhiladelphiaN) to 46

years (Washington, DCM). 

How do users administer heroin?

(Exhibit 9) As reported in past Pulse

Check issues, injecting remains the

most commonly reported route of

administration. Snorting, however,

continues to predominate in many

sites, particularly nonwestern sites. 

Since the last reporting period, 

snorting has increased according to

eight sources in seven cities:

BaltimoreE,M, BostonN (where purity

has increased recently), El PasoM,

MemphisE (where users reportedly

have switched from injecting due to

fear of HIV), MiamiM (where injecting

has declined), New OrleansE

, St. LouisE

(where more new users are snorting).

On the other hand, injecting has

reportedly increased in BostonE and

PortlandE,N, where new hepatitis C

cases in young adults are related to an

increase in injection among that population.

What other drugs do heroin

users take? In some cities, polydrug use remains the norm. Sources

in Billings and Philadelphia, for example, explain that most treatment clients

are polydrug users: they use whatever

Exhibit 8.

Which non-methadone treatment programs in Pulse Check cities have 

substantial percentages* of clients reporting heroin as their primary drug

of abuse? How have those percentages changed (fall 2001 vs spring

2002)?**

*15 percent or more

**Non-methadone treatment sources did not respond in Denver and New Orleans.

Stable

Stable

Increase

Increase

Stable

Increase

Baltimore, MD Decrease

El Paso, TX

Philadelphia, PA

Chicago, IL

Miami, FL

Boston, MA

Washington, DC

Percentage of clients

City/program

10 20 30 40 50 60 70 80 90 100
is available on the market. Cocaine

(powder or crack) continues to be the

most common drug used with heroin,

often injected together as a “speedball.” Marijuana (to extend the heroin

effects), pharmaceutical opiates and

benzodiazepines, and methamphetamine (where available) are also reportedly used with heroin. Shifts and variations are reported in the use of heroin and other drug combinations in several Pulse Check cities:

" Boston, MAE

: Because the veins of

older heroin addicts collapse, many

have shifted from injecting a combination of heroin and powder

cocaine in a speedball to injecting

heroin intramuscularly and, immediately after, smoking crack. Also,

recent heroin initiates often combine

pharmaceutical opiates, benzodiazepines, or marijuana with heroin. 

" Los Angeles, CAE

: The use of 

pharmaceutical opiates (Vicodin®,

OxyContin®, and methadone) 

and crack sequentially with heroin

has increased. 

" Los Angeles, CAM: Methamphetamine used sequentially with heroin

has increased.

" Memphis, TNE

: Amphetamines 

or PCP are sometimes used after

heroin—a new development this

reporting period. 

" Miami, FLE

: New heroin users 

continue to use ecstasy after heroin

to “parachute down.”

" Seattle, WAE

: An emerging group of

heroin users tends to take methamphetamine in combination with

heroin.

Where and with whom is heroin

used? Nearly all epidemiologic/ 

ethnographic and treatment sources

continue to report that heroin is used

privately and alone. Private residences

and public housing developments

remain the most common settings for

heroin use. Several changes or interesting observations are noted since

the last Pulse Check:

" Boston, MAE

: Other settings for

heroin use include the hallways,

stairwells, rooftops, and behind

dumpsters of public housing 

developments; the parking lots of

convenience stores and supermarkets; homeless shelters; public

restrooms; and abandoned lots. 

" El Paso, TXE

, and Seattle, WAE:

Use settings include bathrooms in

fast food restaurants.

" Memphis, TNE

: Users increasingly

take the drug alone in private 

residences. 

" New Orleans, LAE

: Users increasingly take heroin in public, and

motels are a new setting for its use.

HEROIN

Pulse Check: November 2002 page 33

Exhibit 9.

How do users administer heroin?

Boston, MAE,M Boston, MAN

New York, NYM New York, NYE New York, NYN

Philadelphia, PAE,N Philadelphia, PAM

Portland, MEE,M* Portland, MEM*,N

Baltimore, MDE*,M* Baltimore, MDE*,M*,N

Columbia, SCE,M Memphis, TNE*

El Paso, TXE,M,N Miami, FLM

Memphis, TNE*,M,N New Orleans, LAE*,N*

Miami, FLE,N Washington, DCN

New Orleans, LAE*,N*

Washington, DCE,M

Chicago, ILN* Chicago, ILN*

Detroit, MIE*,M Detroit, MIE*,N

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

Sioux Falls, SDE* Sioux Falls, SDE*

Billings, MTM* Billings, MTE,M*

Denver, COE Denver, COM** Denver, COM**,N

Honolulu, HIE,M,N

Los Angeles, CAE,M

Seattle, WAE,M,N

Injecting is most Snorting is most Smoking is most 

common in... common in... common in...

*Respondent considers injecting and snorting as approximately equal.

**Respondent considers snorting and smoking as approximately equal.

Note: The non-methadone treatment sources in Billings, Columbia (SC), Los Angeles, and

Sioux Falls did not provide this information. Northeast Midwest West South
HEROIN

page 34 Pulse Check: November 2002

The changing nature of heroin users (fall 2001 vs spring 2002)...

Several sources report a

younger cohort of heroin

users, new since the last

Pulse Check:

By contrast, several

sources report an aging

heroin-using population:

A few Pulse Check sources

in the South also note

shifts in the race/ethnicity

of heroin users:

Other heroin users demographics have reportedly

shifted in several Pulse

Check cities:

➤ Boston, MAE

: In blue-collar neighborhoods, some White adolescents (mean age 16) are beginning to

inject heroin.

➤ Boston, MAN, and Portland, MEN: Heroin clients are now predominantly young adults, compared with

the last reporting period when older adults predominated.

➤ Miami, FLM and New Orleans, LAE

: Younger users (18–30 years) are coming into treatment more often

than during the last reporting period.

➤ Portland, MEE

: The older group (older than 30) of heroin users is declining as the younger group

(18–30 years) is increasing.

➤ St. Louis, MON: This program notes an increase in adolescent heroin use, but that may be because an

adolescent treatment program was initiated last summer.

➤ Seattle, WAE

, and Washington, DCE: More young adults are using heroin than in the past.

➤ El Paso, TXE

: Heroin users continue to age, and there are more adults (older than 30) than before.

➤ Philadelphia, PAM: Heroin clients (mostly adults, 30 years and older) are continuing to age. 

➤ St. Louis, MOE

: Although heroin users continue to age, the age of first use is dropping.

➤ El Paso, TXM: Hispanics are the predominant heroin users, but more non-Hispanic Whites are coming in

for treatment than during the previous reporting period.

➤ Memphis, TNE

: Whites have become the predominant group and are overrepresented compared with

the general population.

➤ Miami, FLM: Hispanics are the predominant heroin users, and more are coming in for treatment during

this reporting period.

➤ Memphis, TNE

: The trend is toward heroin use in private rather than in public places among White

males who snort and inject. 

➤ Miami, FLE

: The predominant heroin user residence has shifted from the central city area to the suburbs.

➤ New Orleans, LAE

: The predominant socioeconomic position of heroin users has shifted from lower to

middle class, and use is spreading to all areas of the city. 

➤ St. Louis, MOM: Heroin clients are of low socioeconomic position and unemployed more often than

before.
CRACK COCAINE

Pulse Check: November 2002 page 35

CRACK COCAINE✛

Second only to heroin, crack is considered the drug contributing to the

most serious consequences by 21

sources in 14 cities: Boston, New

York, and Philadelphia in the

Northeast; all 7 Pulse Check cities in

the South; Detroit, Chicago, and St.

Louis in the Midwest; and Los Angeles

in the West—a region where most

sources identify methamphetamine as

the most serious drug problem. In

nine of the cities (Chicago, Columbia

[SC], Detroit, Los Angeles, Memphis,

Miami, New Orleans, New York, and

Washington, DC) where crack is

named as the drug contributing to the

most serious consequences, sources

also consider it the most widely used

illicit drug.

Compared with the last reporting

period, crack replaced marijuana as

the most widely used drug according

to the epidemiologic source in

Memphis. By contrast, heroin replaced crack as the most widely used

drug, according to the epidemiologic

source in New Orleans, and heroin

replaced crack as the drug contributing to the most serious consequences

according to the non-methadone

source in Washington, DC.

CRACK: THE DRUG

How available is crack cocaine

across the country? (Exhibits 1

and 2) The majority of law enforcement (15 of 20) and epidemiologic/

ethnographic (13 of 20) sources continue to consider crack widely available in their communities. Except for

two sources (El PasoL and BillingsE

)

who identify crack as not very available, the remaining sources consider

it somewhat available.

As in the last Pulse Check, according

to most law enforcement and epidemiologic/ethnographic sources,

crack availability remained stable

between fall 2001 and spring 2002,

with declines noted by five sources in

four cities (Boston, Honolulu,

Philadelphia, and Seattle), and

increases noted by four sources in

four cities (Billings, Memphis, New

York, and Sioux Falls). 

How and where is crack cocaine

made? Crack continues to be

processed locally (from powder

cocaine) in most Pulse Check cities,

either by local distributors or by

users. According to most sources,

crack is processed locally because

Federal guidelines for distributing

crack are stricter than for powder;

therefore, dealers would rather 

transport powder cocaine than crack. 

Exhibit 1.

How available is crack cocaine across the 20 Pulse Check cities 

(spring 2002)?

Seattle

St.

Louis

Sioux

Falls

Memphis Columbia

New York City

Boston

Washington, DC

Portland

Denver

El Paso

Los

Angeles

Honolulu

Philadelphia

Miami

Detroit

Chicago

Baltimore

New

Orleans

Seattle

Sioux

Falls

Memphis

St.

Louis

Columbia

New York City

Boston

Washington, DC

Portland

El Paso

Los 

Angeles

Honolulu

Philadelphia

Miami

Detroit

Chicago

New

Orleans

Baltimore

Billings

Billings

Denver

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

According to law enforcement sources (N=20)...

Widely Available Somewhat Available Not Very Available

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

Law enforcement respondent, EEpidemiologic/ethnographic

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

page 36 Pulse Check: November 2002

However, many sources, especially in

the West, report crack as processed

prior to arriving in their communities,

including sources in Billings, Denver,

El Paso, Honolulu, Portland (ME),

Seattle, and Sioux Falls.

What are crack prices and purity

levels across the country?

(Exhibit 3) As reported in past Pulse

Checks, crack prices remained stable

in most cities, with exceptions in Los

Angeles and Memphis, where prices

declined. Crack is commonly sold

by the rock (typically 0.1–0.2

grams) for $10–$20, respectively. Only a few street-level purity percentages are reported,

and most are stable since the last

reporting period:

" Los Angeles, CAE

: 80–85 percent

pure

" New York, NYL

: 58 percent pure

(up)

" Philadelphia, PAL

: 80 percent pure

" Portland, MEL

: 80 percent pure

" Seattle, WAL,E: 40–85 percent pure

" Washington, DCL

: 30–60 percent

pure

According to the law enforcement

source in Memphis, in spring 2002,

heroin traces were found in crack and

powder cocaine seized by law

enforcement, especially in the larger

quantities seized. Pulse Check will

continue to monitor this finding in

upcoming issues.

How is crack referred to?

(Exhibit 4) Few slang terms are

reported as new in spring 2002, 

further indicating the relatively stable

crack market across the country. New

terms include “CDs” in the Northeast

and “space” in the South. 

How is crack packaged and 

marketed? In most cities, crack is

packaged in a variety of ways. The

most commonly reported packaging

across all four regions remains small,

plastic, cellophane, glassine, or coin

bags, often the “zipper” type. Often

crack is placed in a torn corner of a

baggie and knotted (“Dominican

knot”), folded in paper or magazine

pages (“bindles”), or pieces of crack

(“rocks”) are sold without packaging

(“loose”). Vials and aluminum foil are

also common forms of packaging. 

Similar to other marketing characteristics, few changes are noted in the

packaging of crack cocaine. The New 

York epidemiologic source notes that,

since fall 2001, packaging has switched

from vials to colored baggies, with the

colors representing crack purity or 

specific dealers. Only in one other city

(Baltimore) are labels used—in that

city, colored tops are used on vials of

crack to identify dealers. 

CRACK: THE MARKET

Who sells crack? Crack sellers are

equally likely to be independent or

organized (often as street gangs), and

sources in six cities report independent and organized sellers as equally

represented. Young adults continue

to be the primary sellers in most

cities, but adolescents are mentioned in six cities: BaltimoreL,E,

ChicagoE, Columbia (SC)L, Los

AngelesL,E, MemphisE, and SeattleL.

Older adults are mentioned in five

cities: BostonL,E, HonoluluE,

PhiladelphiaL, Sioux FallsL, and St.

LouisL. Law enforcement and epidemiologic/ethnographic sources

report no new seller groups since the

last Pulse Check, further suggesting a

stable crack market.

Similar to percentages for heroin and

powder cocaine, about one-third of

law enforcement and epidemiologic/

ethnographic respondents report

crack sellers as very likely to use the

drug, and one-third report them as

somewhat likely to use is the drug

(see Highlights Exhibit 8). The law

enforcement source in El Paso

explains that sellers process the crack

because they are likely to use it. The

Miami law enforcement source

explains that in the city most streetlevel dealers are users, but countywide, dealers don’t use their own

inventories. In ColumbiaL

, sellers

commonly smoke marijuana blunts.

Exhibit 2.

How has crack cocaine availability

changed (fall 2001 vs spring

2002)?

Billings, MTL

Memphis, TNE

New York, NYE

Sioux Falls, SDL

Baltimore, MDL,E

Billings, MTE

Chicago, ILL,E

Columbia, SCL,E

Denver, COL,E

Detroit, MIL,E

El Paso, TXL,E

Honolulu, HIL

Los Angeles, CAL,E

Memphis, TNL

Miami, FLL,E

New Orleans, LAL,E

New York, NYL

Philadelphia, PAE

Portland, MEL,E

Seattle, WAL

Sioux Falls, SDE

St. Louis, MOL,E

Washington, DCL,E

Boston, MAL,E

Honolulu, HIE

Philadelphia, PAL

Seattle, WAE
CRACK COCAINE

Pulse Check: November 2002 page 37

How is crack marketed? Similar 

to marketing techniques for heroin,

crack sales methods vary widely. In

many cities, such as Boston, Columbia

(SC), El Paso, Philadelphia, and

Washington, DC, the particular 

technique for selling crack is identical

to selling heroin. Many sources (in

Columbia, El Paso, Memphis, Miami,

Portland [ME], and Sioux Falls)

report prearranged meetings for the

exchange of crack. Open-air markets

for crack are reported in seven cities

(Chicago, Denver, Detroit, Honolulu,

New Orleans, Seattle, and Washington, DC), and home delivery of the

drug is reported in Boston and

Miami. The law enforcement source

in Sioux Falls points out that crack

sellers avoid vulnerability to law

enforcement by witholding large

amounts of their crack inventory

(“the stash”) from the the street market. Since fall 2001, changes in marketing techniques are rare: in BostonL

,

crack sales continue to be more

“underground” than before, with

more beeper and cell phone use. 

What other drugs do crack dealers sell? No other drugs are reported as sold by crack dealers in Boston,

Los Angeles, and Philadelphia, but in

most cities crack dealers sell other

drugs, especially heroin, powder

cocaine, and marijuana:

" Heroin sold by crack dealers:

BaltimoreE, ChicagoE, DenverE,

MemphisE, MiamiE, New YorkL,

New OrleansE, Portland (ME)E,

and St. LouisE

" Powder cocaine sold by crack 

dealers: BillingsL, ChicagoE, 

DenverE

, El PasoE, MemphisE,

MiamiL, and New YorkL

Exhibit 3.

What are crack cocaine price levels in 19 Pulse Check cities?*

MOST COMMON STREET UNIT

City/Source Unit Size Price

Boston, MAE 1 g 1 g $50

rock NR $20

Boston, MAL "jum" (small rock) 0.1 g $10

New York, NYE bag NR $5–$10

New York, NYL rock, vial NR $20

1 g 1 g $24–$30

Philadelphia, PAE rock NR $5

"trey" 5-mm diameter rock $3 or two for $5

Philadelphia, PAL rock 0.1–0.5 oz $50

Portland, MEL rock 0.5 g $100

Baltimore, MDE rock NR $5–$10

Baltimore, MDL rock NR $10

Columbia, SCL rock NR $20

1 g 1 g $100

El Paso, TXL,E rock 0.25 g $20

Memphis, TNE rock medium sized $5

Memphis, TNL rock 0.2 g $20

Miami, FLL rock NR $10–$20

New Orleans, LAL,E rock 0.25–0.48 g $10–$20

Washington, DCL,E rock, "dime bag" 75 mg $10

Washington, DCL 1 g 1 g $100

Chicago, ILE rock NR $5–$20

1 g 1 g $50–$150

Chicago, ILL rock 0.2 g $20–$25

1 g 1 g $123

Detroit, MIE rock NR $20

Detroit, MIL rock 0.1 g $10

Sioux Falls, SDL rock small $100

St. Louis, ILL,E rock NR $20

1 g 1 g $300–$400

Denver, COE rock NR $20–$30

Denver, COL rock 0.1–0.2 g $20

1 oz 1 oz $950–$1,250

Honolulu, HIE 0.25 g 0.25 g $25–$35

Honolulu, HIL rock 0.25 g $25–$30

1 g 1 g $100–$250

Los Angeles, CAE 1 oz 1 oz $600–$700

1 g 1 g $80

Los Angeles, CAL rock 0.2 g $10

Seattle, WAE rock NR $2, $5, and $10

Seattle, WAL,E 1 g 1 g $100

*Sources in Billings did not provide this information.

NR=Not reported

Sources: Law enforcement and epidemiologic/ethnographic sources Northeast Midwest South West
CRACK COCAINE

page 38 Pulse Check: November 2002

" Marijuana sold by crack dealers:

BaltimoreE, Columbia (SC)L,

DenverL,E, DetroitE, El PasoE,

HonoluluL, MiamiL,E, New YorkL,

PortlandE, St. LouisL,E, Sioux FallsL,

and Washington, DCL

" Ecstasy sold by crack dealers:

DenverL, MiamiE, New YorkL, and

Washington, DCL

" Methamphetamine sold by crack

dealers: BillingsL, DenverL,E, and

HonoluluL

" OxyContin® sold by crack

dealers: MiamiL

Since the last Pulse Check, only one

change was reported in drugs sold 

by crack dealers: in Baltimore, marijuana is now sold by crack dealers.

What types of crimes are related

to crack sales? Crack sales are

associated with prostitution, gangrelated crimes, and violent crimes,

more so than any other drug sales,

according to the majority of law

enforcement and epidemiologic/

ethnographic respondents (see

Highlights Exhibit 7). Violent crimes

include armed robberies in Chicago,

New York, St. Louis, and Sioux Falls;

assaults in New York and Washington,

DC; street robberies in Los Angeles; 

and turf wars in Sioux Falls. No

changes have been reported since 

fall 2001.

Where are crack markets located? More than two-thirds (23 of 33)

of law enforcement and epidemiologic/ethnographic respondents across

the Nation report central city areas as

the primary location of crack sales.

Markets are located primarily in suburban areas in El Paso; in central city

and suburban areas in Los Angeles,

Miami, and Portland (ME); and in all

areas (central city, rural, and suburban areas) in Denver, Detroit,

Memphis, New Orleans, and New

York. The most common sales settings

for crack remain streets (mentioned

by all 20 law enforcement sources),

crack houses, private residences, and

around public housing projects. 

Since the last reporting period, crack

sales have moved predominantly into

the central city areas of Memphis,

and are spreading to all areas of New

Orleans. In PhiladelphiaL

, crack sales

have increasingly moved indoors and

even outdoor sales are constantly

moving from street corner to street

corner to avoid law enforcement. In

Portland, new crack sales locations

since fall 2001 include crack houses

and hotels or motels. 

Exhibit 4. 

How is crack cocaine referred to in the four regions of the country?*

WEST

Rock, base, blow, bump, candy, coca,

cookies, crumb, girl, hard, lady, loose,

piedra, ready rock, scottie, shrile, SPACE,

stones, twinkie, monkey nut (big rock),

Rock, bullets, ma’a (“rock” yam (big rock), bomb (100 rocks)

in Samoan), pohaku

Rock, base,

boulders,

pebbles,

soap, soup

Rock, rock star,

bird (32 oz),

bopper, bumper,

hard stuff, stone

Rock, bumps,

freebase, jums,

CDs, ice cubes

MIDWEST NORTHEAST

SOUTH

*Names in all caps are new this reporting period.

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

Marketing techniques in the East...

➤ Baltimore, MDE

: “Touters” stand on the street and advertise crack by referring to the colored tops on the vials in

which crack is packaged: “black tops are good today.” The colors of the vial tops change daily, and the sales locations

move daily to avoid law enforcement.

➤ Phildelphia, PAL

: Most crack sellers are organized as small, loose confederations of individuals who work together 

for specific transactions, go their separate ways, and then re-form, making them difficult to track. Furthermore,

Philadelphia streets are divided into neighborhoods and blocks, with someone “controlling” a particular block or

neighborhood. If a dealer wants to sell a certain drug, he or she pays “rent” to the person who controls the area. 

This practice helps dealers evade law enforcement and often results in violent turf wars.
CRACK COCAINE

Pulse Check: November 2002 page 39

CRACK: USERS

How many crack users are in

treatment? (Exhibit 5) Primary

crack users constitute at least 10 percent of non-methadone treatment

clients in 11 cities, with a high of 85

percent in Miami. Proportions of

crack clients between fall 2001 and

spring 2002 remained relatively stable

in most cities, with several exceptions: increases are reported in five

cities (ChicagoN, Columbia [SC]N,

MemphisE, St. LouisM, and Sioux FallsN),

and declines are reported in seven

cities, mostly by epidemiologic sources

(in BostonE

, ColumbiaE, DenverE,N,

HonoluluE, MiamiE, PhiladelphiaE,

and Portland [ME]N). The epidemiologic source in Columbia states that

the decrease in crack users may be

related to users switching to other

drugs, especially pharmaceutical opiates. The methadone treatment

source in St. Louis reports that crack

use as a secondary or tertiary drug has

increased. Similarly, the methadone

treatment source in Columbia reports

that positive urinalyses for crack have

increased. Drug users in that city

often stay up all night using crack and

visit methadone clinics the next

morning for a “methadone crash.”

Who uses crack? (Exhibit 6) The

majority of epidemiologic/ethnographic and treatment sources report

that crack users remain young adult

(18–30 years), central city residents

from low socioeconomic backgrounds.

However, sources cite adolescents as

the primary crack users in BillingsN

(along with young adults), Los AngelesN

(along with young adults), and Sioux

FallsN. Mean age of primary crack

users ranges from 23 years in Boston

to 39 years in Chicago. 

Crack users are predominantly male,

according to 75 percent (15 of 20) 

of epidemiologic sources, although

the gender gap is narrowing in 

several cities. For example, in Boston,

Columbia (SC), Denver, Detroit, Los

Angeles, and Seattle, about 40 percent of crack users are female. Blacks

continue to be twice as likely as

Whites to be reported as the predominant user group. Crack users in treatment tend to be court referred and

unemployed. Slightly more than half

have completed high school.

Overall, the number of crack users

has remained relatively stable as a

group since the last Pulse Check

reporting period, with only a few

changes in age, gender, race/ethnicity,

and residence area, as noted on the

following page.

How do users take crack

cocaine? Nearly all epidemiologic/

ethnographic and treatment respondents (48 of 52) report that crack

users primarily smoke the drug.

However, injecting is the primary

route of administration according to

methadone treatment sources in

Columbia (SC) and Memphis; injecting and smoking are evenly split as

routes of administration according to

sources in BillingsN and SeattleE

. 

Exhibit 5.

Which non-methadone treatment programs in Pulse Check cities have 

substantial percentages* of clients reporting crack or powder cocaine 

as their primary drug of abuse? How have those percentages changed

(fall 2001 vs spring 2002)?**

*10 percent or more for either crack or powder cocaine

**Non-methadone treatment sources did not respond in Billings, Denver, Los Angeles, New

Orleans, and Washington, DC.

Stable

Stable

Stable

Stable

Stable

Stable

Stable

Stable

Stable

Stable

Stable

Stable

Increase

Increase

Increase

Stable

Stable

Stable

Increase

Stable

Stable

Stable

Stable

Increase

Miami, FL

New York, NY

Detroit, MI

Sioux Falls, SD

St. Louis, MO

Chicago, IL

Memphis, TN

Philadelphia, PA

Baltimore, MD

Honolulu, HI

Boston, MA

El Paso, TX

Percentage of clients

Crack

Powder

City

10 20 30 40 50 60 70 80 90 100
CRACK COCAINE

page 40 Pulse Check: November 2002

Except in Billings, where crack injection has increased since fall 2001, no

changes in routes of crack administration are reported. 

What other drugs do crack users

take? Other drugs taken by crack

users vary widely, with heroin and

marijuana topping the list, and prescription drugs, such as benzodiazepines or pharmaceutical opiates,

commonly reported:

" Heroin taken in combination with

crack (“speedball”): BaltimoreM,

BostonE, ChicagoE,M, Columbia

(SC)M, DenverN, DetroitM, HonoluluN, MiamiE,M, New OrleansE

,

New YorkE,M, PhiladelphiaE,

Portland (ME)N, and SeattleE,M

" Marijuana taken in combination

with crack in a blunt or joint, or

sequentially to mitigate the crack

effects: BaltimoreE, BillingsN,

BostonE, ColumbiaE, DenverE,

DetroitE,N, El PasoE, HonoluluE,N,

Los AngelesE,N, MemphisE,N,M, New

YorkN, New OrleansE, PhiladelphiaE,N, PortlandE

, St. LouisE, and

SeattleN

" Benzodiazepines taken sequentially:

BostonE, MemphisN,M, MiamiE,

PhiladelphiaN, and PortlandE

" Pharmaceutical opiates taken

sequentially: BaltimoreM,

MemphisM, PhiladelphiaN,

PortlandN, and SeattleM

Other combinations include PCP with

crack (“space basing”) in New York,

and methamphetamine in Honolulu.

The non-methadone treatment source

in Billings reports an increase in 

prescription drug use among crack

users since the last reporting period.

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

in the Pulse Check cities?

Male Female Split evenly

Heroin Powder Cocaine

Percentage of respondents

Crack Methamphetamine Marijuana Ecstasy

Source: Epidemiologic/ethnographic respondents

100

80 

60 

40 

20

0

The nature of crack users has changed only slightly (fall 2001 vs spring 2002)...

Users are aging in

some cities, but

younger users 

are reported in

others:

Gender shifts are

reported in only

two cities:

Only one change

is reported in race/

ethnicity and geographic residence:

➤ Memphis, TNN: Even though young adults (18–30 years) predominate, crack users are aging.

➤ Miami, FLE

: Predominant crack users are adults (>30 years) who continue to age.

➤ Billings, MTN: Adolescents and young adults predominate, but adolescents are increasingly using the drug.

➤ Los Angeles, CAE

: Although adults predominate, younger users (late twenties) are increasing.

➤ Sioux Falls, SDN: Adolescents (13–18 years) predominate, but users are increasingly younger (<13 years). 

➤ Sioux Falls, SDN: Crack users used to be primarily males but are now evenly split between the genders.

➤ Washington, DCE

: Young black females have been increasingly using crack.

➤ Sioux Falls, SDN: The predominant crack users are Whites and American Indians, but American Indians have

increased since fall 2001. Similarly, both central city and rural areas predominate as residences, but crack use is

becoming more common on American Indian reservations in rural areas.
Pulse Check: November 2002 page 41

Similarly, the non-methadone treatment source in Memphis notes an

increase in sequential benzodiazepine

use among crack users. 

Where and with whom is crack

used? As reported in past issues,

crack generally tends to be used in

private and in small groups or among

friends, as reported by the majority of

epidemiologic/ethnographic and treatment sources. It also continues to be

used mostly in the streets, crack houses, private residences, and public

housing developments. Other settings

include homeless shelters, public restrooms, abandoned lots, and alleys in

Boston; vacant lots and buildings in

Philadelphia; and adult video stores

in Honolulu. Sources report few

changes since fall 2001: in Memphis,

restaurants are a new use and sales

setting for crack; in St. Louis, sales

and use activity in parks has

increased; and in Honolulu, use in

public housing developments has

declined due to policing.

CRACK COCAINE
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page 42 Pulse Check: November 2002

CRACK COCAINE
POWDER COCAINE✛

Three Pulse Check sources list powder

cocaine as the drug contributing to the

most serious consequences: in BostonL,

DenverE, and El PasoM. One source in

El PasoN names powder cocaine as the

most widely used drug. 

Compared with the last reporting

period, only a few changes occurred:

methamphetamine replaced powder

cocaine as the drug contributing to

the most serious consequences in

DenverL

, and marijuana replaced

powder cocaine in SeattleN. In El

PasoM, heroin replaced powder cocaine

as the most widely used drug. In

MiamiE, powder and crack cocaine

replaced heroin as the drugs contributing to the most serious consquences—

consequences propelled by the combination of these drugs with heroin or

other opiates. Finally, in Sioux FallsE,N,

powder cocaine is emerging as a new

drug problem in spring 2002.

POWDER COCAINE: THE DRUG

How available is powder cocaine

across the country? (Exhibits 1

and 2) As reported in the past Pulse

Check, more than half (23 of 40) of

law enforcement and epidemiologic/

ethnographic sources consider powder

cocaine widely available in their communities, with no regional patterns.

The remaining sources describe it as

“somewhat available,” with four

exceptions: epidemiologic sources in

POWDER COCAINE

Pulse Check: November 2002 page 43

Exhibit 1.

How available is powder cocaine across the 20 Pulse Check cities 

(spring 2002)?

Seattle

Sioux

Falls

Memphis Columbia

New York City

Boston

Washington, DC

Portland

Denver

El Paso

Los

Angeles

Honolulu

Philadelphia

Miami

Detroit

Chicago

New

Orleans

Baltimore

Seattle

Sioux

Falls

Memphis

Columbia

New York

Boston

Washington, DC

Portland

Denver

El Paso

Los

Angeles

Honolulu

Philadelphia

Miami

Detroit

Chicago

New

Orleans

Baltimore

Billings

St. Louis

St.

Louis

Billings

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

According to law enforcement sources (N=20)...

Widely Available Somewhat Available

Not Very Available

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

Law enforcement respondent, EEpidemiologic/ethnographic

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

Exhibit 2.

How has powder cocaine availability changed (fall 2001 vs

spring 2002)?

Memphis, TNL

New York, NYE

Portland, MEL

Sioux Falls, SDE

Honolulu, HIE

Philadelphia, PAL

Baltimore, MDL,E

Billings, MTL,E

Boston, MAL,E

Chicago, ILL,E

Columbia, SCL,E

Denver, COL,E

Detroit, MIL,E

El Paso, TXL,E

Honolulu, HIL

Los Angeles, CAL,E

Memphis, TNE

Miami, FLL,E

New Orleans, LAL,E

New York, NYL

Philadelphia, PAE

Portland, MEE

Seattle, WAL,E

Sioux Falls, SDL

St. Louis, MOL,E

Washington, DCL,E
Honolulu, Los Angeles, St. Louis, and

Washington, DC, describe it as “not

very available.”

According to the majority of law

enforcement and epidemiologic/ethnographic sources, powder cocaine availability remained stable between fall

2001 and spring 2002, with declines

in two cities and increases in four.

What are powder cocaine prices

and purity levels across the

country? (Exhibit 3) Cocaine purity

varies widely across Pulse Check

cities: from 40 to 80 percent in the

Northeast and from 50 to 90 percent

in the West. Only one source each in

the South and Midwest report purity,

and no changes in purity levels are

reported since fall 2001. New powder

cocaine adulterants are reported only

in Memphis: the epidemiologic

source reports quinine as a new adulterant this reporting period, and the

law enforcement source in that city

reports traces of heroin in crack and

powder cocaine (as reported in the

Crack Cocaine section).

Prices also vary widely across Pulse

Check cities, with most gram prices

hovering around $100. Since the last

Pulse Check, prices declined slightly

in Boston and Los Angeles.

How is powder cocaine referred

to and packaged across the country? (Exhibit 4) In all U.S. regions

powder cocaine remains known as

“blow,” “coke,” or “powder,” but

other slang terms often vary by region.

Sources report few new names in

spring 2002, including “aspirin” in

the South and “snort” in the Midwest.

In Boston, when dealers discuss sales

over cell phones, they use feminine

names, such as “girl” or “sister,” as

code words to disguise the topic of

their conversations.

Like heroin and crack, street-level

powder cocaine is most commonly

packaged in plastic, cellophane, glassine, and zipper bags. It is also commonly folded in paper (“pony packs,”

“papers,” “triple folds,” “diamond

folds,” “whites,” and “bindles”), as

reported in Denver, Detroit, El Paso,

Los Angeles, Memphis, Portland

(ME), St. Louis, and Seattle. Other

less common packaging includes aluminum foil and dollar bills in New

York, capsules in Baltimore, cigarette

packs and vials in Memphis, aluminum foil in New Orleans, balloons

in El Paso, and plastic bags with logos

to indicate dealers in Miami—the

only city where labeling is mentioned

this reporting period. Law enforcement and pidemiologic/ethnographic

respondents report no changes in

packaging since fall 2001. 

POWDER COCAINE: THE MARKET

Who sells street-level powder

cocaine? Law enforcement and 

epidemiologic/ethnographic sources

identify powder cocaine sellers as

independent twice as often as they

identify them as organized. In many

cities (BostonE

, ChicagoL, El PasoL,

Los AngelesL

, MemphisE, PhiladelphiaL,

and Portland [ME]L) independent and

organized structures are equally common. In SeattleL two types of powder

cocaine sellers exist: “go-betweens”

who are addicts and serve as liaisons

between buyers and “the guy in the

car,” who supplies the drug and does

page 44 Pulse Check: November 2002

POWDER COCAINE

Exhibit 3.

What are the prices and purity levels of powder cocaine in 18 Pulse

Check cities?*

City/Source Gram purity Gram price

Boston, MAE NR $50

Boston, MAL 50–60% $60

New York, NYL 75% $28–$30

Philadelphia, PAL 60–80% $120–$125

Portland, MEL,E 40–60% $80–$100

Baltimore, MDL NR $90–$100

Columbia, SCL NR $100

Memphis, TNE NR $45–$100

New Orleans, LAE NR $80–$150

Washington, DCE NR $50–$100

Washington, DCL 30–60% $100

Chicago, ILE NR $50–$100

Chicago, ILL NR $125

Detroit, MIL,E NR $75–$125

St. Louis, MOE 77% $100–$125

Sioux Falls, SDL NR $100

Billings, MTL 50–70% $100

Denver, COL,E 30–90% $100–$125

Honolulu, HIL,E NR $100–$125

Los Angeles, CAL 80% $100

Seattle, WAE 57–68% $35–$50

Seattle, WAL 57–68% $80–$100

*Sources in El Paso and Miami did not provide this information. 

NR=Not reported Northeast Midwest South West
not typically use it. As reported in

past Pulse Checks, young adults

(18–30 years) are almost exclusively

the sellers of the drug, with few

exceptions. Adolescents and young

adults sell powder cocaine in ChicagoE

and Los AngelesL,E; adults (>30 years)

and young adults sell the drug in

BostonL, ChicagoL, El PasoL, and

PortlandL; and adults sell it in El

PasoE. Only one change in seller 

characteristics is noted since the last

reporting period: in PortlandL, powder cocaine sellers are increasingly

organized and are selling greater

quantities of the drug.

Similar to percentages for heroin and

crack cocaine, according to law

enforcement and epidemiologic/ 

ethnographic sources, powder cocaine

sellers often use the drug: about onethird report them as very likely to use

the drug, and about half (a much

higher percentage than for heroin at

30 percent or crack at 31 percent)

report them as somewhat likely to use

the drug (see Highlights Exhibit 8). 

What other drugs do powder

cocaine dealers sell? More 

often than not, law enforcement 

and epidemiologic respondents report

that powder cocaine dealers sell other

drugs, with 10 of 27 respondents

reporting no other drugs sold by

powder cocaine dealers. The most

common other drug sold is marijuana, followed by crack, heroin, and

methamphetamine. In Columbia (SC)L

crack and marijuana are sold by powder cocaine dealers in the streets, but

ecstasy is sold by powder cocaine

dealers in nightclubs. Sources report

no changes in other drugs sold since

the last reporting period.

What types of crimes are related

to powder cocaine sales? Powder

cocaine dealers are often involved in

violent crimes, such as assaults in

New York, robbery and theft in

Memphis, home invasions in Miami,

and street robberies in Los Angeles.

Nonviolent crimes include auto

thefts, break-ins, and larceny in

Columbia (SC); burglaries in El Paso,

Los Angeles, and Billings; transporting

illegal aliens in El Paso; and money

laundering in Miami. Law enforcement

and epidemiologic/ethnographic

sources also mention domestic violence and prostitution as crimes in

which powder cocaine sellers are

often involved.

Where are powder cocaine 

markets located? Unlike heroin

and crack cocaine sales, which are

conducted primarily in central city

areas, powder cocaine sales are more

evenly distributed among geographic

areas. For example, law enforcement

and epidemiologic/ethnographic

sources in nine cities list all areas

(central city, rural, and suburban) as

locations equally likely to have powder cocaine markets. Similarly, both

indoor and outdoor sales are equally

common, according to sources in the

majority of cities (13 of 20). Similar

to crack sales settings, streets, private

residences, and public housing developments are the oft-mentioned powder cocaine settings. Unlike crack

sales settings, nightclubs and bars are

often mentioned as powder cocaine

settings (by 17 of 20 law enforcement

sources), as are raves and concerts (by

8 of 20 law enforcement sources).

POWDER COCAINE

Pulse Check: November 2002 page 45

Exhibit 4.

How is powder cocaine referred to in the four regions of the country?*

WEST

Blow, coca, coke, girl, lady, she, powder, shake,

shrile, snow, soft, toot, white, blanca, white girl,

white horse, white lady, white man, white pants,

snow white, ASPIRIN, bird, candy, DP (dime

pack), eightball, a half (half gram), perico, ppacks, sal (salt), sugar

Coke, flake

Blow, coke, dust,

fast, flake, nose

candy, powder,

sniff, snow, sugar,

white, white boy,

white lady, yao

Blow, coke,

girl, powder,

shirt, SNORT,

white

Blow, coke, flake, flave,

girl, lady, nose candy,

product, aunt, cola, perico,

powder, sister, snow, snow

birds, white, big C, devil's

dandruff, uptown

MIDWEST NORTHEAST

SOUTH

*Names in all caps are new this reporting period.

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

Several new powder cocaine sales

settings are reported (fall 2001 vs

spring 2002)...

➤ Miami, FLL

: The Internet is now

used as a communication tool for

powder cocaine sales. 

➤ New Orleans, LAE

: Sales locations

have expanded to include settings

other than public housing projects.

➤ Philadelphia, PAL

: Sales have moved

indoors. 

➤ Portland, MEE

: Settings now include

private parties and hotel or motels.
POWDER COCAINE: USERS

How many powder cocaine users

are in treatment? (Exhibit 5)

Primary powder cocaine users constitute 10 percent or more of treatment

clients in five cities (Boston, Chicago,

El Paso, Miami, and Sioux Falls),

compared with 11 cities for crack

clients (see Crack Exhibit 5). The

largest proportion, by far, of powder

cocaine clients is in Sioux Falls at 58

percent. Between fall 2001 and spring

2002, proportions of powder cocaine

users remained relatively stable

among treatment clients in most

cities, with several exceptions:

increases are reported in six cities,

and declines are reported in three, 

as shown in the arrows below.

Who uses powder cocaine?

Powder cocaine users are predominantly adult (>30 years) White males,

who live in central city areas. Although

most epidemiologic/ethnographic and

treatment sources agree that powder

cocaine users are predominantly

adults, variations are reported: 14 of

45 respondents report young adults

(18–30 years) as the predominant

powder cocaine users, 3 report adolescents (13–18 years) and young adults

as the predominant age groups, and 2

report adolescents as the predominant

group. Similarly, although males are

most often reported as the predominant gender of powder cocaine users

(by 26 of 45 respondents), 17 respondents report that the genders are

evenly split, and 2 report that females

predominate. Most respondents (21

of 45) report Whites as predominant

users, but Blacks predominate according to 11 respondents, Hispanics predominate according to 4 respondents

(in El Paso, Los Angeles, and New

York), and Blacks and Hispanics predominate according to the nonmethadone sources in Miami and

New York.

How do users take powder

cocaine, and what other drugs

do they take? Snorting remains the

most common administration route.

However, seven respondents (mostly

methadone treatment sources who

identify powder cocaine as used in

combination with heroin) list injecting

as the primary route of administration.

Several epidemiologic/ethnographic

and treatment respondents list a variety of routes as common: snorting

and injecting are equally common in

BillingsN and El PasoM; snorting and

smoking are equally common in

BostonE and MiamiM; and snorting,

smoking, and injecting are equally

common in Sioux FallsN. 

Heroin taken in combination with

powder cocaine as a “speedball”

remains common in many cities across

the Nation (particularly among

methadone treatment clients), including BaltimoreE

, BostonE,M, ChicagoE,M,N,

DenverE,N, El PasoM, Los AngelesM,

MemphisE, MiamiE,M, New YorkE,M,

PhiladelphiaE, Portland (ME)E, St.

LouisM, SeattleM, and Washington, DCE. 

Marijuana also remains commonly

taken with powder cocaine, either in

combination as a cocaine-laced blunt

or joint (“primo”or “tio” in El Paso,

“cocoa puff” in Honolulu, and

“primo” or “p-dog” in Los Angeles)

or sequentially. 

Prescription drugs, such as benzodiazepines or opioids, continue to be

used in combination or sequentially

with powder cocaine in several cities:

Boston, Memphis (alprazolam

[Xanax®] or hydromorphone

[Dilaudid®]), New York, Philadelphia,

Portland, and St. Louis (diazepam). 

POWDER COCAINE

page 46 Pulse Check: November 2002

Exhibit 5.

How has the number of powder

cocaine users changed (fall 2001

vs spring 2002)?

Chicago, ILN

Columbia, SCN

Denver, COE

Honolulu, HIN

Miami, FLE

Sioux Falls, SDE,N

Columbia, SCE

Denver, CON,M

Portland, MEN

Few changes are reported in user characteristics for powder cocaine (fall

2001 vs spring 2002)...

Age distribution

changes:

Gender distribution

changes:

Race/ethnicity distribution changes:

➤ Billings, MTN: The number of young adult (18–30 years)

users increased slightly.

➤ Sioux Falls, SDE,N: The epidemiologic/ethnographic source

reports that the new group of powder cocaine users is

increasingly younger. The non-methadone treatment source

adds that preadolescents and adolescents have increased

since the last reporting period.

➤ Columbia, SCN: Female use is increasing.

➤ Memphis, TNE

: Male use is increasing

➤ Denver, COE

; Miami, FLM; and Sioux Falls, SDE: Hispanics

increased as powder cocaine users (especially younger

Hispanics in Miami).
Club drugs, such as ecstasy, are used

in combination or sequentially with

powder cocaine in Miami (to “bump

up”), Portland (ME), and Seattle. 

Where is powder cocaine used?

As reported in previous Pulse Checks,

powder cocaine tends to be used

indoors, in private, and in small

groups among friends. Private residences are the most common use 

settings, followed by private parties,

nightclubs and bars, cars, and streets.

No changes are reported since fall

2001, but unusual use settings include

boats in Portland (ME) and parking

lots around supermarkets, strip malls,

and convenience stores (for sales and

use) in Miami. 

POWDER COCAINE

Pulse Check: November 2002 page 47

Sources identify several changes

in the route of powder cocaine use

(fall 2001 vs spring 2002)... 

➤ El Paso, TXM: Powder cocaine 

users increasingly mix snorting and

injecting as their preferred route of

administration.

➤ Seattle, WAE

: Anal use of the drug is

a new phenomenon.

➤ Sioux Falls, SDN: Injecting the drug

has increased. 

From powder to crack... 

➤ Memphis, TNN: Powder cocaine

users tend to start out with powder

cocaine in their youth. They then

advance to crack in adulthood.
POWDER COCAINE

page 48 Pulse Check: November 2002

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MARIJUANA

Pulse Check: November 2002 page 49

MARIJUANA✛

Honolulu, Memphis, and New

Orleans are the only three cities

where no Pulse Check source names

marijuana as their community’s most

widely abused drug (see Highlights

Exhibit 3). In the other 17 Pulse

Check cities, 34 law enforcement, epidemiologic/ethnographic, and nonmethadone sources name marijuana

as such. Additionally, three nonmethadone sources—in Columbia

(SC), Seattle, and Sioux Falls—consider marijuana the drug that contributes

to the most serious consequences.

Compared with the last Pulse Check

reporting period, the Seattle nonmethadone treatment source believes

that marijuana has replaced cocaine as

the drug contributing to the most

serious consequences, and the law

enforcement source in Washington,

DC, believes it has replaced crack as

the most widely used drug.

MARIJUANA: THE DRUG

How available is marijuana, in its

various forms, across the country? (Exhibits 1, 2, and 3) As reported in the last several Pulse Checks, all

but 1 of the 40 law enforcement and

epidemiologic/ethnographic sources

consider marijuana widely available in

their communities. The exception

continues to be in Chicago, where the

law enforcement source considers the

drug somewhat available. 

The two most common varieties of

marijuana are local commercial grade

and Mexican commercial grade. The

former is ranked as widely available

by 23 sources in all but 4 of the Pulse

Check cities (Boston, Chicago, Detroit,

and El Paso); the latter is ranked as

such by 21 sources in all but 3 cities

(Miami, Portland [ME], and Washington, DC)—an increase since the last

Pulse Check.

Sinsemilla (seedless marijuana) remains

the third most common variety

(ranked widely available by 16

sources in 12 cities), followed by

hydroponically grown marijuana

(ranked widely available by 12

sources in 9 cities). British Columbian

marijuana (“BC bud”) remains the

least common variety, with only six

sources ranking it as widely available

Exhibit 1.

How available is marijuana across the 20 Pulse Check cities (spring 2002)?

City

According to law enforcement and

epidemiologic/ethnographic sources (N=40)...

Widely Available, according to both source types

Widely Available, according to the epidemiologic/ethnographic source; 

somewhat available according to the law enforcement source

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

Law

enforcement respondent, E

Epidemiologic/ethnographic respondent, NNon-methadone treatment

respondent, and MMethadone treatment respondent.

Exhibit 2.

How has marijuana availability

changed (fall 2001 vs spring

2002)?

Boston, MAE

Denver, COL

Philadelphia, PAL

Baltimore, MDL,E

Billings, MTL,E

Boston, MAL

Chicago, ILL,E

Columbia, SCL,E

Denver, COE

Detroit, MIL,E

El Paso, TXL,E

Honolulu, HIL,E

Los Angeles, CAL,E

Memphis, TNL,E

Miami, FLL,E

New Orleans, LAL,E

New York, NYL,E

Philadelphia, PAE

Portland, MEL,E

Seattle, WAL,E

Sioux Falls, SDL,E

St. Louis, MOL,E

Washington, DCL,E
MARIJUANA

page 50 Pulse Check: November 2002

in four cities: Baltimore, Billings,

New York, and Seattle.

Since the last reporting period, 

availability of marijuana in general

has remained stable, with only two

perceived increases and one perceived

decline, as shown in the first arrows.

Similarly, the numerous varieties have

remained generally stable in availability, although a few shifts are noted 

(in the second arrows), particularly

increases in hydroponic marijuana

and BC bud. The latter variety has

increased mostly in the West.

How is domestic marijuana

grown? Indoor and outdoor growing

operations (“grows”) are reported

about equally:

" Indoors: BillingsL

, BostonL,

DenverL, MemphisL, MiamiL,E, New

OrleansE, New YorkL, PhiladelphiaL,

St. LouisL, and SeattleL,E

" Outdoors: BaltimoreL

, HonoluluL,

Los AngelesL, MemphisE, New

OrleansL, St. LouisE, Sioux FallsL,E,

and Washington, DCL

" Both: ChicagoL

, DenverL, DetroitL,E,

HonoluluE, New YorkE, PortlandL,E,

and Washington, DCE

A few shifts are reported since the

last Pulse Check:

" Boston, MAL

: Increases are noted

in the number of indoor hydroponic grows, the amount grown,

and THC levels. Most marijuana,

however, continues to come from

Canada via Hell’s Angels.

" Denver, COL

: While most marijuana is grown locally indoors, bigger

loads have been coming in from

Mexico.

" Miami, FLL

: Indoor grows continue to be popular, sometimes in

gated communities, sometimes in

houses rented specifically for growing. Since the last reporting period,

Cuban refugees have become

increasingly involved in marijuana

grow houses.

" Philadelphia, PAL

: While local

indoor grows are still not common,

they are increasing.

" Portland, MEL

: Marijuana growing

continues to become more sophisticated, with new seedlings moved

indoors for the winter and then

moved outdoors again in the spring.

" Sioux Falls, SCE

: Outdoor grows

are influenced by weather and 

seasonal changes.

" Washington, DCL

: Hidden outdoor

grows are increasing.

Have street-level prices and

adulteration changed across the

country? (Exhibit 4) Prices and purity levels have remained generally stable since the last reporting period,

with a few exceptions. Five shifts

involve increases:

" Billings, MTL

: The gram price has

increased slightly from $5 to

$10–$20, depending on quality

" Boston, MAL

: Marijuana continues

to increase in potency and price.

" Miami, FLL

: Pound prices have

increased from $4,000 to $5,000.

" New York, NYE

: Purity has

increased.

" Portland, MEE

: Both purity and

prices have increased.

Three shifts involve declines:

" Chicago, ILE

: Prices have declined

at the lower end of the range.

" El Paso, TXL

: Pound prices have

declined from $445–$300 to

$275–$300.

" Honolulu, HIE

: Pound prices have

declined considerably.

Only a few THC levels are reported:

15–22 percent per gram of sinsemilla

in Honolulu; 4–6 percent for

Mexican grade and 25 percent per

Exhibit 3.

Which marijuana varieties have

changed in availability (fall 2001

vs spring 2002)?

Hydroponic

Boston, MAL,E

Columbia, SCL

Denver, COL

Memphis, TNL

Miami, FLE

New York, NYE

Seattle, WAL

BC bud

Billings, MTL

Boston, MAE

Denver, COL

Los Angeles, CAE

Seattle, WAL

Local commercial grade

Boston, MAE

Denver, COL

Sinsemilla

Boston, MAE

Mexican

Denver, COL

Hydroponic

St. Louis, MOE

Local commercial grade

Philadephia, PAL

Mexican

Philadephia, PAL

Seattle, WAL
MARIJUANA

Pulse Check: November 2002 page 51

mid-grade ounce in Los Angeles; and

2–3 percent per pound of Mexican,

12–18 percent per pound of domestic

indoor hydroponic, and 15–25 percent

per pound of BC bud in Seattle.

Marijuana is sometimes sold with

adulterants, with a few instances

reported this period:

" Columbia, SCN,M: Marijuana is

laced with crack, PCP (“chronic”),

or “embalming fluid (“wet joints”).

PCP-laced joints are increasing.

" Miami, FLM: Some dealers lace marijuana with cocaine to get customers

to return. The buyers assume “it’s

just especially potent marijuana.” 

" Washington, DCM: Adulterants

include embalming fluid and 

baby oil.

Have marijuana slang terms

changed across the country?

(Exhibit 5) Among the many slang

terms for marijuana, marijuana 

smoking, and marijuana combinations, only a few are new: “chronic”

in Chicago; “schwagg” and “spliff” 

in Memphis; and “crank” in

Washington, DC.

MARIJUANA: THE MARKET

Who sells marijuana? As reported

in past Pulse Checks, marijuana sellers

are more likely to operate independently than as part of organized operations. However, organizations with

varying degrees of structure do exist

in several cities, such as Memphis,

Miami, and New Orleans in the

South, Chicago and Detroit in the

Midwest, and Billings in the West. 

The vast majority of Pulse Check law

enforcement and epidemiologic/ 

ethnographic sources continue to

report that marijuana sellers are

somewhat or very likely to use their

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

MOST COMMON STREET UNIT 1 OUNCE

City/Source Type Unit Price Price

Boston, MAE Commercial 0.125 oz $20 $100–$125 

0.33 oz bag $50 NR 

Boston, MAL Sinsemilla $80–$100 

New York, NYE Commercial bag $10 NR 

Hydroponic bag $20 NR 

New York, NYL Commercial $100–$200 

Hydroponic or

sinsemilla $300–$1,200 

Philadelphia, PAE NR bag, blunt $5 NR 

Philadelphia, PAL Commercial $150–$200 

Portland, MEL NR joint $5 $175–$225 

Baltimore, MDL NR joint $1–$3 $100 

Columbia, SCL Mexican 

or local 

commercial dime bag, 3–4 g $10 $180 

El Paso, TXE NR bag, five joints $20 NR 

El Paso, TXL Mexican 

commercial 0.25 oz $20 NR 

Memphis, TNE Commercial joint $5 $100 

quarter bag $25 NR 

Memphis, TNL NR 0.25 oz $25 $100 

New Orleans, LAE NR joint $7 NR 

New Orleans, LAL NR joint $5 $300 

Washington, DCE Commercial bag, several joints $5–$10 $100 

blunt $10–$20 

Hydroponic NR NR $480 

Washington, DCL NR 20–bags $20 NR 

Chicago, ILE NR loose bag $5–$10 $80–$200 

Detroit, MIE NR 0.25 oz $200 NR 

one joint $2–$6 

Detroit, MIL NR bag, 1 g $10 NR 

St. Louis, MOL NR small bag $20 $100 

Sioux Falls, SDL Mexican 

commercial $100–$200 

BC bud $400 

Billings, MTL NR 1 g $10–$20 NR 

Denver, COL NR NR NR $100–$200 

Denver, COE BC bud NR NR $600 

Honolulu, HIE NR joint $5–$20 NR 

1 g $25 NR 

Honolulu, HIL Sinsemilla 1 g $25 NR 

Los Angeles, CAE Mexican 

commercial 1 g $10 $60–$80

Mexican 

mid grade 1 g $25 $200–$250 

Los Angeles, CAL Mexican dime bag, 1 g $10 NR 

Seattle, WAE NR 1 g $10–$20 $400

Northeast South West Midwest

*Respondents in Miami did not provide this information.

NR = not reported

Sources: Law enforcement and epidemiologic/ethnographic respondents
MARIJUANA

page 52 Pulse Check: November 2002

own drug, much more so than sellers

of other drugs (see Highlights Exhibit

8). The majority of sources also continue to report young adults (18–30

years) as the predominant sellers.

Adolescents, however, are named as

such in BaltimoreE and New OrleansL.

Both adolescents and young adults

are named by some sources (as in

BillingsL, ChicagoE, HonoluluE, Los

AngelesL,E, MemphisE, and New

OrleansE), while both young adults

and adults older than 30 are named

by others (in BostonL, El PasoL, St.

LouisL,E, and Sioux FallsL

). All three

age groups are named in BaltimoreL.

Since the last Pulse Check, adolescent

sellers have been increasing in

MemphisE.

What types of crimes are related

to marijuana sales? Marijuana

sellers are more likely to be involved

in nonviolent crimes, such as theft,

robbery, and burglary, than in violent

crimes. The drug is seldom associated

with rape, domestic violence, or prostitution (see Highlights Exhibit 7).

When violent crime is reported, it is

sometimes associated with organized

rather than independent dealers, as in

St. Louis. In Sioux Falls, any violent

crime involving marijuana sales typically also involves methamphetamine.

One change for the worse is reported

since the last Pulse Check: in

Memphis, marijuana sales have been

increasingly associated with gangrelated violent crimes, such as murders and shootings.

How and where do marijuana

markets operate? Marijuana sales

often involve acquaintance or referral

networks, posing a challenge to law

enforcement disruption efforts. The

actual exchanges are usually hand-tohand, sometimes at prearranged

meetings (as in Chicago, Columbia

[SC], Honolulu, Memphis, and

Washington, DC) or via home delivery (as in Boston, El Paso, Portland

[ME], and Seattle). Beepers and cell

phones are sometimes involved (as in

Boston, Honolulu, Los Angeles,

Memphis, New Orleans, Seattle, and

Sioux Falls). Open-air markets still

exist in some cities (such as Chicago, 

Honolulu, New Orleans, Philadelphia, Seattle, and Washington, DC),

although sometimes they are held in

more discreet areas of public housing

developments (as in Chicago, New

Orleans, and Washington, DC).

As reported in past Pulse Checks, 

marijuana, more than other drugs,

tends to be sold both indoors and 

outdoors and in all types of geographic areas—central city, suburban, and

rural. The specific market settings

remain varied, with only a handful of

changes since the last Pulse Check:

" Boston, MAL

: Sales continue to

move more underground than in

the past, with an increasing use of

beepers.

" Detroit, MIL

: Sales have increased

in sheer volume.

" Memphis, TNE

: More outdoor

sales are reported, but the number

of sales settings has declined. Sales

around stores or treatment clinics,

reported in the past, are not

reported during this period.

" New Orleans, LAE

: The marijuana

market, once limited to public

housing projects, has spread to all

parts of the city.

" Philadelphia, PAL

: Operation Safe

Streets has generated much market

movement, both indoors and to

other street corners. This movement has had two effects: when

markets move indoors, law enforcement can target specific homes; and

out-of-town buyers have become

particularly confused when they see

the visible police presence, and they

do not know where to “score.”

What other drugs are associated

with marijuana sales? About half

of reporting law enforcement and

Exhibit 5. 

How is marijuana referred to in the four regions of the country?*

WEST

Bud, grass, herb, mary jane,

pot, smoke, weed, babysitter,

chemo, colas, firewood,

pakaloco, (crazy tobacco),

salad, skunk, chronic (bc bud),

crip, triple a (bc bud), kind

bud (high quality), ragweed,

skunkweed, swag (low quality), kona gold, kawaii electric,

maui wowie

Bud, grass, green, mary

jane, pot, reefer, smoke,

weed, blunts, chronic, nickel bags ($5 bags), LG (lime

green), hydro, chiefing

(smoking marijuana)

MIDWEST NORTHEAST

SOUTH

Bud, doobie, dope, pot,

ganja, grass, herb, jay, mary

jane, reefer, smoke, trees,

weed, arizona, blunt, bone,

chronic, gorge, hash, hash

oil, homegrown, hydro,

joint, loose shank, purple

haze, roach, scrub, sinse or

sins (sinsemilla), vermont,

blazing (smoking marijuana)

Bud, doobie, dope, fire, herb, ganja, grass, green, jane, mary jane, pot, smoke, trees, weed, blow,

bush, clover, crank, dip, mota, salad, schwagg, red bud (hydroponic), bubbleberry (hydroponic),

gold bud, hydro, teak (hydroponic), ink (hydroponic), kryptonite or krippy (high-grade hydroponic), ragweed (low grade), ditchweed (low grade), kindbud, THC, chronic (PCP laced), wet

joints (embalming fluid laced), macaroni, macaroni and cheese ($10 of cocaine and $5 pack of

marijuana), blunt, spliff, baggies

* Bolded names are new this reporting period.

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

Pulse Check: November 2002 page 53

epidemiologic/ethnographic sources

report that marijuana dealers sell no

other drugs. In St. Louis, the gangrelated distributors sell other drugs,

while the independent low-level dealers do not. Conversely, in Sioux Falls,

larger marijuana dealers sell only

marijuana, while other dealers sell

crack or methamphetamine as well.

In Chicago, heroin and cocaine are

sometimes sold on the same streets as

marijuana, but not by the same people.

The drugs most commonly reported as

sold by marijuana dealers, in descending order of frequency, are as follows:

" Crack: Columbia (SC)L

, DenverE,

HonoluluL, New OrleansL,E, New

YorkL, St. LouisE, and Sioux FallsL

" Powder cocaine: ColumbiaL

,

DenverE, HonoluluL, MemphisL,

MiamiL, and New YorkL

" Heroin: BaltimoreL

, DenverE, New

OrleansL, New YorkL, and St.

LouisE

" Ecstasy: DenverL

, HonoluluL,

MiamiL,E, and New YorkL

" Methamphetamine: BillingsL

,

DenverL,E, HonoluluL, and Sioux

FallsL

" Flunitrazepam (Rohypnol®, or

“roches”): El PasoE

MARIJUANA: THE USERS

How many marijuana users are in

treatment, and how do they get

there? (Exhibits 6 and 7) Marijuana

use by clients in treatment has

remained relatively stable in most

Pulse Check cities since the last

reporting period. The drug accounts

for sizable proportions of clients in

treatment at non-methadone programs represented by several Pulse

Check sources, as shown in the graph.

Furthermore, these percentages are

even higher when including all use,

whether primary, secondary, or tertiary. For example, 100 percent of the

clients in the Seattle and Sioux Falls

programs report any marijuana use.

In methadone programs, virtually all

marijuana use is secondary or tertiary. 

Marijuana users are predominantly

referred to treatment through courts

or the criminal justice system, more

so than users of other drugs, as

reported in past Pulse Checks. School

referrals to treatment are also more

likely among marijuana users than

among users of other drugs. Referral

sources have remained generally 

stable since the last reporting period,

with three exceptions:

" New York, NYM: More people are

being referred through the parole

system.

Exhibit 6.

Which non-methadone treatment programs in Pulse Check sites 

have substantial percentages* of clients reporting marijuana as their 

primary drug of abuse? How have those percentages changed (fall 2001

vs spring 2002)?

*30 percent or more

Stable

Stable

Stable

Some increase

Stable

Stable

Stable

Stable

Seattle, WA

Sioux Falls, SD

Los Angeles, CA

Chicago, IL

Miami, FL

Philadelphia, PA

Detroit, MI

St. Louis, MO

Percentage of clients

City

10 20 30 40 50 60 70 80 90 100

Exhibit 7.

How are different drug users referred to treatment?

Sources: Non-methadone treatment respondents

Note: Many respondents list more than one referral source.

Marijuana

Heroin

Crack

Court/

criminal

justice

School Alcohol/drug

abuse health

care provider

Health

care

provider

Individual Employer

Number of respondents (N=19)

20

15

10

5

0 0
MARIJUANA

page 54 Pulse Check: November 2002

" Portland, MEN: Referrals from

other health providers have been

increasing.

" Sioux Falls, SDN: More self-referrals

and family referrals are reported.

Who uses marijuana? (Exhibits 8

and 9) While young or older adults

are most frequently reported as the

predominant marijuana-using group,

several sources report adolescents as

such: BaltimoreE

, ChicagoN, Columbia

(SC)M’N, El PasoE’N, DenverE, Los

AngelesE, and New OrleansE. An additional 11 sources report adolescents

along with one or both older age

groups as the predominant group.

Moreover, one source in Sioux FallsN,

reports adolescents along with 

preadolescents (<13 years). 

As the table shows, the differences

between the populations described by

epidemiologic/ethnographic, nonmethadone treatment, and methadone

treatment sources are particularly

apparent with regard to marijuana.

Marijuana users also differ in many

ways from users of other drugs. For

example, as the graph shows, they are

more likely to reside in all locations

(central city, suburban, and rural areas),

rather than be concentrated in just one

or two areas.

How do users take marijuana?

Joints remain the most common 

vehicle for smoking marijuana, as

reported in past Pulse Checks. However, blunts (hollowed-out cigars

filled with marijuana) are more common than joints in many cities, such

as BaltimoreN, ChicagoN, Columbia

(SC)N, MemphisN, New OrleansE, New

YorkE

, and PhiladelphiaE,N. Other, less

commonly reported delivery systems

include pipes (in ColumbiaN, DenverE,

Los AngelesN, MemphisE, and Sioux

FallsE), bongs (in DenverE, HonoluluN,

Los AngelesE

, and SeattleN), and bowls

(in ColumbiaN and Los AngelesE).

Wraps, made of either tobacco leaves

or colored or flavored papers, are a

more recently reported vehicle for

smoking marijuana (in El PasoE,

MiamiM, PhiladelphiaE, and

Washington, DCE).

A few shifts are noted since the last

report:

" Boston, MAN: Blunts are becoming

more common.

" Boston, MAE

: Blunt wraps are

increasing, while there is a movement away from paper.

" El Paso, TXE

: Use in joints has

been declining as colored and flavored papers are becoming more

common. 

" Memphis, TNN: Blunts have been

increasingly used for the past 5

years. They have now become

more common than joints.

Exhibit 9.

Where are drug users most likely to reside?

Sources: Epidemiologic/ethnographic respondents Note: Some respondents list two areas per city.

Rural Areas

Suburbs

Central City

All Areas

Marijuana Ecstasy

0 0

Powder cocaine Crack Heroin

Number of respondents (N=19)

20

15

10

5

0

Exhibit 8. 

Who is most likely to use marijuana?

Different source groups deal with quite different populations. Thus, each group paints a

slightly different picture of the kind of people most likely to use marijuana...

Age Cuts across all groups Young adults Older adults 

Average mean age 22.25 (n=11) 22.85 (n=7) 35.8 (n=6) 

Gender Half report males; Males (but 7 report Males (only 3 report

half report even equal gender splits) equal gender splits)

gender splits 

Race/ethnicity Varies widely Varies widely Varies widely 

Socioeconomic 

status Cuts across all groups Low Low 

Residence Cuts across all areas Central city Central city

Education (highest Junior high and high

level completed) NR school equally likely High school

Employment NR Student or Unemployed

unemployed

Predominant user Epidemiologic/ Non-methadone Methadone treatment

characteristic ethnographic sources treatment sources sources tend to retend to report... tend to report... port...
MARIJUANA

Pulse Check: November 2002 page 55

" Miami, FLM: Blunts are increasing,

and blunt wraps are a new 

phenomenon.

" Philadelphia, PAE

: People are

switching daily from blunts to 

flavored blunt wraps. Sales outlets

are becoming more prevalent, and

these places are staying open later.

" Washington, DCE

: Blunts are

becoming less common. Joints are

“in,” and flavored papers for joints 

are becoming more popular.

Where and with whom is 

marijuana used? Only one change

is reported since the last Pulse Check:

in El Paso, users are smoking marijuana more openly, in broad daylight, in

public places, whereas in the past, use

tended to be more private. Elsewhere,

as reported in the last Pulse Check,

epidemiologic/ethnographic and 

non-methadone treatment sources

generally continue to agree that marijuana is equally likely to be used

either publicly or privately. Methadone treatment sources, however, 

still tend to report more private than

public use. Most sources also report

either that users are more likely to

smoke marijuana in small groups

rather than alone, or else that smallgroup use and solo use are equally

likely. However, five sources report

solo use as more likely, and four of

those five are methadone treatment

sources (from Chicago, El Paso, 

New York, and Seattle). The variety

of specific use settings reported by all

sources is innumerable.

What other drugs do marijuana

users take? Three new developments are reported since the last

Pulse Check:

" El Paso, TXE

: A new drug is being

used with marijuana: ketamine

(“special K”).

" El Paso, TXM: Clients are smoking

joints laced with cocaine. 

" New Orleans, LAE

: Use of 

marijuana laced with PCP is 

making a comeback.

Elsewhere, marijuana frequently 

continues to be used with alcohol,

and it continues to be smoked with a

The nature of marijuana users is changing in some cities (fall 2001 vs spring 2002)...

Since the last reporting period, no changes are reported in socioeconomic status or place of residence. A few shifts are reported, however, in age, gender, race/ethnicity, and employment status.

Several age shifts reflect a decline

in the age of marijuana users: 

Only one gender shift is reported: 

Racial/ethnic distributions have

remained relatively stable, with

two exceptions:

Two treatment sources note

changes in their clients’ 

employment status: 

A market strategy aimed at girls...

El Paso, TXE

: Sold at convenience stores,

headshops, and drug stores, particularly

in the downtown area, wraps are longer

than regular cigarette joint papers. They

are particularly aimed at girls, who like

the various colors and flavors, such as

strawberry, banana, and orange.

➤ Boston, MAN: While this specific program is only for people older than 18, other programs are

showing an increase in adolescent users.

➤ Columbia, SCE

: An increasingly younger population was seen last reporting period, and this trend

has continued. 

➤ Honolulu, HIE

: The number of young adult users in treatment is increasing.

➤ Los Angeles, CAN: The number of younger users is increasing.

➤ Memphis, TNN: The number of preadolescent users in the community, outside of the program, 

is increasing.

➤ Sioux Falls, SDN: The number of preadolescent (<13 years) and adolescent (13–17 years) users 

is increasing.

➤ Memphis, TNE

: The number of female users has increased. 

➤ El Paso, TXM: While marijuana users are primarily Hispanics, more White people are being seen.

➤ Memphis, TNE

: Marijuana use, equally common among both Blacks and Whites, has increased

among both groups. 

➤ New York, NYM: While users are still predominantly unemployed, employment has increased

slightly, both at admission and during treatment. Parolees tend to be employed more.

➤ Sioux Falls, SDN: The number of unemployed clients has increased, as has the number who are

marijuana dealers.
MARIJUANA

page 56 Pulse Check: November 2002

variety of other substances, either

sequentially or in combination:

" Benzodiazepines: Boston,

Memphis, and Philadelphia

" Club drugs (such as ecstasy, 

ketamine, LSD): Boston, Columbia

(SC), El Paso, Los Angeles, and

Portland (ME)

" Crack: Chicago, Columbia,

Denver, Honolulu, Memphis, New

Orleans, New York, Philadelphia,

and St. Louis (Crack combined

with marijuana is referred to as

“primos” in Denver and Memphis

and “turbos” in Philadelphia.)

" Formaldelhyde: Seattle (“Sherms”

or “s” refer to this combination.)

" Heroin: Boston, Chicago, El Paso,

Miami, New Orleans, New York,

and Portland (ME) (In New York,

“woolie” or “woola blunt” are

slang names for heroin and 

marijuana in combination.)

" Methamphetamine: Billings,

Denver, Honolulu, and Sioux Falls

" Other opiates: Boston, Memphis,

and Philadelphia

" PCP: Chicago, Los Angeles, New

Orleans, Philadelphia, Portland,

and Sioux Falls (PCP in combination with marijuana is called “joy

stick” or “happy stick” in Boston

and “loveboat” or “wet” in

Philadelphia.)

" Powder cocaine: Boston, El Paso,

Honolulu, Memphis, Miami, New

York, and Philadelphia (“Greek”

refers to this combination in Miami.)

What are the consequences of

marijuana use? (Exhibit 10) In 

trying to assess the consequences of

marijuana use, many factors come

into play, including the other drugs

sometimes combined with marijuana.

However, as the following examples

indicate, some Pulse Check sources 

do note adverse consequences—sometimes medical, sometimes societal—

involving the marijuana-using populations with whom they have contact:

" Baltimore, MDM: A high percentage of clients have asthma, and marijuana makes the condition worse.

" Boston, MAN: Clients who use

marijuana have reduced incentive,

and some even experience paranoia.

" Los Angeles, CAN: Non-motivation

is a problem among marijuanausing clients.

" Memphis, TNE

: Several marijuana

dealers involved in gang-related

crimes have been shot.

" Miami, FLE

: Marijuana is associated with high-risk sexual behavior

in adolescents. It has been detected,

often without other drugs, in many

adolescent and young adult homicide victims. Among recent marijuana-related emergency department

episodes, substantial percentages

have been reportedly due to (in

descending order) depression or

suicide ideation, psychotic episodes

(such as hallucinations, anxiety,

bizarre behavior, or delusions),

trauma (accidents), altered mental

status, and chest pain.

" New York, NYM: Clients who use

marijuana are more likely to 

experience depression.

" Philadelphia, PAE

: Emergency

department visits involving 

marijuana have increased. Philadelphia now has the highest rate in

the country.

" Sioux Falls, SDN: Mental health

issues have been increasing among

marijuana-using clients, including

new admissions.

Exhibit 10.

What adverse consequences do substantial percentages* of Pulse Check

sources attribute to the use of marijuana, either alone or in combination

with other drugs?

*>20 percent

Sources: Epidemiologic/ethnographic, non-methadone treatment, and methadone treatment

respondents

Arrests

Poor academic performance

Deteriorating family/social relationships

Poor workplace performance

School absenteeism or truancy

Short-term memory loss

Workplace absenteeism

Dropping out of school

Unemployment

Emergency department visits

Auto accidents

Percentage of sources (N=58)

Consequence

10 20 30 40 50 60
METHAMPHETAMINE

Pulse Check: November 2002 page 57

METHAMPHETAMINE✛

Methamphetamine is reported as an

emerging or intensifying problem in

10 cities: Columbia (SC), Denver,

Detroit, El Paso, Memphis, Miami,

New York, St. Louis, Seattle, and

Sioux Falls (see Highlights Exhibit 6).

Furthermore, sources believe the drug

contributes to the most serious consequences in eight cities, particularly in

the West: Billings, Denver, Honolulu,

Los Angeles, Memphis, St. Louis,

Sioux Falls, and Seattle (see Highlights

Exhibits 3 and 4). It is considered the

most widely abused drug by sources

in Billings, Denver, Honolulu, and

Memphis. Since the last reporting

period, law enforcement sources

believe methamphetamine has replaced powder cocaine in Denver and

marijuana in Memphis, as the drug

contributing to the most serious consequences (see Highlights Exhibit 5). 

METHAMPHETAMINE: THE DRUG

How available is methamphetamine, in its various forms,

across the country? (Exhibits 1

and 2) Methamphetamine is still not

very available according to many (16

of 40) law enforcement and epidemiologic/ethnographic sources. However,

13 sources consider it widely available,

particularly throughout the West, and

11 consider it somewhat available.

St. Louis

Memphis Columbia

New York City

Boston

Washington, DC

Portland

Denver

El Paso

Los

Angeles

Honolulu

Philadelphia

Miami

Detroit

Chicago

Baltimore

New

Orleans

Sioux

Falls

Billings

Seattle

Seattle

St. Louis

Memphis Columbia

New York City

Boston

Washington, DC

Portland

Denver

El Paso

Los

Angeles

Honolulu

Philadelphia

Miami

Detroit

Chicago

Baltimore

New

Orleans

Billings

Sioux

Falls

Exhibit 1.

How available is methamphetamine across the 20 Pulse Check cities 

(spring 2002)?

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

According to law enforcement sources... (N=20)

Widely Available Somewhat Available

Not very Available

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

Law enforcement respondent, EEpidemiologic/ethnographic

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

Exhibit 2.

How has methamphetamine 

availability changed (fall 2001 vs

spring 2002)?

Boston, MAL

Billings, MTL

Chicago, ILL,E

Columbia, SCL

Denver, COL

Detroit, MIE

Honolulu, HIE

Los Angeles, CAE

Memphis, TNL,E

Miami, FLE

New York, NYL,E

Sioux Falls, SDE

Baltimore, MDL,E

Billings, MTE

Boston, MAE

Columbia, SCE

Denver, COE

Detroit, MIL

El Paso, TXL,E

Honolulu, HIL

Los Angeles, CAL

Miami, FLL

New Orleans, LAL,E

Philadelphia, PAL,E

Portland, MEL,E

St. Louis, MOL,E

Seattle, WAL,E

Sioux Falls, SDL

Washington, DCL,E
METHAMPHETAMINE

page 58 Pulse Check: November 2002

Locally produced methamphetamine

seems slightly more available than

Mexican methamphetamine across

the Pulse Check cities: 21 sources rate

the local product as either somewhat

or widely available, whereas only 17

sources give those ratings to the

Mexican product. 

Since the last reporting period,

methamphetamine availability (all

varieties combined) has remained 

stable, according to the majority (25

of 40) of law enforcement and epidemiologic/ethnographic sources in

17 sites. The remaining sources (15 in

12 sites) believe it has increased. No

declines are reported for any varieties. 

Only four sources (in Billings,

Denver, Los Angeles, and Memphis)

believe that Mexican methamphetamine has increased. By contrast, 

locally produced methamphetamine

has increased in 12 cities: BillingsL

,

BostonL, ChicagoL, DenverL, DetroitE,

Los AngelesE, MemphisL,E, MiamiE,

New YorkL

, Portland (ME)L, Sioux

FallsE, and Washington, DCE.

Availability of “ice,” nearly 100 percent

pure methamphetamine, is generally

stable, but it has increased in Billings,

Denver, Honolulu, and Memphis—the

only cities where it is considered somewhat or widely available. 

What are street-level methamphetamine prices and purity 

levels across the country?

(Exhibit 3) Gram prices are most

commonly reported at about $100,

but they range from $20–$60 in Seattle

to $330 in Chicago. The highest

reported purities are in Honolulu and

Seattle. In Seattle, locally produced

methamphetamine is more pure than

Mexican methamphetamine, which

continues to be diluted with methylsulfonylmethane (MSM). Mexican

national traffickers are also starting to

cut methamphetamine with MSM in

Los Angeles, but purity there has nevertheless increased at the ounce level

(from 15–20 percent to 30–35 percent)

since the last reporting period. Only

one other shift is reported since the last

period: in Honolulu, the 1/4 gram

price of ice, also known as “clear,”

declined by 20 percent. All other prices

and purity levels are stable.

How is methamphetamine

referred to across the country?

(Exhibit 4) Methamphetamine 

continues to be called by long-standing names, such as “meth,” “speed,”

“crank,” and “crystal.” Other slang

terms are often based on the color,

consistency, appearance, or weight of

the local product. Only a few terms

are newly reported during this period

(but are not necessarily new), including the following: “crystal methedrine”

(BostonN); “CR” (Sioux FallsL

); “fast”

(DenverL); “geeter” and “work”

(BillingsN); and “peanut butter,” “pink

hearts,” “poppers,” “rock,” “tweak,”

and “yellow jackets” (St. LouisE).

METHAMPHETAMINE: 

THE MARKET

Who sells methamphetamine?

Sellers continue to be predominantly

independent operators, according to

law enforcement and epidemiologic/ 

ethnographic sources. Organized sales

structures, however, are reported in

Billings, Detroit, and El Paso, while

both types of structures are reported

in Chicago, Denver, Los Angeles,

Since the last reporting period, the number of small, local 

methamphetamine labs increased in nine Pulse Check cities...

Despite the increases, however, availability levels remain low in many of these cities:

➤ Boston, MAL

: Four box labs were seized. None had ever been seized before.

➤ Chicago, ILL

: Clandestine labs were seized for the first time.

➤ Denver, COL

: Seizures of box labs, especially in hotels or motels where they now

have interdictions, have increased.

➤ Detroit, MIE

: The number of clandestine labs has increased.

➤ Los Angeles, CAL

: The number of small labs continues to increase, but large operations still predominate.

➤ Miami, FLE

: Seven small labs were seized for the first time.

➤ Portland, MEL

: An increase in labs over the past 2 or 3 years involves mostly

Mexican migrant workers, some transplanted from the Southwest. Most of that

methamphetamine, however, is believed to be going to Canada, rather than the

local streets.

➤ St. Louis, MOE

: While stationary labs still predominate, mobile labs are growing in

popularity. Cooking in cars and trucks helps producers in two ways: it eludes identification by law enforcement; and motion helps the chemical reaction. Motels are

a new production setting during this reporting period: the temporary nature of

these setups, again, challenges disruption efforts. Clandestine labs are also set up in

Federal parklands, where toxic byproducts pose a danger to hikers and campers.

➤ Sioux Falls, SDL,E: Both local box labs and large operations have increased.

Production has shifted from the cold method to the nazi method.
Memphis, Philadelphia, St. Louis, and

Seattle. Sometimes, as in Denver and

St. Louis, independent sellers tend to

sell locally produced methamphetamine, while organized groups sell the

Mexican product.

Young adults (18–30 years) are generally the predominant seller groups.

However, adults (>30 years) are

mentioned in Honolulu, Philadelphia,

Portland (ME), and St. Louis, while

both groups are mentioned in

Billings, Boston, and Sioux Falls.

Adolescents (13–17 years) sell

methamphetamine in New Orleans

(where they are the predominant

group), Los Angeles, and Memphis.

Similar to reports in the last few Pulse

Checks, more than half of respondents

believe methamphetamine sellers are

very likely to use the drug. In many

cases, as in El Paso, sellers process their

own methamphetamine, so they are

particularly likely to use it.

What types of crimes are related

to methamphetamine sales? (See

Highlights Exhibit 7) In general, the

level of criminal activity appears to be

relatively stable since the last Pulse

Check. Similar to findings in the last

Pulse Check, methamphetamine

accounts for 33 percent of domestic

violence among drug sellers, as reported by law enforcement and epidemiologic/ethnographic respondents—compared with 28 percent for powder

cocaine, 19 percent for crack, 11 percent for heroin, and 8 percent for

marijuana. It also accounts for substantial percentages of nonviolent crime

(20 percent), violent crime (16 percent), prostitution (15 percent), and

gang-related crimes (12 percent)

among sellers. Examples of reported

violent crimes include turf wars and

shootings in Sioux Falls. Examples of

nonviolent crimes include theft of 

precursors or other materials to set up

labs (in El Paso and Memphis), gun

possession (in Los Angeles), and burglary or theft (in Billings, Los Angeles,

St. Louis, and Sioux Falls). 

What other drugs do methamphetamine sellers sell? Methamphetamine dealers sell no other

drugs according to respondents in eight

cities: ChicagoL, Columbia (SC)L, El

PasoL, Los AngelesL, MemphisL, PhiladelphiaL

, Portland (ME)L, and St.

LouisL,E. Among those who do sell

other drugs, they include:

# Crack: BillingsL

, DenverL,E, El PasoE,

and Sioux FallsL

# Powder cocaine: DenverE

, El PasoE,

HonoluluL, New OrleansL, and

Washington, DCL

# Heroin: DenverE and HonoluluL

# Marijuana: BaltimoreL

, DenverL,E,

HonoluluL,E, MemphisE, SeattleL,

and Sioux FallsL

# Ecstasy: BaltimoreL

, El PasoE, and

Washington, DCL

The El Paso epidemiologic source

points out that methamphetamine dealers “would go broke if they didn’t sell

other drugs.” No significant changes

are reported during this reporting 

period in the other drugs sold.

Exhibit 3. 

How much does methamphetamine cost in 13 Pulse Check cities?

Reported purities

NR=not reported

Sources: Law enforcement and epidemiologic/ethnographic respondents

METHAMPHETAMINE

Pulse Check: November 2002 page 59

Columbia, SCL $175 NR

Columbia, SCE NR $40/ 2oz liquid

El Paso, TXL NR $20/ 3oz g

Memphis, TNL $125 NR

Memphis, TNE $100 NR

New Orleans, LAL $100 NR

Chicago, ILL $330 NR

Detroit, MIE $100 NR

St. Louis, MOL $100 NR

St. Louis, MOE (outside city) $37–$100 $700–$1,300/oz

Sioux Falls, SDL NR (“eightball”) $150–$225/ coz

$9,000–$11,000/lb

Billings, MTL (powder) $100 NR

(crystal) $125

Denver, COL $100–$150 NR

Denver, COE a$90–$110 b

$700–$1,200/oz

Honolulu, HIL $200–$300 $50–$100/ 3g

Honolulu, HIE $100–$200 c

$50/ 3g

Los Angeles, CAL NR d

(“teener”) $125/ 1/16 oz

Los Angeles, CAE NR e

$500–$700/oz

(“eightball”) $100–$120/ coz

(“teener”) $60/ 1

/16 oz

Seattle, WAL f$20–$60 f

$350–$650/oz

Seattle, WAE $20–$60 NR

City Gram price Other price/unit

Midwest West South a

10–20% d40% b

10–20% e30–35% c

95% f95% nazi method; 75% red phosphorus method
The methamphetamine market has changed somewhat (fall 2001 vs spring 2002)...

Market disruptions

have caused declines 

in availability:

Increases in both

younger and older 

sellers are reported 

in some cities:

The market is shifting

geographically: 

New market settings

are noted in a few

cities: 

Trafficking has been

linked to terrorism: 

METHAMPHETAMINE

page 60 Pulse Check: November 2002

How is street-level methamphetamine sold? Disrupting

methamphetamine sales is challenging

because, as the vast majority of law

enforcement and epidemiologic/

ethnographic respondents report, it is

primarily sold hand-to-hand, usually

via acquaintance networks or personal

introduction, and usually at a clandestine, predetermined meeting place.

Sometimes beepers and cell phones

are involved in these transactions (as

in Honolulu, Los Angeles, Memphis,

St. Louis, and Sioux Falls), and occasionally runners are involved (as in 

El Paso). Open methamphetamine

markets in specific neighborhoods are

mentioned in only a handful of cities

(Chicago, Denver, Detroit, New

Orleans, and Philadelphia).

Where are methamphetamine

markets located? The geographic

location of methamphetamine markets varies widely, according to law

enforcement and epidemiologic/

ethnographic respondents. Regional

differences are less apparent than

they were in the last Pulse Check.

# All areas (central city, suburban,

and rural) are the scene of methamphetamine sales in cities spanning

all regions: BaltimoreL, BillingsL,

DenverL,E, DetroitE

, MemphisL,

PhiladelphiaL

, SeattleL, and 

Sioux FallsL. 

# Central city selling locations are

more prominent in HonoluluL, New

OrleansL, and Washington, DCL.

# Both central city and suburban 

selling locations are reported in

ChicagoL, HonoluluE, and Los

AngelesL.

➤ Philadelphia, PAL

: The market has continued its 5-year decline due to two disruptions: precursors were made

less available; and numerous lab operators and chemists were arrested.

➤ Los Angeles, CAE

: After pseudoephedrine prices rose, that precursor was mostly smuggled from Canada. 

But, with heightened border control since September 11, not as much is getting through. For example, a 

large bust at the Michigan border was directly related to the lower supply in Los Angeles.

➤ Baltimore, MDL

: Adolescents are now involved in sales.

➤ Billings, MTL,E: Older adults are increasingly selling.

➤ Memphis, TNE

: Sellers are getting younger. 

➤ Seattle, WAE

: Age range has broadened: while sellers are still predominantly young adults, adolescents and

older adults are increasingly involved.

➤ Sioux Falls, SDE

: Older adults (55–65 years) have been caught selling during the past year.

➤ Chicago, ILL

: Labs have been seized inside the city for the first time.

➤ Memphis, TNE

: Sellers are increasingly moving to more rural areas.

➤ Miami, FLE

: Seven small labs were seized for the first time: in the past, such seizures occurred only in 

western and central Florida. 

➤ New York, NYL

: Local methamphetamine has spread from Upstate New York into the Long Island area. 

➤ St. Louis, MOE

: People are moving production from rural into city and suburban areas. Entrepreneurs see

these areas as untapped markets and are establishing new connections.

➤ Seattle, WAL

: Law enforcement pressure has pushed markets further out into previously unaffected areas.

Almost all counties in Washington are reporting some activity: any leveling off in previous hot spots has 

been offset by increases in rural areas. 

➤ Chicago, ILL

: Street sales are noted for the first time, mostly on the North Side. However, methamphetamine

is not sold at the same locations as crack or heroin.

➤ Columbia, SCL

: Methamphetamine sales are reported in nightclubs and bars for the first time.

➤ MemphisL

: Methamphetamine is now being sold on the Internet.

➤ Seattle, WAL

: Some people now openly sell methamphetamine as such, not disguised as ecstasy, at dances,

raves, and other events. 

➤ New York, NYL

: Several cases of pseudoephedrine diversion have involved terrorist groups who traffic drugs

(including heroin) to fund their activities. 
METHAMPHETAMINE

Pulse Check: November 2002 page 61

# Both central city and rural selling

areas are reported in MemphisE. 

# Nearby rural areas are the primary

sales locations reported in BostonL

,

PortlandL, and St. LouisL,E.

# Suburban areas are the most common selling sites in Columbia (SC)L

and El PasoL,E.

More than half of responding law

enforcement and epidemiologic/

ethnographic sources report that

methamphetamine is sold both

indoors and outdoors. However, sales

take place primarily indoors in eight

cities: BostonL

, ChicagoL, ColumbiaL,

El PasoL, New OrleansL, Portland

(ME)L, St. LouisL,E, and Washington,

DCL.

Similar to reports in previous Pulse

Checks, private residences are the

most frequently mentioned specific

settings for methamphetamine sales

across Pulse Check cities. The next

most common settings are nightclubs

or bars, private parties, raves and

concerts, and hotels or motels.

Respondents also frequently mention

cars, parks, public housing developments, schools, and college campuses.

Less frequently mentioned sales locations (six or fewer respondents) include

in or around malls (in Baltimore,

Billings, Denver, Honolulu, Memphis,

and Philadelphia), supermarkets (in

Baltimore, Billings, Denver, Memphis,

and Philadelphia), crack houses (in

Billings, Denver, Honolulu,

Philadelphia, and Sioux Falls), and

around treatment clinics (in Baltimore,

Denver, Memphis, and Philadelphia).

Crack houses in Sioux Falls are known

as “meth houses.”

METHAMPHETAMINE: 

THE USERS

How many methamphetamine

users are in treatment? (Exhibit

5) Among programs represented by

Pulse Check treatment sources, only a

handful have substantial percentages

of people who report methamphetamine use. In addition to the increases

noted in the table, some increases are

reported in treatment programs where

the numbers are still relatively low, as

in Columbia (SC)N and DenverN.

Who uses methamphetamine?

Methamphetamine users across Pulse

Check cities are likely to be either

young adults (18–30 years) or adults

older than 30. Average mean age,

based on information provided by

treatment and epidemiologic/

ethnographic sources across the sites,

is 29.2 (n=13). Adolescents, however,

are named as the predominant users

by four non-methadone treatment

sources: in Billings, Columbia (SC),

Los Angeles, and Sioux Falls. Males

are the predominant users according

to sources in 12 cities, but sources in

8 cities indicate that men and women

are equally likely to use methamphetamine. More women than men use

the drug according to sources in three

cities: Columbia (SC)E,N, El PasoE

, and

MemphisM. In El Paso, many of the

female users are dancers, many are

unemployed, and many use it either

for weight loss or for increased energy. 

Methamphetamine users continue to

come from predominantly low or

low-to-middle socioeconomic groups.

Those in treatment tend to be 

Exhibit 4. 

How is methamphetamine referred to in the four regions of the country?*

Crank, crystal,

crystal meth,

crystal

methedrine,

eightballs, elbows

(1 pound), half

elbows (1⁄2

pound), glass, ice, OZs, quarter

ounces, meth,

speed

Anhydrous, bathtub meth, black, black beauty, brown, CR, california,

chemical, christmas trees, crank, crystal, fire, getgo, glass, ice, meth,

nazimeth, peanut butter, pink, pink hearts, poppers, red, rock, soap,

spackle, speckled birds, tweak, white, white crosses, yellow jackets

Beannies, black beauties, blade, christmas tree meth, cinnamon, crank,

crys, crystal, crystal meth, holiday meth, ice, meth, speed, sugar

Crank, crystal,

fast, geeter,

glass, ice, meth,

speed, work

*Bolded names are newly reported during this reporting period (but are not necessarily new).

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

WEST MIDWEST

NORTHEAST

SOUTH

Batu, clear,

ice, shabu,

tic, wash

Rural

Urban
METHAMPHETAMINE

page 62 Pulse Check: November 2002

unemployed, and the majority are

court referred. Users also continue to

be primarily Whites, according to all 

but two of the reporting Pulse Check

sources: Asian/Pacific Islanders 

predominate in the Honolulu nonmethadone treatment program, and

Hispanics predominate in the Los

Angeles non-methadone program.

The Los Angeles epidemiologic source

notes a gradual increase in

Asian/Pacific Islanders in treatment,

though their numbers remain low.

American Indians are mentioned as

users in Billings and Sioux Falls;

Hispanics are mentioned in Denver

and Sioux Falls; and Blacks are mentioned in Columbia, Miami,

Memphis, and Sioux Falls.

How, where, and with what other

drugs do users take methamphetamine? Methamphetamine can

be smoked, injected, snorted, or taken

orally, and these routes of administration continue to vary 

widely across the Pulse Check cities.

Often, several routes are equally 

likely in a given city. A few changes

are noted since the last Pulse Check:

# Billings, MTN: Smoking is increasing, but injecting remains common.

# Honolulu, HIE

: A small group of

injectors is emerging, but nearly all

users still smoke.

# Los Angeles, CAM: While injecting

still predominates, newer users tend

to smoke.

# Memphis, TNE

: Users are generally

shifting from smoking and oral use

to snorting.

# Sioux Falls, SDE

: New younger

(15–16 years) methamphetamine

users tend to move fairly quickly

from snorting and smoking to

injecting.

Methamphetamine tends to be used

in private settings, often in small

groups among friends. Private residences remain the most commonly

mentioned use settings, followed by

private parties. Other common settings include nightclubs, cars, public

housing developments, college 

campuses, and hotels or motels.

Marijuana remains the most 

commonly reported drug taken by

methamphetamine users. The two

drugs are usually used sequentially,

but sometimes they are combined, as

reported in Detroit, Memphis,

Portland (ME), and Sioux Falls

(where “lacing” is increasing). Several

other drugs are mentioned:

# Benzodiazepines, such as alprazolam (Xanax®) or diazepam:

Honolulu, Los Angeles, Memphis,

Philadelphia, and Portland

# Club drugs, such as ecstasy, GHB,

and amylnitrate (“poppers”): Los

Angeles

# Crack: Memphis

Exhibit 5.

Which treatment programs in Pulse Check sites have substantial 

percentagesa of clients reporting methamphetamine use? How have 

those percentages changed (fall 2001 vs spring 2002)?

City/Program Primary use Any useb Fall 2001 vs Spring 2002

Billings, MTN 17% 32% Stable 

Honolulu, HIN 68% NR Some increase 

Honolulu, HIM 0 10% Some increase 

Los Angeles, CAM 0 8% Stable 

St. Louis, MON Approximately 12%c NR Stable 

St. Louis, MOM 0 10% Some increase 

Seattle, WAN 7% 7% Some increase 

Sioux Falls, SDN >80%d 100% Large increase

a

7 percent or more

b

Primary + secondary + tertiary use

c

35 percent among rural residents, 1.5 percent among central city residents

d

A small program for adolescents only

Sources: Non-methadone and methadone treatment providers

Methamphetamine is often 

associated with the gay scene...

➤ Boston, MAE

: Methamphetamine use

is limited to gay clubs.

➤ Los Angeles, CAE

:

Methamphetamine is often used in

the gay party scene.

➤ Miami, FLE

: Methamphetamine has

generally been available only in the

gay community in the techno dance

scene on Miami Beach, where users

sell the drug to one another.

However, it may be spreading

through that venue to other populations, in the same way that ecstasy

grew out of the club scene, as evidenced by increased activity in emergency departments: DAWN mentions

of amphetamine/methamphetamine

outnumber those involving ecstasy.

➤ New York, NYE

: Methamphetamine

use has increased in gay communities. One gay men’s organization is

now holding three to eight methamphetamine-related meetings per

week, primarily because of the

increase in methamphetaminerelated HIV.
METHAMPHETAMINE

Pulse Check: November 2002 page 63

# Depressants, such as phenobarbital: El Paso

# Heroin: Boston and Seattle

# Powder cocaine: Portland

# Prescription opiates: Billings,

Columbia (SC), Los Angeles (particularly hyrocodone, or Vicodin®),

and Memphis (particularly hydromorphone, or Dilaudid®).

# Sildenafil (Viagra®): Miami

Users on the move...

Methamphetamine users’ residence locales continue to vary across different Pulse

Check cities. Two contrasting trends continue to be noted:

➤ Toward rural areas: Users have been spreading into rural areas of Denver and

Memphis, and into the reservation areas of Sioux Falls. In Memphis, this spread is

related two trends: increased gang activities in rural areas and increased access to the

rurally produced drug.

➤ Away from rural areas: In Los Angeles, use has been shifting from rural to central

city and suburban areas because manufacture has spread. The St. Louis problem is

also starting to creep into the city.
METHAMPHETAMINE

page 64 Pulse Check: November 2002

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DIVERTED SYNTHETIC OPIOIDS

Pulse Check: November 2002 page 65

DIVERTED SYNTHETIC

OPIOIDS✛

This reporting period marks the third

time that Pulse Check has monitored

the illegal diversion and abuse of 

synthetic opioids, particularly OxyContin® (oxycodone hydrochloride

controlled-release), prescribed to

patients suffering from severe persistent pain—a legitimate medical need.

Some signs indicate that diversion

and abuse of this pharmaceutical

might have peaked during the last

reporting period. For example, two

issues ago, the drug was described as

an emerging problem by sources in

14 cities; that number increased to 18

cities in the last Pulse Check; and it is

back down to 14 cities during the

current reporting period. 

How serious is abuse and diversion of synthetic opioids, and

where is the problem emerging

across the country? (Exhibit 1)

Only the Miami law enforcement

source considers OxyContin® the

drug with the most serious consequences in a Pulse Check community—a decline from the last Pulse

Check, when it was also considered

the most serious problem in New

Orleans and Portland (ME). It does,

however, remain the second most

serious problem in PortlandM, as well

as in BillingsL,N, Columbia (SC)M, El

PasoM, and HonoluluE.

OxyContin® diversion and abuse is

described as an emerging problem by

law enforcement and epidemiologic/ 

ethnographic sources in 14 cities. The

six cities where no sources consider it

an emerging problem during this period are Chicago, Detroit, Los Angeles,

Miami, Portland, and Sioux Falls.

Chicago is the only Pulse Check city

where the drug was not described as

an emerging problem during any of

the three latest reporting periods.

That city’s law enforcement source

explains that the drug is not encountered on the street, although it has

been reported in seizures.

In addition to OxContin®, diversion

of methadone, another opiate, is

reported as an emerging problem in

Portland (ME). Diverted hydrocodone (Vicodin®) is increasingly

available in New Orleans and is

increasingly identified in poison control calls in Detroit. Other diverted

opiates are becoming problematic in

Billings, Boston, Columbia (SC), and

Denver.

DIVERTED OXYCONTIN®: THE

DRUG

How available is diverted

OxyContin®? (Exhibits 2 and 3)

Only four sources consider diverted

OxyContin® widely available, but

more than half of the law enforcement and epidemiologic/ethnographic

sources describe it as somewhat available. Availability has remained stable

in 13 cities according to half of the

sources, has increased in 10 cities

according to about one-third of the

sources, and has declined in 4 cities

according to 4 sources. 

As the arrow exhibit shows, stable

trends are particularly evident in the

Midwest. The decline in Philadelphia

is attributed to a combination of legislation, arrests, education, and press

about deaths and arrests. Demand

there, however, appears stable at high

levels. In Portland (ME), the problem

was at its highest point last year.

Since then, prescriptions have

declined, and pharmacists are not

stocking as much. Educating doctors

and pharmacists, changes in prescription policies, numerous conferences,

and wide press coverage have all

made a difference. By contrast, the

increase in nearby Boston is eviExhibit 1. 

Where is OxyContin® diversion and abuse emerging across the 20 Pulse

Check cities?

E,N

N

L,E

E,L,M

E

L

L,E,N,M

E,M,N

N

M

M

M

L

L,E,N,M

New York City

OxyContin® reported as

emerging in spring 2002

OxyContin® not reported

as emerging in spring 2002

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

Law enforcement respondent, EEpidemiologic/ethnographic

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

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

treatment respondents.
DIVERTED SYNTHETIC OPIOIDS

page 66 Pulse Check: November 2002

denced by a continued increase in

pharmacy robberies. Furthermore,

sales there appear more organized

than in the past. In Honolulu, law

enforcement officials are investigating

“bad doctors,” who seem to be writing more prescriptions. 

How much does diverted

OxyContin® cost? The most 

common price remains $1 per milligram, as reported by sources in

BostonL

, BaltimoreL, DenverE, DetroitL

MemphisE, HonoluluE, and Portland

(ME)E. Since the last Pulse Check, the

Detroit epidemiologic source reports

that the milligram price has increased

from $1 to $1–$1.50. Conversely,

prices declined in BostonE (from $1

to $0.50–$1) and PhiladelphiaE (from

$1 to $0.50–$0.75). Stable prices are

reported elsewhere. Other reported

milligram prices include $2–$3 in

BillingsL

, $0.50–$1 in HonoluluL, and

$1.50–$2 in Washington, DCL. 

DIVERTED OXYCONTIN®: 

THE MARKET

How is OxyContin® diverted?

Numerous diversion techniques 

continue: forging, doctoring, or

manipulating prescriptions; feigning

Exhibit 3.

How has diverted OxyContin®

availability changed (fall 2001 vs

spring 2002)?*

*The Chicago law enforcement source and

the Portland epidemiologic source did not

provide this information.

Baltimore, MDL

Boston, MAL,E

Columbia, SCL,E

Honolulu, HIL,E

Los Angeles, CAL

Memphis, TNL

Miami, FLL

New Orleans, LAE

New York, NYL

Seattle, WAL,E

Memphis, TNE

Miami, FLE

Philadelphia, PAL

Portland, MEL

Baltimore, MDE

Billings, MTL,E

Chicago, ILE

Denver, COL,E

Detroit, MIL,E

El Paso, TXL,E

Los Angeles, CAE

New Orleans, LAL

New York, NYE

Philadelphia, PAE

St. Louis, MOL,E

Sioux Falls, SDL,E

Washington, DCL,E

Exhibit 2. 

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

(spring 2002)?

Seattle

St. Louis

Sioux

Falls

Memphis Columbia

New York City

Boston

Washington, DC

Portland

El Paso

Los

Honolulu

Philadelphia

Miami

Detroit

Chicago

Baltimore

Seattle

St. Louis

Memphis Columbia

New York City

Boston

Washington, DC

Portland

Denver

El Paso

Honolulu

Philadelphia

Miami

Detroit

Chicago

Baltimore

New

Billings

Sioux

Falls

Billings

Orleans

New

Orleans

Angeles

Los

Angeles

Denver

Widely Available

Not Very Available

Somewhat Available

Not Available

According to law enforcement sources (N=20)... 

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

Pulse Check: November 2002 page 67

illness, then selling legitimate prescriptions (“doctor shopping”); 

robbing pharmacies; unscrupulous

doctors or other health professionals

selling legitimate prescriptions or 

running pain clinics; and pharmacists

or other pharmacy staff committing

prescription theft or fraud. The

diverted drug sometimes comes into

communities from other States or

countries. For example, some pills

enter Detroit from Indiana and via

the Canadian border.

Since the last reporting period, 

prescription fraud and diversion from

pain clinics have been declining in

Miami, as authorities have identified

and prosecuted physicians. Similarly,

in Portland (ME), pharmacy thefts are

continuing to decline, despite a recent

break-in in the suburbs involving

5,000 doses. 

By contrast, in nearby Boston, people

are increasingly paying (in money or

pills) or duping others into robbing

pharmacies for them. The actual 

robbers fall into two groups: armed,

businesslike professionals; and

addicts, “low professionals,” and 

second stringers. Additionally, a new

practice is reported in Boston: swapping sex (with doctors) for prescriptions. An increasing amount of

OxyContin® is also being diverted in

New York. In Philadelphia, unlicenced pharmacy technicians are

becoming an increasing source of

diversion. In the West, doctors and

pharmacists in Seattle are getting

bolder and more active and are

increasing in number, so State agencies are increasingly paying attention.

Similarly, in Honolulu, prescription

fraud is increasingly coming to the

attention of authorities.

Who sells diverted OxyContin®?

As reported in the last Pulse Check,

nearly all law enforcement and epidemiologic/ethnographic sources

report that sellers of diverted

OxyContin® are predominantly independent. Miami and New Orleans

remain exceptions, with organized

sales structures predominating. Both

independent and organized sales are

reported in Baltimore and Los

Angeles. Sellers tend to be young

adults (18–30 years) or adults (>30

years), according to all respondents,

with both age groups mentioned an

equal number of times, as in the last

Pulse Check. They are somewhat or

very likely to use the drug themselves,

according to more than half of

responding law enforcement and 

epidemiologic/ethnographic sources. 

These seller characteristics appear 

relatively stable, with two exceptions:

in BostonL

, sellers continue to be

increasingly younger; and in

Columbia (SC)L, sellers are now

somewhat likely to use their own

drug—a change from the last Pulse 

Check, when they were not at all 

likely to do so.

What types of crimes are related

to diverted OxyContin® sales?

Sellers of this diverted pharmaceutical

are involved in nonviolent crimes in

nine Pulse Check cities. Specifically,

fraudulent or stolen prescriptions are

mentioned in Boston, Columbia (SC)

(where this activity is a new development), and Memphis; and robbery,

burglary, larceny, and other property

crimes are mentioned in Billings,

Boston, Baltimore, and New Orleans.

Violent crimes are mentioned by law

enforcement sources in Boston,

Honolulu, Los Angeles, and Portland

(ME). Prostitution is mentioned in

Baltimore and Billings.

What other drugs are sold by

diverted OxyContin® sellers? As

reported in the last two Pulse Checks,

other prescription opiates and heroin

are the most common other drugs

sold by diverted OxyContin® sellers, 

Diverted OxyContin® goes by

many slang terms...

➤ “Oxy” or “oxys”: The most 

commonly reported terms

➤ “OCs”: Boston, MA; Billings, MT

➤ “Ox”: Columbia, SC; 

New Orleans, LA

➤ “Os”: Philadelphia, PA

➤ “Oxycotton”: Columbia, SC

➤ “40s” and “80s”: Miami, FL 

➤ “Blue” and “valerie”: Memphis, TN

➤ “Cotton”: St. Louis, MO

➤ “Killer”: A new term in Billings, MT

➤ “Pills”: New Orleans, LA

➤ “Rush” A new term in Portland, ME

Diverted OxyContin® sellers: A

closer look...

➤ Boston, MAL

: One seller group consists of well-armed professionals who

rob pharmacies and are in sales

strictly for the business. Another

group consists of addicts, second

stringers, and “low professionals.”

➤ Columbia, SCL

: Diverted

OxyContin® is often sold by female

senior citizens known as “pill ladies.”

Additionally, some users are now

beginning to sell the drug.

➤ Seattle, WAL

: Clear and substantiated

evidence has emerged during this

reporting period that doctors and

pharmacists are involved in selling

diverted OxyContin®.
DIVERTED SYNTHETIC OPIOIDS

page 68 Pulse Check: November 2002

according to law enforcement and

epidemiologic/ethnographic sources

in seven cities (Boston, Columbia

[SC], Honolulu, Miami, Philadelphia,

Portland [ME], and Washington, DC).

Other drugs sold include marijuana

and methamphetamine in Billings;

cocaine in Boston; crack cocaine in

Miami; other prescription pills, such

as benzodiazepines or clonidine

(Catapres®), in Memphis and

Washington, DC; and ecstasy and

GHB in New Orleans.

Where are diverted OxyContin®

markets located? Contrary to the

widespread belief that OxyContin®

diversion is a rural phenomenon, law

enforcement and epidemiologic/

ethnographic sources in eight cities

(Billings, Boston, Columbia [SC],

Honolulu, Los Angeles, Philadelphia,

Portland [ME], and Washington, DC)

report that sales occur primarily in

central city locations. In another five

cities, sources report that markets for

the diverted pharmaceutical are located in all types of areas (central city,

rural, and suburban). Rural areas are

the primary location according to

only one source (DetroitL

), the suburbs predominate according to one

other source (New OrleansL), and

both suburban and rural areas are the

primary locations according to two

sources (DetroitE and MemphisE

).

Markets are located predominantly

indoors according to sources in eight

cities. Both indoor and outdoor sales

are reported in six cities. Outdoor

sales predominate only in two cities:

in Miami, OxyContin® is sold on the

street in some neighborhoods, such as

Liberty City and Little Haiti, sometimes in the same places where crack

is sold; similarly, in Washington, DC,

open-air markets are located in certain areas. In New York, the drug has

not emerged as a street drug at this

time: only two incidents of street

contacts are reported by street

researchers during this reporting period, despite increased emphasis on

tracking street activity.

Two changes are reported since the

last Pulse Check, both in the South. In

Memphis, sales had been confined to

suburban indoor locations but are

now spreading onto the streets.

Similarly, in New Orleans, sales are

now spreading beyond the housing

projects where they were previously

confined.

How is diverted OxyContin®

sold? Sales techniques vary from city

to city. Therefore, disrupting the market requires a wide range of strategies.

For example, it is particularly difficult

to track diversion and make arrests in

Boston because dealers do not generally sell diverted OxyContin® to people

they don’t know. Rather, they have a

set of customers who page them, tell

them what they want, and have the

drugs home delivered—similar to

transactions in that city involving

heroin, powder cocaine, and marijuana. In nearby Portland, diverted

OxyContin® sales are also similar to

heroin sales, so the two drugs could be

targeted with similar disruption strategies. Occasionally, in that city, word

gets out quickly when someone has

diverted a large amount of OxyContin®, and users swarm to that

individual, creating a disruption

opportunity. Elsewhere in the

Northeast, in Philadelphia, some users

obtain their drug by loitering around

treatment centers and homeless shelters, while others get it directly from

the diversion source: pharmacies. 

Getting the drug directly from pharmacies via forged prescription is also

mentioned in the South: in Columbia

(SC) and Memphis. In Memphis,

however, some of the pills obtained

in that manner are also sold on the

black market. “Pill houses,” or residences where drugs can be obtained,

are mentioned in Columbia. In New

Orleans, dealers use any means at

hand, including cell phones, pagers,

private introductions, and hand-tohand street sales, thereby necessitating multiple disruption strategies.

Hand-to-hand transactions predominate in Washington, DC’s open-air

markets. In the West, hand-to-hand

sales and acquaintance networks are

reported in Billings. In Honolulu’s

open-air markets, buyers know who

the sellers are. In Los Angeles, some

people obtain the drug via message

boards on the Internet. 

OXYCONTIN®: THE ABUSERS

How many OxyContin® abusers

are in treatment? (Exhibit 4)

OxyContin® is the primary drug of

abuse among substantial percentages

of clients in several treatment programs in Pulse Check sites, particularly

in the Columbia (SC) and Portland

(ME) methadone programs. It

accounts for even higher percentages

of clients who report any use (either

Markets in many indoor settings... 

Private residences are the most commonly specified indoor sales location.

Other examples include the following:

➤ Nightclubs and bars: Memphis, New

Orleans, and Philadelphia

➤ In or around supermarkets: Billings,

Memphis, and Washington, DC

➤ In or near treatment clinics: Billings,

Memphis Phildelphia, and

Washington, DC

➤ Cars: Billings, Memphis, and

Portland
DIVERTED SYNTHETIC OPIOIDS

Pulse Check: November 2002 page 69

primary, secondary, or tertiary) in several cities, such as MiamiM (40 percent), St. LouisM (15 percent), BostonN

(8 percent), Los AngelesM (4 percent),

and—most dramatically—in

MemphisM, where all 300 clients in the

program report some use of the drug.

Since the last reporting period,

among the treatment programs where

abuse of this drug is reported, the

number of users has increased substantially in 3, increased somewhat in

16, and remained stable in 10.

Additionally, in El Paso, more users of

OxyContin® are coming into detox.

Those individuals, however, obtain

the drug via legal prescriptions. While

no treatment sources report declines,

the epidemiologic sources in Miami

and Washington, DC, do note slight

declines in the number of abusers. In

Miami, abusers are now more likely

to use other types of legal and illegal

narcotics, such as heroin, hydrocodone (Vicodin®), or methadone.

Who abuses OxyContin®? In Pulse

Check cities where the drug is

abused, the majority of treatment and

epidemiologic/ethnographic sources

report that adults older than 30 are

the predominant abusers. More than

one-third of those sources, however,

name young adults (18–30 years) as

such, and sources in Columbia (SC)N

and Sioux FallsE name adolescents.

Young adults are reported as an

emerging group in nine cities, and

adolescents are emerging as a user

group in Boston, where the ethnographic source notes that younger 

siblings of older users are increasingly

mixing these pills with alcohol. The

Boston non-methadone treatment

source adds that youngsters steal the

pills from their parents, that they

sometimes use guns to obtain the pills

from pharmacies, and that they are

increasingly involved in overdoses

because they don’t realize how powerful the drug is, so they take more

than one at a time. Eleven sources 

provided mean ages, for an average

of 33.6 years across sites. 

About half of the sources report that

males are the predominant abusers,

about one-third of them report males

and females as equally likely to abuse

the drug, and sources in four cities—

DenverM, St. LouisM, SeattleN,M, and

Sioux FallsE—report that females 

predominate. Whites predominate in

most cities, while low and middle

socioeconomic groups are reported

about equally.

Abusers reside predominantly in 

central city areas, according to treatment and epidemiologic/ethnographic

sources in 10 of the Pulse Check

cities—again, dispelling the myth of

“hillbilly heroin.” The suburbs are

reported as the predominant residence

in seven cities. All three geographic

locations (central city, suburban, and

rural) are reported in Columbia (SC),

New Orleans, and Portland (ME);

both central city and rural areas are

reported in another three cities; and

both central city and suburban areas

are reported in another three.

Exhibit 4.

Which treatment programs in Pulse Check sites have substantial 

percentages* of clients reporting OxyContin® as their primary drug of

abuse? How have those percentages changed (fall 2001 vs spring 2002)?

* 4 percent or more

Sources: Non-methadone and methadone treatment respondents

Large increase

Large increase

Large increase

Some increase

Some increase

Stable

Some increase

Some increase

Some increase

Columbia, SCM

Portland, MEM

Memphis, TNM

Miami, FLM

St. Louis, MOM

Philadelphia, PAN,M

Portland, MEN

Baltimore, MDM

Denver, COM

Percentage of clients

City/program

10 20 30 40 50 60 70 80 90 100

Availability is down, but use and 

consequences are up...

➤ Portland, MEE

: People continue to

be introduced to diverted

OxyContin® despite lower availability, possibly because they consider it a “higher class” than heroin, which is a more “dirty drug.” 

➤ Philadelphia, PAE

: While availability is reported as either downL or

stableE

, mortality and emergency

department episodes involving the

drug have increased dramatically.
How is OxyContin® taken? Oral

use remains the most common route

of administration, according to treatment and epidemiologic/ethnographic

sources in 13 cities. Injection, however,

is reported by sources in four cities

(BaltimoreE, Columbia [SC]M,

HonoluluE, and Washington, DCE),

while both injecting and oral use are

equally likely according to sources in

another four (BillingsN,M, HonoluluM,

MiamiN,M, and SeattleE). Snorting is

the predominant route of administration according to sources in DetroitE

,

MemphisM, and Portland (ME)N,M,

while both snorting and oral use are

equally likely in PhiladelphiaM. All

three routes of administration are

equally likely in the Portland

methadone program.

OxyContin® and heroin continue to

be used as substitutes for one another,

as mentioned in BaltimoreE

,

HonoluluM, MiamiE, PhiladelphiaN,

PortlandE,N, and St. LouisM. The 

two are also sometimes taken sequentially, as reported in MiamiE and

PhiladelphiaE. In Miami, some heroin

users, primarily younger Black injectors, are switching to OxyContin®,

hydrocodone, and methadone.

OxyContin® abusers also frequently

take other synthetic opioids, such as

hydrocodone, hydromorphone

(Dilaudid®), and other forms of oxycodone (Percodan® and Percocet®)—

either as substitutes or in combination—as mentioned in BostonE,M,

ColumbiaE, El PasoM, MiamiE,

PhiladelphiaE

, and St. LouisN. In

Boston, many users are switching

their primary drug of abuse from

Percocet® to OxyContin®.

Benzodiazepines, such as alprazolam

(Xanax®) and diazepam, are taken by

OxyContin® abusers in several cities:

as a substitute in BostonM; sequentially in MemphisM and PhiladelphiaE,N;

and in combination in ColumbiaM.

Alcohol, marijuana, or both are sometimes taken sequentially with

OxyContin®, as reported in BillingsN,

BostonN, MemphisE,M, PhiladelphiaE,N,

and SeattleN. Crack is taken sequentially with the drug in PhiladelphiaE

,

and methamphetamine is taken either

sequentially or as a substitute in

BillingsN.

DIVERTED SYNTHETIC OPIOIDS

page 70 Pulse Check: November 2002
“ECSTASY”

Pulse Check: November 2002 page 71

Ecstasy is emerging, or continuing to

emerge, as a drug of abuse in all but

five Pulse Check cities: Detroit,

Miami, New Orleans, New York, and

Portland (Exhibit 1). However, it has

been reported as emerging in those

five cities during previous reporting

Pulse Check periods, suggesting it has

either leveled off or—as is likely the

case in Miami and New York—is now

an established drug of abuse. 

ECSTASY: THE DRUG

How available is ecstasy in Pulse

Check communities? (Exhibit 2)

Ecstasy, typically in pill form, is 

considered widely available by 

the majority (25) of the 40 law 

enforcement and epidemiologic/ 

ethnographic sources. Only three

sources consider it not very available:

in BillingsE

, El PasoL, and Sioux FallsL.

The remainder consider it somewhat

available.

Since the last reporting period, about

half of the responding law enforcement and epidemiologic/ethnographic

sources report that ecstasy availability

has increased, and approximately half

report that it has remained stable,

often at elevated levels. Only two

report declines: in MiamiE and Sioux

FallsL.

How is ecstasy referred to

across the country, and how are

logos and packaging used as

marketing tools? (Exhibit 3) In

order to market their product,

“cooks” in many areas produce 

ecstasy pills in a variety of colors 

and shapes, with numerous logos,

labels, and stamps. Corporate names,

fashion designers, and cartoon characters are often featured, with constant changes in some cities as different fads come and go. Many users

derive their slang terminology from

these logos, labels, and shapes. “X,”

however, remains the most common

slang name for ecstasy, as reported in

nearly every Pulse Check site. “E” is

also common, as are “roll” and

“XTC.” 

As reported in past Pulse Checks,

tablets continue to be sold predominantly as loose pills. Additionally,

pills are sometimes packaged in small

plastic bags, plastic prescription bottles, plastic wrap, folded paper, coin

bags, and tinfoil. Cigarette packs, a

more unusual packaging, are reported

in St. Louis. Some large-quantity

packaging is reported: in Detroit, a

“jar” contains 3,200 pills; in Denver,

up to 20,000 pills are heat-sealed in

plastic and strapped to the body.

Exhibit 1. 

Where is ecstasy emerging across the 20 Pulse Check cities?

N

L

M

L

L,E

E

N

L

N

L E,M

L,E,N

E

L

L

City

Ecstasy reported as emerging in spring 2002

Ecstasy not reported as emerging in spring 2002

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

Law enforcement respondent, EEpidemiologic/ethnographic

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

“ECSTASY” (METHYLENEDIOXYMETHAMPHETAMINE OR MDMA)✛

Exhibit 2.

How available is ecstasy, and how

has availability changed, across

the 20 Pulse Check cities (fall

2001 vs spring 2002)?

40

35

30

25

20

15

10

5

0 Availability

Widely Available Number

Somewhat Available

Not Very Available

Change

No Response

(N=40)

Sources: Law enforcement and epidemiologic/

ethnographic respondents

Stable

Up Down
“ECSTASY”

page 72 Pulse Check: November 2002

What substances are added to

or sold as ecstasy? During this

reporting period, fewer sources

report adulterated ecstasy than in the

last Pulse Check. Reported adulterants

include mescaline and methamphetamine in Memphis, and codeine, 

dextromethorphan (DXM), and 

paramethoxyamphetamine (PMA) in

Los Angeles. Mescaline, previously

reported in Sioux Falls, has not been

seen there in the past year. In Seattle,

adulterants are less toxic than those

reported in the last Pulse Check.

Fraud is now more common there:

for example, one batch of confiscated

“ecstasy” actually consisted of hormone replacement pills. Fraudulent

substitutions are also reported in

Detroit and St. Louis. According to the

New York non-methadone treatment

source, most clients in the program

“fully believe that the drug is a mix of

cocaine and something else.” In the

Miami area, the medical examiner

recently detected 147 “methylated

amphetamine compounds”—substances sold as ecstasy—in decedents.

What are street-level ecstasy

prices across the country?

(Exhibit 4) Pill prices range from

lows of $5 in El Paso and $7 in New

Orleans to a high of $100 in St.

Louis, but the most common prices

are about $20–$25. In New York,

ecstasy is cheaper on the street than

in clubs. Conversely, in Seattle, prices

are lower at raves than in the community. Prices appear relatively stable

since the last reporting period. The

only reported changes are an increase

in New YorkE and declines in

PhiladelphiaE and MiamiL. Reducedprice sales in Miami are at the singlepill and 100-pill level, paralleling a

shift in user demographics. The high

profit margin is an incentive for users

to sell ecstasy at clubs, raves, and to

friends. Once these young user-dealers

cover their costs, unlike the more

Exhibit 3. 

How is ecstasy referred to and marketed across the 20 Pulse Check cities?*

Boston, MA X, MDMA, adam, essence, flipping, rolling Logos: bulldog, calvin klein, hearts, lightning, mcdonalds, nikes, 

playboy, tulips, yin and yang signs, many more

New York, NY NR Yes (but names unavailable)

Philadelphia, PA E None

Portland, ME X, E, pure X, roll NR 

Baltimore, MD X, E, essence, eve, lovers, speed None

Columbia, SC E, four-leaf-clover, rolls, S, smurfs Tablets of all colors

Logos: balloons, cartoon characters, diamonds

El Paso, TX E, tachas Red pill with E

Memphis, TN X, XTC, adam, beans, clarity, lover’s special, 

rolls, stacks, double stacks, tabs None

Miami, FL X, E, beans, mercedes, rolls, roll X All kinds, change often

New Orleans, LA X, XTC, pill, tabs None

Washington, DC X, E, igloo, mercedes, pikachu, pills, rolls Different colors, round shape; E, animals, igloo, mercedes, 

pikachu, pills, rolls

Chicago, IL X, E, rolls Cartoon stamps

Logos: CK (for calvin klein), mitsubishi, motorola, other 

corporate names and fashion brand names

Detroit, MI X, E Logos vary widely

Sioux Falls, SD X, E, roll, snackies (more mescaline based), Logos: elephants, mitsubishi, nike, sun face

speedies (more amphetamine based) 

St. Louis, MO X, E, XTC, candy, rolls, shamrock, tabs Proliferation of logos

Billings, MT Peace, serenity, tranquility None

Denver, CO X, E, adam, the bean, pills, rolls, tabs, wafers Batman, jimmy neutron, many more (change continually)

Honolulu, HI X, E None

Los Angeles, CA Love drug Logos: blue dolphin, calvin klein, dove, blue smile, ferarri, 

green apple, mitsubishi

Seattle, WA X, E Logos: mcdonalds, mitsubishi, yin-yang

City Slang terms Marketing labels, logos, colors, shapes 

Northeast Midwest West South

*Bolded names are new since the last reporting period.

Sources: Law enforcement, epidemiologic/ethnographic, and treatment respondents
organized wholesale-level dealers,

they keep the leftovers as a personal

“stash,” sell to friends at discount, or

even give them away. High profits are

also evident in Los Angeles.

ECSTASY: THE MARKET

Who sells ecstasy? As reported in

previous Pulse Checks, young adults

(18–30 years) continue to be the predominant street-level ecstasy sellers,

according to the majority of responding law enforcement and epidemiologic/ethnographic sources. However,

sources in Baltimore, Detroit,

Honolulu, Los Angeles, Memphis,

and St. Louis report ecstasy sellers as

evenly split between young adults and

adolescents. Moreover, sources in El

Paso, New Orleans, and Seattle

report sellers as primarily adolescents.

Only one source in Baltimore reports

adults older than 30 as the predominant sellers. 

Ecstasy sellers continue to be 

predominantly independent, according to the majority of responding law

enforcement and epidemiologic/

ethnographic sources. Both independent and organized sellers are reported

in El Paso, Miami, and Portland

(ME). 

Nearly all respondents believe that

sellers are very likely or somewhat

likely to use their own ecstasy (see

Highlights Exhibit 8). Only one

(MiamiE) believes that sellers are not

very likely to use it. Sellers in

Memphis are more likely to use than

last year. In Denver, adolescents tend

to sell single pills and to use themselves, while adults (25–35 years) sell

larger quantities and do not typically

use.

Are ecstasy sellers involved in

other crimes? As reported in the

past, street-level ecstasy sellers are

not typically involved in other crimes

or violence. Among those who are,

the most common crime continues to

be drug-assisted rape, reported in

nine cities: Columbia (SC)L

, DenverL,

DetroitL , HonoluluL, Los AngelesL,

MemphisL

, New OrleansL, New YorkE,

and Sioux FallsL. Nonviolent crime is

reported in eight cities: BillingsL,

DetroitL, El PasoL,E, HonoluluL, Los

AngelesL, MemphisE, St. LouisE, and

Sioux FallsL. Two examples of nonviolent crimes are tagging and vandalism 

in El Paso, and petty theft and

shoplifting in St. Louis.

Where are ecstasy markets

located? Ecstasy sales span all 

geographic areas:

" All three types of areas (central city,

suburban, and rural) are reported

in half of the Pulse Check cities:

BaltimoreL

, Columbia (SC)L,

MemphisL, MiamiE, New YorkL,

PhiladelphiaL, Portland (ME)L, 

and Washington, DCL.

" Central city market locations are

more prominent in BillingsL,

HonoluluL, New YorkE, New

OrleansL, and Washington, DCE.

" Central city and suburban locations

are equally common in BaltimoreE,

ChicagoE, DenverE, HonoluluE, Los

AngelesL, MemphisE, St. LouisL, and

SeattleL.

" Suburban areas are the primary

market sites in BostonL

, DetroitE, 

El PasoL,E, MiamiL, St. LouisE, and

Sioux FallsL

.

Whereas markets for drugs like heroin and cocaine are increasingly moving indoors in some cities, the ecstasy

market is continuing to move outdoors. Disrupting the market therefore requires new and broader strategies. More than half of responding

law enforcement and epidemiologic/

ethnographic sources now report that

ecstasy is sold both indoors and outdoors: BaltimoreL

, BillingsL, ColumbiaL,

DenverL, El PasoL, HonoluluL,E,

MemphisE, MiamiL,E, New YorkL,

“ECSTASY”

Pulse Check: November 2002 page 73

Exhibit 4.

How much does a pill (one dose)

of ecstasy cost in the 20 Pulse

Check cities?

City Price

Boston, MAL $20–$25

Boston, MAE $25

New York, NYL $25–$38

New York, NYE $15–$25 (street)

$25–$35 (clubs)

Philadelphia, PAL $20–$35

Philadelphia, PAE $15–$20

Portland, MEL $25

Baltimore, MDL $18–$20

Columbia, SCL $25–$30

El Paso, TXL $20

El Paso, TXE $5–$8

Memphis, TNL $20

Memphis, TNE $25

Miami, FLL $11–$18

New Orleans, LAL $7

Washington, DCL $18–$25

Washington, DCE $20–$35

Chicago, ILL $25

Chicago, ILE $20–$40

Detroit, MIL,E $20–$30

St. Louis, MOL $100

St. Louis, MOE $20–$30

Sioux Falls, SDL $30–$50

Billings, MTL $25

Denver, COL $25

Denver, COE $10–$20

Honolulu, HIL $25–$45

Honolulu, HIE $17–$40

Los Angeles, CAE $25–$40

Seattle, WAL,E $10–$20 (raves)

$20–$30 (street)

Northeast South Midwest West

Profit by the pill...

Los Angeles provides an example of

ecstasy’s high profit potential:

➤ A wholesale-level dealer pays $8 per

pill (a “boat” of 1,000 pills for

$8,000).

➤ The pills are sold to mid-level and

then low-level dealers.

➤ The user pays up to $40 per pill.
“ECSTASY”

page 74 Pulse Check: November 2002

PhiladelphiaL, Portland (ME)L, St.

LouisE, and Sioux FallsL. One source

(El PasoE) reports only outdoor sales.

Elsewhere, the drug is still sold 

primarily indoors.

The most commonly reported indoor

market locations, according to law

enforcement sources, are still raves

and concerts (reported in nearly every

Pulse Check city), followed (in

descending order of report frequency)

by nightclubs and bars, college 

campuses, parties, private residences,

schools, cars, hotels or motels, and

the Internet.

How is ecstasy sold? Ecstasy sales

are often venue oriented and usually

involve acquaintance networks or 

private introductions to sellers. Handto-hand exchanges are common. In

some cities, sellers approach buyers

or buyers approach sellers, as reported

in Honolulu, Philadelphia, Portland

(ME), Seattle, Sioux Falls, and

Washington, DC. Beepers and cell

phones are mentioned in only five

cities (Columbia [SC], Los Angeles,

New Orleans, St. Louis, and Sioux

Falls), and prearranged meetings are

mentioned in only two (Chicago and

Memphis). In Chicago, hawkers walk

around in semipublic settings, such as

nightclubs and raves, announcing

“caps” or “rolls,” while in Seattle buyers know who to ask for at the door,

and that person directs them to the

sellers. By contrast, in Boston, most

drugs are sold before users enter clubs.

What other drugs do ecstasy

dealers sell? Law enforcement and

epidemiologic/ethnographic sources

in nine Pulse Check cities report that

ecstasy sellers do not typically sell

other drugs. In the other cities, the

most common other drugs sold, as

reported in the last Pulse Check, are

club drugs, including GHB, ketamine,

and, to a lesser extent, LSD.

Marijuana is sold by ecstasy dealers in

nearly half the Pulse Check cities

(Baltimore, Billings, Denver, El Paso,

Miami, Philadelphia, Portland,

Seattle, and Sioux Falls), methamphetamine in four cities (Billings,

Denver, Philadelphia, and

Washington, DC), powder cocaine in

another four cities (Baltimore,

Columbia [SC], Miami, and

Philadelphia), crack in three

(Baltimore, Denver, and Washington,

DC), and other pills, typically benzodiazepines and opiates, in Memphis

and Philadelphia.

The ecstasy market has changed somewhat (fall 2001 vs spring 2002)....

New marketing strategies

include changing pill colors,

shapes, logos, and labels: 

New trafficking techniques are

reported:

Markets continue spreading

beyond the club and rave

scenes: 

More adolescents and young

adults are selling ecstasy in

some cities: 

Some new seller groups are

reported: 

➤ Columbia, SCL

: Pills come in more colors than during the last reporting period. Home-pressed pills

are no longer seen, nor are mercedes or elephant logos.

➤ Denver, COL

: Logos and labeling are constantly changing, depending on the latest fads.

➤ St. Louis, MOE

: An increase in logos reflects the proliferation of pills, many of which are really 

contaminants.

➤ Seattle, WAL

: Pills now come in blue and orange, not just white as in the past—reflecting an increase

in availability and variety of pills and a broadening in the number and creativity of domestic cooks. 

➤ Miami, FLE

: Body packing of ecstasy from Canada has increased. Some smuggling by cruise ship 

passengers is reported. 

➤ Chicago, ILL

: Ecstasy is being seen on the street for the first time. 

➤ New York, NYE

: Ecstasy continues to spread outside of raves, especially on the streets and in 

buildings, particularly in The Bronx and Staten Island.

➤ St. Louis, MOE

. Once associated only with raves inside the city, ecstasy has now moved to high

schools and colleges in suburban areas and might eventually reach rural schools. 

➤ Seattle, WAL,E: Ecstasy has “jumped out of the pack of other party drugs” and is hitting schools and

the streets: “Every kid in school knows someone who can get it.”

➤ Miami, FLL

: Young adults continue to be more involved, especially via connections in high schools.

➤ Los Angeles, CAL

: More adolescents are selling than in the past.

➤ Seattle, WAL

: More young adults are actively involved. 

➤ Philadelphia, PAL

: New organized Russian and Israeli groups are reported.

➤ Portland, MEL

: Occasional organized groups of out-of-State promoters are becoming more frequent.

➤ Washington, DCE

: Club owners, bartenders, and bouncers are increasingly allowing people to sell

ecstasy on their premises. 
“ECSTASY”

Pulse Check: November 2002 page 75

ECSTASY: THE USERS

How many ecstasy users are in

treatment? Despite ecstasy’s

increasing involvement in mortality

and emergency department episodes

in many cities, clients in treatment

generally do not report ecstasy as a

primary drug of abuse. Further, only

a handful of Pulse Check treatment

sources report that clients in their

programs use it as a secondary or 

tertiary drug: SeattleN (10 percent);

PhiladelphiaM (8 percent); BaltimoreM

(<5 percent); MiamiN (4 percent);

and PortlandN (4 percent). However,

slight increases are reported in all those

programs, as well as in other programs

where the numbers are lower. 

Who uses ecstasy? Ecstasy users

tend to be young adults (18–30

years), particularly according to 

epidemiologic/ethnographic sources.

However, several non-methadone

sources believe that adolescents are

the primary user group (in Billings,

Columbia, Portland, Seattle, and

Sioux Falls), while several sources,

both among epidemiologists/ethnographers and treatment providers,

believe that young adults and adolescents are equally likely to use the

drug. As reported in past Pulse

Checks, ecstasy users tend to be 

evenly split between the genders (see

Crack Exhibit 6). Also as reported

previously, Whites predominate as

ecstasy users in nearly all cities.

Hispanics are named as the 

primary user group in only two cities

(Los AngelesN and MiamiN), as are

Blacks (in BaltimoreE,M and

Washington, DCN). All three groups

appear equally represented in New

YorkE. Whites and Asians are equally

likely to use ecstasy in HonoluluE. In

Los Angeles, three distinct user groups

are reported: the “ravers,” who tend

to be White, followed by the “hip-hop

crowd,” who are generally Black, and

then the gay circuit partygoers. 

Ecstasy users tend to come from 

middle socioeconomic backgrounds.

However, low socioeconomic groups

are mentioned as predominant in

BaltimoreE,M, BillingsN, ChicagoN, Los

AngelesN, and PhiladelphiaM, while

high socioeconomic groups are mentioned in DenverE

, DetroitE, HonoluluE,

Los AngelesE, MiamiN, St. LouisE, Sioux

FallsE, and Washington, DCE. The suburbs are mentioned slightly more often

than the central city as the area where

ecstasy users are most likely to live.

Where do users take ecstasy? As

reported in past Pulse Checks, nearly

all epidemiologic/ethnographic and

treatment sources report that ecstasy

is used predominantly in groups or

among friends. It is equally likely to

be used in public and private settings,

most typically (in descending order of

report frequency, with 10 or more

reports each) at raves, private parties,

nightclubs or bars, private residences,

and college campuses. In some cities,

ecstasy is sold but not used in specific

settings: the most frequent instances

are high schools (as in Chicago,

Detroit, Honolulu, and Miami), the

streets (as in El Paso, Miami, and New

York), and in or around malls (as in El

Paso, Miami, and New York).

Conversely, ecstasy is used but not

sold at parties and raves in Sioux Falls.

How and with what other drugs is

ecstasy taken? Ecstasy tablets are

almost always consumed orally, as

reported in past Pulse Checks.

Exceptions, however, are occasionally

reported. In Boston, for example,

some users in their late teens and

early twenties inject ecstasy and ketamine intramuscularly. In Sioux Falls,

an increasing number of users report

crushing and snorting ecstasy. 

Ecstasy continues to be taken, either

in combination with or sequentially,

with alcohol, marijuana, or both. It is

also taken with an array other substances, both legal and illegal:

" LSD: Boston, Chicago, Denver, Los

Angeles, and St. Louis

" GHB: Boston, Miami, Los Angeles,

and Sioux Falls

" Ketamine: Boston, Denver, El Paso,

and Los Angeles

" Prescription pills (benzodiazepines

or antidepressants): Los Angeles,

Memphis, and Miami

" Heroin: New York and Philadelphia

" Cough syrup: Philadelphia

" Camphor/menthol inhalants:

Memphis

" Sildenafil (Viagra®): Miami and 

St. Louis

" Nitrous oxide: Chicago

Some theories about why ecstasy

numbers in treatment appear low...

➤ Columbia, SCE

: “The numbers are

small and probably underestimated

because they don’t seek treatment.”

➤Memphis, TNN: “The drug is not in

the program because we serve mostly

adults. But the problem is rising in

the community, especially among

adolescents at parties. I anticipate seeing more young adults showing up in

the future.”

➤ Los Angeles, CAE

: “Ecstasy is slower

to show up in indicators than other

drugs because people are not always

asked about it.”

➤ New York, NYM: “The program

doesn’t test for it (ecstasy). It’s generally not seen in this older chronic

‘doper’ population.” 
“ECSTASY”

page 76 Pulse Check: November 2002

The changing nature of ecstasy users and use patterns (fall 2001 vs spring 2002)...

Younger students are using

ecstasy in some cities: 

Increasing use is reported

among some minorities and

socioeconomic groups: 

Use is increasing in some rural

areas: 

Some use settings are shifting: 

Some drug combinations have

changed: 

➤ Baltimore, MDE: Anecdotal evidence is increasing about ecstasy use in middle schools. 

➤ Boston, MAE

: Ecstasy use is increasing slowly but steadily among minority high school students.

Additionally, it is increasing among students in private schools.

➤ Memphis, TNE

: Since the last reporting period, socioeconomic status has been shifting from high to

middle.

➤ New York, NYE

: Blacks are increasingly using ecstasy, and Hispanics are a growing market for street

ecstasy.

➤ St. Louis, MON: Blacks continue to increase as an ecstasy-using population.

➤ Sioux Falls, SDN: More American Indians are using ecstasy. 

➤ El Paso, TXE

: Ecstasy use, which had been limited to warehouses in the central city, has moved further out into rural areas—largely because police have moved the users out.

➤ St. Louis, MOE

: A growing number of rural residents are coming into the city to buy ecstasy.

➤ Sioux Falls, SDN: American Indians are increasingly using ecstasy on rural reservations. 

➤ Baltimore, MDE

: Ecstasy is increasingly used on the street.

➤ El Paso, TXE

: In addition to the new raves in rural areas, raves of 200–300 adolescents at a time are

taking place clandestinely at night on unpoliced, unlit golf courses within the city. Ravers, who can

easily disperse, find each other by using laser pointers or by putting “glow sticks” around their

wrists and necks.

➤ Los Angeles, CAE

: Ecstasy use is becoming more prevalent in private settings, such as residences and

parties. It is not just a club drug anymore.

➤ St. Louis, MOE

: Ecstasy is increasingly used while alone, not just in groups and among friends, as in

the past. 

➤ El Paso, TXE

: Ketamine use with ecstasy is a new phenomenon.

➤ Miami, FLE

: Since September 11, more combinations—although fewer cases—have been reported.

Also, LSD use is less reported than in the past.

➤ Sioux Falls, SDN: Marijuana use with ecstasy is increasing. 
OTHER DRUGS OF CONCERN

Pulse Check: November 2002 page 77

OTHER DRUGS OF 

CONCERN✛

This round of Pulse Check discussions

focused on the illicit or illicitly used

drugs described in the previous chapters: heroin, crack cocaine, powder

cocaine, marijuana, methamphetamine,

diverted synthetic opioids, and ecstasy.

During the course of these discussions,

however, sources sometimes mentioned other drugs of concern in their

communities.

BENZODIAZEPINES 

" Benzodiazepines are mentioned as

an emerging drug problem in

BostonE. Alprazolam (Xanax®) and

clonazepam (Klonopin®), in particular, are widely abused in Boston

methadone programs.

" Benzodiazepines are considered the

drugs with the most serious consequences by methadone treatment

sources in Baltimore, Honolulu

(where they have replaced heroin

since the last reporting period),

Memphis, and Miami. 

" In general, alprazolam is the 

most frequently mentioned 

benzodiazepine. 

" Benzodiazepine use has increased in

MemphisE, especially among White

adult females in rural areas. Dealers

are reported as older and more

rural than in the past. Alprazolam is

particularly common among

methadone clients.

" Benzodiazepine abuse has increased

somewhat among methadone treatment clients in St. Louis.

" High school students in Miami are

increasingly abusing alprazolam,

sometimes with ecstasy, sometimes

by itself.

CLONIDINE (Catapres®)

" Abuse of clonidine, often prescribed for high blood pressure, is

mentioned as an emerging drug

problem in BaltimoreM.

" The drug is sold on the streets in

New York.

DEXTROMETHORPHAN (DXM)

" Dextromethorphan abuse is reported as an emerging problem in

Denver.

" Treatment clients in Sioux FallsN are

increasingly abusing over-the-counter preparations containing DXM,

taking 15 or more pills at a time.

" Abuse of such over-the-counter

preparations has also increased

somewhat in Detroit.

FLUNITRAZEPAM (Rohypnol®, or

“roches”) 

" Once commonly referred to as “the

date rape drug” in many States, 

epidemiologic, legislative, and law

enforcement efforts have paid off.

The only Pulse Check sources to

mention the drug as an ongoing

problem are in El Paso, where it

accounts for substantial percentages

of treatment admissions.

" In El Paso, the drug continues to be

involved in prostitution, gangrelated activity, violent and nonviolent crime, domestic violence, and

drug rape. 

" The El Paso epidemiologic source

notes two changes: users are now

selling their product; and, with the

aging of the population, more

adults older than 30 are involved 

in sales and use.

GHB (gamma hydroxybutyrate)

" GHB is mentioned as an emerging

problem in Denver and Los

Angeles.

" The drug is reported as widely

available in DenverE

, Los AngelesL,

MiamiL

, and New OrleansL.

Availability has increased in Los

AngelesL,E, MemphisL

, and Sioux

FallsL. It has declined in MiamiE and

St. LouisL,E.

" Almost anyone can produce GHB

because precursors and recipes are

available on the Internet.

" Like ecstasy, it is often associated

with the club or rave scene.

" GHB sellers tend to be young

adults who operate independently

and are somewhat likely to use

their own drug.

" Some epidemiologic/ethnographic

sources note GHB sellers’ involvement in different types of crime:

drug rape (in Los Angeles,

Memphis, St. Louis, and Sioux

Falls), other violent crimes (in

Memphis, New Orleans, and

Washington, DC), nonviolent

crimes (in Detroit, Memphis, and

Sioux Falls), domestic violence (in

Memphis), and gang-related activity

(in Memphis and New Orleans).

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

Law enforcement respondent, EEpidemiologic/ethnographic

respondent, NNon-methadone treatment respondent, and MMethadone treatment respondent.
OTHER DRUGS OF CONCERN

page 78 Pulse Check: November 2002

KETAMINE (“special K”)

" Ketamine is reported as an 

emerging or intensifying drug 

problem during this period in

Denver, El Paso, New Orleans, 

and Sioux Falls. It is increasingly

available in Memphis.

" The drug is sometimes associated

with the club or rave scene.

" Like GHB sellers, ketamine sellers

tend to be young adults who operate

independently and are somewhat

likely to use their own drug. 

" Ketamine is sometimes stolen from

veterinarian offices, as reported in

New OrleansL.

KHAT 

" A natural stimulant from the Catha

Edulis plant, khat is found in a

flowering evergreen tree or large

shrub from East Africa and

Southern Arabia. Its leaves 

contain psychoactive ingredients

structurally and chemically similar

to d-amphetamine.

" Khat leaves are widely available in

Boston, and availability continues

to increase with the continued

growth in east African populations

who abuse the substance.

LSD (lysergic acid diathylamide)

" No sources report LSD as widely

available.

" One source (MiamiE

) notes that a

supply is no longer seen because

people don’t seek out the drug.

PCP (phencyclidine 

hydrochloride)

" PCP is reported as an emerging

problem in Philadelphia and

Washington, DC.

" Availability is up in Baltimore, particularly in more rural areas, where

the drug is sometimes mixed with

crack.

SILDENAFIL (Viagra®)

" Many counterfeit pharmaceutical

tablets, particularly sildenafil, 

continue to be illegally distributed

over the Internet. Many of these

products contain adulterants.

" In Miami, sildenafil continues to be

used together with ecstasy (a combination known as “sextasy” and a

practice called “hammerheading”)

or with methamphetamine (“tina”).

What are some street prices of other drugs of concern?

GHB Chicago, ILL Dosage unit $5

Denver, COE Capful (5 ml) $5–$20

Los Angeles, CAL Capful $20

Miami, FLL Dosage unit $10

New Orleans, LAL Dosage unit $5–$20

St. Louis, MOE Capful $5

1 oz $40

Seattle, WAL 100 dosage units $100

Ketamine Boston, MAL Bottle (1 oz) $50

Columbia, SCL Vial (2 oz) $125

Philadelphia, PAL Vial $10–$20

Rohypnol El Paso, TXL Pill (2 mg) $2

LSD Philadelphia, PAL Tab $3–$5

Seattle, WAL Dose $5

PCP Honolulu, HIE 3 g $10–$20

Philadelphia, PAE Liquid or leaves $5

St. Louis, MOE Fluid oz $350

Washington, DCL 1 oz $350–$500

“love boat” (marijuana = 

700–800 mg PCP) $40

Drug City Most common unit sold Price
APPENDIX 1: METHODOLOGY

Pulse Check: November 2002 page 79

APPENDIX 1: METHODOLOGY

How were the sites selected?

(See map in the Introduction) A total

of 20 sites were studied for this issue

of Pulse Check. During 2000, we

selected sites using Census Bureau

regions and divisions with a goal of

achieving geographic and demographic

diversity. In addition, we made an

effort to select sites in areas with 

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

applied the following methodology in

selecting sites.

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

New York in Region I (Northeast

Region); Texas in Region II (South

Region); Illinois in Region III

(Midwest Region); and California in

Region IV (West Region). In three of

these States, we selected the most

populous metropolitan areas: New

York City, Chicago, and Los Angeles.

In Texas, however, we selected El

Paso—a known high trafficking area

with particularly high levels of unemployment, population growth, and

poverty—because of its proximity to

the United States border with Mexico.

We included four rural States, one 

per census region. (Rural States are

defined by the Census Bureau as

those in which 50 percent or more of

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

rural sites selected are as follows:

! Region I (Northeast): Portland,

ME—Of the three rural States in

the Northeast Region (including

New Hampshire and Vermont),

Maine has the only Atlantic coastline and shares the longest border

with Canada. It also includes an

ONDCP-designated High Intensity

Drug Trafficking Area (HIDTA).

Portland is Maine’s most populous

metropolitan area.

! Region II (South): Columbia, SC—

The three other rural States in the

South census region are Kentucky,

Mississippi, and West Virginia.

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

corridor makes that State a strategic choice. Recent cocaine seizures

in Columbia further highlight its

strategic importance.

! Region III (Midwest): Sioux Falls,

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

Midwest Region’s two rural States

(North Dakota and South Dakota).

! Region IV (West): Billings, MT—

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

Region, and Billings is its most

populous metropolitan area.

The remaining 12 sites were selected

to ensure that the entire list included

at least 2 sites from each of the 9

Census Bureau divisions (East North

Central, Mountain, Middle Atlantic,

New England, Pacific, South Atlantic,

South East Central, South West

Central, and West North Central).

Additional selection criteria included

population density, representation of

racial/ethnic minorities, and emphasis

on high drug trafficking areas. 

Applying these criteria resulted in the

final selection of the following 20

Pulse Check sites:

Baltimore, MD*

Billings, MT

Boston, MA

Chicago, IL

Columbia, SC

Denver, CO

Detroit, MI

El Paso, TX

Honolulu, HI

Los Angeles, CA

Miami, FL

Memphis, TN

New Orleans, LA

New York City, NY

Philadelphia, PA

Portland, ME

St. Louis, MO

Seattle, WA

Sioux Falls, SD

Washington, DC

How do the 20 sites vary demographically? Appendix 2 highlights

the demographic diversity of these 20

sites. For example, their population

density per square kilometer ranges

from a sparse 18.6 in Billings, MT, to

a crowded 2,931.6 in New York City.

Their unemployment rates range from

a 2.4 low in Sioux Falls, SD, to a 6.2

high in El Paso, TX. The racial/ethnic

breakdowns in the 20 sites further

exemplify their diversity: White representation ranges from 21.2 percent in

Honolulu, HI, to 96.0 percent in

Portland, ME; Black representation

ranges from 0.4 percent in Billings,

MT, to 43.2 percent in Memphis, TN;

and Hispanic representation ranges

from less than 1 percent in Portland,

ME, to 78.3 percent in El Paso, TX.

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

covering the January–June 2001 period; Birmingham, AL, was dropped as of the July–December 2001 issue in order to maintain balanced 

geographic representation.
APPENDIX 1: METHODOLOGY

page 80 Pulse Check: November 2002

What other data are available at

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

sources will be useful for framing,

comparing, corroborating, enhancing,

or explaining the information obtained

for Pulse Check. The following data

sources are available in nearly every

site: ONDCP’s past Pulse Check

reports; the National Institute on Drug

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

Substance Abuse and Mental Health

Services Administration (SAMHSA)

Drug Abuse Warning Network

(DAWN); and the National Institute of

Justice (NIJ) Arrestee Drug Abuse

Monitoring (ADAM) program.

Who are the Pulse Check

sources, and how were they

selected? Consistent with previous

issues, the information sources for

Pulse Check were telephone discussions with 4 knowledgeable individuals

in each of the 20 sites: 1 ethnographer

or epidemiologist, 1 law enforcement

official, and 2 treatment providers.

Ethnographers and epidemiologists

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

Pulse Check program; membership in

NIDA’s CEWG; research activities in

local universities; or service in local

community programs. We recruited

law enforcement officials by contacting

local police department narcotic units,

Drug Enforcement Administration

(DEA) local offices, and HIDTA 

directors. All but 2 of the 40 epidemiologists, ethnographers, and law

enforcement sources who reported

for this issue of Pulse Check were the

same, or associated with the same

agencies, as those who reported for

the previous issue.

To identify treatment sources for the

Mid-Year 2000 issue of Pulse Check,

we randomly selected providers from

the 1998 Uniform Facility Data Set

(UFDS), a listing of Federal, State,

local, and private facilities that offer

drug abuse and alcoholism treatment

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

50 percent of their clientele as having

a primary alcohol abuse problem,

served a caseload of fewer than 100

clients, or provided only prevention

or detox services. We then divided

the remaining facilities into two

groups—methadone and nonmethadone treatment facilities—in

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

widely. We selected one from each of

these two categories of programs for

each of the 20 selected sites. Because

Billings, MT, and Sioux Falls, SD, have

no UFDS-listed methadone treatment

facilities, we selected two nonmethadone facilities in those sites.

Since the Mid-Year 2000 issue of

Pulse Check, in order to preserve 

continuity, all actively available treatment sources have been retained.

Additionally, to ensure regular reporting, any treatment provider who

becomes unavailable to participate is

being replaced via purposeful, rather

than random, selection based on 

consultation with experts in the field.

Altogether, we recruited 40 treatment

sources: 18 methadone providers 

(1 from each Pulse Check site except

for Billings and Sioux Falls, where

methadone treatment is unavailable),

and 22 non-methadone providers (1

from each Pulse Check site plus extra

sources from Billings and Sioux Falls).

Thus, a total of 80 sources have been

identified and recruited, and for this

Pulse Check issue we successfully

obtained information from 78 of

them: a response rate of 98 percent.

Two participants were unavailable:

one of the two the non-methadone 

treatment providers from Sioux Falls;

and the methadone treatment

provider from New Orleans.

What kind of data were collected,

and how? For each of the 78

responding sources, we conducted a

single telephone discussion lasting

about 1 hour. We asked sources to

explore with us their perceptions of

the change in the drug abuse situation

between fall 2001 and spring 2002.

We discussed a broad range topic

areas with these individuals, as delineated in Appendix 5. 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. Some

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

communities extending beyond their

individual programs. Among the three

Pulse Check source types, law

enforcement officials appeared to 

be most knowledgeable about drug

availability, trafficking patterns, seller

characteristics, sales practices, and

other local market activities; they

were not asked to discuss user groups

and characteristics.
Race Percenta Violent Percent PopulaMSA American Crime/ Persons Unem- tion

Size* Indian/ Asian/ 100,000 Under 18 ploy- Density/

Pulse Check (S,M, Alaska Pacific Percent Popu- Below Pov- ment Square Percent Percent

Site L, X)a White Black Native Islander Hispanic lationb erty Levela Ratea KMc Urbana Rurala

Boston, MA-NH 

PMSA L 82.5 6.8 0.2 4.9 5.9 505 2.3 3.3 353.3 96.3 3.7

New York, NY PMSA X 48.8 24.4 0.4 9.2 25.1 1,037 6.7 6.1 2,931.6 99.4 0.6

Philadelphia, PANJ PMSA X 72.2 20.0 0.2 3.4 5.0 667 3.8 4.6 495.7 94.8 5.2

Portland, ME S 96.0 0.9 0.4 1.2 0.8 730 2.3 2.9 368.7 68.2 31.8

Baltimore, MD PMSA L 67.4 27.2 0.3 2.7 2.0 581 3.2 3.8 110.9 90.4 9.6

Columbia, SC M 63.9 32.0 0.4 1.5 2.5 868 3.9 4.1 136.8 78.8 21.2

El Paso, TX M 74.1 3.0 0.7 1.1 78.3 668 10.2 6.2 267.5 97.0 3.0 

Memphis, TN L 52.9 43.2 0.2 1.5 2.3 1,081 6.3 4.8 141.9 87.9 12.1

Miami, FL PMSA L 69.7 20.1 0.2 1.4 57.3 1,532 5.8 6.0 432.0 99.3 0.7

New Orleans, LA L 57.3 37.4 0.4 2.1 4.4 918 7.1 4.9 148.2 93.5 6.5

Washington, DCMD-VA-WV PMSA L 60.0 25.9 0.3 6.7 8.7 537 2.3 3.4 281.1 90.4 9.6

Chicago, IL PMSA X 65.8 18.8 0.2 4.7 17.1 NA 3.9 4.7 610.5 98.1 1.9

Detroit, MI PMSA L 71.2 22.8 0.4 2.3 2.9 870 4.0 4.4 433.3 93.6 6.4

Sioux Falls, SD S 93.5 1.3 1.8 1.0 1.9 252 2.3 2.4 45.8 87.9 12.1

St. Louis, MO L 78.3 18.2 0.3 1.4 1.5 NA 3.7 4.2 155.2 78.3 21.7

Billings, MT S 93.0 0.4 3.1 0.6 3.7 187 3.9 3.5 18.6 83.3 16.7

Denver, CO PMSA L 79.3 5.4 0.9 3.0 18.8 385 2.6 3.2 203.2 96.0 4.0

Honolulu, HI M 21.2 2.2 0.2 55.0 6.7 268 3.1 4.3 556.4 98.4 1.6

Los Angeles-Long 

Beach, CA PMSA X 48.6 9.6 0.7 12.2 44.6 1,027 6.8 5.9 887.3 99.3 0.7

Seattle-BellevueEverett, WA PMSA L 78.4 4.3 1.0 9.8 5.2 419 2.2 3.6 203.7 93.1 6.9

West Midwest South Northeast

APPENDICES 2 AND 3: SITE DEMOGRAPHICS AND OTHER DATA SOURCES

Pulse Check: November 2002 page 81

*Small = <300,000 persons; Medium = 300,000–1 million persons; Large = 1 million–5 million persons; Extra Large = >5 million persons aSource: 2000 U.S. Census, 2000 data bSource: 2001 County and City Extra: Annual Metro, City, and County Data Book, Tenth Edition. Eds: Gaquin, D.A., and Littman, M.S.

Washington, DC: Bernan Press, 1998 data 

cSource: 2001 County and City Extra: Annual Metro, City, and County Data Book, Tenth Edition. Eds: Gaquin, D.A., and Littman, M.S. 

Washington, DC: Bernan Press, 1999 data 

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

1

High Intensity Drug Trafficking Area of the

Drug Enforcement Administration (DEA)

2

Community Epidemiology Work Group of

the National Institute on Drug Abuse (NIDA)

3

Drug Abuse Warning Network of the

Substance Abuse and Mental Health

Services Administration (SAMHSA)

4

Arrestee Drug Abuse Monitoring program 

of the National Institute of Justice (NIJ)

Note: Shaded boxes indicate that selected

citiy is in a rural State.

Pulse Check Site HIDTA1 State CEWG2 DAWN3 ADAM4

Boston, MA ! !!

New York, NY ! ! !!

Philadelphia, PA ! ! !!

Portland, ME !

Baltimore, MD ! !!

Columbia, SC

El Paso, TX ! !

Memphis, TN !

Miami, FL ! ! !!

New Orleans, LA ! ! !!

Washington, DC ! ! !!

Chicago, IL ! ! !!

Detroit, MI ! ! !!

Sioux Falls, SD !

St. Louis, MO ! !!

Billings, MT

Denver, CO ! ! !!

Los Angeles, CA ! ! !!

Honolulu, HI !! !

Seattle, WA ! ! !!

West Midwest South Northeast

APPENDIX 2: POPULATION DEMOGRAPHICS IN THE 20 PULSE CHECK SITES
APPENDIX 4: PULSE CHECK SOURCES

page 82 Pulse Check: November 2002

Pulse Check Site Epidemiology/Ethnography Law Enforcement 

Baltimore, MD James Peterson Robert J. Penland

Johns Hopkins University Washington-Baltimore HIDTA

School of Public Health 

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

Montana State University at Billings City/County Special Investigations Unit

Department of Health and Physical Education 

and Human Services 

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

Organization prefers anonymity Boston Police Department

Drug Control Division

Chicago, IL Larry Ouellet, Ph.D. Individual prefers anonymity

EPI/BIO COIP Chicago Police Department

School of Public Health Organized Crime Division, Narcotic

and Gang Investigations Section

Columbia, SC Individual prefers anonymity C.O. Clark

Department of Alcohol and Columbia Police Department

Other Drug Abuse Services Organized Crime and Narcotics Unit 

Denver, CO Bruce D. Mendelson, M.P.A. Curt Williams and Rob McGregor

State Treatment Needs Assessment Contract Denver Police Department

Colorado Department of Human Services Fugitive Location and Apprehension Group

Alcohol and Drug Abuse Division 

Detroit, MI Richard F. Calkins Individual prefers anonymity

Michigan Department of Community Health Southeast Michigan HIDTA

Division of Quality Management and Planning

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

Aliviane, Inc. Organization prefers anonymity

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

University of Hawaii Honolulu Police Department

Department of Sociology Narcotics, Vice Division 

Los Angeles, CA Beth Finnerty, M.P.H. Eric Lillo

University of California, Los Angeles Los Angeles Police Department

Integrated Substance Abuse Programs (ISAP) 

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

Department of Psychiatry Memphis Police Department

University of Tennessee Vice Narcotics Unit 

Miami, FL James N. Hall Prefers anonymity 

Up Front Drug Information Center 

New Orleans, LA Gail Thornton-Collins Lieutenant Reginald Jacque

New Orleans Health Department New Orleans Police Department

Narcotics Major Case Section

New York, NY John A. Galea, M.A. Individual prefers anonymity

New York State Office of Alcoholism Drug Enforcement Administration

and Substance Abuse Services New York Division 

Street Studies Unit Unified Intelligence (S-13)

Philadelphia, PA Samuel J. Cutler Ken Bergmann

Philadelphia Behavioral Health System Organization prefers anonymity

Coordinating Office for Drug 

and Alcohol Abuse Programs

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

Public Health Division, Maine Drug Enforcement Administration 

Department of Health and Human Services

City of Portland 

Seattle, WA Thomas R. Jackson, M.S.W. Steve Freng

Evergreen Treatment Services High Intensity Drug Trafficking Area 

Sioux Falls, SD Darcy Jensen Jerry Mundt 

Prairie View Prevention Services Sioux Falls Police Department

Narcotics Division 

St. Louis, MO James M. Topolski, Ph.D. Detective Leo Rice

Missouri Institute of Mental Health St. Louis Police Department

Narcotics Division 

Washington, DC Jerry Brown Sergeant John Brennan

Department of Health Washington, D.C. Police Department

HIV/AIDS Administration Major Narcotics
APPENDIX 4: PULSE CHECK SOURCES

Pulse Check: November 2002 page 83

Pulse Check Site Non-Methadone Treatment Methadone Treatment 

Baltimore, MD Adrienne Britton-Robinson, BA, CAC Cindy Shaw

Total Health Care Institute for Behavior Resources (IBR Reach)

Billings , MT Mona Sumner (Illegal in the State of Montana)

Rimrock Foundation 

Rhonda Stennerson

South Central Mental Health Center

Journey Recovery Program

Boston, MA Jim Sweeney Lawrence O’Toole

Gavin House Habit Management 

Chicago, IL Nick Gantes Individual prefers anonymity

Gateway Foundation Cornell Interventions

Columbia, SD Laura Truesdale Jim Van Frank

Palmetta Baptist Medical Center Columbia Metro Treatment Center 

Outpatient Behavioral Health Services

Denver, CO Tim McCarthy Pamela J. Manuele, RN, BSN, ANPC, CCJS

Arapahoe House Comprehensive Addiction Treatment Services

Detroit, MI Peter Mason Octavius Sapp, C.A.C.

Renaissance West Community Health Services City of Detroit, Department of Human Services

Drug Treatment Program

El Paso, TX Armando Salas Julie Renteria, L.V.N.

Aliviane Men’s Residential Facility El Paso Methadone Maintenance

and Detox Treatment Center 

Honolulu, HI Prefers anonymity Lorianne Bean

Lisa Cook

Marcia Tsuehoriuchi

Drug Addiction Services of Hawaii 

Los Angeles, CA Mari Radzik, Ph.D. Individual prefers anonymity

Substance Abuse Treatment Program Aegis Medical System 

Division of Adolescent Medicine 

Children’s Hospital of Los Angeles 

Memphis, TN Bonnie Moody, LCSW Rusty Titsworth

Community Behavioral Health Center Memphis Center for Research and Addiction Treatment

Miami, FL Michael Miller, Ph.D. Prefers anonymity

The Village South, Inc. 

Addiction Treatment Center 

New Orleans, LA Eleanor Glapion Nonrespondent

New Orleans Substance Abuse Clinic 

New York, NY Prefers anonymity Individual prefers anonymity

Lower Eastside Service Center

Philadelphia, PA Chris Sweeney Prefers anonymity

Northeast Treatment 

Portland, ME Stephen Leary Marty O’Brien

Milestone Foundation, Inc. Discovery House Maine

Seattle, WA Ramona Graham Victoria Evans

Center for Human Services Therapeutic Health Services 

Sioux Falls, SD Nicole McMillin (Illegal in the State on South Dakota)

Volunteers of America Dakotas

Nonrespondent

St. Louis, Missouri Mike Morrison Cheryl Gardine

Bridgeway Counseling DART 

Washington, D.C. James Shepard LaTonya Sullivan

Organization prefers anonymity Organization prefers anonymity
APPENDIX 5: DISCUSSION AREAS

page 84 Pulse Check: November 2002

APPENDIX 5: DISCUSSION AREAS BY SOURCE TYPE*

Topic L E M N

SPECIAL SECTION: A LOOK AT LOCAL DRUG MARKETS

How difficult is it for users/undercover police to buy specific drugs?** ! !

During this reporting period, has there been a time when users could not buy specific drugs? If yes, when and why? ! !

Is there any particular day, week, or month that local drug markets seem more active? If yes, when? To what do you

attribute this phenomenon? ! !

Where do users buy their drugs most of the time? ! !

Which specific neighborhood(s) in your city has the greatest concentration of drug sales? ! !

What else, besides cash, do users trade or exchange for drugs? !

What else, besides cash, do dealers accept in exchange for drugs? !

What has, in the past, deterred street buys of any particular drug? In your opinion, what would, in the future, deter 

such buys? ! !

List and describe any recent targeted law enforcement or legislative policy directives or initiatives. How did it impact on

your community’s overall drug abuse problem, either for better or worse? ! !

What gaps or challenges, if any, do you perceive in your community’s current law enforcement efforts? !

What are any recent developments or trends in your State, in areas beyond your city, that could eventually affect your

city’s drug abuse problem—either for better or worse—in the future? ! !

How do street-level drug dealers communicate with their fellow street dealers? With their suppliers? With their buyers? !

How do dealers transport drugs to their selling locations? !

To the best of your knowledge, what happens to the cash collected by street-level dealers? !

Do you have any suggestions for ways to disrupt local drug market activity? !

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 widely abused drug in your community? 

Second most widely 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 available is the drug in your community (for each drug, asks about various forms)? ! !

How has availability changed? ! !

What are the most common and second most common units of sale and corresponding standard units of the drug? ! !

What is the purity range for the drug during the current reporting period? During the last reporting period? ! !

What is the price range during the current reporting period? During the last reporting period? ! !

Are there any adulterants? If yes, please list and indicate if any are new this reporting period. ! !!!

Why have price, purity, or adulterants changed or why have they remained stable? ! !

What is the source for your price, purity, and adulterant information? ! !

What are the street names, and are any of these new this reporting period? ! !!!

What types of packaging are used, and are any of these new this reporting period? ! !

Are labels or brand names used? If yes, please list and indicate if any are new this reporting period. ! !

Have street names, packaging, or label/brand names changed since the last reporting period? ! !

How is the drug locally manufactured, processed, or grown? ! !

Have there been any changes in the local manufacturing process since the last reporting period?If yes, please describe. ! !

THE SALE**

What is the predominant affiliation of local, street-level sellers? ! !

What is the predominant age range of local, street-level sellers? ! !

How likely are sellers to use their own drugs? ! !

In what types of other crimes are sellers involved? ! !

Have there been any changes in seller characteristics since the last reporting period? If yes, please describe. ! !

Are there any new sellers groups this reporting period? If yes, please describe. ! !

What is the geographical area where most street-level sales of the drug occur? ! !

Is the drug sold mostly indoors, outdoors, or evenly split between both? ! !

In what settings is the drug sold? ! !

How is the drug sold? ! !
APPENDIX 5: DISCUSSION AREAS

Pulse Check: November 2002 page 85

THE SALE** (continued) L E M N

Are other drugs sold by this type of dealer? If yes, please list the drugs. ! !

Have any of the drugs sold with this drug changed since the last reporting period? If yes, please describe. ! !

Have any of the drug scene characteristics changed since the last reporting period? If yes, please describe. ! !

THE USERS: Predominant characteristics**

How did the number of users chnage since the last reporting period? !

What is total numbe of primary users (of each drug) in your program? Total number of users (primary+secondary+

tertiary) of each drug? How did these numbers change since the last reporting peroid? ! !

What is the predominant age range of the drug users, and has it changed since the last reporting period? !!!

What is the predominant gender, and has it changed since the last reporting period? !!!

What is the predominant racial/ethnic group, and has it changed since the last reporting period? Is this group underrepresented, overrepresented, or about equal compared with the general population in your area? !!!

What is the predominant socioeconomic position, and has it changed since the last reporting period? !!!

What is the most common geographical residence, and has it changed since the last reporting period? !!!

What is the predominant route of administration, 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

for the drug? What are the street names for this combination or practice? !! !

Is the drug used mostly in public or in private? !! !

Is the drug used mostly alone or in groups/among friends? !!!

What are the common settings for the use of this drug? !!!

What is the most common referral source, and has it changed since the last reporting period? ! !

What is the predominant education level, and has it changed since the last reporting period? ! !

What is the most common frequency of use, and has it changed since the last reporting period? ! !

What is the predominant employment status, and has it changed since the last reporting period? ! !

What are the adverse consequences of marijuana abuse, and have they changed since the last reporting period? !!!

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. !

Among all clients in your program, and among first-time admissions, what is the total number of primary users (of each drug)?

Total number of users (primary+secondary+tertiary) of each drug? How did these numbers change since the last reporting 

period? For the first-time admission group, if increased, repeat all questions under “the users: predominant characteristics.” ! !

METHADONE DIVERSION/TREATMENT

What is the availability of methadone treatment in your community? !

How has treatment availability changed since the last reporting period? !

What is the capacity of public methadone treatment? Private methadone treatment? !

How has the capacity of public methadone treatment changed since the last reporting period? Private methadone treatment? !

COMMUNITY CONTEXTS

Have drug-related consequences (HIV/AIDS, hepatitis C, liver cirrhosis, drug-related automobile accidents, high-risk

pregnancy, drug overdoses, alcohol DTs, tuberculosis, other) increased, decreased, or remained stable since the last ! !

reporting period? If changed, explain. 

Have any psychatric commorbidity diagnoses increased or decreased as a concern among your clients since the last

reporting period? ! !

Do any potential barriers (limited slot capacity, lack of trained staff to treat comorbid clients, violent behavior among presenting clients, age restrictions, other) prevent your program from serving all individuals who seek treatment? If yes, explain. ! !

TREATMENT BACKGROUND

What is your program’s maximum capacity? ! !

What is your current enrollment? ! !

Does your program’s clientele reflect the population of your local community? If no, please describe. ! !

L

Law enforcement

E

Epidemiologic/ethnographic

MMethadone treatment

NNon-methadone treatment 

*Please note that for the methadone and non-methadone treatment interviews, “community” was replaced with “program.”

**Respondents were asked about heroin, crack, powder cocaine, methamphetamine, marijuana, ecstasy, OxyContin®, 

and any other drugs (specify) for each of the discussion areas.
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