PULSE CHECK

Trends in Drug Abuse

Mid–Year 2000

Executive Office of the President

Office of National Drug Control Policy

Washington, DC 20503

NCJ 186747

March 2001
ACKNOWLEDGEMENTS

ACKNOWLEDGEMENTS

The Office of National Drug Control Policy (ONDCP) acknowledges the contributions made by the 74 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, Rebecca Chalmers, Gail Bassin, and the staff of Johnson, Bassin & Shaw, Inc., produce the Pulse

Check for ONDCP, under Contract Number 282-98-0011, Task Order Number 008. Anne McDonald Pritchett,

Office of Programs, Budget, Research, and Evaluation, 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>. 

Click on “Publications.”

NCJ 186747

March 2001
CONTENTS

Pulse Check: Mid-Year 2000 page iii

CONTENTS

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

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Heroin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Cocaine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Marijuana . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

Methamphetamine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

Special Topic: “Ecstasy” and Other Club Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

Appendix 1: Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

Appendix 2: Population Demographics in the 20 Pulse Check Sites . . . . . . . . . . . . . . . . . . . . . . . . . 66

Appendix 3: National-Level Data Sources Available in the 20 Pulse Check Sites . . . . . . . . . . . . . . . 67

Appendix 4: Pulse Check Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

EXHIBITS

Highlights

Exhibit 1. How serious is the perceived drug problem? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

Exhibit 2. How has the perceived drug problem changed between 1999 and 2000? . . . . . . . . . . . . . . . . . . . . . . . .2

Exhibit 3. What are the most serious drug problems in the 20 Pulse Check communities? . . . . . . . . . . . . . . . . . . .2

Exhibit 4. In which sites has the “most serious” drug problem changed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

Exhibit 5. What new problems have emerged or intensified during 2000? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

Exhibit 6. How available are illegal drugs in Pulse Check communities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

Heroin

Exhibit 1. How has heroin availability changed (1999 vs 2000)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7

Exhibit 2. How available are the different forms of heroin? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

Exhibit 3. How is heroin referred to, and what types of heroin predominate, 

in different regions of the country? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

Exhibit 4. Heroin gram prices and purity, by heroin type and city . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

Exhibit 5. What age group is most likely to use heroin? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

Exhibit 6. How do users administer heroin? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 

Exhibit 7. Where and with whom is heroin used? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Exhibit 8. How has heroin use impacted the health of users? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

Exhibit 9. Where is street-level heroin sold? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

Exhibit 10. What other drugs do heroin dealers sell? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

Exhibit 11. Heroin brand names in selected Pulse Check sites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
CONTENTS

page iv Pulse Check: Mid-Year 2000

Cocaine

Exhibit 1. How available is cocaine? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22

Exhibit 2. How has crack cocaine availability changed (1999 vs 2000)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23

Exhibit 3. Crack cocaine gram prices and purity by city . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23

Exhibit 4. How has powder cocaine availability changed (1999 vs 2000)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24

Exhibit 5. Powder cocaine gram prices and purity by city . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25

Exhibit 6. How is crack cocaine referred to across different regions of the country? . . . . . . . . . . . . . . . . . . . . . .25

Exhibit 7. How is powder cocaine referred to across different regions of the country? . . . . . . . . . . . . . . . . . . . .25

Exhibit 8. How has the number of novice crack users in Pulse Check sources’ 

treatment programs changed (1999 vs 2000)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

Exhibit 9. What age group is most likely to use crack? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

Exhibit 10. Where and with whom is crack used? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29

Exhibit 11. Where and with whom is powder cocaine used? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32

Exhibit 12. Where is street-level crack sold? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35

Exhibit 13. What other drugs do crack dealers sell? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35

Exhibit 14. Where is street-level powder cocaine sold? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37

Exhibit 15. What other drugs do powder cocaine dealers sell? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37

Marijuana

Exhibit 1. How available are the different forms of marijuana? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40

Exhibit 2. How has marijuana availability changed (1999 vs 2000)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40

Exhibit 3. Marijuana prices by ounce, by type and city . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41

Exhibit 4. How is marijuana referred to in different regions of the country? . . . . . . . . . . . . . . . . . . . . . . . . . . . .43

Exhibit 5. How are different drug users referred to treatment? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44

Exhibit 6. How are marijuana sellers organized? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47

Exhibit 7. Where is street-level marijuana sold? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47

Exhibit 8. What other drugs do marijuana dealers sell? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48

Methamphetamine

Exhibit 1. How available is methamphetamine by U.S. region? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

Exhibit 2. How has methamphetamine availability changed by region? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

Exhibit 3. Methamphetamine gram prices and purity by region and city . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50

Exhibit 4. How is methamphetamine referred to in different regions of the country? . . . . . . . . . . . . . . . . . . . . . .51

Exhibit 5. Where is street-level methamphetamine sold? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54

Special Topic: “Ecstasy” and Other Club Drugs

Exhibit 1. How available are club drugs across the United States? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57

Exhibit 2. How available are the different forms of ecstasy? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57

Exhibit 3. Has club drug availability changed between 1999 and 2000? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .58

Exhibit 4. Slang terms for club drugs and club drug combinations across the United States . . . . . . . . . . . . . . . . . .58

Exhibit 5. Ecstasy prices per pill by region and city . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59

Exhibit 6. Where do ecstasy users tend to live? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .60

Exhibit 7. Where is street-level ecstasy sold? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61

Exhibit 8. How are ecstasy pills labeled in reporting Pulse Check cities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61

Exhibit 9. Club drug user and seller characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .62
HIGHLIGHTS

Pulse Check: Mid-Year 2000 page 1

Unlike previous issues of Pulse Check,

this issue reports on changes between

1999 and 2000. Future Pulse Checks

will be issued by the Office of

National Drug Control Policy

(ONDCP) twice annually. The current

report is based on discussions with

epidemiologists, ethnographers, law

enforcement officials, and methadone

and non-methadone treatment

providers. More specifically, 74 telephone discussions were conducted

between September and October

2000. Based on these conversations,

two key features characterize an 

otherwise stable illicit drug problem 

in comparing 1999 and 2000. 

! An emerging club drug scene 

continues to grow across the

Nation. 

! In some cities, heroin has

increased in supply, in purity levels, and in the number of users. 

Following are the highlights of 

findings on heroin, cocaine, 

marijuana, methamphetamine, club

drugs, and prescription drug abuse.

! Heroin:

" In several areas, sources note

increases in supply, purity, 

aggressive marketing strategies,

and indoor selling. 

" Several increases are noted in 

the numbers of younger people,

often suburbanites, starting to

use the drug, usually via 

snorting. 

" In New York and Portland

(Maine), some adolescents are

reportedly shifting from snorting

to injecting as the primary route

of administration.

! Crack and powder cocaine:

" Availability is stable in the 

majority of sites.

" Only a few isolated changes are

reported in user groups. Some

young people are increasingly

abusing powder cocaine, 

sometimes as a club drug, as

noted by sources in Boston,

Columbia (South Carolina),

Denver, Los Angeles, Memphis,

Miami, and New Orleans.

" While epidemiologic and 

ethnographic sources report 

few signs of crack initiation, 

treatment sources in 10 cities,

spanning all regions of the 

country, report increases in

novice use of crack.

" Street-level crack and powder

cocaine sellers usually use their 

own drug and are often involved

in violence, according to law

enforcement sources in nearly

every site.

! Marijuana: 

" According to law enforcement,

epidemiologic, and ethnographic

sources, availability is stable in

the majority of sites; however,

potency has increased in at least

seven cities, mostly due to

improved cultivation techniques,

such as hydroponic growing of

marijuana.

" Users span a wide range of age,

racial/ethnic, gender, socioeconomic, and residence groups, 

with adolescent users often 

outnumbering young adult users. 

" Law enforcement sources 

indicate that sellers span a wide

age range but are predominantly

adolescents and young adults. 

" Sellers are usually users, as 

reported by law enforcement

sources in nearly every site, but 

are seldom involved in violence.

! Methamphetamine: 

" Availability has increased in

numerous sites, particularly in

the West, but findings are mixed

elsewhere. 

" Lab seizures have increased,

often due to increased targeted

law enforcement efforts. 

" While the methamphetamine

scene is generally a rural 

phenomenon, it has started

spreading to some suburban and

inner-city areas, as in Seattle. 

" Demographic shifts are noted,

such as an increase in methamphetamine use among women in

Denver and Honolulu, increased

adolescent use in Los Angeles,

and the initiation of use in New

York’s gay community. 

" Route of administration varies

widely across sites, and some

shifts are noted.

! Club drugs: 

" Availability of club drugs has

increased dramatically across the

Nation, especially for ecstasy,

which has increased in nearly

every city. 

" Ketamine availability is 

increasing in most cities, whereas

gamma hydroxybutyrate (GHB)

and flunitrazepam (Rohypnol) is

concentrated in the South and

West, where availability trends

are mixed. 

MID-YEAR 2000 PULSE CHECK HIGHLIGHTS
HIGHLIGHTS

page 2 Pulse Check: Mid-Year 2000

" Club drug users and sellers

tend to be young, white, middleclass males and females who use

or sell the drugs in combination

with other drugs, such as 

hallucinogens, cocaine, heroin,

marijuana, methamphetamine,

and prescription drugs. 

" Club drug activity generally

occurs in suburban areas,

although ecstasy activity is 

moving to urban areas as well. 

" Ecstasy user and seller groups

are also expanding to include

more blacks and Hispanics, and

use and sales settings continue to

expand from exclusively nightclubs and raves to high schools,

streets, and open venues. 

" As the ecstasy supply increases,

the use of ecstasy adulterants,

especially other stimulants, is

also increasing.

! Prescription drugs:

" OxyContin®: This long-acting

form of the opiate oxycodone,

prescribed for severe pain, is

abused in some areas, such as

Portland, Maine. Recently, it has

been involved in numerous overdoses and prescription altering

schemes in Portland, especially

in rural areas.

" Viagra® (sildenafil citrate): Use

of this drug with methamphetamine has resulted in medical

consequences in the Los Angeles

gay community. It is also used

with club drugs in that city to

gain a “better bump.”

How serious is the perceived

drug problem? (Exhibit 1) Among

the Pulse Check sources, 73 discussed

their perception of how serious the

illegal drug problem was in their

communities during 2000. The

majority (71 percent) describe the

problem as “very serious,” and about

one-quarter (27 percent) consider it

to be “somewhat serious.” Only one

source (in El Paso) describes drugs as

a “not very serious” problem in the

community. No one considers drugs

“not a problem.”

How has the perceived drug

problem changed between 1999

and 2000? (Exhibit 2) In comparing

the two reporting periods, nearly half

(45 percent) of the 73 responding

sources describe their community’s

drug problem as “unchanged.” About

one-third (36 percent) consider the

situation to have worsened somewhat,

and 16 percent feel the problem has

gotten much worse. Only two sources

(in Memphis and New York) perceive

that their community’s drug problem

has become less serious.

What are the most serious drug

problems in the 20 Pulse Check

communities? (Exhibits 3 and 4)

Cocaine is most commonly described

as the most serious drug problem,

especially in terms of adverse consequences. Sources, however, tend to

combine both crack and powder

cocaine into one category. If those

two cocaine forms could be separated,

it is possible that heroin would equal

or even surpass crack as the most

serious drug problem.

Exhibit 3. What are the most 

serious drug problems in the 20

Pulse Check communities?

Exhibit 1. How serious is the 

perceived drug problem?

Very

Serious

Percent (N=73)

Somewhat

Serious

Not

Very

Serious

Sources: Epidemiologic, ethnographic, 

treatment, and law enforcement respondents

100

90

80

70

60

50

40

30

20

10

0

Exhibit 2. How has the perceived

drug problem changed between

1999 and 2000?

Percent (N=73)

Sources: Epidemiologic, ethnographic, 

treatment, and law enforcement respondents

100

90

80

70

60

50

40

30

20

10

0

Much Same

Worse

Somewhat

Worse

Less Serious

No Longer a

Concern

Percent (N=70)

Sources: Epidemiologic, ethnographic, 

treatment, and law enforcement respondents

100

90

80

70

60

50

40

30

20

10

0 Heroin Marijuana

Cocaine Methampetamine

Most

serious

Second

most

serious
HIGHLIGHTS

Pulse Check: Mid-Year 2000 page 3

Marijuana is perceived as the most

serious drug problem by seven

sources in six cities (Billings, Boston,

Columbia, Denver, Los Angeles, and

Sioux Falls), and methamphetamine is

considered the most serious drug

problem by another seven sources in

three cities (Billings, Honolulu, and

Sioux Falls).

In only five Pulse Check sites do any

sources perceive a change between

1999 and 2000 in the drug that presents the most serious problem: heroin

replaced cocaine as the most serious

drug problem according to sources in

three cities (Detroit, New Orleans,

and Portland); and, conversely,

cocaine replaced heroin as the most

serious drug problem according to

sources in Birmingham and El Paso. 

What new problems have

emerged or intensified during

2000? (Exhibit 5) Club drugs, 

particularly “ecstasy” (methylenedioxymethamphetamine, or MDMA),

are named as the largest emerging

illicit drug problem in all but two

sites: Billings and Birmingham. 

Methamphetamine is a distant 

second, with sources in five sites,

spanning all census regions, naming 

it as an emerging problem. 

Heroin is named as an emerging

problem by sources in four sites:

Billings, Birmingham, Columbia, 

and Miami. 

Marijuana is named in two sites

(more as an intensifying, rather than

an emerging, problem): Honolulu

and Washington, DC. 

Crack is described as an emerging

problem by only one source, in

Billings. 

Abuse of prescription drugs is named

as the most serious emerging problem

in three sites: Billings, (particularly

sedatives); Birmingham, and Portland,

(OxyContin).

How available are the major 

illegal drug groups in Pulse

Check communities? (Exhibit 6)

Marijuana, by far, is the most widely

available illicit drug, according to law

enforcement, epidemiologic, and

ethnographic sources. It is followed

by cocaine, then heroin. As reported

in previous Pulse Checks, methamphetamine continues to be the least

widely available of the four major 

illegal drug groups, with supply

remaining concentrated heavily in the

western Pulse Check sites (Billings,

Denver, Honolulu, Los Angeles, and

Seattle).

Exhibit 6. How available are 

illegal drugs in Pulse Check

communities?

Widely

available

Somewhat

available

Not very

available

Marijuana

(N=35)

Heroin

(N=31)

Percent

Cocaine

(N=31)

Methamphetamine

(N=35)

Sources: Law enforcement, epidemiologic,

and ethnographic respondents

100

90

80

70

60

50

40

30

20

10

0

Site/Source 1999 2000

Detroit, MIE Cocaine Heroin

New Orleans, LAL,E Cocaine Heroin

Portland, MEL Cocaine Heroin

Birmingham, ALE Heroin Cocaine

El Paso, TXE Heroin Cocaine

L Law enforcement respondents

E Epidemiologic/ethnographic respondents

Exhibit 4. In which sites has the

“most serious” drug problem

changed?

Exhibit 5. What new problems have emerged or intensified during 2000?

Club drugs

Boston, MAE,M

Chicago, ILL,E

Columbia, SCE,M

Denver, COL

Detroit, MIE

El Paso, TXE

Honolulu, HIN

Los Angeles, CAL,E

Memphis, TNL

Miami, FLE,M

New Orleans, LAL,E

New York, NYL,E

Philadelphia, PAE

Portland, MEN

Seattle, WAL,E

Sioux Falls, SDL,M

Washington, DCL

Methamphetamine

Birmingham, ALE

Denver, CON

Philadelphia, PAE

Seattle, WAM

Sioux Falls, SDE

Heroin

Billings, MTN

Birmingham, ALN

Columbia, SCN

Miami, FLL

Prescription Drugs

Billings, MTE

Boston, MAN

Portland, MEL,E

Marijuana

Honolulu, HIE

Washington, DCE

Crack

Billings, MTL

L Law enforcement respondents

E Epidemiologic/ethnographic respondents

N Non-methadone treatment respondents

M Methadone treatment respondents
Pulse Check: Mid-Year 2000 page 5

INTRODUCTION

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 hardcore drug-abusing populations, emerging drugs, new routes of

administration, varying use patterns,

changing demand for treatment, drugrelated criminal activity,

and shifts in supply and

distribution patterns.

Pulse Check regularly

addresses four drugs of

serious concern: cocaine,

marijuana, heroin, and

methamphetamine.

Additionally, the current

issue provides information on the emerging

problem of “ecstasy”

(methylenedioxymethamphetamine, or MDMA)

and other club drugs.

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.

Enhancements to Pulse Check

As in the past, the Pulse Check data

collection methodology has involved

telephone discussions with three types

of sources: law enforcement officials;

epidemiologists and ethnographers;

and treatment providers from selected

sites across the country. Additionally,

the current Pulse Check issue reflects

the latest in ONDCP’s ongoing effort

to enhance the project and keep up

with the changing nature of the

Nation’s drug abuse situation in 

several ways:

! Expansion of study sites—

Using a systematic site sampling

plan, described in the Methodology

appendix, 20 study sites were

selected, as highlighted on the map

above.

Some of these cities are past Pulse

Check sites, some are new ones.

These sites reflect several enhancements: greater geographic diversity

than in the past; distribution 

across the four census regions; 

representation of both rural and

urban areas; and overlap with

other sources such as ONDCP’s

High Intensity Drug Trafficking

Area (HIDTA) sites.

! New sources plus past sources

to provide a more comprehensive snapshot of hardcore drug

abuse problems—As detailed in

the Methodology appendix, new sources were

recruited based on a

range of selection criteria and identification

strategies. To preserve

continuity—since much

of the information is

qualitative and relies on

the source’s observations of patterns and

trends—many of the

selected individuals are

also past Pulse Check

sources.

! Data collection

enhancements— Past Pulse Check

discussion guides were enhanced

with probing questions to elicit

more explanations and insights

into the data and 

policy-relevant issues, as further

described in the appendix.

! A “new look” for the report—

The new report format was

designed to visually integrate 

the qualitative and quantitative

information gathered.

Use and Interpretation of Pulse

Check Information

By contacting professionals from 

different disciplines—ethnography/

epidemiology, law enforcement, and

treatment—a rich picture of the

changing drug abuse situation

emerges. Though this approach offers

The 20 Pulse Check Sites
page 6 Pulse Check: Mid-Year 2000

INTRODUCTION

substantial strengths in timeliness and

depth, Pulse Check is not a measure

of the prevalence of drug abuse or its

consequences. As an anecdotal source

of information, 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 is limited to a report

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, 74 provided information for this Pulse Check issue. The

information presented in this report

is based solely on the observations

and perceptions of those 74 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 74.

Any contradictory reports within an

individual site are not necessarily a

Pulse Check limitation. Just as the site

sampling methodology was designed

to reflect the country’s geographic

and population diversity, recruiting

four sources per site was incorporated

into the design to reflect diversity

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

site might perceive cocaine to be the

community’s most serious problem,

while an ethnographic source at that

same site might consider the most

serious problem to be heroin. And

they would both be right—because

each might come in contact with 

different populations or each might

deal with a specific geographic 

neighborhood. 

Information from treatment sources

is particularly susceptible to variance

because some facilities target specific

populations. Furthermore, treatment

providers from methadone and nonmethadone programs are likely to

have very different perspectives on

their communities’ drug problems

because their respective clientele differ in the nature of their drug problems. 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

September and October 2000 from

telephone conversations with 74

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 first 6

months of 2000 and in comparison

to the same 6 months in 1999.

The law enforcement sources who

provided information include 19 

narcotics officers from local police

departments, field office agents of the

Drug Enforcement Administration

(DEA), and representatives of High

Intensity Drug Trafficking Areas

(HIDTAs). The 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 34 providers (from 19

non-methadone programs and 16

methadone programs) randomly

selected for each site from the 1998

Uniform Facility Data Set (UFDS).

These sources offer a wealth of 

information that, when taken 

together, provides a comprehensive

snapshot of drug abuse patterns in

communities across the country.

Further, these individuals provide

expertise that can alert policy makers

to any short-term changes or newly

emerging problems concerning specific

drugs, drug users, and drug sellers.

The appendices at the end of this

report provide a list of these sources,

describe the methodology used to

select them, and discuss the content

of the approximately 1-hour 

conversations held with them.
HEROIN

Pulse Check: Mid-Year 2000 page 7

HEROIN: THE PERCEPTION

How serious a problem is heroin 

in Pulse Check communities?

During 2000, heroin was perceived as

the most serious drug problem by 19

sources in 8 Pulse Check cities (26 

percent of 70 responding sources): 

Los Angeles and Seattle in the West;

Detroit in the Midwest; Columbia

(South Carolina) and New Orleans in

the South; and Boston, Philadelphia,

and Portland (Maine) in the Northeast.

It ranked second only to cocaine (all

forms). Furthermore, heroin was considered the second most serious drug

problem by 20 percent of Pulse Check

sources (N=66). Finally, it was seen

as an emerging problem drug by 4

sources in 4 cities, 3 of which are

in the South (8 percent of 52

reporting sources): Billings,

Birmingham, Columbia, 

and Miami. 

Has the perception of

the heroin problem

changed between 1999 and

2000? 

In comparing the two reporting

periods, sources citing heroin as the

most serious drug problem in their

communities increased from 22 to 26

percent. Furthermore, during the current reporting period, four sources

reported that heroin replaced cocaine

(all forms) as the most serious drug

problem in their communities: the

epidemiologic source from Detroit,

both the epidemiologic and the law

enforcement sources from New

Orleans, and the law enforcement

source from Portland. Conversely,

epidemiologic and ethnographic

sources in Birmingham and El Paso

reported that cocaine (either form)

replaced heroin as the most serious

drug problem. Heroin was reported

as an emerging drug problem during

the current reporting period by

sources in Billings, Birmingham,

Columbia (all non-methadone 

treatment providers), and Miami (law

enforcement source). 

HEROIN: THE DRUG

Availability, Purity, and Price

How available is heroin across

the country? Of the 31 law 

enforcement, epidemiologic, and

ethnographic sources discussing this

question, 61 percent (n=19) report

heroin as widely available in their

communities, and 32 percent (n=10)

report it as somewhat available. Only

in Sioux Falls is heroin reported as

not very available (by the epidemiologic source) or not available at all

(by the law enforcement source).

Has heroin availability changed?

(Exhibit 1) Nearly half (45 percent) 

of the 29 responding epidemiologic,

ethnographic, and law enforcement

sources perceive that heroin availability increased in their communities

from 1999 to 2000, while 55 percent

(17 sources) perceive that availability

remained stable. No declines are

reported. According to epidemiologic and ethnographic sources,

heroin availability increased in

seven sites, four of which are

southern (Billings,

Birmingham, El Paso,

Miami, New Orleans,

Portland, and Seattle); law

enforcement sources report

increases in six sites

(Birmingham, Chicago, Honolulu,

New Orleans, Portland, and

Washington, DC).

What kind of heroin is available

across the country? (Exhibits 2 

and 3) South American (Colombian)

white and Mexican black tar heroin

are the most common types of heroin

in Pulse Check cities, cited as widely

available by eight and seven sources,

respectively, and as somewhat 

available by five and eight sources,

respectively. 

TRENDS IN DRUG USE: 1999 VS 2000

Exhibit 1.

How has heroin availability

changed (1999 vs 2000)?*

L Law enforcement respondents

E Epidemiologic/ethnographic respondents

*Sources in Detroit did not respond.

Billings, MTE

Birmingham, ALL,E

Chicago, ILL

El Paso, TXE

Honolulu, HIL

Miami, FLE

New Orleans, LAL,E

Portland, MEL,E

Seattle, WAE

Washington, DCL

Boston, MAL,E

Columbia, SCL,E

Denver, COL,E

El Paso, TXL

Honolulu, HIE

Los Angeles, CAL

Miami, FLL

New York, NYL

Philadelphia, PAE

St. Louis, MOL,E

Sioux Falls, SDL,E

Washington, DCE
HEROIN

page 8 Pulse Check: Mid-Year 2000

Colombian heroin is a high-purity,

snortable heroin most common in

the Northeast; Mexican black tar

heroin is a lower purity, injectable

heroin most common in the West

and South. Heroin forms in the

Midwest vary widely and may

include Colombian, Mexican,

Southeast Asian, and Southwest

Asian. 

How pure is heroin across the 

country? (Exhibit 4) Street-level

Colombian heroin ranges from 25 to

80 percent pure, and typically is at

the higher end of that range. 

Street-level Mexican black tar heroin

ranges from 14 to 60 percent pure,

according to Pulse Check sources,

with the highest purity occurring

near the U.S.-Mexican border in 

El Paso.

Exhibit 2.

How available are the different forms of heroin?

Sources: Law enforcement, epidemiologic, and ethnographic respondents

70

60

50

40

30

20

10

0

Heroin

(any form)

(N= 31)

Not Very

Available

Widely

Available

Percent

Somewhat

Available

Colombian

(N=25)

Mexican

black tar

(N=25)

Mexican brown

(N=25)

Has street-level heroin purity

changed?

Heroin purity increased in eight sites

and declined in two from 1999 to

2000:

Purity may be increasing in several

areas along with increases in supply 

(availability) and increasingly aggressive

marketing, according to law enforcement, epidemiologic, and ethnographic

sources. 

Have street-level heroin prices

changed?

Only a few changes in heroin prices

were reported from 1999 to 2000:

Street prices often decline due to

increases in supply. According to Pulse

Check sources, heroin prices declined

due to increased supply (availability) in

Denver, Honolulu, and Miami.

However, in Chicago, heroin prices

increased, as did its availability and use. 

Boston, MA

Chicago, IL

Columbia, SC

Denver, CO

Detroit, MI

Honolulu, HI

Memphis, TN

Miami, FL

El Paso, TX

Seattle, WA

Denver, CO

Honolulu, HI

Memphis, TN

Miami, FL

Chicago, IL

El Paso, TX

What are street-level heroin

prices across the country?

(Exhibit 4) Street-level heroin prices

tend to be similar across the country

regardless of heroin type. During

2000, heroin prices ranged from $70

to $300 per gram in reporting areas,

with Mexican black tar ranging from

$90 to $300, Mexican brown ranging

from $75 to $150, and Colombian

white ranging from $75 to $300. The

most common unit of street sale in

reporting cities is a bag (unspecified

amount) of heroin, which sells from

$5 to $30. Packaging of heroin sold

at the street level ranges from

$20–$25 per bindle (about 1/34

gram) in Columbia, to $2 per 

2-cc needle in Miami, and $20 per

“fix” in El Paso. 

How is heroin referred to across

the country? (Exhibit 3) Street names

throughout the United States often

vary by geographic region and by type

of heroin. However, some terms, such
HEROIN

Pulse Check: Mid-Year 2000 page 9

Exhibit 4. 

Heroin gram prices and purity, by heroin type and city*

CITY GRAM PRICE PURITY

Mexican black tar

El Paso, TX $80–$160 60%

Honolulu, HI $125–$200 20–30%

Los Angeles, CA $150–$300 25%

Seattle, WA $90–$120 14–58%

St. Louis, MO $100 NR

Mexican brown

Chicago, IL $150 NR

New Orleans, LA $75 7%

South American 

(Colombian) white

Miami, FL $100–$200 70–80%

New York, NY $70–$95 25–70%

Philadelphia, PA $75–$300 70–75%

Heroin adulterants have changed

in several cities between 1999

and 2000:

! Columbia, SC: Scapolamine has

decreased as a heroin adulterant.

! Miami, FL: Use of adulterants has

increased; virtually any white powder

is being used as a heroin adulterant. 

! Seattle, WA: There has been a 

perceived increase in adulterants.

! Washington, DC: Purity has

increased, and use of adulterants has

decreased.

WEST

Tar, chiva, boy, dope,

“cheeba, sheeba,

shiva,”

brown, smack, H,

dope, stuff, s_ _t,

cheese, horse,

brown sugar, carga,

down.

Tar, chiva, boy

Horse, H, boy, foil,

smack, carga, heron,

sheeba, shiva, chiva,

papers, mud, tar, 

black powder, 

dogfood, s_ _t,

dope, junk.

Jerry Springer,

orange line,

brown tape,

747, blue bag,

yellow bag,

brown bag,

silk, blue,

steel, no

name, 2000,

scramble

(adulterated),

snort (pure),

thanie, chiva

white, mud,

H, dope.

Boy, blow, blows,

raw, horse, H,

smack.

Horse, H,

smack,

dope,

nurse.

Exhibit 3. 

How is heroin referred to, and what types of heroin predominate, 

in different regions of the country?

MIDWEST

NORTHEAST

SOUTH

as “horse” and “H,” are common

across regions. Street names (slang)

and brand names (dealer designations)

are often interchangeable, as is the case

in New York and Washington, DC.

(Note: Brand names are further 

discussed later in this chapter, under

“How is heroin packaged and 

marketed?”) New heroin names

encountered during 2000 included

“cheese” in Denver (referred to by

youth) and “thanie” in Washington,

DC. A particularly wide range of

street names is reported by sources in

Washington, DC, which is located on

the outer edge of the South Region.

What adulterants are added to 

heroin? Heroin adulterants cited by

law enforcement, epidemiologic, and

ethnographic sources include baby

powder, scapolamine, lactose, manite,

strychnine, baking soda, manitol, 

isotol, quinine, procaine, powdered

rug cleaner, cocaine, lidocaine, and

ketamine. In Washington, DC, 

laxatives are often added to heroin

that has been adulterated with manite

to assuage its constipating effects,

and meat tenderizers used as 

adulterants may cause skin abscesses.

In Pulse Check sites with highly pure

snortable heroin, adulterants are 

few or nonexistent. 

Washington,

DC.

Mostly Mexican

black tar available

Mostly Colombian

white available

Heroin type varies

Sources: Law enforcement, epidemiologic, and ethnographic respondents

*Respondents in 10 sites did not provide this information.

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

page 10 Pulse Check: Mid-Year 2000

Then and Now: 

How have heroin users changed across the country (1999 vs 2000)?*

According to epidemiologic and ethnographic According to treatment sources...

sources...

THE NORTHEAST

A new cohort of suburban snorters, first reported Boston, Younger users are increasingly snorting heroin, using it 

about 3 years ago, continues to grow. MA casually, and experimenting with dangerous drug 

combinations, including heroin plus PCP. 

While the larger established heroin user groups remain New York, There is an increase in younger adult heroin users due to its 

relatively stable, some new groups are emerging. For NY easy accessibility. They view heroin as a social drug instead 

example, young suburban adolescents are increasingly of a back alley drug. Younger adults are also getting more 

initiating use by snorting, and some are shifting to involved in selling heroin.

injection use; and Russian youths in their late teens and

early twenties, residing in inner-city neighborhoods, are 

increasingly “shooting” heroin. 

Some younger teens have been experimenting with Portland, Heroin use has increased noticeably among young adults.

heroin for the past few years. This shift has continued ME Although males are the primary users, female use 

to increase during the past year. Also in that city, older is increasing.

males have been introducing heroin to younger females. 

THE MIDWEST

Reports suggest more younger users, more suburban Chicago, Heroin use is increasing among younger adults. Snorting

users, and more injecting (but snorting still predominates). IL has become more common than injecting as availability 

continues to increase. Drug overdoses have increased.

Heroin deaths increased in suburban Macomb County. Detroit, Heroin is more available to younger suburban users. 

New use among young suburbans is a potentially MI Treatment outreach remains in the urban area, 

emerging problem. but the need to reach younger adults in suburban 

communities is being noticed.

A recent increase in heroin use is probably due to new St. Louis, No changes are reported.

younger users. A recent increase in snorting could be MO

due to fear of AIDS, increased heroin purity, or possibly 

both factors.

HEROIN: THE USERS

Who, Where, How, and With What?

How have heroin users changed

across the country between 1999

and 2000? Epidemiologic, ethnographic, and treatment sources in 13 of

Pulse Check’s 20 cities perceive numerous changes in various heroin-using

populations and the ways they use the

drug. No user changes, however, are

reported in Billings, Birmingham,

Columbia, Memphis, Philadelphia,

Seattle, or Sioux Falls. Several common

themes emerge, all involving increases:

in younger populations, in recreational

heroin use, in snorting, in suburban

use, and in overdoses among younger

adults (age 18–30).

How old are heroin users?

(Exhibit 5) According to epidemiologic

and ethnographic sources in the 

majority of Pulse Check sites, particularly in the Northeast and Midwest,

the people most likely to use heroin

are generally older than 30, with

younger adults (generally in their

twenties) comprising a smaller 

proportion of users in those sites.

However, younger adults (age 18–30)

are more likely than older adults to

use heroin in Billings, Birmingham, 

El Paso, Los Angeles, and New

Orleans. Teenage use is reported in 

several cities, including Los Angeles,

Miami, New Orleans, Portland (where

the numbers are still low), Seattle,

Sioux Falls, St. Louis, and Washington,

DC; increases in use by teens is 

reported in Los Angeles, New Orleans,

New York, and Portland.

*No major changes in heroin-using populations are reported by sources in seven sites: Billings, Birmingham, Columbia, Memphis, Philadelphia,

Seattle, and Sioux Falls.
HEROIN

Pulse Check: Mid-Year 2000 page 11

Then and Now: 

How have heroin users changed across the country (1999 vs 2000)?*

According to epidemiologic and ethnographic According to treatment sources...

sources... 

THE WEST

Slightly increasing numbers are reported for younger Denver, Heroin is less expensive and easy to find on the street. 

heroin users (age 18–25), new users, and white users; CO Younger, white adults are using the drug at work and 

slightly declining numbers are reported for users combining use with cocaine and alcohol. Snorting

age 26–34 and for black and Hispanic users. and smoking are increasing, and users believe

While the vast majority of heroin users still inject, that they will not be at risk for overdosing. 

a slight increase in smoking and inhaling suggests a 

change in route of administration.

No changes are reported. Honolulu, Females use heroin more often than males. Novice 

HI users are experimenting with smoking heroin, but 

the majority still inject.

Teens are perceived to be increasingly abusing Los Heroin users are able to maintain some type of employment.

heroin, increasingly smoking it, and using with Angeles, Gang members and female users are showing up more

peers rather than alone. CA frequently in treatment.

THE SOUTH

The number of black heroin users appears to be El Paso, White suburban users (young adults) are increasing, but

increasing. TX Mexican-Hispanics remain the primary user group.

The second largest group of heroin users is Miami, Recreational heroin use, emerging among young adults,

reportedly becoming younger. FL is considered “South Beach chic.” More females are using the 

drug, and its use crosses over all ethnic groups. It is being used

orally and in group settings, especially on weekends in clubs.

More younger people are starting to snort heroin. New Orleans, As availability is increasing, adolescents are snorting the drug, 

LA often due to the misconception that this practice is safe. As a 

result, drug overdoses by snorting are increasing.

The younger group of heroin users are a small but Washington, Older adults are more likely to use heroin, but younger 

growing problem. The number of snorters, a DC users are increasing. More users are snorting heroin, as 

relatively new group, is increasing. more pure heroin becomes available on the street. 

According to responding treatment

providers, age breakdowns follow a

somewhat regional pattern in their 

specific programs. For example, young

adults (age 18–30) account for the

largest group of heroin clients in most

Northeast Region programs (New

York, Philadelphia, and Portland).

Boston is an exception, however, with

adolescents featuring most prominently

in the methadone program, and older

adults (age 30 and older) most 

prominent in the non-methadone 

program. Similarly, in the South

Region, young adults outnumber older

clients in numerous programs (in

Birmingham, Columbia, Memphis, and

Washington, DC), and adolescents are

the largest heroin group at the New

Orleans non-methadone program. In

the Midwest and West Regions, however, the younger and older adult age

groups are split fairly evenly among the 

cities and between responding methadone and non-methadone programs.

Are there gender differences in

who uses heroin? All but 1 of the 20

epidemiologic and ethnographic

sources agree that males are more likely than females to use heroin, at least

among the largest user groups. The

exception is Seattle, where males and

females are equally likely to use the

drug. The sexes, however, are evenly

split in some of the smaller user

groups, such as late adolescents in

Portland (whose numbers are still low)

and a suburban cohort of white 

middle-class users in Seattle’s suburbs.
HEROIN

page 12 Pulse Check: Mid-Year 2000

Four Pulse Check treatment sources

report females to be the largest heroinusing group: Columbia, Honolulu,

Memphis, and New York. (Note: The

New York source is from a treatment

program targeted at women.) In

Miami, males and females are equally

likely to use. According to treatment

sources in El Paso and New York, an

increase in female heroin use has led

to an increase in prostitution.

Is any racial/ethnic or socioeconomic group more likely to use

heroin? Heroin appears to present

an equal opportunity problem to all

racial/ethnic groups. The Pulse Check

cities are representative of the

Nation’s diversity, and the heroin

problem appears to mirror that 

diversity. For example, according to

epidemiologic and ethnographic

sources, whites are the primary users

in Billings, Boston, Denver (where

they are in majority, but underrepresented relative to the city’s 

population), Miami, Philadelphia,

Portland, Seattle (where they are

slightly underrepresented), and Sioux

Falls; blacks are more likely than

other groups to use heroin in

Chicago, Detroit (where they are

overrepresented relative to the city’s

population), New Orleans, St. Louis,

and Washington, DC; and Hispanics

are the primary user group El Paso,

Los Angeles, and New York.

Pulse Check treatment sources 

similarly report diverse racial/ethnic

An Unusual Population of Youthful

Heroin Users

New York, NY: Russian youths in their

late teens and early twenties are increasingly shooting heroin, according to the

ethnographic source. This population is

particularly difficult to reach because of

cultural bias in views on treatment,

approaches to treatment, and access to

treatment.

>50 percent of sources report 30+ years.

>50 percent of sources report 18–30 years.

About 50 percent of sources report 30+, and

50 percent of sources report 18–30.

Insufficient respondents to draw a conclusion.

Exhibit 5.

What age group is most likely to use heroin?

According to non-methadone treatment sources...

According to epidemiologists and ethnographers...

According to methadone treatment sources...

West

West

West

South

South

South

Midwest Midwest

Midwest Northeast

Northeast

Northeast

(Nonrespondent: Seattle)

(Nonrespondents:

Billings, Denver,

Honolulu, Miami,

New York,

Philadelphia 

and St. Louis) (Nonrespondents: Billings,

Los Angeles, Memphis, 

St. Louis, Seattle, and

Washington, D.C.)

Different Sources, Different Populations

Epidemiologic and ethnographic sources tend to

report somewhat older user groups than do treatment sources —highlighting the need for multiple

sources in order to capture all populations and get

a more comprehensive picture.
HEROIN

Pulse Check: Mid-Year 2000 page 13

distributions at their programs: whites

are the primary users in Billings, Los

Angeles, Memphis, New York, Sioux

Falls, and Portland; blacks are most

likely to use in Chicago and Detroit;

and Hispanics are more likely than

other groups to use heroin in El Paso.

Unlike race/ethnicity, socioeconomic

status (SES) seems to play a major role

in the groups of people most likely to

use heroin: in every Pulse Check city,

the largest group of users reported by

epidemiologic, ethnographic, and treatment sources is in the lower SES category. However, the second-most-likely

user groups show more diverse SES:

for example, the middle class is cited

by epidemiologic and ethnographic

sources in Boston, Chicago, Los

Angeles, Miami, Seattle, and St. Louis;

and the upper class is cited in Miami.

Some treatment sources note that

heroin use by middle-class whites is

growing as the glamorization of heroin becomes more accepted. In Miami,

for example, heroin is emerging as a

popular drug among the “beach

chic”—white, middle-to-upper-class,

urban young adults. In Seattle and

Los Angeles, the glamorization and

use of heroin is crossing all classes

and ethnic groups.

Are high school dropouts more

likely to use heroin? According to

responding treatment sources, among

clients at the different programs for

whom heroin is the primary drug of

use, about one-half completed and

one-half did not complete high school.

For example, heroin clients at reporting programs are more likely to be

high school graduates in Birmingham,

Denver, Detroit, El Paso (nonmethadone), Honolulu, Miami,

Portland, and Sioux Falls. Conversely,

they are more likely to have only

“some high school” education at the

programs in Boston, Chicago,

Columbia, El Paso (methadone), Los

Angeles, New York, New Orleans,

Philadelphia, and Seattle.

Where do heroin users tend to

reside? Inner-city areas are generally

cited by epidemiologists and ethnographers as the most likely place of

residence for heroin users. El Paso’s

largest heroin-using group is the

homeless. The suburbs, however, are

reported as a place of residence for

some users in many sites, including

Boston, Chicago, Denver, Detroit,

Los Angeles, Miami, New York,

Seattle, and St. Louis. Moreover, 

epidemiologists and ethnographers

report that use in the suburbs has

increased recently in at least four

sites: Boston and New York in the

Northeast, and Chicago and Detroit

in the Midwest.

Treatment sources similarly indicate

that most heroin users reside in urban

areas. However, they too note heroin

users in many suburban areas, including Billings, Boston, Denver, Honolulu, and New York, with an increase

in suburban users in El Paso. As a

matter of fact, most of the clients in

one of the Detroit programs live in

the suburbs and come into the city

for treatment.

How do heroin users administer

heroin? (Exhibit 6) Injecting is the

most common route of heroin administration, according to epidemiologic

and ethnographic sources in the

majority of cities. Snorting, however,

features more prominently than

injecting in Chicago, Detroit, New

Where do young new users live?

New York, NY: According to the 

ethnographic source, “a growing 

population of young affluent white 

adolescents in Long Island have been 

initiating heroin use: they start off 

snorting, then many move to injecting.

Many come into needle exchange programs in Brooklyn, pick up free needles,

buy heroin, return to Long Island, and

sell enough to support their habit. Many

are being thrown out of their homes.”

Similarly, a treatment source in New

York indicates that both male and female

use is growing in the suburbs among

white college-educated groups.

Denver, CO: Anecdotal reports 

suggest a big change in new users: they

are younger, more affluent, suburban,

white users who subscribe to “heroin

chic.” Anecdotal reports also suggest

more rural and suburban adolescents are

using “chiva.”

Portland, ME: “Many street-involved

kids ‘hang’ on the street and use 

heroin,” reports the epidemiologic source

in that small urban community. “Also,

some students who consider themselves

‘artistic’ subscribe to heroin ‘chic.’”

Exhibit 6. 

How do users administer heroin? 

Injecting is most common in...

Snorting is most common in...

DenverE

HonoluluE,M

Los AngelesE,N,M

SeattleE,M

ChicagoE,M

DetroitM

Sioux FallsE,M

St. LouisE

BirminghamE,N

ColumbiaE,N,M

El PasoE,N,M

MemphisE,N,M

MiamiE

New OrleansM

Washington, DCE,N,M

BostonE,N,M

PhiladelphiaE,N

PortlandE,N,M

ChicagoE

DetroitE,N

Sioux FallsM

MemphisM

MiamiN

New OrleansE,N

New YorkE

E According to epidemiologists/ethnographers

N According to non-methadone treatment providers

M According to methadone treatment providers West South South Northeast Northeast Midwest Midwest
HEROIN

page 14 Pulse Check: Mid-Year 2000

Orleans, and New York; and the

number of snorters is also fairly high

in several cities, including Boston,

Miami, St. Louis, and Washington,

DC. An unusual form of snorting is

reported among St. Louis’ younger

user group (late teens and early 

twenties): they often mix the heroin

with water in an eyedrop squeeze

bottle and snort it from the bottle. In

Sioux Falls, smoking is reported as

the most common route of administration among the younger (age

17–25) using population. “Chasing

the dragon”—placing heroin on aluminum foil, lighting a fire underneath

it, and sniffing the resulting smoke

through a straw or other means—is

reported by epidemiologists in New

York and Honolulu.

Treatment sources report a similar 

pattern for route of administration

across the country, with injection 

predominating in Boston, Chicago,

Detroit, El Paso, and New York.

Snorting is more common in

Columbia, Miami, Memphis, and New

Orleans. In Sioux Falls, young adults

are the most likely to use heroin via

snorting. In Billings, Denver, and

Seattle, smoking is the route of 

initiation to heroin for younger adults.

Adolescent snorters are reported in

New Orleans and Miami. In a

Washington, DC, treatment program,

snorting among all clients is increasing. Columbia treatment sources

report that snorters prefer this practice

to injection because they mistakenly

view it as nonaddictive. 

Treatment sources in Boston, Chicago,

and New York attribute increases in

heroin overdoses to the myth among

users that snorting prevents overdoses.

Even more disturbing than these misconceptions about snorting, however,

is the possible shift in young people’s

perceptions about injecting. The New

York ethnographer reports an increase

in suburban adolescents shifting from

snorting to injecting, with a growing

number traveling to inner-city needle

exchange programs. A similar phenomenon is noted in Portland, Maine, a

much smaller, more sparsely populated, more rural site: the epidemiologist

there, too, reports adolescents in 

needle exchange programs.

What other drugs do heroin

users take? Cocaine is the drug

most often taken along with heroin,

either in combination (“speedballing”) or sequentially, according 

to epidemiologists and ethnographers

in the majority of Pulse Check cities

(Boston, Chicago, Detroit, El Paso,

Los Angeles, Miami, New Orleans,

New York, Philadelphia, Seattle, and

Washington, DC). Speedballs can

involve either powder cocaine 

(often cooked) or crack (sometimes

dissolved, as in Boston); they are 

generally injected, but they can 

also be smoked. In New York, for

example, speedballs are both injected

and smoked.

Heroin users also sometimes consume

benzodiazepines, according to epidemiologists and ethnographers in six

Pulse Check cities: Boston, Miami,

New York, Philadelphia, Portland, and

Seattle. In Boston, they are taken

sequentially, substitutionally, or sometimes simultaneously with heroin.

Concurrent benzodiazepine usage is

also reported in Portland, but most

heroin in that city is consumed 

without other drugs. Specifically,

alprazolam (Xanax®) is mentioned 

in New York and Philadelphia and 

clonazepam is mentioned in Seattle.

Additionally, the New York ethnographer reports that heroin users also

consume other prescription drugs

such as amitriptyline (Elavil®) and

clonodine (Catapres®), often purchased around methadone clinics, 

to enhance their heroin high or to

calm them down.

Miami’s younger heroin-using cohort

consumes a variety of substances,

including methylenedioxymethamphetamine (“ecstasy” or MDMA) and 

ketamine (“special K”) as well as 

powder cocaine and benzodiazepines.

The younger cohort in Washington,

DC, consumes marijuana and malt

liquor. Alcohol is also mentioned by

epidemiologic and ethnographic

sources in Denver (a distant second in

use among the younger cohort),

Detroit, Philadelphia, and St. Louis.

The majority of Pulse Check treatment

sources across the country report that

primary heroin clients also use 

alcohol. In Los Angeles, they also use

cocaine. In El Paso, “speedballing” is

defined as methamphetamine plus

heroin, and in Honolulu heroin is

used in combination with “ice.” In a

Birmingham program, the concurrent

Heroin Use in the Music Industry

Los Angeles, CA: The epidemiologic

source reports the perception that a

disproportionate number of people in

the music industry use heroin and 

are becoming increasingly impaired

because of their addiction. Unlike the

“grunge rockers” of the early 1990s,

this group is not part of the “heroin

chic” scene; rather, they behave more

like “a cohort that will be around 

for a while.”

Are youth forgetting the fear of

needles?

Portland, ME: Needle exchange

workers are being approached by youth

younger than 18 who view injecting as

a “badge of courage.”
HEROIN

Pulse Check: Mid-Year 2000 page 15

use of opiates and benzodiazepines

surpasses the use of heroin as the 

primary drug problem. Methadone

clinics in Memphis, Portland, and 

St. Louis identify an increase in the

past year of opiate and related 

pharmaceuticals use. Younger users in 

Boston are combining heroin with

PCP. In most sites where heroin use

among young adults is reported, 

these younger users reportedly 

experiment with dangerous drug

combinations that frequently 

produce psychotic states.

Where and with whom is heroin

used? (Exhibit 7) Heroin use tends

to be an indoor activity. Some street

use, however is noted by epidemiologic and ethnographic sources in

Boston, Detroit, El Paso, Honolulu,

and New York. Even the street settings, however, tend to be in private

areas, such as quiet back alleys. 

The indoor settings are more varied,

ranging from apartments, cars, and

abandoned houses to the bars of El

Paso, the clubs of Miami, the coffee

shop bathrooms of Seattle, and the

“shooting galleries” of Boston, Miami

(where they are known as “get-off

houses”), New York, and Philadelphia. According to the Philadelphia

epidemiologic source, a shooting

gallery in that city, as opposed to a

“hit house,” is a place where “the 

hitter does the injecting for you.”

Use tends to be alone, but small

group settings (particularly among

younger users) are reported by epidemiologists and ethnographers in

Birmingham, Denver, Honolulu, Los

Angeles, and St. Louis.

Treatment providers report that heroin

use is becoming more recreational and

social. The increase in heroin availability in most of the Pulse Check sites,

and the misconceptions among users

that snorting is less dangerous and

does not cause overdose, are the bases

of the emerging social dynamic.

Treatment providers in Columbia,

Boston, Honolulu, Sioux Falls, and

Seattle report the casual use of heroin

among young adults. In most sites, the

use of heroin occurs at home and is

seen as an indoor activity. 

Exhibit 7. 

Where and with whom is heroin used?*

Site Setting or context

Denver, CO In homes, small group settings (not in shooting galleries)

Honolulu, HI In small groups, quiet back alleys (don't cause trouble)

Los Angeles, CA At home (alone or with other groups of users)

Seattle, WA At home, in bathrooms of coffee shops, in bars

Chicago, IL In apartments; some in automobiles

Detroit, MI In homes, cars, private settings on street (no shooting galleries

or group use)

Sioux Falls, SD In housing units

St. Louis, MO In very private, small groups or alone; some anecdotal data

about social use at parties, in small groups

Birmingham, AL In fellow user's house 

El Paso, TX In bars, on streets; sometimes in parks, in homeless shelters;

more rarely, in friends' homes 

Memphis, TN Not applicable ("a cocaine and alcohol town")

Miami, FL In "get-off" houses (shooting galleries); some in clubs

New Orleans, LA In abandoned houses, indoor settings; some in social 

settings indoors

Washington, DC In abandoned buildings, alleys, apartments; some on streets

Boston, MA On street, in shooting galleries; some indoors

New York, NY Indoors (shooting galleries, private hallways, abandoned

apartments), but also on streets, in parks

Philadelphia, PA In "hit" houses, shooting galleries (hitter does injecting for you)

Portland, ME Underground, in room or apartment; no street scene; difficult to

be anonymous in rural environment, so law enforcement can move

in easily, tends to push activity indoors 

Sources: Epidemiologic and ethnographic respondents

*Sources in two sites did not respond: Billings and Columbia. West Northeast South Midwest
HEROIN

page 16 Pulse Check: Mid-Year 2000

Exhibit 8.

How has heroin use impacted the health of users?

Health Pulse Check Adverse

Consequences Site Impact Comments

HIV/AIDS El Paso, TX The practice of unprotected sex has not declined.

Miami, FL HIV/AIDS is increasing due to exchanging sex for drugs.

New Orleans, The number of cases has increased statewide.

New York, NY Clients elect not to get tested for HIV/AIDS.

Portland, ME The popularity of heroin is seen as the cause of increased cases of HIV/AIDS.

Seattle, WA The number of local area HIV/AIDS cases has increased dramatically.

Los Angeles, CA HIV cases have remained stable in the program over the past year but have 

increased in the local area due to unprotected sex. 

Billings, MT HIV/AIDS has decreased over the last year; the change is credited to 

effective education. 

Columbia, SC

Hepatitis C Billings, MT Health professionals view the increase in hepatis C as a serious problem.

Columbia, SC Hepatitis C cases have increased in the program and in the local area.

Los Angeles, CA Clients seeking admission frequently test positive for hepatitis C. 

Cases have increased in the community due to use of unclean needles. 

Portland, ME Treatment providers attribute a dramatic increase in hepatitis C to more

rigorous testing.

Washington, DC Cases have remained stable.

Comorbidity Honolulu, HI The mixing of dangerous drugs has caused an increase in psychiatric and societal 

issues problems and crime.

Los Angeles, CA Cases of conduct disorders have increased.

New York, NY Many clients are presenting with psychiatric disorders.

Portland, ME Dually diagnosed clients have increased.

Although heroin use is occurring in

isolated areas in Chicago, it is seen in

clubs in Miami and at work in

Denver. 

How is heroin impacting the

health of users? (Exhibit 8) In 

general, responding treatment

providers indicate that heroin use is

having an increased medical impact

on the health of their clients, 

particularly with respect to acquired

immunodeficiency syndrome (AIDS),

human immunodeficiency virus

(HIV), hepatitis C, and comorbidity 

(dual diagnosis of substance abuse

and mental health disorders). Stable

or declining trends are reported by 

treatment sources in only four Pulse

Check cities: Billings, Columbia, and

Los Angeles (for HIV/AIDS); and

Washington, DC (for hepatitis C).

Sources: Methadone and non-methadone treatment providers
HEROIN

Pulse Check: Mid-Year 2000 page 17

What are the barriers to 

treatment? Several treatment sources

indicate that heroin users face a 

variety of barriers—ranging from 

staff issues to limited slot capacity to 

transportation problems—in obtaining

effective treatment:

! Billings, MT: Trained and 

certified staff are in short supply.

! Birmingham, AL: The number 

of available treatment beds is 

insufficient to meet the need.

! Columbia, SC: The local area 

lacks a good mass transit system,

thus impacting client access 

to treatment.

! Chicago, IL: Programs lack the

monetary support to hire and

retain quality staff, especially

trained psychiatric staff.

! Los Angeles, CA: Funding for

treatment slots has been reduced.

Transportation issues present 

challenges for providers who are

trying to keep clients in treatment.

! New Orleans, LA: The program

lacks funding to provide transportation for clients. In addition, a

medical detoxification facility

would assist in improving services

for clients.

! Sioux Falls, SD: The area is 

economically depressed, and few

funding options are available.

Clients have a difficult time 

locating treatment and finding 

the transportation to get them to

treatment.

! Washington, DC: Clients cannot

afford medications, and some 

cannot afford the sliding scale.

HEROIN: THE SELLERS

Who, How, Where, and with What?

How are street-level heroin 

sellers organized? According to 

law enforcement sources, heroin 

distributors are affiliated with trafficking organizations in only 4 of 17

reporting Pulse Check cities:

Dominican nationals work for

Colombian trafficking organizations in

Boston, street sellers are affiliated with

Mexican and South American cartels

in Denver, and sellers are affiliated

with Mexican trafficking organizations

in El Paso and Honolulu. Other 

organized distributors in U.S. cities

include street gangs in Chicago, El

Paso, Memphis, and Seattle; loose-knit

gangs in Columbia; Dominican national organizations in Portland; and

Hispanic organizations in Washington,

DC. Also in Washington, DC, streetlevel heroin is distributed by fairly

independent individuals with three to

four people working for them. In Los

Angeles, heroin is distributed primarily

among family and friends; in Portland,

heroin addicts sell some of the streetlevel heroin.

Information from epidemiologic and

ethnographic sources in Pulse Check

cities corroborates the affiliation of

street-level heroin distributors with

traffickers in Boston, Denver, and

Honolulu. Additionally, epidemiologic

and ethnographic sources report that

street gangs distribute heroin in

Miami, New York (where gangs are

known as “crews”), and St. Louis. In

St. Louis and Philadelphia, organized

crime groups unconnected with street

gangs reportedly sell heroin; in

Washington, DC, young crews, 

which are smaller and more loosely

organized than typical street gangs,

plus their “runners” are involved in

heroin sales. Many street-level heroin

sellers are independent in Detroit and

New York.

How old are street-level heroin 

sellers? The ages of heroin sellers

vary by type of distribution, according

to law enforcement sources. For

example, young adults (18–30) tend

to be involved in street gangs, whereas both young adults and older adults

(<30) are involved with traffickingaffiliated organizations. Only in

Miami are adolescents, as well as

young adults, cited by law enforcement officials as heroin distributors,

although the El Paso ethnographer

states that many heroin sellers are as

young as 14. Although the law

enforcement source in Honolulu

states that older adults typically sell

heroin, the epidemiologic source there

adds that many youth, who are

“picked up” in bars in Mexico and

offered free trips to Hawaii, sell 

heroin in Honolulu.

Where is street-level heroin

sold? (Exhibit 9) Law enforcement

sources agree that most heroin sales

take place in inner-city areas.

However, in Portland, it is also sold

in rural and suburban areas; in

Philadelphia, it is sold throughout the

city; and in Miami, it is sold in nightclubs throughout the city. 

Drug Use and Violence Among 

Heroin Sellers

Independent and trafficking-affiliated

heroin sellers are cited as using heroin

more frequently than gang-affiliated

sellers. Often, they sell the drug to use

it. Violence—namely turf wars and

gunfire among organized distributors—

is associated with heroin sales in most

(13) cities. In most Pulse Check cities,

violence is less associated with heroin

sales than with powder and crack

cocaine sales. 
HEROIN

page 18 Pulse Check: Mid-Year 2000

Additionally, epidemiologic and

ethnographic sources in Denver and

St. Louis note that although heroin is

mostly sold in inner-city areas, it is

also beginning to be sold in more suburban areas of the cities. Pulse Check

sources report that heroin is sold on

street corners, indoors in private residences, in crack houses, in cars, in

shooting galleries, and in indoor,

commercial settings. Additional 

settings for heroin sales, according 

to epidemiologic and ethnographic

sources, include shopping centers in

Boston, bars in El Paso, and hotels in

Portland.

How is street-level heroin sold?

Hand-to-hand sales in cities such as

Los Angeles, Memphis, and

Washington, DC, are the most common way to sell user-level heroin;

however, many law enforcement

sources cite prearranged, deliveryservice sales as common. For example, a Boston law enforcement source 

compares the heroin delivery system—a new and more discreet way of

selling—to a pizza delivery service: 

buyers contact sellers, and sellers 

deliver heroin to buyers’ residences. 

In Chicago, buyers contact sellers,

and sellers drive up to buyer’s residences and honk. Beeper and cell

phone use continues in several other

cities, including Chicago, Memphis,

and Portland, where buyers contact

sellers, and both meet on the street or

in an apartment for the exchange.

Corroborating law enforcement 

information, epidemiologic and

ethnographic sources report the use

of cell phones and beepers in buyerlevel heroin sales. They are used for

home deliveries in Boston, Chicago,

Denver, Honolulu, and Seattle and

are also used in Detroit, Philadelphia,

and St. Louis. In New York, where

Then and Now:

How have street-level heroin sales changed (1999 vs 2000)?

Heroin sales are

becoming more

discreet in some

Pulse Check cities:

There are 

indications of 

an increase in

heroin sales in

some cities:

Other features of

the sales scene

have changed in 

some cities:

" Boston law enforcement and epidemiologist/ethnographer:

Heroin is not being sold as often on the street or openly as it was

1 year ago. Law enforcement: “Heroin distribution has become

more of a pizza delivery service operation in which a dealer has a

list of names or contacts and s/he drives to customers’ houses to

deliver the product.”

" Boston law enforcement: Fewer brand-named bags and more

plain, glassine bags of heroin were encountered during 2000.

" Chicago law enforcement: During this reporting period, fewer

sellers are driving up to customers’ residences and honking; 

sellers are becoming more cautious and won’t sell heroin unless

they know a customer.

" New York epidemiologist/ethnographer: Due to street policing,

some heroin sales activity has moved indoors.

" Washington, DC, epidemiologist/ethnographer: In some areas,

heroin sales are moving inside due to street policing, 

gentrification, and neighborhood development.

" Miami epidemiologist/ethnographer: Former cocaine-only sellers

are now selling heroin and cocaine.

" Seattle law enforcement: Dealers who sell cocaine and heroin

have increased, and speedball use is common. 

" Washington, DC, law enforcement: “Heroin is on a comeback:

former crack dealers are selling heroin, and shooting galleries are

supplanting crack houses.”

" Denver and St. Louis epidemiologist/ethnographer: The use of

pagers and cell phones for heroin sales has increased.

" New Orleans law enforcement: Heroin dealers (and users) are

younger than they were 1 year ago.

" New York treatment provider: Drug selling has increased, and

younger adults are increasingly involved in the trade.

" Seattle law enforcement: Heroin-sales-related violence is down.
HEROIN

Pulse Check: Mid-Year 2000 page 19

street sales are prevalent, sellers use

signals, such as a safety pin pinned to

a seller’s clothing, to show buyers

that they are selling heroin. In

Philadelphia, street sales involve the

use of lookouts, beepers for setting 

up meetings, and hiding places for

camouflaging heroin “stashes.”

What other drugs do heroin 

dealers sell? (Exhibit 10) Drugs

commonly sold by heroin dealers

include crack and powder cocaine,

especially powder cocaine for use 

in combination with heroin (“speedball”). In Denver, methamphetamine

and marijuana are also sold by heroin

dealers; in Miami, heroin is sold by

MDMA dealers in the nightclub scene,

and marijuana is often sold by heroin

dealers; in Honolulu, methamphetamine (“ice”) is often sold with heroin;

and in Seattle and Washington, DC,

diverted pharmaceuticals, such as

methadone and clonazepam

(Klonopin), are sold by heroin dealers.

Only in Boston and Columbia are

other drugs reportedly not sold by

heroin dealers. 

How is heroin packaged and 

marketed? (Exhibit 11) In Pulse

Check cities, heroin is sold mostly in

small, plastic zipper bags; wrapped in

tin foil; in corners of plastic bags that

are cut off and knotted around the

heroin; and in glassine bags. In El Paso

and Los Angeles, it is sold in balloons,

and in Detroit, it may be sold in lottery tickets or paper gum wrappers.

In many cities, plastic bags containing

heroin or other heroin packaging may

sport colored stamps, designs, logos,

or brand names. For example in

Chicago, faces are stamped on some

bags; in Boston, aliens, stars, and 

devils appear on some bags; in

Philadelphia, new logos of orange 

basketballs and bees appeared in 2000;

and in Washington, DC, the plastic

bags containing heroin often are 

colored (and are referred to as “black

bag,” “blue bag,” and “yellow bag”). 

Heroin logos and brand names vary 

by locality, with Philadelphia’s and

some of Columbia’s current brands

Denver, CO #

Honolulu, HI #

Los Angeles, CA # #

Seattle, WA ## #

Chicago , IL #

Birmingham, AL # #

Columbia, SC # #

El Paso, TX #

Memphis, TN # #

Miami, FL # #

New Orleans, LA # #

Washington, DC ## # #

Boston, MA # #

New York, NY #

Philadelphia, PA ## #

Portland, ME # #

Private Crack Shooting Commercial

Site Street Residences Houses Galleries Settings Cars

Exhibit 9. Where is street-level heroin sold?*

Source: Law enforcement respondents

*Sources in four sites did not respond: Billings, Detroit, St. Louis, and Sioux Falls.

Diverted

Crack Powder Mari- Metham- Pharma- No Other

Site Cocaine Cocaine juana phetamine ceuticals Ecstasy Drugs Sold

Honolulu, HI #

Los Angeles, CA #

Seattle, WA # #

Denver, CO # ## #

St. Louis, MO # #

Chicago, IL #

Detroit, MI #

Columbia, SC #

El Paso, TX #

New Orleans, LA # #

Memphis, TN #

Miami, FL ## #

Washington, DC ## #

Philadelphia, PA # #

Boston, MA #

Portland, ME # #

Sources: Law enforcement, epidemiologic, and ethnographic respondents

*Sources in four sites did not respond: Billings, Birmingham, New York, and Sioux Falls.

Exhibit 10. What other drugs do heroin dealers sell?* West South West South Northeast Midwest Northeast Midwest
HEROIN

page 20 Pulse Check: Mid-Year 2000

connoting death and some of New

York’s and Columbia’s brands 

alluding to movie titles, high-class

product names, and other pop culture

products. New York dealers alter

brand names and markings frequently —sometimes weekly or even

daily—in the belief that they are 

staying one step ahead of the law.

In many cities, including Chicago,

Denver, Los Angeles, Honolulu,

Memphis, Miami, and Seattle, heroin

bags are not labeled, perhaps so that

sellers can avoid connection to a

product and possible conviction. 

HEROIN: THE COMMUNITY

What is the impact of and 

community reaction to the heroin

problem? The growing heroin problem in some Pulse Check communities

has triggered events which, in turn,

have kicked off a wide range of community responses, such as task forces,

law enforcement initiatives, legislation,

and media attention. These responses,

in turn, have affected heroin users,

heroin dealers, and the ways in which

heroin data can be interpreted. During

the current reporting period, this 

cyclical relationship is evident in the

following examples: 

! Boston, MA: According to the

Pulse Check epidemiologic source,

the increase in heroin overdoses

and deaths over the last 3 years

has recently translated into more

awareness and concern, including

interagency coordination, a data

gathering initiative, and a law

enforcement initiative targeted 

at heroin. 

! New York, NY: The ethnographic

source states that police initiatives

have affected the heroin situation

in two ways: heroin dealers are

increasingly transacting sales

indoors; and the dealers are 

constantly changing brand names,

which they perceive can be traced

back to them. 

! Philadelphia, PA: The methadone

treatment source reports that drug

courts, and law enforcement

efforts in general, are responsible

for an increase in the number of

clients in treatment for heroin

problems.

! Portland, ME: According to 

treatment sources, law enforcement accounts for the decrease 

in heroin-related crime. 

! Portland, ME: Several recent 

overdoses involving OxyContin®,

a long-acting form of the opiate 

oxycodone, prescribed for severe

pain, has ignited much attention

from the local media and district

attorney’s office. This drug has

been problematic among heroin

injectors, especially in the rural

areas, for some time; however, 

it is only recently that a new phenomenon has arisen—prescription

altering. Several meetings have

been held with physician groups

about prescription protection.

! Seattle, WA: The Pulse Check

epidemiologic source reports on

several recent developments: 

" The county posted on their website a Seattle drug trends report,

developed for the National

Institute on Drug Abuse (NIDA)

Community Epidemiology Work

Group (CEWG); the posting 

subsequently sparked several

community responses, such as an

international heroin conference

and a lot of media attention. 

Exhibit 11. 

Heroin brand names in selected Pulse Check sites.

Columbia, SC

New York, NY

Philadelphia, 

PA

Portland, ME

Washington, 

DC

Playboy, skull-to-skull, Mercedes, crossbones

Aries, HBO, payday, iceburg, blackout, Desert Storm, double 

jeopardy, red bag, that s_ _t, face off, high energy, attraction, 

slamming, gladiator, the power, side affects, millenium 2000, white

angel, limit, hot shot, Pokemon, king of New York, Viagra, cobra,

final notice, psycho, Tommy Hilfiger, cocheese, mankind, the heap,

embryo, beyond 2000, DVD, straight to the head, smack down,

Power Ranger, Goya, top choice, west side, hit me off, Genesis, heat,

warning, one way, passion, rough rider, top of the ninth, K9, excellent, spider, eternity, Gatorade, flying high, tyson, sniper, f_ _k you,

iceberg, Lexus, drama, 24 hours

Poison, pure hell, suicide, dead calm, murder, homicide, x-hell, 

diabolic, VZ, spice girl, turbo, one+done, black demon, hate monger,

ex-con, death row, demolition, murder one, hard to kill, died in

peace, lethal injection, Old Navy

Red eagle, dolphin, black eagle, batman

Jerry Springer, orange line, brown tape, 747, blue bag, 

yellow bag, 2000
HEROIN

Pulse Check: Mid-Year 2000 page 21

" An FBI allegation connecting

heroin addicts to a recent

increase in bank robberies led to

a meeting with the local drug

court and Division of Substance

Abuse to look at exercising

mandatory sentences. 

" A mayoral and county executive

heroin task force is examining

issues such as prevention, treatment, media, harm reduction 

messages, and emergency 

medical response. 

" The local health department has

established a task force on how

to interact with emergency 

medical personnel to prevent

heroin overdoses. 

" The increased focus of 

policymakers and legislators on

the heroin problem during the

last year and a half has led to

increased treatment capacity and

to discussion on innovative ways

to expand treatment access, such

as a physician-based methadone

program in a hospital. 

" A recent article in a local 

newspaper sparked interest in

the record number of drug

arrests and heroin deaths. 

Several methadone treatment sources

report an increase in media attention

on heroin addiction: 

! Columbia, SC: Articles have 

portrayed methadone treatment in

a positive light. 

! Memphis, TN: The media have

helped clients become aware of

links between heroin use and HIV. 

! Seattle, WA: The media is 

responsible for "fast-tracking"

clients in jail to treatment. 

! Portland, ME: The media has

placed attention on non-heroin

opiates. 

! Sioux Falls, SD: The public and

community seem better informed

due to media attention on heroin.
CRACK AND POWDER COCAINE

page 22 Pulse Check: Mid-Year 2000

CRACK AND POWDER COCAINE:

THE PERCEPTION 

How serious a problem is cocaine

in Pulse Check communities?

Sources in more than half of the Pulse

Check sites (12 of 20) consider cocaine,

in crack and powder forms combined,

to be the most serious drug problem in

their communities (41 percent of 70

responding sources). Half of those sites

are in the South (Birmingham,

Columbia [South Carolina], El Paso,

Memphis, Miami, and Washington,

DC), and the other half span the 

country’s three other regions: Chicago,

Detroit, and St. Louis in the Midwest;

Denver and Los Angeles in the West;

and only New York in the Northeast.

(Note: In discussing their perception of

how serious their communities’ drug

problem is, most Pulse Check sources

do not distinguish between the two

forms of cocaine.) Cocaine is also considered the second most serious drug

problem by 29 percent of Pulse Check

sources (N=66). Although it is the

most mentioned drug problem, it is

considered an emerging problem in

only one site: Billings, Montana

(according to a law enforcement

source). 

Has the perception of the seriousness of the cocaine problem

changed between 1999 and 2000?

Cocaine continues to be considered the

most serious drug problem across sites,

with more than 7 of 10 sources 

ranking it as either the most serious or

second most serious drug problem. In

some communities, sources note that

heroin replaced cocaine (either form)

as the most serious drug problem over

the past year; in Detroit, New Orleans,

and Portland (Maine), some (but not

all) sources indicate that heroin is 

overtaking cocaine. Conversely, in

Birmingham and El Paso, sources indicate that cocaine is replacing heroin.

CRACK COCAINE: THE DRUG 

Availability, Purity, and Price

How available is crack cocaine

across the country? (Exhibit 1) Of

the law enforcement, epidemiologic,

and ethnographic sources discussing

this question, 81 percent (N=31)

report crack as widely available in

their communities, and 17 percent

report it as somewhat available. Only

in Sioux Falls is it considered not 

very available (as reported by the 

epidemiologic source).

Has the availability of crack

cocaine changed between 1999

and 2000? (Exhibit 2) The majority 

(53 percent) of responding sources

report crack availability as stable.

Only one-fourth (N=32) report an

increase in crack availability, and only

19 percent report decreased availability. According to law enforcement

sources, crack availability increased in

three sites (Billings, Denver, and

Portland) and decreased in four sites

(Chicago, Honolulu, Sioux Falls, and

Washington, DC). Ethnographic and

epidemiologic sources report increases

in five southern and northeastern sites

(Birmingham, El Paso, Miami, New

York, and Portland) and declines in

two western sites (Denver and

Honolulu).

How pure is crack cocaine

across the country? (Exhibit 3)

Crack purity varies widely, ranging

from 20 percent (in Denver) to 90

percent (in Honolulu and Washington,

DC) in the 11 Pulse Check sites where

purity was reported. 

Exhibit 1. 

How available is cocaine?

Sources: Law enforcement, epidemiologic,

and ethnographic respondents

100

90

80

70

60

50

40

30

20

10

0

Cocaine

(both forms)

(N=31)

Not Very

Available

Widely

Available

Percent

Somewhat

Available

Crack

cocaine

(N=36)

Powder

cocaine

(N=35)

Has crack purity changed?

Only a few changes in crack purity

were noted between 1999 and 2000:

A Sioux Falls treatment source suggests

that purity has increased because the

dealers’ crack manufacturing process 

is improving.

Columbia, SC

Memphis, TN

Portland, ME

Sioux Falls, SD

Birmingham, AL

Chicago, IL
CRACK AND POWDER COCAINE

Pulse Check: Mid-Year 2000 page 23

How is crack cocaine made?

Typically, in Pulse Check communities,

local crack sellers and, less often,

crack users process powder cocaine

into crack cocaine. In most cities, baking soda is the standard ingredient

added to powder cocaine to make

crack, as cited by law enforcement

sources. However, sources mention

other adulterants, including sugar in

Portland, lidocaine in Sioux Falls,

brake fluid and rat poison in

Memphis, and vitamin B-12 in

Birmingham. Epidemiologic and

ethnographic sources similarly

note crack adulterants, such

as diphenhydramine

(Benadryl®) in Boston and

Detroit, procaine (Novocaine®)

and “anything white” in Detroit,

and the pain reliever aurosol

(Ambesol®) in Portland. 

What are crack cocaine prices

across the country? (Exhibit 3)

The cost of a crack cocaine gram

ranges from $20 in Miami to $250 in

Honolulu. According to law enforcement, epidemiologic, ethnographic,

and treatment provider sources, crack

most commonly sells by the rock for

$3 to $35 depending on geographic

location and rock size. Crack also

sells as “kibbles and bits” (small

amounts of rock) in Seattle for $2

to users with little money.

Similarly, in Washington, DC,

“crumbs” (small amounts of

rock) sell for $3 and “working

bags” (bags containing several

small rocks) sell for $20.

Have crack prices changed?

Crack prices remained stable between

1999 and 2000, with the following

exceptions: 

According to sources in Birmingham,

prices have declined due to the

decreased quality and the increased

availability of crack on the street.

Similarly in Columbia, prices are

declining because crack may be more

accessible. 

The Sioux Falls price increase might be

related to increased purity. In Chicago,

however, purity has decreased; the

price increase, according to the law

enforcement source, might reflect an

increase in major seizures at the 

kilogram level. 

Exhibit 2.

How has crack cocaine availability

changed (1999 vs 2000)?

L Law enforcement respondents 

E Epidemiologic/ethnographic respondents

*Sources in Detroit did not respond.

Billings, MTL

Birmingham, ALE

Denver, COL

El Paso, TXE

Miami, FLE

New York, NYL

Portland, MEL,E

Boston, MAL,E

Columbia, SCL

Denver, COE

El Paso, TXL

Los Angeles, CAL

Memphis, TNL

Miami, FLL

New York, NYL

New Orleans, LAE

Philadelphia, PAL,E

St. Louis, MOL,E

Seattle, WAL,E

Sioux Falls, SDE

Washington, DCE

Birmingham, AL

Columbia, SC

Memphis, TN Chicago, IL

Sioux Falls, SD

Exhibit 3. 

Crack cocaine gram prices and

purity by city*

CITY GRAM PRICE PURITY

Billings, MT $100 NR

Denver, CO $150 20%

Honolulu, HI $100–$250 90%

Los Angeles, CA $70–$100 NR

Seattle, WA $60 40–85%

Birmingham, AL $80 <70%

Columbia, SC $100 NR

El Paso, TX $80 80%

Miami, FL $20 NR

Washington, DC $100 30–90%

New York, NY $28 50–75%

Chicago, ILL

Honolulu, HIL,E

Sioux Falls, SDL

Washington, DCL

Changes in Crack Rock Size

! Birmingham, AL: The law 

enforcement source notes that a new

crack adulterant, vitamin B-12, is

being used to make crack rock

appear larger so dealers can sell

them for a higher price.

! Philadelphia, PA: Rocks have

become smaller since late 1999, 

but price per rock has not 

changed, so dealers are now 

making more money according 

to the epidemiologic source.

Sources: Law enforcement, epidemiologic and

ethnographic respondents

*Sources in nine sites, mostly in the Northeast

and Midwest, did not provide this information.

West South Northeast
CRACK AND POWDER COCAINE

page 24 Pulse Check: Mid-Year 2000

POWDER COCAINE: THE DRUG 

Availability, Purity, and Price

How available is powder cocaine

across the country? (Exhibit 1)

Powder cocaine (cocaine hydrochloride

[HCl]) is judged as widely available,

yet somewhat less available than crack,

with 60 percent of law enforcement,

epidemiologic, and ethnographic

sources (N=35) reporting it as widely

available, particularly in the South, and

37 percent reporting it as somewhat

available. It is considered widely

available in eight cities (Columbia,

Denver, Memphis, Miami, New

York, New Orleans,

Philadelphia, and Seattle) and

widely or somewhat available

in five cities (Birmingham,

Boston, El Paso, Portland, and St.

Louis). Honolulu sources differ in

their perspective on the powder

cocaine supply: the law enforcement

source states that it is widely available; the epidemiologic source states

it is not very available.

Has powder cocaine availability

changed between 1999 and

2000? (Exhibit 4) Most (61 percent)

of the 31 responding law enforcement,

epidemiologic, and ethnographic

sources, spanning 15 of the 20 Pulse

Check cities, perceive powder cocaine

availability as stable. About onequarter (26 percent) of the sources,

spanning eight cities, perceive it as

increasing; and 13 percent (in three

cities) perceive it as declining. 

How pure is powder cocaine

across the country? (Exhibit 5)

The purity of powder cocaine varies

widely, ranging from 25 percent (in

Honolulu) to 90 percent (in Boston

and Miami).

What are powder cocaine prices

across the country? (Exhibit 5)

Powder cocaine gram prices typically

mirror or are slightly lower than

crack prices, although typically crack

cocaine can be purchased in smaller

(and less expensive) amounts (rocks)

than powder cocaine (grams). Powder

cocaine ranges from $20 per gram in

Sioux Falls to $200 in Honolulu and

Washington, DC. Some of the lowest

prices are found in the South.

What adulterants are added to

powder cocaine? Powder cocaine

adulterants cited by law enforcement

sources include lactose, isotol, 

manitol, inositol, baking soda, 

and sugar. In 1999 in Miami, law

enforcement officials seized powder

cocaine colored blue and yellow 

with food coloring, perhaps used to

disguise the cocaine.

Exhibit 4.

How has powder cocaine availability changed (1999 vs 2000)?*

L Law enforcement respondents 

E Epidemiologic/ethnographic respondents

*Sources in Detroit did not respond.

Boston, MAE

Columbia, SCL

Denver, COL,E

El Paso, TXE

Miami, FLE

New York, NYL

Philadelphia, PAE

Portland, MEL

Billings, MTL

Birmingham, ALE

Boston, MAL

El Paso, TXL

Los Angeles, CAL

Memphis, TNL

Miami, FLL

New York, NYL

New Orleans, LAL,E

Philadelphia, PAL

Portland, MEE

St. Louis, MOL,E

Seattle, WAL,E

Sioux Falls, SDE

Washington, DCL

Chicago, ILL

Honolulu, HIL

Washington, DCE

Has powder cocaine purity

changed? Several changes in powder

cocaine purity are reported from 1999

to 2000:

In most cases, these changes are 

similar to those noted for crack. In

Chicago, however, treatment sources

note a decline in crack purity but an

increase in the purity of powder cocaine.

Chicago and Portland treatment sources

suggest that powder cocaine purity has

increased because the sale and use rates

have decreased. In El Paso dealers are

adding more adulterants to powder

cocaine in an attempt to increase their

profits.

Boston, MA

Chicago, IL

Columbia, SC

Portland, ME

Birmingham, AL

El Paso, TX

Washington,

DC
CRACK AND POWDER COCAINE

Pulse Check: Mid-Year 2000 page 25

Exhibit 5. 

Powder cocaine gram prices and

purity by city

CITY GRAM PRICE PURITY

Billings, MT $100 NR

Denver, CO $100–$125 15–75%

Honolulu, HI $100–$200 25%

Los Angeles, CA $70–$100 80–85%

Seattle, WA $30 57–68%

Chicago, IL $50–$125 NR

Sioux Falls, SD $20–$100 NR

St. Louis, MO $100 NR

Birmingham, AL NR <70%

Columbia, SC $100 NR

El Paso, TX $30–$40 80%

Miami, FL $40–$60 40–90%

New Orleans, LA $35 35%

Washington, DC$100–$200 60%

Boston, MA $90–$100 70–90%

New York, NY $50–$120 75%

Philadelphia, PA$100–$125 60–80%

Portland, ME $90–$100 60–70%

Exhibit 6. 

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

Street names (slang) throughout the United States vary by

geographic region. Crack and powder cocaine names are

not interchangeable in most U.S. cities.

WEST

Twenty, hard, I wanna be a rock star,

rock, crack, stones, yay (both powder

and crack) onion (1 oz), cookie (41/2 oz),

g (gram), quarter (1/4 oz), rock, boulders,

butter, crack, kibbles and bits, rock,

O.J., white, snow bird, lady, blow,

smack, dick, crack coke, piedra

Rock, ma’a, 

(Samoan for rock)

Rock, girl, p-dogs

(combined with

marijuana), crack,

rock, dope, 

boulders, pebbles, 

kibbles and bits,

seconds (second hit

on the crack pipe)

Rock, crack

Crack, rock

MIDWEST NORTHEAST

SOUTH

Exhibit 7. 

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

WEST

Powder, white lines,

girl, blow, sniff, coke,

up, flake, white

Girl, powder, C,

blow, snow,

blanks, coke,

white stuff

MIDWEST NORTHEAST

SOUTH

Yay, blow,

snow, coke,

flake, dope

Powder, white dragon,

girl, blow, soda, coca,

blanca, shake, bump,

snow, soft

Girl, blow,

snow, coke

Sources: Law enforcement, treatment, epidemiologic and ethnographic respondents

Sources: Law enforcement, treatment, epidemiologic and ethnographic respondents

Sources: Law enforcement and 

epidemiologic/ethnographic respondents

Respondents in Detroit and Memphis did not

provide this information. West Northeast South Midwest
CRACK AND POWDER COCAINE

page 26 Pulse Check: Mid-Year 2000

CRACK COCAINE: THE USERS

Who, Where, How, and With What?

How have crack cocaine users

changed across the country

between 1999 and 2000?

According to epidemiologic and

ethnographic sources, crack trends

appear generally stable across the

country, with a few exceptions, as

noted below. Several treatment

sources, however, note increases in

the number of crack clients in their

programs, particularly among the

younger population.

Are people initiating crack use?

(Exhibit 8) Epidemiologic and

ethnographic sources report few signs

of crack initiation. For example, the

New York ethnographic source reports

that new users are not entering the

scene, but a high level of chronic use

by long-term addicts continues. From

the treatment perspective, however,

some sources do note novice use

among clients. As the arrows show (in

Exhibit 8), treatment sources in six

Pulse Check sites report stable trends

in novice crack use at their programs. 

However, treatment sources in 10

cities, spanning all regions of the

country, report an increase. Further,

eight of those sources perceive the

increase at their programs to parallel

an increase in their local communities.

A Boston treatment source, for 

example, reports that novice users are

increasing in number and reportedly

prefer “freebasing”; moreover, in the

local area, the source comments that

“smoking crack is so common that

even some public safety professionals

use this drug, and they don’t feel that

it is a problem.” 

Then and Now: 

How have crack cocaine users changed across the country 

(1999 vs 2000)?*

According to epidemiologic and ethnographic sources... 

Denver, The number of crack users younger than 18 has increased slightly,

CO as has the number who are females. The number of white and Hispanic

crack users is also increasing, while the number of black users is 

declining. A growing number of crack users are reporting no income.

Smoking has declined slightly, while snorting has slightly increased.

New York “Speeder” is a new and problematic combination: crack is diluted 

NY with lemon juice and vinegar, heroin is added, then the combination 

is lit up and injected. This combination reportedly can create a fungus

throughout body.

Washington, Two relatively recent user groups are reported: a somewhat younger 

DC group starting to smoke crack in blunts, and heroin shooters who are

starting to smoke crack.

According to treatment sources...

Columbia, Adult crack clients, age 25–44, have been increasing.

SC

Honolulu, A second generation of crack users is appearing.

HI

Memphis, More younger users and female users are emerging.

TN

Seattle, An increase in all age groups may be attributable to low crack prices.

WA The number of female crack clients has increased, with more women

reporting initiation to crack from male companions.

Discussion: Why do epidemiologic,

ethnographic, and treatment

sources sometimes see different

trends in the same city?

U.S. cities abound with people 

from various neighborhoods, various

cultures, and various socioeconomic

backgrounds. Each of the four sources

in any Pulse Check city provides a 

different perspective on the drug 

situation because they deal with 

different populations. For example,

young affluent partygoers or clubgoers

are not likely to seek treatment, at

least in their early stages of drug use;

thus, any increased powder cocaine

snorting in the club scene is more 

likely to be detected by an ethnographic

source. By contrast, a treatment

provider might be in a better position

to detect an increased crack-smoking

problem in a specific neighborhood.

*No major changes in crack-using populations are reported by sources in 13 sites.
CRACK AND POWDER COCAINE

Pulse Check: Mid-Year 2000 page 27

How old are crack cocaine

users? (Exhibit 9) According to

Pulse Check epidemiologic and ethnographic sources, crack users tend to be

older adults (30 years and older). Four

exceptions occur in Birmingham,

Honolulu, Los Angeles, and Sioux

Falls: in those cities, the younger

crack-using populations exceed the

older user groups. In Sioux Falls, the

crack-using population is particularly

young: 18–24 years. Young crack

users (in their late teens through 

early twenties) are reported as the

population second most likely to use

crack in Billings, Honolulu, Seattle,

and Washington, DC.

Exhibit 8.

How has the number of novice

crack users in Pulse Check

sources’ treatment programs

changed (1999 vs 2000)?*

Northeast

BostonN

New YorkN

PortlandN

South

El PasoM

MemphisM

New OrleansN

Midwest

ChicagoM

Sioux FallsN,M

West

DenverN

Los AngelesM

Northeast

New YorkM

South

MiamiN

Midwest

DetroitN

West

HonoluluN

Los AngelesN

SeattleN,M

PhiladelphiaM

N Non-methadone providers

M Methadone providers

*Sources in five sites did not respond:

Billings, Birmingham, Columbia, St. Louis,

and Washington, DC.

Note: Not enough methadone treatment sources responded in order to draw any conclusions.

Exhibit 9.

What age group is most likely to use crack?

>50 percent of sources report 

30+ years.

>50 percent of sources report 

18–30 years.

About 50 percent of sources report

30+, and 50 percent of sources report

18–30.

Insufficient respondents to draw a 

conclusion.

According to non-methadone treatment sources...

According to epidemiologists and ethnographers...

West

South

Midwest Northeast

West

South

Midwest Northeast

(Nonrespondents: Billings,

Philadelphia, St. Louis, Seattle,

and Washington, D.C.)

(Nonrespondents: New Orleans

and Portland)

Different Sources,

Different Populations

As in the case of heroin, 

epidemiologic and 

ethnographic sources tend to

report somewhat older user

groups than do treatment

sources—once again highlighting the need for multiple

sources in order to capture

all populations and get a

more comprehensive picture.
CRACK AND POWDER COCAINE

page 28 Pulse Check: Mid-Year 2000

By contrast, treatment sources in 18

sites identify young adults (18–30

years) as the predominant age group

of crack clients, followed by older

adults. Moreover, a non-methadone

treatment provider in New Orleans

identifies adolescents as the 

predominant group. Only in Billings

do older adults in a reporting program outnumber the young adults. 

Are there gender differences in

who uses crack? The majority of

crack users tend to be male, as

reported by epidemiologic and ethnographic sources in every Pulse Check

city except four: the group reported

most likely to use crack in Miami is

age 35-and-older and female; in

Sioux Falls and Washington, DC,

users are evenly split between males

and females; and in Seattle, male

users only slightly outnumber female

users among the group most likely to

use crack.

Similarly, in most cities, treatment

sources report that the majority of

crack clients are male, with three

exceptions where females are in the

majority: Boston, Chicago, and

Seattle. Moreover, the number of

female crack clients has increased at

programs in Memphis and Seattle. 

In the latter, female clients report 

initiation to crack use via male 

companions. 

Is any racial/ethnic or 

socioeconomic group more likely

to use crack? Blacks account for the

largest proportions of crack users in

13 of the 20 Pulse Check cities,

according to epidemiologic and 

ethnographic sources. In Boston, black

and Hispanic representation among

crack users is approximately equal.

Whites are more likely than other

racial/ethnic groups to use crack in

Billings, Denver, and El Paso; and the

Sioux Falls crack-using population

crosses all racial/ethnic categories. 

Crack-using populations are predominately in lower SES categories 

in all but 2 of the 20 cities, according

to epidemiologists and ethnographers: in El Paso, crack users are 

predominantly middle class; and in

Sioux Falls, users cross all SES 

categories but are primarily from an

upper SES group. Additionally, in the

cities where the lower SES groups

predominate, some crack users come

from other groups. For example,

lower/middle SES groups are reported

in Honolulu and Los Angeles;

Miami’s younger (age 20–30) white

and Hispanic suburban group is

described as “middle and upper” SES;

and Detroit has a small, young, black

user group that crosses all SES categories.

Treatment programs in the Northeast

region vary by city in the racial/ethnic

distribution of their crack clients.

Among programs responding on race,

whites account for the largest 

proportion of crack clients in Boston

and Portland, reflecting those cities’ 

population distributions; blacks are

overrepresented in New York and

Philadelphia, where they account for

the largest crack-using groups at

reporting treatment programs. In the

South, blacks are generally overrepresented, accounting for the largest

proportion of crack clients in five 

out of seven Pulse Check treatment

programs reporting on race: the nonmethadone programs in Birmingham,

Columbia, Memphis, and New

Orleans, and the methadone program

in Washington, DC. Whites, however,

account for the largest proportion of

crack clients in the Birmingham and

Memphis methadone programs,

whereas Hispanics account for the

largest proportion in El Paso. In the

Midwest, blacks are demographically

overrepresented, accounting for the

largest crack-using population at

three of seven reporting programs:

the non-methadone programs in

Chicago and Detroit, and the

methadone program in Chicago.

Whites predominate in Sioux Falls.

The West has the most variation

across sites in the racial/ethnic groups

that account for the largest number

of crack clients: whites in Billings;

Asian/Pacific Islanders in Honolulu;

Hispanics in Los Angeles; and blacks

in Denver and Seattle, where they are

overrepresented.

Like the epidemiologic and 

ethnographic sources, treatment

sources generally report that crack

users are found in the lower SES

groups. However, in Billings,

Birmingham, Boston, El Paso, and

Sioux Falls, crack users are often in

the middle SES groups. 
CRACK AND POWDER COCAINE

Pulse Check: Mid-Year 2000 page 29

Where do crack users tend to

reside? Without exception, 

epidemiologic and ethnographic

sources report crack as primarily an

inner-city drug, but some suburban

use is reported. In Honolulu, for

example, some people from rural

areas come into the inner city to buy

the drug. Detroit’s young crack-using

population reside both in the inner

city and in the suburbs. Similarly,

Miami has a young (age 20–30) male

cohort of crack users who reside in

the suburbs.

Treatment sources generally concur

that the majority of crack users reside

in inner-city areas. In only 4 of 25

programs where place of residence

was discussed, sources cite non-innercity areas: Boston, Sioux Falls, and

New York sources report that users

are more likely to live in the suburbs;

an El Paso source reports that they

are more likely to live in rural areas.

Where and with whom is crack

used? (Exhibit 10) Crack use, as the

table indicates, takes place in a wide

variety of contexts and settings.

Epidemiologic and ethnographic

sources mention indoor settings

slightly more often than street 

settings, but the latter still feature

prominently in many cities. New

York’s ethnographic source notes that

the drug is sold and used on the street

because it is short acting. The indoor

settings range from crack houses to

private parties, residences, abandoned

buildings, bars, porn parlors, and

video shops. 

In some areas, epidemiologists 

categorize the various user groups by

their use settings and contexts: in

Miami, for example, crack houses are

the venue for the user group of older,

black, inner-city females, while the

younger, male users who are white

and Hispanic middle- and upper-class

suburbanites tend to use crack at 

private parties, in houses, and in cars.

Treatment sources concur that crack

use takes place in a variety of settings,

mostly involving group contexts. Solo

use is reported in only a few programs—in Denver, Miami, Columbia,

El Paso, and Washington, DC—but

group use is also reported in some of

those programs. Crack houses are

reported in Birmingham and Chicago

(also known there as “smoke 

houses”). Other reported venues

include parties (in New Orleans), the

street (in Honolulu), and the home

(in Birmingham, Denver, El Paso,

Portland, Sioux Falls, Los Angeles,

and Memphis).

Exhibit 10. 

Where and with whom is crack used?*

City Setting or context

Denver, CO In crack houses (more for distribution than use)

Honolulu, HI In bars, porn parlors, video shops (used as crack houses);

not in public; houses, parties

Los Angeles, CA At home, on street, in crack houses

Seattle, WA On street, in back alleys

Chicago, IL In apartments; some in crack houses

Detroit, MI Private settings (same as heroin); some party scene

Sioux Falls, SD At parties

St. Louis, MO Some in crack houses, often in vacant houses, sometimes 

on the street, usually used alone or in small groups, 

use is usually private

Birmingham, AL In crack houses

El Paso, TX At friends’ homes, parties; some crack houses; 

sometimes gay bars

Memphis, TN Probably crack houses and private residences

Miami, FL In crack houses; private parties, houses, cars

New Orleans, LA On street, in houses, everywhere

Washington, DC In apartment buildings, abandoned buildings, some on street

Boston, MA Mostly on the street, a few crack houses

New York, NY On street, in parks, shooting galleries

Philadelphia, PA In crack houses; sometimes for barter (sex for crack, 

goods for crack–not a lot of credit or price negotiation)

Portland, ME NA (Not much crack) Risky Contexts

Philadelphia, PA: Sex for crack is part of

the bartering context in crack houses.

West Northeast South Midwest

Sources: Epidemiologic and ethnographic respondents

*Sources in two sites did not respond: Billings and Columbia.
CRACK AND POWDER COCAINE

page 30 Pulse Check: Mid-Year 2000

How do crack users take their

drug? Smoking, by far, is the 

predominant route of administration

among all user groups in nearly all

cities. But epidemiologic and ethnographic sources report some unusual

practices. In Boston, for example,

crack is sometimes dissolved in lemon

juice or vinegar and then injected.

Crack injection is also reported in

Billings, Chicago, New York, and

Washington, DC. Crack snorting is

reported in Chicago. 

Similarly, treatment sources report

smoking as the most common method

of ingesting crack. They, too, note

some unusual exceptions: injection is

the most common route of crack

administration among clients at the El

Paso methadone program, and it is

also cited among clients of the New

Orleans and Sioux Falls nonmethadone programs. At the latter

program, novice crack users are

among those who inject. Further,

novice users at the Boston nonmethadone program freebase 

their crack. 

What other drugs do crack users

take? Alcohol is the most common

substance consumed with crack,

according to epidemiologic and

ethnographic sources in nearly every

city. Marijuana and heroin are also

reportedly taken by crack users in

many cities (marijuana in Denver,

Detroit, El Paso, Honolulu, Miami,

New Orleans, New York, Philadelphia, St. Louis, and Washington, DC;

heroin in Chicago, New Orleans,

New York, and Seattle). In Philadelphia, crack users also take alprazolam

(Xanax®) and phencyclidine (PCP).

Treatment sources concur that 

alcohol is commonly abused by crack

users, as reported in Birmingham,

Boston, Columbia, Denver, Honolulu,

Miami, New Orleans and Portland.

Marijuana use among crack users is

reported by treatment sources in

Birmingham, Boston, El Paso, Miami,

and Sioux Falls. And heroin is used by

crack users in Boston, Chicago, and 

New Orleans.

POWDER COCAINE: THE USERS

How have powder cocaine users

changed across the country

between 1999 and 2000? Powder

cocaine users follow a somewhat 

different trend than do crack users.

Signs of increase in some powdercocaine-using populations, particularly

younger ones, are reported by 

epidemiologic and ethnographic

sources in five cities: Boston, Denver,

Los Angeles, Miami, and Memphis.

By contrast, treatment providers

report varying trends among novice

users of powder cocaine. The number

of novice users in treatment has

declined at programs in four Pulse

Check cities (Denver, Detroit,

Honolulu, and Philadelphia),

remained stable in eight programs (in

Boston, Chicago, El Paso, Los

Angeles, Miami, New York, Portland,

and Seattle), and increased in four (in

New York, Sioux Falls, Columbia,

and Memphis).

How old are powder cocaine

users? In the majority of Pulse Check

cities, epidemiologic and ethnographic

sources report that powder cocaine

users are likely to be in their thirties

and older. However, users tend to be

slightly younger (twenties through

early thirties) in five cities: Billings,

Birmingham, Honolulu, Los Angeles,

and Seattle. In El Paso, powder

cocaine users are most likely to be

between ages 14 and 21. 

As is the case with crack treatment

clients, powder cocaine clients in

Pulse Check cities are often likely to

be young adults, according to treatment sources in Birmingham, Boston,

Memphis, New York, Portland, and

Washington, DC. Moreover, 

adolescents are reported as the largest

powder cocaine-using group in Los

How do crack cocaine users wind

up in treatment? 

According to the responding Pulse

Check treatment sources, courts and

the criminal justice system are the most

common referral sources for clients

entering treatment for crack addiction.

Individual referrals follow closely as

the second most common referral

source.

Drug Slang

“Geek joint”: The Miami term for

crack plus marijuana in a joint

“Diablito”: The New York term for

crack plus marijuana in a cigarette

“Speeder”: The New York term for

crack diluted with lemon juice and 

vinegar, combined with heroin, and lit

“Kibbles and bits”: The Seattle 

term for very small amounts of loose

rocks of crack sold to people with 

little money
CRACK AND POWDER COCAINE

Pulse Check: Mid-Year 2000 page 31

Angeles. Older adults, however, are

most likely to use powder cocaine,

according to Chicago, Denver,

Detroit, El Paso, Honolulu, and

Miami treatment sources.

Are there any gender differences

in who uses powder cocaine? In

only three Pulse Check cities do epidemiologic and ethnographic sources

report that males and females are

equally likely to use powder cocaine:

Boston, El Paso, and Philadelphia. In

all other Pulse Check cities, epidemiologic and ethnographic sources agree

that males are more likely to use.

According to treatment sources, 

however, females actually outnumber

males in three methadone programs:

in Chicago, Sioux Falls, and

Washington, DC. (Females are also in

the majority at the non-methadone

programs in New York, but that program targets women and children.)

At the Honolulu non-methadone 

program, the treatment source

reports that older men give powder

cocaine to younger women.

Is any racial/ethnic or socioeconomic group more likely to use

powder cocaine? Powder cocaine

users are more similar to heroin users

than to crack users in that their

racial/ethnic diversity mirrors the

Nation’s diversity. According to 

epidemiologists and ethnographers,

whites are more likely than other

groups to use powder cocaine in eight

Pulse Check cities (Billings, Denver,

Honolulu, Los Angeles, New Orleans,

Portland, Seattle, and St. Louis);

blacks are the primary user group in

nine cities (Birmingham, Boston,

Chicago, Columbia, Detroit, Los

Angeles, New York, Philadelphia, and

Washington, DC); and Hispanics are

more likely to use it in two (El Paso

and Miami). Native Americans are

reported as the second most likely

racial/ethnic group to use powder

cocaine in Billings.

Powder cocaine users and crack users

also differ socioeconomically: unlike

crack users, whom epidemiologists

and ethnographers tend to report in

the lower SES categories, powder

cocaine users in the majority of the

Pulse Check cities are in middle SES

categories or they span a wider range

of categories. The few exceptions

include Chicago, Detroit, Philadelphia,

and Washington, DC, where powder

cocaine users tend to be in the lower

SES categories.

Similarly, treatment sources suggest

that powder cocaine clients come

from a wide range of SES backgrounds: among 14 programs where

SES classification is discussed, powder

cocaine users are most likely to be

middle SES according to 6 sources (in

Detroit, El Paso, Honolulu, Memphis,

and Sioux Falls), upper SES according

to 3 (in Birmingham, Denver, and

Miami), and lower SES according to

5 (in Chicago, Los Angeles, New

York, Portland, and Washington, DC).

Where do powder cocaine users

tend to reside? As is the case with

their diverse race/ethnicity and SES

classification, powder cocaine users

seem more akin to heroin users than

to crack users in their places of 

residence. Epidemiologic and 

ethnographic sources report both

inner-city and suburban residences for

the various user populations in the

various cities. The suburbs are mentioned specifically for some user

groups (in addition to inner-city

groups) in Birmingham, Detroit, Los

Angeles, Miami, and St. Louis. In

some cities, such as Boston, powder

cocaine use extends from the city into

the outlying areas. In other cities,

such as Seattle and Washington, DC,

many users reside in small affluent

neighborhoods within the city, not

necessarily in the downtown areas.

Then and Now: 

How have powder cocaine users changed across the country 

(1999 vs 2000)?*

According to epidemiologic and ethnographic sources... 

Boston, MA The local high school study shows a small upward “blip,” 

but use remains stable at a low level in that population.

Denver, CO Increased use is reported among those age 25 and younger,

and among females and whites.

Los Angeles, Increases are reported among young people and among whites.

CA The drug is back on college campuses, and some of the stigma 

associated with it attenuating. It is also leaking back into the 

club scene.

Miami, FL A group of multidrug users in the club scene—not necessarily

a new group, but a newly discovered group—includes powder 

cocaine as a ritualistic part of their “evening of drugs.”

Memphis, TN The number of users appears to be increasing slightly.

*No major changes in powder-cocaine-using populations in 15 sites.
CRACK AND POWDER COCAINE

page 32 Pulse Check: Mid-Year 2000

By contrast, 11 of the 14 treatment

sources reporting on place of residence state that powder cocaine users

are more likely to live in inner-city

areas. The suburbs, however, are a

more likely place of residence for

powder cocaine clients in the Sioux

Falls methadone program and the

Detroit non-methadone program; and

powder cocaine clients at the New

York non-methadone program are

more likely to live in rural areas.

Where and with whom is powder

cocaine used? (Exhibit 11) Like

heroin, powder cocaine is usually

used indoors, both privately and in 

social contexts, including private residences, raves, parties, and nightclubs,

as indicated in the table (Exhibit 11).

Street use is reported only in Boston,

El Paso (parks), and Washington, DC

(alleys). Memphis is the only city

where crack houses are mentioned as

a site for powder cocaine use.

Nearly all treatment sources report

that powder cocaine is generally used

in groups. Only in Denver and

Chicago is solo use reported. The

home is the most commonly reported

setting. Other reported settings

include clubs (in Miami), work (in

Denver), and parties (in Columbia

and Washington, DC).

How and with what other drugs

do powder cocaine users take

their drug? Powder cocaine users,

like crack users, often consume 

alcohol, according to epidemiologists

and ethnographers in nearly every

city. In many cities, they combine

powder cocaine with heroin, often in

a speedball, as reported in Chicago,

New York (where speedballs are both

injected and snorted), Philadelphia

(where the combination is cooked

and injected), Seattle, and

Washington, DC. Marijuana is 

another substance commonly 

combined with powder cocaine, as

reported in seven cities: Denver,

Detroit, El Paso, Los Angeles, Miami,

Philadelphia, and Washington, DC. 

Some powder cocaine users also use

ecstasy, as reported by epidemiologists

and ethnographers in several cities: in

Los Angeles, where the two drugs are

part of the “rave salad of drugs”; in

Miami, where the two drugs, along

with “everything else” are part of the

club scene; and in Philadelphia,

where powder cocaine users also 

use propoxyphene (Darvon®), 

oxycodone (Percodan®), and 

phencyclidine (PCP).

Clients in treatment for powder

cocaine use continue to primarily

snort their drug. However, treatment

sources note some exceptions: smoking is reported at the non-methadone

programs in Billings and Birmingham

and at the methadone program in

Washington, DC; freebasing is reported at the Denver non-methadone 

program; and injecting is reported at

the non-methadone programs in

Birmingham and Honolulu and at the

Memphis methadone program. 

Exhibit 11. 

Where and with whom is powder cocaine used?*

City Setting or context

Denver, CO At home; at work

Honolulu, HI At parties; some in homes

Los Angeles, CA At raves; some at schools, dance clubs

Seattle, WA Alone in cars, houses; some at parties

Chicago, IL In apartments; some at parties

Detroit, MI In private settings (same as heroin); some party scene 

Birmingham, AL In fellow user’s house 

Columbia, SC At parties

El Paso, TX In parks, at parties; some in apartment buildings

Memphis, TN In crack houses

Miami, FL At home; some in clubs

New Orleans, LA At home

Washington, DC In abandoned buildings, alleys, apartments; some in clubs, 

parties, bars, apartments

Boston, MA On the street; some at home

New York, NY In private homes, apartments; some in bars, nightclubs

Philadelphia, PA At parties, in groups; some in homes

Portland, ME In residences, more in social context than heroin, fits into 

party drug scene

West Northeast South Midwest

Sources: Epidemiologic, ethnographic, and treatment respondents

*Sources in three sites did not respond: Billings, Sioux Falls, and St. Louis.
CRACK AND POWDER COCAINE

Pulse Check: Mid-Year 2000 page 33

Treatment sources also report that

powder cocaine clients at their 

programs use additional drugs: 

marijuana (in Billings, Birmingham,

Miami, New York, and Sioux Falls);

heroin (in Boston, Miami, and

Columbia [“speedballs”]); LSD

(“acid”) (in Boston); and alcohol (in

Birmingham, Memphis, Miami,

Portland, and Washington, DC).

CRACK COCAINE: THE SELLERS

Who, How, Where, and With What?

How are crack cocaine sellers

organized? According to law

enforcement sources in Pulse Check

cities, crack sellers are seldom affiliated with trafficking organizations,

unlike street-level heroin sellers.

However, similar to heroin sellers,

crack sellers often are involved in

gangs in many cities (Chicago,

Columbia, Denver, Honolulu, Los

Angeles, Memphis, Portland, and

Washington, DC). Law enforcement

sources also report that crack sellers

are independent in some cities,

including Boston, El Paso, Portland

(where they are often crack addicts),

Sioux Falls, and Washington, DC

(where they may have three to four

people working for them).

“Doing a Bump”

According to the Miami epidemiologic

source... 

“In the club scene, a ‘bump’ (line) of

powder cocaine is used to bump up the

clubbers to another level of stimulation

and alertness as an introduction to an

evening of drugs. Cocaine is a ritualistic

part of the evening. These individuals

are cautious about quantity, using only 

a little of each drug.”

Then and Now:

How have crack sellers and sales changed (1999 vs 2000)?

Signs point 

to a decrease in

crack-related

activity in many

Pulse Check

cities:

Signs point to an

increase in crackrelated activity in

some Pulse Check

cities:

Crack marketing

has changed in

several cities:

Crack distribution

methods have

changed in several

Pulse Check cities:

" Boston law enforcement and Detroit epidemiologist: 

Crack-related violence has declined.

" Denver epidemiologist: Crack distribution is diminishing because

of its poor quality.

" Miami law enforcement: “Crack is no longer the primary drug of

sale for most drug dealers; it is sold on the side.”

" Seattle and Washington, DC, law enforcement: The number of

crack houses has decreased.

" Memphis law enforcement: Crack-related gang activity 

has increased.

" New Orleans law enforcement: Crack-related violence 

has increased. 

" Seattle law enforcement: “Recently, crack-related, 

law enforcement activity has increased in central city areas—

the same areas where the crack epidemic of the 1980s and 

1990s occurred.”

" New York ethnographer: “Sellers are starting to sell 

crack rock(s) wrapped in cellophane because crack is now 

available in larger quantities.”

" Philadelphia epidemiologist: “Vials containing crack (referred 

to as ‘skinny’) are starting to reappear.”

" Boston epidemiologist: Crack distribution is becoming more 

discreet, and turf wars are declining.

" Denver epidemiologist: Gang control of crack distribution is

declining in some areas due to the decentralization of gangs. 

" New Orleans epidemiologist: “Crack dealers are now a 

one-stop shop for all types of illicit drugs.”

" Washington, DC, epidemiologist: Young adult sellers 

(typically members of crews) are beginning to use crack.

" Washington, DC, law enforcement: Many formerly 

crack-only dealers have started to sell heroin and crack. 
CRACK AND POWDER COCAINE

page 34 Pulse Check: Mid-Year 2000

Epidemiologic and ethnographic

sources in many cities agree with law

enforcement sources that crack-selling

organizations often involve gangs, as

reported in Chicago, Denver, Detroit,

El Paso, Miami, New Orleans, and

anecdotally in St. Louis and

Washington, DC (where gangs are

loosely organized, smaller than most

street gangs, and known as “crews”).

Only in Honolulu did the Pulse Check

epidemiologic source report crack 

sellers as affiliated with trafficking

organizations (Mexican). In New York,

crack sellers are reportedly independent, and in Philadelphia, crack sellers

are organized, but not as street gangs.

How old are crack sellers? In

almost all Pulse Check cities, law

enforcement officials cite young adults

(18–30 years) as street-level crack

dealers. However, in almost half of the

sites, adolescents (in Birmingham,

Boston, Columbia, Denver, Los

Angeles, New Orleans, Portland, 

St. Louis, and Washington, DC) and

preadolescents (in Denver) are also

involved in crack sales. Young adults

are also the most common age group

reported as crack sellers by 

epidemiologic and ethnographic

sources, although sources also mention

adolescents as sellers in Chicago,

Detroit, El Paso, and New York. In

Washington, DC, older adults, as well

as younger adults, sell crack. As with

heroin, the Honolulu source reports

that youth are picked up in bars in

Mexico and offered free trips to

Hawaii to sell crack there.

Where is crack cocaine sold?

(Exhibit 12) Law enforcement, 

epidemiologic, and ethnographic

sources agree that most crack sales

occur in inner-city areas. However,

law enforcement sources report that in

Birmingham, crack is also distributed

in suburban areas; in Portland, it is

also sold in rural and suburban areas;

and in Philadelphia, it is sold throughout the city. Additionally, the epidemiologic source in New Orleans reports

that crack is sold “everywhere.” 

Crack is sold mostly on street corners,

indoors in private residences, and in

crack houses, according to law enforcement sources. Epidemiologic and

ethnographic sources add that in New

York crack is sold in the street, and in

Portland crack is often sold in hotels. 

How is crack cocaine sold?

Hand-to-hand crack street sales in

cities such as Los Angeles, Memphis,

and Washington, DC, are the most

common way crack is sold. But, as

found in the last issue of Pulse Check,

telephone and beeper sales, as well as

home delivery, continue to be used to

purchase and deliver illegal drugs. For

example, law enforcement sources

cite phone and beeper contact sales as

common in Chicago, Memphis,

Portland, and Sioux Falls. In Sioux

Falls, word-of-mouth contact is also

common. 

Epidemiologic and ethnographic

sources add that telephone orders are

also used to sell crack in Detroit; in

Miami, crack is often sold around a

two-to-three-block area, and the 

buyers and sellers identify one another

with hand signals; in New York, sellers

approach prospective buyers on the

street; in Philadelphia, street sales

involve lookouts, beepers, and hiding

places for crack stashes; and in St.

Louis, dealers often deliver crack to

private residences.

What other drugs do crack 

dealers sell? (Exhibit 13) Crack

dealers are often polydrug sellers, as

was found in the last issue of Pulse

Check. Drugs they sell include heroin,

powder cocaine, marijuana, 

methamphetamine, MDMA, and

diverted pharmaceuticals. In only five

cities (Boston, Chicago, El Paso,

Honolulu, Portland, and Seattle) do

law enforcement sources report that

crack dealers sell no other drugs.

Conversely, epidemiologic and 

ethnographic sources in Chicago and

Portland report that crack dealers

sometimes sell heroin. Also in

Detroit, New York, and St. Louis, 

epidemiologic and ethnographic

sources add that crack dealers 

sometimes sell heroin.

Drug Use Among Crack Sellers 

According to law enforcement sources

in all Pulse Check sites, except for four

(Columbia, Los Angeles, Miami, and

New Orleans), crack sellers use the

drug. The Washington, DC, epidemiologic source reports that young adult

sellers (typically members of “crews”)

are beginning to use crack.

Violence Related to Crack Sales 

According to law enforcement sources

in all cities but El Paso and Seattle,

crack dealers are involved in violence,

including homicides, strong-arm tactics

with other dealers, and turf wars. The

Washington, DC, law enforcement

source states that crack sellers are the

most violent drug-selling group. 

City Snapshots: How do heroin

sales differ from crack cocaine

sales? 

Boston law enforcement: “Crack

cocaine dealers are less discreet than

heroin dealers and are not as involved

in the delivery method of selling their

product.”

Denver epidemiologist: “Fewer beepers

and pagers are used for crack sales than

for heroin sales—crack distribution is a

sloppier market.”
CRACK AND POWDER COCAINE

Pulse Check: Mid-Year 2000 page 35

How is crack packaged and 

marketed? Dealers often sell crack in

small, plastic zipper bags; in plain,

glassine bags; in the torn-off corners of

plastic bags tied with one knot (known

as the “Dominican tie” in some cities);

in bindles; in film canisters; and as

loose “rocks.” Crack containers are

rarely labeled, according to law

enforcement sources. However,

according to epidemiologic and 

ethnographic sources in Portland and

Boston, small plastic bags containing

crack are often stamped with logos,

perhaps to appeal to younger users.

Additionally, epidemiologic and 

ethnographic sources report that in

Boston dealers sometimes sell crack in

balloons, and in New York they sell it

in a variety of differently shaped vials

with variously colored tops and as

“puffs” from a crack pipe. In Seattle,

very small amounts of loose rocks,

known as “kibbles and bits” are sold

to people with little money, as are

“seconds,” the second inhalation of

crack from a pipe. 

POWDER COCAINE: THE SELLERS

Who, How, Where, and With What?

How are street-level powder

cocaine sellers organized?

According to law enforcement sources,

the affiliations of powder cocaine 

distributors vary. The most mentioned

affiliations (in seven cities each) are

gangs and independent sellers. Gangs

are reported in Honolulu, Los

Angeles, and Seattle in the West;

Chicago in the Midwest; and El 

Paso and Memphis in the South.

Independent sellers are reported in 

Los Angeles in the West; Sioux Falls in

the Midwest; El Paso, Memphis, and

Washington, DC (where three to four

people typically work for them) in the

South; and Boston and Portland

(where these sellers are mostly addicts)

in the Northeast.

Compared with heroin, powder

cocaine sellers are not cited as often as

affiliated with trafficking organizations:

only in Denver, where they are affiliated with Mexican and South American

cartels, is sellers’ involvement with 

trafficking organizations mentioned. In

both New Orleans and Washington,

DC, Hispanic organizations are said to

be major sellers of powder cocaine. In

Exhibit 12. Where is street-level crack sold?*

Denver, CO #

Honolulu, HI #

Los Angeles, CA #

Seattle, WA # #

Chicago , IL #

Birmingham, AL # #

Columbia, SC # #

El Paso, TX #

Memphis, TN # #

Miami, FL #

New Orleans, LA # #

Washington, DC ## # #

Boston, MA # #

Philadelphia, PA ## #

Portland, ME # #

Private Crack Shooting

City Street Residences Houses Galleries Cars

Sources: Law enforcement, epidemiologic, and ethnographic respondents

*Sources in four sites did not respond: Billings, Detroit, St. Louis, and Sioux Falls.

Diverted

Powder Mari- Metham- Pharma- No Other

City Cocaine Heroin juana phetamine Ecstasy ceuticals Drugs Sold

Denver, CO # ##

Honolulu, HI #

Los Angeles, CA # #

Seattle, WA #

Chicago, IL #

Detroit, MI #

St. Louis, MO # #

Birmingham, AL #

El Paso, TX #

Memphis, TN #

Miami, FL ## #

New Orleans, LA # #

Washington, DC ## #

Philadelphia, PA #

Portland, ME ## #

Sources: Law enforcement, epidemiologic and ethnographic respondents

*Sources in five sites did not respond: Billings, Boston, Columbia, New York, and Sioux Falls.

Exhibit 13. What other drugs do crack dealers sell?* West Northeast South Midwest Northeast West South Midwest
CRACK AND POWDER COCAINE

page 36 Pulse Check: Mid-Year 2000

Columbia, the nightclub crowd is now

affiliated with powder cocaine sales. 

Epidemiologic and ethnographic

sources add that in El Paso, the nightclub crowd is affiliated with powder

cocaine sales; in Denver, Mexican

nationals tied to Hispanic gangs 

primarily sell the drug; in Philadelphia,

sellers are organized, but not as street

gangs; and in Washington, DC, sellers

are members of crews (small, loosely

organized gangs). 

How old are street-level powder

cocaine sellers? Street-level 

powder cocaine sellers range widely

in age, from 17 to 65 years, with

young adults (18–30) mentioned by

law enforcement sources in 10 cities

(Boston, Columbia, El Paso, Los

Angeles, Memphis, Miami, Portland,

St. Louis, Sioux Falls, and

Washington, DC), followed by older

adults in six cities (Boston, Chicago,

Los Angeles, Memphis, St. Louis, and

Sioux Falls). Law enforcement sources,

including those from Denver, New

Orleans, and Philadelphia, state that

the ages of street-level powder cocaine

sellers range widely.

Similarly, all reporting epidemiologic

and ethnographic sources (nine of

nine) cite young adults as powder

cocaine sellers, followed by older

adults (three of nine sources). Only in

El Paso, are adolescents mentioned as

involved in sales. In Honolulu, as is

the practice with heroin and crack

cocaine sales, youth are reportedly

picked up in bars in Mexico and

offered free trips to Hawaii to sell

powder cocaine there.

Where is powder cocaine sold?

(Exhibit 14) In many Pulse Check

cities, street-level powder cocaine

sales, like heroin and crack sales, take

place in inner-city areas; unlike heroin and crack sales, powder cocaine is

also sold in suburban areas.

Furthermore, many law enforcement

sources, including those in Denver, 

El Paso, Los Angeles, Miami, and

Philadelphia, state that powder

cocaine sales occur citywide. The

Memphis epidemiologic source

reports that powder cocaine sales are

more widespread throughout the city

than crack sales.

Powder cocaine is sold throughout

the United States indoors in residences, outdoors on the street,

indoors in commercial buildings

(including nightclubs, private bars,

and restaurants), and in crack houses.

According to the Memphis law

enforcement source, its sale is more

covert than crack or heroin sales.

Additionally, epidemiologic and

ethnographic sources report powder

cocaine sales in cars, houses, and bars

in El Paso, houses and hotels in

Portland, homes in St. Louis, and

homes and nightclubs in New York. 

Then and Now:

How have street-level powder cocaine sales changed (1999 vs 2000)?

Powder cocaine

distribution

has changed 

in several Pulse

Check cities:

Club drug sales

are changing 

the way powder

cocaine is sold in

some Pulse Check

cities: 

" Boston law enforcement: The more discreet delivery service

method of sale was not seen 1 year ago.

" Chicago law enforcement: Sales are more discreet than they were

1 year ago. 

" Denver epidemiologist: “One-on-ones” (equal amounts of heroin

and powder cocaine) are no longer sold.

" Los Angeles law enforcement: The number of powder cocaine

sellers has increased.

" Miami law enforcement: Violence among Haitian cocaine-selling

organizations (which was rated as very high) has increased, but

violence among Jamaican cocaine-selling organizations has

declined.

" Columbia law enforcement: The nightclub crowd is increasingly

affiliated with powder cocaine sales. “Powder cocaine may be

becoming the drug of choice in that setting.”

" Columbia law enforcement: Now MDMA sometimes is sold 

with powder cocaine. 

" New Orleans law enforcement: “As rave drug sales 

have increased in certain settings (raves and nightclubs), powder

cocaine sales have decreased.”

Drug Use Among Cocaine Sellers

Most law enforcement sources state that

powder cocaine sellers use their product.

Nearly all independent powder cocaine

sellers are said to use the drug, while

fewer organized sellers reportedly use it. 

Violence Related to Powder

Cocaine Sales 

Violence is associated with powder

cocaine sales in all reporting cities, except

for El Paso and Washington, DC, 

according to law enforcement sources.
CRACK AND POWDER COCAINE

Pulse Check: Mid-Year 2000

How is street-level powder

cocaine sold? Most powder cocaine

transactions, according to Pulse Check

law enforcement sources, involve a

phone or beeper; further, in many

cities, sellers use a delivery service

method, in which dealers have lists 

of contacts, and sellers drive to customers’ houses to deliver the product.

Only sources in Washington, DC, and

Memphis mention hand-to-hand

powder cocaine sales. 

Reporting epidemiologic and ethnographic sources concur with law

enforcement sources that powder

cocaine sales typically involve beepers, telephone orders, deliveries, and

meetings between sellers and buyers.

In St. Louis, sales reportedly occur

through acquaintance networks.

What other drugs do powder

cocaine dealers sell?

(Exhibit 15) According to law

enforcement sources, other drugs sold

by powder cocaine dealers include

heroin, crack cocaine, marijuana,

methamphetamine, and MDMA.

Epidemiologic and ethnographic

sources (in Detroit, El Paso,

Philadelphia, and Portland) agree

with law enforcement sources that

heroin is often sold by powder

cocaine dealers. The Denver 

epidemiologic source reports that

some crack and heroin dealers sell

powder cocaine. 

How is street-level powder

cocaine packaged? Powder

cocaine is sold mostly in plastic 

sandwich bags in Pulse Check cities,

although it is also sold wrapped in tin

foil (in Chicago and Denver), paper

diamond folds (“bindles”) (in El Paso

and Portland), in corners of plastic

bags knotted around the drug (in El

Paso), in manilla baggies (in Miami),

and in small glass vials (in Sioux

Falls). In Miami, the manilla baggies

are stamped with pictures, such as

unicorns, which serve as brand identifications. Cartoon characters stamped

on powder cocaine packaging often

serve as brands in Chicago. Law

enforcement sources from most

Denver, CO #

Honolulu, HI #

Los Angeles, CA # #

Seattle, WA #

Chicago , IL #

St. Louis, MO #

Sioux Falls, SD #

Birmingham, AL # ##

Columbia, SC #

El Paso, TX # # ##

housing 

New Orleans, LA developments #

Washington, DC #

Boston, MA #

New York, NY # #

Philadelphia, PA ## #

Portland, ME # #

City Private Crack Nightclubs/

Street Residences Houses Bars Cars

Exhibit 14. Where is street-level powder cocaine sold?*

Sources: Law enforcement, epidemiologic, and ethnographic respondents

*Sources in four sites did not respond: Billings, Detroit, Memphis, and Miami

City Heroin Crack Marijuana Metham- Ecstasy No Other

Cocaine phetamine Drugs Sold

Denver, CO ###

Honolulu, HI #

Los Angeles, CA #

Seattle, WA # #

Chicago, IL #

Detroit, MI # #

St. Louis, MO #

El Paso, TX # #

Memphis, TN # #

Miami, FL ## #

New Orleans, LA # #

Washington, DC #

Philadelphia, PA # #

Portland, ME # #

Exhibit 15. What other drugs do powder cocaine dealers sell?*

West Northeast South

West Northeast South Midwest

Midwest

Sources: Law enforcement, epidemiologic, and ethnographic respondents

*Sources in six sites did not respond: Billings, Birmingham, Boston, Columbia, New York, and

Sioux Falls.

page 37
CRACK AND POWDER COCAINE

page 38 Pulse Check: Mid-Year 2000

reporting Pulse Check cities (including Columbia, Honolulu, Memphis,

Portland, and Sioux Falls) state that

brand names are not used on powder

cocaine packaging.

Additionally, epidemiologic and

ethnographic sources report the use

of balloons for packaging powder

cocaine in El Paso and Boston. In

Detroit, “seals” (paper wrappers that

resemble magazine covers and do not

absorb the powder) are often used to

package powder cocaine; in Miami,

pictures on plastic bags sometimes serve

as brands; and in Washington, DC,

“Pacman” was reportedly used as a

brand name in 2000. 

COCAINE: THE COMMUNITY

What is the impact and 

community reaction to the

cocaine problem? According to 

epidemiologic and ethnographic

sources, the high levels of cocaine use,

despite its stabilization in many communities, continues to affect events and

the quality of life in those communities

in a variety of ways:

! Birmingham, AL: Studies of crack

users who successfully participate

in treatment show a substantial

reduction in their risk for HIV.

The epidemiologic source notes

the connection between crack use

and HIV risk, particularly surrounding unsafe and risky sexual

activity, for both men and

women—suggesting that the perception of injecting as the main

source for an increase in HIV is

not necessarily true.

! Denver, CO: Deaths involving

cocaine and heroin have been

increasing over the past several

years. But the two types of mortality stem from different causes: the

heroin-related deaths result from

both the increase in new users and

from purity changes; the cocainerelated deaths are more related to

older users whose addiction has

intensified and whose health has 

deteriorated.

! Detroit, MI: A decline in the

homicide rate reflects a long-term

decline in heroin- and crackrelated violence.

! Honolulu, HI: A large multidrug,

multiperson bust in neighboring

Maui early in 2000 involved large

amounts of cocaine (as well as

black tar heroin and methamphetamine), temporarily impacting

cocaine availability.

! Memphis, TN: A dramatic

increase in Department of Housing

and Urban Development (HUD) 

housing initiatives, particularly for

the homeless, is believed to have

contributed to a slight decline in

alcohol abuse and cocaine use.

! New Orleans, LA: A regional task

force on cocaine and heroin use,

consisting of regional and local

police departments and sheriffs in

many Louisiana parishes, as well as

the Drug Enforcement Administration (DEA) and Food and Drug

Administration (FDA), is considering the inclusion of the New

Orleans area due to its drug problem.

! Seattle, WA: With the area’s 

economic boom, and the 

gentrification of the downtown

area, more attention is being

focused on “cleaning up the street,”

particularly with regard to the

street trade of crack. Local businesses’ efforts to develop the downtown area into a destination point

have led the press to change their

profile of the crack situation, with a

greater attention to quality of life.

The resulting community response

has been a coordinated one, not

just involving law enforcement, and

has included the rise of drug courts

over the past 3 years. The media

has been increasingly focusing on

the record number of crack arrests,

even mapping out the course of

those arrests.

Law enforcement sources also note a

variety of interrelationships between

cocaine use, community life, community events, and community responses:

! El Paso, TX: Gang activity and

prostitution associated with

cocaine has remained stable.

! Los Angeles, CA: Violent criminal

acts (turf issues) and nonviolent

criminal acts (robberies and 

burglaries) have increased. The

level of prostitution activities 
CRACK AND POWDER COCAINE

Pulse Check: Mid-Year 2000 page 39

related to cocaine, however, has

remained stable.

! Miami, FL: A seizure in the first 

2 months of 2000 involved 3,436

pounds of cocaine. In addition,

nonviolent criminal acts associated

with cocaine have increased.

! Philadelphia, PA: Large cocaine

seizures are reported. For example,

a recent seizure of 75 pounds of

cocaine has impacted somewhat on

the cocaine supply.

What cocaine treatment issues

do communities face? Treatment

sources point out several interrelationships between the cocaine

problem, the treatment system, and

community issues such as law

enforcement referrals, funding, 

outreach, and prevention programs:

! Birmingham, AL: Cocaine-related

problems have caused longer 

waiting lists and increased the

need for case management. The

increase in waiting lists has caused 

treatment providers to refer 

clients out to other programs. 

! Miami, FL: The number of

cocaine users needing treatment

has increased, but the number of 

available treatment slots is limited.

Program outreach is responsible

for an increase in prevention 

and awareness.

! New Orleans, LA: Law 

enforcement referrals to cocaine

treatment are increasing, 

particularly through drug courts.

The increase has caused programs

to function at high capacity.

Insufficient funding for cocaine

treatment has left gaps in treatment follow-through. Women and

children are sent to special treatment facilities.

! Sioux Falls, SD: Outreach and 

prevention has helped reduce 

numbers in treatment.
MARIJUANA

page 40 Pulse Check: Mid-Year 2000

MARIJUANA: THE PERCEPTION

How serious a problem is 

marijuana in Pulse Check

communities? During this reporting

period, marijuana was perceived as

the most serious drug problem by 7

sources in 6 Pulse Check cities (10 

percent of 70 responding sources):

Billings, Denver, and Los Angeles in

the West; Sioux Falls in the Midwest;

Columbia (South Carolina) in the

South; and Boston in the Northeast.

Overall, it is the third most commonly named “most serious” problem in

the 20 Pulse Check cities—the same

as methamphetamine—following

cocaine and heroin. Furthermore,

marijuana is considered the second

most serious drug problem by 15

sources in 10 cities (23 percent of 66

responding sources): Billings,

Birmingham, Chicago, Columbia,

Detroit, El Paso, Honolulu,

Memphis, Sioux Falls, and St. Louis. 

Has the perception of the 

marijuana problem changed

between 1999 and 2000? No

changed perceptions are reported:

any sources who perceived marijuana

as their community’s most serious

drug problem during 2000 also listed

it as such in 1999. However, the epidemiologic source in Honolulu notes

an increase in the marijuana problem

following decreased interdiction

efforts on the Big Island of Hawaii;

and the Washington, DC, epidemiologic source notes increased press

coverage of marijuana trafficking.

MARIJUANA: THE DRUG

Availability, Purity, and Price

How available is marijuana

across the country? (Exhibit 1)

Of the 34 law enforcement, 

epidemiologic, and ethnographic

sources discussing this question, the

vast majority (91 percent) report 

marijuana, in all its varieties, as widely

available—consistent with reports

from the last few issues of Pulse

Check. Only three sources describe

the drug as “somewhat available” 

(the law enforcement sources in

Boston, Chicago, and El Paso).

The most common variety of 

marijuana is locally produced 

commercial grade, ranked as widely

available by 20 law enforcement, 

epidemiologic, or ethnographic

sources in 14 Pulse Check cities (71

percent of 28 responding sources)

spanning all regions of the country:

Billings, Denver, Honolulu, and

Seattle in the West; Sioux Falls

and St. Louis in the Midwest; El

Paso, Memphis, Miami, New

Orleans, and Washington, DC, in the

South; and New York, Philadelphia,

and Portland (Maine) in the

Northeast. Only three sources report

marijuana as only “somewhat available,” four report it as not very available, and only one source (in Miami)

rates it as not available at all. 

Exhibit 1.

How available are the different forms of marijuana?

Sources: Law enforcement, epidemiologic, and ethnographic respondents

100

90

80

70

60

50

40

30

20

10

0

In general

(N= 34)

Not Very Available

Widely Available

Percent

Somewhat Available

Sinsemilla

(N=26)

Local commercial

grade

(N=28)

Mexican

Commercial

(N=28)

British

Columbian

(N=28)

Not Available

Exhibit 2.

How has marijuana availability

changed (1999 vs 2000)?*

Billings, MTL

Birmingham, ALE

Denver, COL

El Paso, TXE

Miami, FLE

New York, NYE

Portland, MEL,E

Sioux Falls, SDE

Birmingham, ALL

Boston, MAL,E

Columbia, SCL

Denver, COE

El Paso, TXL

Honolulu, HIL

Los Angeles, CAL

Memphis, TNL

Miami, FLL

New York, NYL

New Orleans, LAL,E

Philadelphia, PAL,E

Sioux Falls, SDL

Seattle, WAL,E

St. Louis, MOL,E

Washington, DCE**

Chicago, ILL

L Law enforcement respondents 

E Epidemiologic/ethnographic respondents

*Sources in Detroit did not respond.

**Respondent reports that availability “fluctuates.”
MARIJUANA

Pulse Check: Mid-Year 2000 page 41

Mexican commercial grade is the 

second most common variety reported in Pulse Check cities, cited as

widely available by 13 sources in 12

cities (46 percent of 28 responding

law enforcement, epidemiologic, and

ethnographic sources), again spanning

all regions of the country: Billings,

Denver, Honolulu, and Los Angeles

in the West; Chicago, Sioux Falls, and

St. Louis in the Midwest; Birmingham

and El Paso in the South; and Boston,

New York, and Philadelphia in the

Northeast. Another 10 sources in 8

cities consider Mexican commercial

as somewhat available, two sources

(in Boston and Miami) rate it as not

very available, and three sources (in

New Orleans, Philadelphia, and

Washington, DC) say Mexican 

commercial marijuana is not available

at all in their communities. 

Sinsemilla, or the seedless variety of

marijuana, is the third most common

type of marijuana available in Pulse

Check cities. It is reported as widely

available by 9 sources in 7 cities (35

percent of 26 responding sources):

Billings, Denver, and Honolulu, in the

West; St. Louis in the Midwest;

Memphis and Miami in the South;

and Portland in the Northeast. It is

considered somewhat available by

another 12 sources in 10 cities, and

not very available by 5 sources in 5

different cities.

One of the least commonly reported

marijuana varieties is British

Columbian (“BC bud”), with only two

sources (in Billings—perhaps due to its

proximity to the Canadian border—

and New York) reporting it as widely

available, and six sources (in Billings,

Denver, Miami, Portland, Seattle, and

Sioux Falls) reporting it as somewhat

available. By contrast, it is considered

not very available by 10 sources in 9

cities, and not available at all by 7

sources in 6 cities. Another variety,

Jamaican or Caribbean marijuana, is

reported in Miami. 

Has marijuana availability

changed? (Exhibit 2) Availability of

marijuana remains stable at high levels

in 14 Pulse Check cities, according to

about two-thirds (n=19) of the 29

responding epidemiologic, ethnographic, and law enforcement sources

who discussed this subject. Only nine

sources (31 percent) in eight cities

report increased availability, and only

one source—a law enforcement official

in Chicago—reports a decline.

Similarly, the majority of law 

enforcement, epidemiologic, and

ethnographic sources report that

availability for the different marijuana

varieties has remained stable, and

nearly all the remaining sources

report increased availability. Only five

cases of declining availability are

reported: for Mexican commercialgrade, by the law enforcement source

in Billings; for sinsemilla, by the

ethnographic source in El Paso and

the epidemiologic source in Sioux

Falls; and for British Columbian 

marijuana, by the ethnographic

source in El Paso and the 

epidemiologic source in Seattle.

How potent is marijuana across

the country? (Exhibit 3) According

to law enforcement, epidemiologic,

and ethnographic sources, the

tetrahydrocannabinol (THC) content

of commercial-grade marijuana ranges

from 4 to 15 percent in Pulse Check

cities, with most at the lower end of

that range. Sinsemilla, a higherpotency marijuana, ranges from 5 to

30 percent THC content, and British

Columbian ranges from 15 to 30

percent. Hydroponic marijuana

(“hydro”), available in most Pulse

Check cities, is a high-potency 

marijuana, with a typically higher

THC content than sinsemilla. In 

New York, it is more potent and

much more popular than local, 

outdoor-grown marijuana (“bio”). 

Exhibit 3. 

Marijuana prices by ounce, by

type and city*

OUNCE PURITY

CITY PRICE (% THC)

Commercial

grade (domestic 

or Mexican)

Billings, MT $120 NR

Birmingham, AL $20–$25 NR

Boston, MA $100–$200 NR

Columbia, SC $80–$150 NR

Denver, CO $100–$300 4.5%

El Paso, TX $200–$300 NR

Los Angeles, CA $300–$500 4–6%

Memphis, TN $50 NR

Miami, FL $200–$400 NR

New Orleans, LA $20–$120 NR

Philadelphia, PA $150–$200 NR

Portland, ME $350 NR

Seattle, WA $150 8–15%

Sioux Falls, SD $50–$500 NR

Washington, DC $120 NR

Sinsemilla

Denver, CO $100–$500 15–20%

El Paso, TX $40 NR

Honolulu, HI $400–$800 5–21%

Los Angeles, CA $1,000–$2,000 20–25%

Miami $400 12–26%

New York, NY $70–100 NR

Portland, ME $450 NR

British 

Columbian 

(BC) bud

Denver $500 15–20%

Seattle $300–425 20–30%

Sources: Law enforcement, epidemiologic,

and ethnographic respondents

*Respondents in Chicago, Detroit, and 

St. Louis did not provide this information.
MARIJUANA

page 42 Pulse Check: Mid-Year 2000

Then and Now: 

How have marijuana users changed (1999 vs 2000)?*

According to epidemiologic and ethnographic sources... 

Denver, CO The number of younger (<18) users has declined, the number of older (35+) users has increased, and the number 

of users age 18–34 has remained stable. 

Memphis, TN More young people appear to be smoking marijuana, and the number of black female marijuana users has increased.

Miami, FL Some users have recently revived an old practice, which supposedly increases marijuana’s THC level: they roll 

a big joint of marijuana, dip it into a new product known as “hash oil” (see description on page 45), let it dry, then

smoke it.

New York, NY Younger users are getting even younger (12 and 13 years old). Many youngsters smoke “bidis” or 

“beedies”—thin, brown, 3-inch long Indian cigarettes surrounded by a pink thread—pretending that they 

are marijuana joints (although they contain tobacco)

Philadelphia, While marijuana users appear to be aging, an increase is noted among teens. The number of black 

PA users is also increasing.

Washington, Continuing an ongoing trend, the number of female marijuana users has increased.

DC

What are street-level marijuana

prices across the country?

(Exhibit 3) Commercial-grade 

marijuana prices range from $20–$25

per ounce in Birmingham to

$300–$500 per ounce in Los Angeles.

Sinsemilla and British Columbian

prices tend to be higher. Hydroponic

marijuana costs $800–$2,500 per

pound in New York and $400–$600

per pound in Washington, DC.

Marijuana joints, blunts, and bags are

common quantities sold in Pulse

Check cities: commercial-grade blunts

range from $5 in Philadelphia to

$10–$20 in Washington, DC; 

commercial-grade joints range from

$1–$3 in Columbia to $10–$15 in

Los Angeles; and $5, $10, and $20

street bags can be purchased in many

cities, including Chicago, Philadelphia,

and Washington, DC. In Miami, 

marijuana dealers often sell hash oil

(1–20 percent THC content) at $25

per ounce.

How is marijuana referred to

across the country? (Exhibit 4)

Similar to reports in previous Pulse

Check issues, “grass,” “Mary Jane,”

“pot,” “reefer,” and “weed” remain

the common slang terms for marijuana

throughout the United States. Other

marijuana street names vary by geographic region. In Chicago, “philips”

is new slang (in 2000) for marijuana.

MARIJUANA: THE USERS

Who, Where, How, and With What?

How have marijuana users been

changing across the country?

Epidemiologic and ethnographic

sources generally agree that marijuana

use appears to have stabilized at elevated levels, covering a wide range of

demographic and socioeconomic

groups. In Portland, Maine, for 

example, marijuana users continue to

Has marijuana potency changed?

THC levels increased in seven Pulse

Check cities between 1999 and 2000,

while levels declined in only one city:

As reported in the last Pulse Check

issue, most sources attribute any 

increases to improved cultivating 

techniques by marijuana growers 

(especially hydroponic growers).

Chicago, IL

Denver, CO

El Paso, TX

Memphis, TN

New York, NY

Sioux Falls, ND

Washington, DC

Billings, MT

Have marijuana prices changed?

Prices increased in only three of the

seven Pulse Check cities where THC

levels increased; thus, in Denver, El

Paso, Memphis, and Washington, DC,

potency is up, but prices are stable.

Prices declined in two cities.

Chicago, IL

New York, NY

Sioux Falls, SD

Columbia, SC

Honolulu, HI

* No major changes in marijuana-using populations are reported by sources in 14 sites.
MARIJUANA

Pulse Check: Mid-Year 2000 page 43

outnumber heroin and cocaine users.

Some changes, however, are noted in

a few cities, as indicated above.

How old are marijuana users?

As reported in Pulse Check issues over 

the past few years, marijuana users

continue to span all ages, according to

epidemiologic and ethnographic

sources in many cities. In Portland,

Maine, for example, marijuana use is

initiated in high school and use continues through middle age. Similarly, the

St. Louis epidemiologic source reports

fairly high use “among everyone, from

teenagers up to adults in their early

fifties.”

Adolescent users often outnumber 

the young adult and older adult user

groups, according to epidemiologic

and ethnographic sources in Boston,

Columbia, Denver, El Paso, Seattle,

Sioux Falls, and St. Louis. El Paso has

the youngest reported age range

(10–14 years) for the group most likely to use marijuana; by contrast, that

city also has the oldest age range

(45–54) reported for the group second

most likely to use marijuana. Users as

young as 10 years are also reported in

Honolulu, and 12-year-old users are

reported in New York and Seattle.

The Denver epidemiologic source

suggests that the older (35+) group is

increasingly using the highly potent

and readily available marijuana in the

mistaken notion that it alleviates “the

aches and pains of getting older.”

According to treatment sources, 

adolescents outnumber other age

groups among marijuana clients at

programs in 11 of the 20 Pulse Check

cities: Billings, Boston, Chicago,

Columbia, Denver, Detroit, Los

Angeles, Miami, New Orleans,

Portland, and Sioux Falls. Young adults

are more likely to use marijuana at

reporting programs in the other

cities. Pre-adolescents constitute the

second largest group of marijuana

clients at programs in Billings and

Sioux Falls. In Seattle, treatment

sources report that the availability of

potent marijuana has promoted more

use and related debilitating circumstances. Some treatment sources, as in

Boston, report that a growing number

of adolescents consider marijuana use

to be safe. 

Are there any gender differences

in who uses marijuana? In four

Pulse Check cities—Honolulu, Los

Angeles, New Orleans, and Portland—

males and females are equally likely

to use marijuana, according to epidemiologic and ethnographic sources.

Elsewhere, males outnumber females

within the larger user groups. In

many of those cities, however, such as

Memphis, the percentage of users

who are females is larger for marijuana than for other drugs. Moreover, in

Billings, females outnumber males in

that city’s younger (age 15–24) and

smaller user group. 

Treatment sources concur that most

marijuana users in their programs are

male. However, at programs in

Chicago, New York, and Sioux Falls,

females are more likely to be in treatment for marijuana use than males. In

Birmingham, female and male users

are about equal in number. Female

users appear to be catching up to

their male counterparts at programs

in several Pulse Check cities, including

El Paso, Honolulu, Memphis, and

Portland.

Is any racial/ethnic or socioeconomic group more likely to

use marijuana? Even more than the

heroin problem, the marijuana 

problem cuts across all racial/ethnic

groups. Epidemiologic and ethnographic sources report that racial/

ethnic distributions are fairly representative of their respective cities’ 

populations in Boston, Chicago,

Honolulu, Los Angeles, New Orleans,

New York, and St. Louis. White users

are more prominent in Birmingham,

Denver (but they are underrepresented

there), Miami (where Hispanics are a 

Exhibit 4. 

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

WEST

Doobies (joints), Jane,

13, smack, chronic,

green, reefer, carb, MJ

Philips (new),

bud, happy smoke

MIDWEST NORTHEAST

SOUTH

Bio (outdoor grown,

commercial-grade),

hydro (hydroponic),

stogies, blizzies,

dutchies, L’s (blunts),

ditchweed (local,

outdoor-grown)

Wood, tree, hay, broccoli, greeny

green, herb, bud, smoke, MJ, morta,

bud, mata, mota, gunge, Acapulco

gold, Maui wowie, kryptonite, fire,

woodie, hash, stick, black rope,

hydro (hydroponic) 

Bud, Maui wowie, Kona

gold, ganja, pakalolo

(crazy tobacco)

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

page 44 Pulse Check: Mid-Year 2000

close second), Portland, and Seattle.

Blacks are more likely to use marijuana in Columbia, Detroit (where they

are overrepresented), Memphis,

Philadelphia, and Washington, DC.

Treatment sources in the majority of

cities, more so than epidemiologic and

ethnographic sources, report that marijuana users in their programs are predominantly black. Whites, however,

predominate among marijuana clients

at programs in Boston, Denver, Miami,

Portland, and Sioux Falls. Reflecting

general population distributions in

their respective cities, Hispanics are

the largest racial/ethnic group among

marijuana clients at the programs in

Los Angeles and El Paso, and Asian/

Pacific Islanders are the predominant

group in treatment in Honolulu. In

the Sioux Falls methadone program,

Native Americans constitute the second largest group of marijuana clients.

As with race/ethnicity, marijuana use

knows no socioeconomic bounds: 

epidemiologic and ethnographic

sources report that all SES groups are

represented relatively evenly among

marijuana users in at least 10 Pulse

Check cities: Boston, Chicago, Denver,

Detroit, Honolulu, Los Angeles, New

Orleans, Portland, Seattle, and Sioux

Falls. Similarly, marijuana use cuts

across all SES groups in Miami, but

the middle class predominates there; it

also runs the gamut of SES groups in

New York, but lower-to-middle SES

groups are cited as more prominent;

and it is found among all groups in St.

Louis, but it is slightly more common

among that city’s lower SES groups.

By contrast, epidemiologic and ethnographic sources do note predominance

of specific SES groups in five cities. In

Birmingham, the largest group of 

marijuana users is in the middle SES

group; the lower middle class is cited

in El Paso; the lower-to-middle SES

groups are cited in Memphis; and the

lower SES groups are cited in

Philadelphia and Washington, DC.

Both the lower and middle SES groups

are represented among marijuana

clients at reporting non-methadone

programs in Pulse Check cities. The

lower SES group is more likely to use

marijuana at the programs in Billings,

Chicago, El Paso, Honolulu, New

York, New Orleans, and Washington,

DC. The middle SES group, however,

has higher representation at the 

non-methadone programs in Denver,

Detroit, Miami, Memphis, and

Portland.

Where do marijuana users tend

to reside? More so than other drug

users, marijuana users reside “everywhere”—a term used by numerous

responding epidemiologists and

ethnographers to refer to inner-city,

other urban, suburban, and rural

places of residence. Two of the few

exceptions are Birmingham, where

marijuana users are reportedly more

likely to reside in the suburbs, and

Philadelphia, where urban areas

reportedly predominate.

Treatment sources paint a slightly 

different picture, however, with the

majority of marijuana clients at the

reporting non-methadone programs

generally residing in inner-city areas.

Suburban users, however, reportedly

predominate at the non-methadone

programs in Denver, New York, and

Portland, while rural users are most

prominent at the Billings and

Honolulu programs.

How do marijuana users wind up

in treatment? (Exhibit 5) Of the 

17 non-methadone treatment sources

discussing this question, nearly half

(47 percent, n=8) report that 

marijuana clients at their programs

come mainly from court or criminal

justice referrals—more so than crack

clients (40 percent) or heroin clients

(38 percent). By comparison, schools

are the primary referral source for

marijuana clients at only three 

programs (in Billings, Detroit, and

Portland), and other health care

providers are the primary referral

source at another three (in Boston,

Honolulu, and New York).

How do marijuana users take 

marijuana? As was found in the last

few Pulse Check issues, “blunts,” or

hollowed-out cigars, are reported 

Exhibit 5.

How are different drug users referred to treatment?

Sources: Non-methadone treatment respondents

50

40

30

20

10

0

Court/crim- School Other health Individual Other com- Alcohol/DA

inal justice provider munity referral care provider

Marijuana Crack

Percent (N=17)

Heroin
MARIJUANA

Pulse Check: Mid-Year 2000 page 45

as common vehicles for smoking 

marijuana in several cities, including

Boston, Chicago, Philadelphia, and

Washington, DC, according to 

epidemiologic, ethnographic, and

treatment sources. Boston marijuana

users also reportedly smoke “bongs”

and “joints.” Detroit and New

Orleans, by contrast, do not have

large blunt cultures. Joints are the

most common marijuana vehicle in

those cities, as well as in Los Angeles

and Portland. In Seattle, grams of

“bud” are smoked through glass pipes

or other pipes.

What other drugs do marijuana

users take? Epidemiologic and

ethnographic sources in nearly every

Pulse Check city report that marijuana

users also use alcohol (sometimes malt

liquor). Cocaine use is also reported

among marijuana users in some cities.

For example, blunts in Boston and

Philadelphia sometimes contain 

marijuana combined with either 

powder cocaine or crack. In New

York, marijuana is combined with

powder cocaine in either a blunt or a

cigarette. Crack is also reportedly used

by marijuana smokers in Washington,

DC (as a dip, and sometimes including

heroin too), and Detroit. Adolescent

marijuana smokers in the Miami 

suburbs use both forms of cocaine. 

Heroin is sometimes included in

blunts in Boston and in either 

cigarettes or blunts in New York. 

Also in New York, marijuana is 

sometimes dipped in phencyclidine

(PCP). PCP use by marijuana smokers

is also an ongoing problem in 

Philadelphia, where the Pulse Check

epidemiologic source reports occurrences of hallucinogenic behavior,

such as people jumping into traffic 

or off buildings. In New Orleans, by

contrast, PCP lacing is not the norm

but, rather, an occasional practice by

“uptown” affluent young marijuana

users. A Washington, DC, treatment

source reports that clients are 

smoking high-purity marijuana laced

with PCP.

Some epidemiologic and ethnographic

sources mention other drugs used by

marijuana smokers: flunetrazepam

(Rohypnol) in El Paso; alprazolam

(Xanax®) in Philadelphia; and methylenedioxymethamphetamine

(MDMA, or “ecstasy”), lysergic acid

(LSD), and some methamphetamine

among a small group of young, white,

middle-class partygoers and clubgoers

in Washington, DC.

Treatment sources, like epidemiologic

and ethnographic sources, report that

marijuana is used most commonly

with alcohol. Additionally, marijuana

users, both at their programs and 

in their local communities, also use

cocaine (in Birmingham, Chicago,

Columbia, Detroit, El Paso,

Honolulu, Los Angeles, and Miami),

PCP (in Chicago), club drugs 

(in Denver), methamphetamine (in

Billings and Seattle), and ice (in

Honolulu, where the marijuana 

supposedly smooths out the effects 

of ice).

“Hash Oil” or “Jamaican Crude”: 

A New Substance Used in a New 

Practice

Miami, FL: Not the traditional, highly

refined “hash oil,” this new product is

a highly flammable, highly viscous dark

green (almost black) oil. It is produced

by a crude operation: after the marijuana plant harvest, the leftovers are

boiled down in 55-gallon drums and

shipped in gas containers. Some users

dip marijuana joints into this substance,

let it dry, and then smoke it, believing

that this practice increases the 

marijuana’s THC level.

What are some slang terms for

drug combinations involving 

marijuana?

The New York ethnographer reports

several street names for marijuana 

combinations:

!$$“Illie” or “illing”: Marijuana dipped

in PCP

!$$“B-40”: A blunt plus a 40-ounce 

bottle of beer or malt liquor, via one

of two techniques:

Users dip the blunt into the “40,”

drip-dry it, and smoke it, or they puff

the blunt, blow smoke into the 40,

shake it, and drink it.

!$$“Coolie”: Marijuana plus powder

cocaine in a cigarette or blunt

!$$“Woola” or “woolie”: Marijuana plus

heroin in a cigarette or blunt

Elsewhere, treatment sources report

additional terms:

!$$“Happy stick”: The Chicago term for

marijuana laced with PCP

!$$“Primo”: The Chicago term for 

marijuana plus powder cocaine

!$$“Geek joint”: The Columbia and

Miami term for marijuana laced 

with cocaine and smoked

!$$“Tobacco 51s”: The Detroit term 

for marijuana plus cocaine
MARIJUANA

page 46 Pulse Check: Mid-Year 2000

Where and with whom is 

marijuana used? The word 

“everywhere,” once again, is 

frequently mentioned by Pulse Check

epidemiologic and ethnographic

sources, not just in response to where

marijuana users reside, but also in

response to where they use the drug.

From the malls and railroad tracks of

El Paso to the beaches of Honolulu

to the reggae concerts of Miami,

marijuana is used in a wide range of

settings and contexts, both indoors

and outdoors, both alone and 

socially.

Similarly, treatment sources report that

marijuana users smoke their drug both

alone and socially, and almost anywhere: at home, in cars, at parties, on

the job (as reported in Denver), in the

street, and in other public areas. At

the Seattle methadone program, 

solitary use of marijuana has increased

since the previous reporting period;

however, group use still predominates

at that program and in the greater

local area. Additionally, eight of the

non-methadone treatment sources

report frequent use (four to six times 

a week) or daily use of marijuana in

their local communities (in Billings,

Birmingham, Boston, El Paso, 

Los Angeles, Miami, New Orleans,

Portland).

MARIJUANA: THE SELLERS

Who, How, Where, and With What?

How are street-level marijuana

sellers organized? (Exhibit 6) The

way marijuana sellers are organized

in the United States varies widely,

with independent dealers cited most

often as marijuana dealers. Biker

gangs are mentioned as dealers in

Seattle (where they sell high-quality

British Columbian marijuana) and in 

Detroit. However, street gangs are

mentioned much less often as

involved with marijuana sales than

with heroin or cocaine sales. In

Denver, as with heroin and cocaine,

Mexican cartels are involved with

marijuana sales. In Memphis, some

marijuana is sold by marijuana growers. Epidemiologic and ethnographic

sources add that in Miami, many

small organizations consisting of

3–10 male members sell marijuana.

Then and Now:

How have street-level marijuana sales changed (1999 vs 2000)?

Signs point to

increasing marijuana availability

and sales in some

Pulse Check cities:

Other features and

methods of sales

have changed in

some cities:

" Memphis law enforcement: Indoor marijuana growing increased.

" Philadelphia epidemiologist/ethnographer: “In 2000, we’ve seen

more marijuana availability, more volatility in the market, and

more competition for selling.”

" Washington, DC, law enforcement and epidemiologist/ethnographer: Marijuana sales, use, and related violence have increased.

" Chicago law enforcement: “Marijuana sellers are more 

cautious now.”

" Miami epidemiologist/ethnographer: New people are entering

the marijuana sales business. The weight of street-level marijuana

buys has changed recently: the 1/4- gram amount replaced the

ounce.

" Philadelphia epidemiologist/ethnographer: Sales of 

formaldehyde-soaked marijuana joints increased.

" St. Louis epidemiologist/ethnographer: “Younger, small time

marijuana dealers are beginning to sell ecstasy.”

" Seattle law enforcement: More British Columbian marijuana

(“BC bud”) is staying in the local market. Furthermore, biker

gangs selling the drug may have left the United States for British

Columbia and may be becoming more organized.

" Washington, DC, law enforcement: Law enforcement officials

first encountered local hydroponic marijuana (“hydro”) in 2000.
MARIJUANA

Pulse Check: Mid-Year 2000 page 47

How old are street-level 

marijuana sellers? As with seller

affiliation, the ages of street-level

marijuana sellers vary widely, ranging

from 10 to 65 years. According to

most law enforcement sources,

adolescents and young adults 

predominate among marijuana sellers.

Epidemiologic and ethnographic

sources concur that the ages of 

marijuana dealers range widely. Those

sources cite adolescents and young

adults as the predominant age groups

of marijuana sellers.

Where is street-level marijuana

sold? (Exhibit 7) In reporting Pulse

Check sites, marijuana is sold

throughout the city, with many

sources reporting it as sold “everywhere.” In Birmingham, Boston,

Memphis, and New Orleans, it is sold

in inner-city, as well as suburban,

areas. In El Paso’s inner-city areas,

smaller amounts of marijuana are

sold per transaction than in its suburban areas. In Birmingham, suburban

distributors receive marijuana from

sources outside the State, store large

quantities in the suburbs, then contact city residents to distribute there,

in crack houses and on street corners. 

According to law enforcement

sources, marijuana is sold mostly on

the street, followed by homes and

nightclubs. It is sold in high schools

in New Orleans and even in hospitals

in Columbia. Epidemiologic and

ethnographic sources agree that marijuana is commonly sold in private 

residences, streets, and nightclubs,

but they cite schools as the second

most common place (along with

streets) for marijuana sales. They add

that in El Paso, marijuana is sold at

concerts; in Miami, it is sold at open

street markets; in New York, small

amounts are sold on the street, and

larger amounts are sold indoors; and

in Philadelphia, it is sold in streets,

rundown areas, and abandoned 

buildings. 

How is street-level marijuana

sold? As with the setting of marijuana

sales, marijuana distribution methods

vary widely. Hand-to-hand marijuana

sales are mentioned by Los Angeles,

Memphis, and Washington, DC, law

enforcement sources. Beepers are used

in Memphis, and beepers and cellular

phones are used in Chicago, where

sellers also drive up to residences and

honk. According to the epidemiologist in Boston, most marijuana is sold

through informal networks of friends.

Some telephone ordering of marijuana is reported in Detroit, and delivery

services are noted in St. Louis.

Exhibit 6. How are marijuana 

sellers organized?*

Site How organized? 

Denver, CO Mexican trafficking 

organizations 

Honolulu, HI Independent 

New Orleans, Independent; 

LA crack-dealing gangs 

Seattle, WA Independent; biker 

gangs 

Detroit, MI Biker gangs 

Columbia, SC Closely knit groups 

Miami, FL Small gangs 

Washington, Independent; 

DC Hispanic organized 

groups 

Portland, ME Independent 

New York, NY Independent 

Source: Law enforcement respondents

*Respondents in 10 sites did not provide this

information.

Drug Use Among Marijuana Sellers

Almost all responding law enforcement

sources (15 of 17) report that marijuana sellers use their drug. Only in two

sites (Miami and Seattle) do marijuana 

sellers reportedly not use the drug. 

Marijuana Sales-Related Violence

Violence among marijuana sellers is

reported by law enforcement sources

only in five areas (Birmingham, Boston

[at low levels], Denver, Miami, and

Washington, DC). Epidemiologic and

ethnographic sources agree that 

violence related to marijuana sales is

nonexistent or low level.

Exhibit 7. 

Where is street-level marijuana

sold?

Sources: Law enforcement, epidemiologic,

and ethnographic respondents

10

9

8

7

6

5

4

3

2

1

0

Street

Law Enforcement

Number of cities

Setting

Epidemiologists/

ethnographers

Private

Residences

Nightclubs

In/

Around

Schools

West South Northeast Midwest
MARIJUANA

page 48 Pulse Check: Mid-Year 2000

What other drugs are sold by 

marijuana dealers? (Exhibit 8)

Crack cocaine and heroin are the most

common drugs other than marijuana

sold by marijuana dealers, according to

law enforcement, epidemiologic, and

ethnographic sources. Other drugs sold

by marijuana dealers include powder

cocaine, methamphetamine, ecstasy,

LSD, and PCP. The latter is combined

with marijuana and sold in several

cities, including El Paso, New York,

and Washington, DC. In St. Louis,

younger marijuana dealers sometimes

sell ecstasy, and in Seattle, sources state

that other drugs sold by marijuana

dealers depend on what drugs are

available. In Philadelphia, adolescents

report sales of formaldehyde-soaked

marijuana joints. In five sites (three of

them in them Midwest), no other drugs

are reportedly sold with marijuana. 

How is marijuana packaged and

marketed? The most common 

packaging for marijuana in U.S. cities

is plastic zipper bags, according to

Pulse Check sources. Sources also 

mention wrapped bundles in El Paso,

cigar boxes in New Orleans, and

small, glassine bags or by the bale in

Portland. In Washington, DC, local

hydroponic marijuana (“hydro”) is

packaged in small, glass bottles, and

commercial-grade marijuana is often

sold in $10 “street bags.” Brand names

or labels for marijuana were not mentioned except in New York (where

plastic bags containing marijuana are

stamped with four leaf clover designs),

in El Paso (where brand names include

“red colitas”), and in Miami (where

brand names for sinsemilla include

“krippie” and “Seattle,” and brand

names for commercial-grade marijuana

include “regs”).

MARIJUANA: THE COMMUNITY

What is the impact of and community reaction to the marijuana

problem? Widespread marijuana use

has had a variety of repercussions in

local communities; conversely, the

varied community responses have had

varied impact on the problem:

! Denver, CO: The epidemiologic

source links the recent increase 

in marijuana-related hospital 

emergency room visits to the

increase in new users. 

! Honolulu, HI: After operating for

15 years, the Big Island’s Operation

Green Harvest marijuana eradication effort has been nearly stopped

by threats of legal action against

the county council. The epidemiologic source notes concern about

increased marijuana availability

throughout the State.

! Miami, FL, and New York, NY:

According to treatment sources, 

marijuana has become the target for

program outreach activities. In

Miami, illegal drugs used by youth

are particularly targeted. As a result,

treatment programs are noting more

calls for help from youth, but there

are not enough treatment slots 

available to treat them.

! Portland, ME: Maine’s new medical

marijuana bill, which allows for 

possession of a number of plants,

has not been fully operationalized.

Its impact, notes the epidemiologic

source, remains to be seen.

! St. Louis, MO: According to 

the epidemiologic source, large 

marijuana seizures occur every few

weeks on the local interstate highway, increasing the general public’s

awareness of the problem. A treatment source notes an increase in

marijuana-related media attention in

the local area.

! Washington, DC: The epidemiologic source reports a new sentencing practice: selling more than half a

pound of marijuana, which used to

be a misdemeanor (up to 1 year in

jail), is now considered a 5-year

felony. Also, a recent drug bust in

neighboring Prince George’s County

involved 38 pounds of marijuana.

City Heroin Crack Powder Metham- Ecstasy Halluci- No Other Cocaine Cocaine phetamine (MDMA) nogens Drugs Sold

Honolulu, HI #

Los Angeles, CA #

Seattle, WA ## #

Chicago, IL #

Detroit, MI #

Sioux Falls, SD #

St. Louis, MO ## #

El Paso, TX # ##

Memphis, TN #

Miami, FL # #

New Orleans, LA # #

Washington, DC # #

Boston #

New York, NY #

Portland, ME #

Sources: Law enforcement, epidemiologic, and ethnographic respondents

*Sources in five sites did not respond: Billings, Birmingham, Columbia, Denver, and Philadelphia.

Exhibit 8. What other drugs do marijuana dealers sell?* West Northeast South Midwest
Pulse Check: Mid-Year 2000 page 49

METHAMPHETAMINE: 

THE PERCEPTION

How serious a problem is 

methamphetamine in Pulse

Check communities? During 2000,

methamphetamine was perceived as

the most serious drug problem by 7

responding sources (10 percent of 70)

in 3 cities: Billings and Honolulu in

the West; and Sioux Falls in the

Midwest. Furthermore, it was 

considered the second most serious

drug problem by 6 responding

sources (9 percent of 70) in 5 cities:

Billings and Denver in the West;

Memphis in the South; and Sioux

Falls and St. Louis in the Midwest. 

Has the perception of the

methamphetamine problem

changed between 1999 and

2000? No changes are reported: all

sources who considered methamphetamine as either the first or second

most serious drug problem in their

cities during 2000 also reported that

the drug’s status had remained stable

since the previous year. The drug,

however, was seen as an emerging or

intensifying problem by five sources

in five cities: Denver and Seattle in

the West; Sioux Falls in the Midwest;

Birmingham in the South; and

Philadelphia in the East.

METHAMPHETAMINE: THE DRUG

Availability, Purity, and Price

How available is methamphetamine? (Exhibit 1) More than any

other drug on which Pulse Check

reports, methamphetamine availability

varies by U.S. region: in the West, it is

considered widely available by every

reporting source (in Billings, Denver,

Honolulu, Los Angeles, and Seattle); in

the Midwest, it ranges from widely

available to somewhat available (in

Sioux Falls and St. Louis) to not very

available or not available at all (in

Chicago); in the South, it ranges from

not available (in Miami) to widely 

available (in Birmingham and

Memphis); and in the Northeast,

methamphetamine is reported as either

not very available or somewhat available (by sources in Boston, New York,

Philadelphia, and Portland).

How has methamphetamine

availability changed? (Exhibit 2)

Nearly half (48 percent) of Pulse

Check sources report increases in

methamphetamine availability

between 1999 and 2000, and another

48 percent of responding sources

report stable availability between

those time periods; only 4 percent

report declines. By region, the vast

majority of western sources 

(86 percent) report methamphetamine

availability increases, while southern

and midwestern sources report mostly

increasing or stable trends, and 

northeast sources generally report 

stable trends (85 percent). 

Exhibit 1.

How available is methamphetamine by U.S. region?

METHAMPHETAMINE

100

90

80

70

60

50

40

30

20

10

0

Sources: Law enforcement, epidemiologic, and ethnographic respondents

All regions

(N= 35)

Not Very or Not Available

Widely Available

Percent

Somewhat Available

West

(N=8)

Midwest

(N=6)

Northeast

(N=8)

South

(N=13)

Exhibit 2.

How has methamphetamine availability changed by region?

Sources: Law enforcement, epidemiologic, and ethnographic respondents

100

90

80

70

60

50

40

30

20

10

0

Across the U. S.

(N=27)

Up Stable

Percent

Down

West

(N=7)

South

(N=9)

Northeast

(N=7)

Midwest

(N=4)
METHAMPHETAMINE

page 50 Pulse Check: Mid-Year 2000

What type of methamphetamine is

available? Low- to mid-grade

methamphetamine is the most available type of methamphetamine

according to 10 law enforcement,

epidemiologic, and ethnographic

sources in 7 cities: Billings, Denver,

Los Angeles, and Seattle in the West;

Sioux Falls and St. Louis in the

Midwest; El Paso in the South; and

Boston in the Northeast. “Ice” (nearly

100 percent pure methamphetamine)

is not very available or not available

at all, according to the majority (63

percent) of Pulse Check sources.

However, it is widely available

according to sources in four cities in

the West (Billings, Denver, Honolulu,

and Los Angeles) and one city in the

South (Memphis). Ice is considered

“somewhat available” by sources in

only three cities: Birmingham, El

Paso, and New York.

Most methamphetamine available 

in the United States is produced in 

clandestine labs, either in Mexico or

locally. The ephedrine/pseudoephedrine reduction method and coldcooking method (“nazi method” made

with anhydrous ammonia and lithium)

are the two types of methamphetamine

manufacturing most cited by Pulse

Check sources, and many sources

report both methods within one area.

Two other methods mentioned are the

red phosphorous and the phenyl-2-

propanone (P2P) methods. Local 

clandestine lab “busts” (especially in

rural areas) seem to be increasing in

many Pulse Check cities, including

Denver, Memphis, St. Louis, and

Seattle.

How pure is methamphetamine,

and how much does it cost?

(Exhibit 3) Actual methamphetamine

purity levels are reported only by law 

enforcement, epidemiologic, and

ethnographic sources in Denver, El

Paso, Honolulu, Los Angeles, and

Portland. Purity changes between 1999

and 2000 were reported only by treatment sources in Billings, where purity

levels decreased, and in Chicago and

Columbia, where they increased. 

Gram prices for methamphetamine

range from $40–$60 in El Paso to

$80–$330 in Chicago. In Honolulu,

high-purity ice (widely available there)

costs $200–$300 per gram. From

1999 to 2000, prices increased only in

Chicago and Denver, and decreased

only in Columbia and Memphis

according to law enforcement, 

epidemiologic, and treatment sources.

How is methamphetamine

referred to? (Exhibit 4) Street names

(slang) for methamphetamine across

the United States include crank, meth,

speed, and crystal. Other names are

based on the appearance of the

methamphetamine available. For

example, “sparkle” is a somewhat

shiny methamphetamine available in

Denver, “clear” is a clear high-purity

methamphetamine in Honolulu, and

“peanut butter” describes the yellowish methamphetamine available in

Washington, DC.

METHAMPHETAMINE: THE USERS

Who, Where, How, and With What?

How old are methamphetamine

users? In most Pulse Check sites,

young adults are most likely to use

methamphetamine, except in Miami

and Los Angeles where treatment

sources indicate that adolescents are

the most common age group. Older

adults also use methamphetamine in

many areas. In Denver, use among

young adults is slightly up while older

adult use appears to be declining

slightly. Los Angeles treatment

providers are observing an increase in

adolescent clients.

Is any racial/ethnic or socioeconomic group more likely to use

methamphetamine? According to

epidemiologic and ethnographic

sources in 13 Pulse Check reporting

cities, whites appear to be the 

Changes in methamphetamine 

manufacture?

According to epidemiologic and 

ethnographic sources...

! Seattle, WA “Mexican methamphetamine may be losing its market

share due to the increase of locally

produced methamphetamine.” 

! Philadelphia, PA “Traditionally, 

cookers used the ‘P2P [phenyl-2-

propanone] method’ to manufacture

methamphetamine, but more recently,

the ephedrine reduction and ‘nazi’

methods are being used.”

Exhibit 3. 

Methamphetamine gram prices

and purity by region and city*

CITY GRAM PRICE PURITY

Billings, MT $100 NR

Denver, CO $100–$125 20%

Honolulu, HI $200–$300 60%

Los Angeles, CA $80–$100 $15–$20

Seattle, WA $80–$120

Chicago, IL $80–$330 NR

St. Louis, MO $100

Columbia, SC $125 NR

El Paso, TX $40–$60 50%

Miami, FL $80–$100 NR

New Orleans, LA $150 NR

Washington, DC $150

New York, NY $200

Philadelphia, PA $80–$100

Portland, ME $120 50%

West Northeast South Midwest

Sources: Law enforcement, epidemiologic,

and ethnographic respondents

*Respondents in five sites did not provide this

information: Birmingham, Boston, Detroit,

Memphis, and Sioux Falls.
METHAMPHETAMINE

Pulse Check: Mid-Year 2000 page 51

predominant users of methamphetamine. Some use, however, is reported

among other racial/ethnic groups,

especially in cities where they are 

substantially represented, such as the

following: Hispanics in Denver and

Los Angeles; Native Americans in

Billings and Sioux Falls; and Filipinos

in Honolulu. In particular, the Los

Angeles epidemiologist reports an

increase in methamphetamine use

among Hispanics. Treatment

providers report similarly, except in

El Paso where they serve a Hispanic

population reportedly using 

methamphetamine. In Washington,

DC, epidemiologic and ethnographic

sources suggest possible new use in

the black community. Middle and

lower socioeconomic groups are more

likely to use methamphetamine,

except in New Orleans where 

moderate to upper socioeconomic

groups are reported by epidemiologic

and ethnographic sources.

Are there any gender differences

in who uses methamphetamine?

The majority of methamphetamine

users are male, except in five Pulse

Check cities: in Los Angeles, New

Orleans, Sioux Falls, and Washington,

DC, users are evenly split between

males and females; and in El Paso,

users are more commonly females.

Methamphetamine use is reportedly

an increasing problem among women

in Denver and Honolulu. The drug is

a particular problem within the gay

communities in Los Angeles and

Seattle, where the drug is perceived

by users as a “health aid” to combat

chronic fatigue associated with HIV.

Sparkle Ice, clear,

batu, wash

Motorcycle

crack

Elbow (1 lb),

pellet

Peanut butter (yellow),

hydro (high-quality

powder), glass (high

purity), ice (highest

purity)

Exhibit 4. 

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

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

*No major changes in methamphetamine-using populations are reported in 14 sites.

Then and Now:

How have methamphetamine users changed across the country (1999 vs 2000)?*

According to epidemiologic, ethnographic, and treatment sources... 

Denver, CO According to epidemiologic and ethnographic sources, use among young adults is slightly up, while older adult 

use appears to be declining slightly, and the problem is reportedly increasing among women. Treatment sources 

report an increase in cocaine use as a secondary drug. Users have switched from snorting to injecting, according to

both types of respondents. 

Honolulu, HI Methamphetamine use is reportedly an increasing problem among women.

Los Angeles, Treatment sources observe an increase in adolescent clients, and the epidemiologic source reports an 

CA increase in use among Hispanics. Continuing a 5-year upward trend, smoking has increased.

New York, NY According to the ethnographic source, methamphetamine use is beginning to be observed in the gay community

Seattle, WA Smoking has increased, according to treatment sources. According to the epidemiologic source, anecdotal reports of

methamphetamine-related child abuse and neglect and cases of domestic abuse have increased. That source also notes the

spread of methamphetamine use from older adults to adolescents and young adults.

Washington, DC The epidemiologic source suggests initiation of use in the black community.

WEST MIDWEST NORTHEAST

SOUTH
METHAMPHETAMINE

page 52 Pulse Check: Mid-Year 2000

In Denver, gays reportedly inject

cocaine with methamphetamine.

Methamphetamine use is also 

beginning to be observed in the gay

community in New York, according

to epidemiologic and ethnographic

sources.

Where do methamphetamine

users tend to reside? Suburban

and rural areas are the most likely

place of residence for methamphetamine users in Birmingham, Chicago,

Detroit, New Orleans, Los Angeles,

and St. Louis. Conversely, methamphetamine use is more frequently

observed among those in urban areas

in Billings, Boston, El Paso, Memphis,

and Philadelphia. Methamphetamine

use appears to be a problem in all

types of areas in Denver, Honolulu,

and Seattle.

How do users administer methamphetamine? Route of administration

varies widely across Pulse Check cities,

with no clear regional pattern.

Injecting is the most common route in

Billings, Denver, Philadelphia, and 

Seattle, according to epidemiologic

and ethnographic sources; by contrast,

users in Chicago, Detroit, and

Washington, DC, most frequently

snort methamphetamine. Smoking 

is the most common route of administration in Honolulu, Los Angeles

(where it is increasing), and Sioux

Falls. In Birmingham and El Paso,

epidemiologic and ethnographic

sources report that oral administration is the most common route, while

treatment providers report injecting

as the most common route. In

Denver, users have been switching

from snorting to injecting, according

to epidemiologic and ethnographic

sources. In Seattle, treatment sources

cite an increase in smoking. 

What other drugs do 

methamphetamine users take?

Many methamphetamine users also

have problems with other licit and

illicit substances of abuse. Alcohol is

the most common substance they use.

Marijuana is also frequently used, as

in Denver, where it is used to “come

down” after methamphetamine use.

Other drugs cited by epidemiologic

and ethnographic sources are cocaine

injection in Denver (in the gay community), club drugs in New Orleans

and Washington, DC, and poppers 

in Seattle. In the Los Angeles gay

community, medical consequences

have resulted from methamphetamine

taken with sildenafil citrate (Viagra®).

Treatment providers in Denver report

an increase in cocaine use as a secondary drug, and the El Paso nonmethadone source lists heroin, injected with methamphetamine as a

“speedball,” as the most common

concurrently used drug.

Where and with whom is

methamphetamine used?

Methamphetamine use tends to

be a group activity, according to 

epidemiologic and ethnographic

sources. They cite parties, raves, 

trailer parks, bars, bathhouses, and

homes as the usual places for

methamphetamine use. In contrast,

treatment sources indicate that

methamphetamine is often taken

alone in many cities. In most reporting cities, methamphetamine is used

several times each week, but multiple

daily use is reported by epidemiologic

and ethnographic sources in Billings,

Columbia, and Seattle.

METHAMPHETAMINE: 

THE SELLERS

Who, How, Where, and With What?

How are street-level methamphetamine sellers organized?

Methamphetamine distributors are

affiliated with trafficking organizations

in 5 of the 12 reporting Pulse Check

cities where law enforcement sources

reported on the subject. Ties with

Mexican organizations are reported

in Denver, Honolulu, and Seattle.

Domestic organizations are reported

in Denver and Honolulu (Californian

groups), and biker gangs are reported

in New Orleans and Philadelphia.

Other Philadelphia distributors

include some Italian groups and some

independent groups. Independent

groups are also cited by the other

seven reporting law enforcement

sources in the following cities:

Boston; El Paso, where the law

enforcement source notes that 

“makers are users”; Los Angeles,

where the drug is obtained from

friends and intimates; Memphis;

Sioux Falls, where “independents”

who deal methamphetamine are

slightly more organized, via family

ties, than those who distribute 

other drugs; and St. Louis, where

independent distributors are affiliated

with other users and sellers.

Methamphetamine in the Gay

Community

Denver, CO: According to the 

epidemiologic source, gays of all ages

inject cocaine and methamphetamine.

Los Angeles, CA: Methamphetamine

taken with sildenafil citrate (Viagra®)

has produced adverse medical effects in

the gay community, according to the

epidemiologic source.

New York, NY: The Pulse Check

ethnographic source notes, “You don’t

see much methamphetamine, but gays

have been starting to use it within the

last year, especially in bars. Now that the

AIDS epidemic is slowing, the ‘fear factor’ among younger gays is down, and

they are going back to risky behaviors.”
METHAMPHETAMINE

Pulse Check: Mid-Year 2000 page 53

Epidemiologic and ethnographic

sources corroborate the Mexican 

connection in Denver and Seattle and

also indicate a similar connection in

Sioux Falls. They cite biker gangs in

Detroit (where those gangs are not a

visible group) and New York, local

cooks in Seattle and the rural areas

outside of Detroit, small “mom-andpop” lab operators in St. Louis rural

areas, and independent distributors in

Washington, DC.

How old are street-level

methamphetamine sellers? In 

9 of the 12 Pulse Check cities where

law enforcement sources reported on

seller age, the age range is remarkably

wide: 20–50 in Billings; 18–40 in

Boston; 15–65 in Denver; 17–earlyfifties in Honolulu; 20–40 in Los

Angeles; early-twenties-late-forties in

Memphis; 20–45 in New Orleans;

and “all ages” in New York. In

Seattle, the law enforcement source

notes that it is “hard to establish 

a(n age) pattern for the local labs

because the stuff is everywhere.” By

contrast, sellers’ age ranges are narrower in El Paso (18–25), Sioux Falls

(20–35), and St. Louis (26–38).

Epidemiologic and ethnographic

sources generally note that sellers are

in their twenties and thirties, except

in Detroit where the small number of

methamphetamine sellers have a

wider age range of 20–50.

Then and Now:

How have street-level methamphetamine sales changed (1999 vs 2000)?

Despite the many reported increases in availability, the methamphetamine sales scene 

has remained remarkably stable since the previous reporting period, with only a few

exceptions:

Lab seizures have

increased: 

The number of

sellers has

increased:

The problem has

spread from rural

areas:

" Detroit epidemiologist: Methamphetamine labs have recently

been seized in western Michigan.

" Denver epidemiologist: Many methamphetamine lab busts 

have recently been reported in the Rocky Mountain area: for

example, in the second quarter of fiscal year 2000, 166 such

busts were reported.

" Seattle epidemiologist and law enforcement: The number of

local lab seizures has gone up dramatically, totaling 76 in the

first 8 months of 1998, 171 during the same period in 1999,

and 233 during that period in 2000. 

" Sioux Falls epidemiologist: The number of methamphetamine

busts has increased.

" Memphis law enforcement: The number of sellers has

increased.

" Seattle epidemiologist: The number of sellers, both local and

Mexican, has increased. 

" Seattle epidemiologist and law enforcement: While the

methamphetamine scene remains generally a rural phenomenon,

it has started spreading to suburban and inner-city areas. 

Violence Among Methamphetamine 

Sellers

Violence is a part of the methamphetamine sales scene in 11 of 12 Pulse Check

cities whose law enforcement sources 

discussed this question. In Honolulu, for

example, “ice” plays a large role in

domestic violence (both on the part of

the perpetrators and victims) and it is

involved in other violent criminal acts. 

In Seattle, methamphetamine-related

domestic violence (again, both on the

part of the perpetrators and victims) 

has reportedly increased since the last

reporting period. Sioux Falls is another

example, with methamphetamine

involved in gang activity, prostitution,

violent criminal acts, and domestic violence (perpetrators). Only in El Paso is

violence not seen as part of the methamphetamine scene.

Epidemiologic and ethnographic sources,

however, describe a more mixed picture.

Low-level methamphetamine-related violence is reported in Denver, Detroit,

Honolulu (only when turf problems are

encountered), St. Louis (domestic violence

in rural areas), and Washington, DC.

Higher levels of violence are reported in

Seattle, involving both turf wars and

domestic violence and both local and

Mexican sellers. By contrast, methamphetamine is not associated with violence

in Birmingham and Chicago.
METHAMPHETAMINE

page 54 Pulse Check: Mid-Year 2000

Do methamphetamine sellers

use their own drugs? In all 13

cities whose Pulse Check law 

enforcement sources discussed this

question, methamphetamine sellers

do indeed use their own drug. As a

matter of fact, just about all the 

sellers in Denver reportedly do so, 

as do the majority in Honolulu and

approximately 80 percent of sellers in

St. Louis. In Seattle, “cooks” often

start their trade because they are users

to begin with. In Sioux Falls, however,

quite a few methamphetamine sellers

do not use their drug.

Epidemiologic and ethnographic

sources confirm that the sellers use

their own drug. In Seattle, however,

while local cooks reportedly use their

own methamphetamine, Mexican 

sellers do not.

Where and how is street-level

methamphetamine sold?

(Exhibit 5) Methamphetamine is often

sold in rural areas, as reported by law

enforcement sources in Memphis,

Seattle, and St. Louis. In other cities,

however, it is sold in urban areas: in El

Paso, labs are small enough to be in

residential areas; in Memphis, methamphetamine is sold in the inner city, but

to a lesser extent than in rural areas; in

New Orleans the drug is processed in

rural areas but sold in urban areas; in

New York it is sold in both residential

and commercial urban areas; in

Philadelphia, it is sold in the northern

part of the city; and in Seattle sales are

beginning to spread from the rural

areas into the suburbs and inner city.

Moreover, methamphetamine is reportedly sold “all over” or “citywide,”

according to law enforcement sources

in Billings, Honolulu, Los Angeles, 

and Sioux Falls. Epidemiologic and

ethnographic sources corroborate

many of these reports and add that

methamphetamine is also sold in the

suburbs of Birmingham and Chicago.

Methamphetamine sales take place

both outdoors—as reported in

Denver, Honolulu, Los Angeles, and

Memphis—and indoors in a variety

of settings, such as private residences,

bars, clubs, restaurants, parties, cars,

truck stops, and even places of business. The drug is often sold in small

closed social groups—hand-to-hand,

friend-to-friend, or acquaintance-toacquaintance—as reported in El Paso,

Los Angeles, Memphis, St. Louis, and

Sioux Falls. None of the midwestern

sources report methamphetamine

sales in the club or bar scene.

What other drugs do 

methamphetamine dealers sell?

Only five law enforcement sources

report that methamphetamine dealers

also sell other drugs:

! Denver, CO: Marijuana, cocaine

! Honolulu, HI: Marijuana, cocaine,

heroin (“everything”)

! New Orleans, LA: Methcathinone

(“cat”)

! Seattle, WA: Marijuana

! Sioux Falls, SD: Marijuana

The Seattle epidemiologic source 

corroborates that methamphetamine

sellers also sell marijuana, and the

Washington, DC, epidemiologic source

adds that some methamphetamine 

sellers also sell “ecstasy” and LSD.

How is methamphetamine 

packaged and marketed? Small

plastic bags are the most commonly

reported packaging for methamphetamine, according to Pulse Check law

enforcement sources in El Paso,

Honolulu, Los Angeles, New Orleans,

New York, Sioux Falls, and St. Louis.

Other reported packaging includes

foil in Denver and, in Memphis,

either a small cellophane pack or wax

paper knotted up. An epidemiologic

source adds that methamphetamine in

Detroit is packaged in paper wrappers.

Private Bars,

resi- restaurants, Busi- Hand-to- Truck

City dences Street clubs, parties nesses hand Cars stops

Billings, MT #

Denver, CO # #

Honolulu, HI ## # #

Los Angeles, CA # # ##

Seattle, WA #

Chicago, IL #

St. Louis, MO # ##

Sioux Falls, SD #

El Paso, TX # #

Memphis, TN ## # #

Washington, DC #

New York, NY #

Sources: Law enforcement, epidemiologic, and ethnographic respondents

*Sources in eight sites did not respond: Detroit in the Midwest; Birmingham, Columbia, Miami,

and New Orleans in the South; and Boston, Philadelphia, and Portland in the Northeast.

Exhibit 5. 

Where is street-level methamphetamine sold?* West South Northeast Midwest
METHAMPHETAMINE

Pulse Check: Mid-Year 2000 page 55

METHAMPHETAMINE: THE COMMUNITY

How is the impact of and community reaction to the methamphetamine problem? Methamphetamine affects 

communities in many ways: it is associated with violence, as discussed above, and with adverse medical consequences. 

As a result, media attention often focuses on the problem and communities react with a variety of prevention efforts, 

law enforcement efforts, and changing sentencing practices.

Adverse medical

consequences: 

Media and other

prevention efforts: 

Law enforcement

efforts: 

Changing sentencing practices: 

" Honolulu, HI: Methamphetamine-related episodes are sporadically reported from psychiatric

wards, where the drug is viewed as a real problem.

" Detroit, MI: The Pulse Check epidemiologic source notes some media efforts, such as TV spots,

targeted at methamphetamine. It is still too early to assess the impact on the community.

" Honolulu, HI: The Women’s Amphetamine Treatment for Community Health (WATCH) has

sponsored several public service announcements (PSAs) targeting female users of crystal methamphetamine. The epidemiologic source notes, however, that these PSAs are usually aired at around

2:00 am, thus having a limited impact. 

" Sioux Falls, SD: The epidemiologic source suggests that the community’s education efforts, based

on zero tolerance and increased parent involvement, have resulted in a drop in adolescent use of

methamphetamine.

" Seattle, WA: Methamphetamine lab education sessions for the community were started in

Olympia, Washington, a little more than a year ago. The sessions are extremely popular and are

growing statewide; they now train others to educate. The law enforcement source notes that the

impact of these sessions should be evident by the next Pulse Check issue. 

" Detroit, MI: Recent methamphetamine lab busts have gotten some publicity. 

" Los Angeles, CA: Newspaper reports of major methamphetamine seizures so far have not affected

supply, which remains high.

" Seattle, WA: The epidemiologic source notes that the sharp increase in methamphetamine lab

seizures is the direct result of the Washington State Patrol response team, which targets these labs.

The law enforcement source suggests that these efforts are completely reactive: as the community

knows more, the budget targeted at methamphetamine increases, and more busts occur.

" Sioux Falls, SD: The epidemiologic source links the increase in methamphetamine busts as to a

methamphetamine task force. 

" Denver, CO: Law enforcement efforts have targeted methamphetamine specifically.

" Miami, FL: Some law enforcement efforts and legislation have targeted precursors: in a major

national case, massive amounts of ephedrine were seized in the Ft. Lauderdale area, where a drug

ring was involved in warehousing the drug for shipment to Los Angeles. 

" Portland, ME: Possession of methamphetamine is now considered a felony, according to the 

law enforcement source, who also notes that more aggressive judges are taking more interest in

these cases.
CLUB DRUGS

page 56 Pulse Check: Mid-Year 2000

The last issue of Pulse Check

addressed “club drugs” as a special

topic because of increasing reports

that a wide variety of illicit drugs

were being used and sold, mostly by

white youth from middle to upper

SES groups, in nightclub and rave settings. Since then—amid concern

about increased consequences and

possible spread to other populations

and broader settings and contexts—

this problem has continued to be

monitored by numerous sources,

including the Drug Abuse Warning

Network (DAWN), the Monitoring

the Future (MTF) study, the

Community Epidemiology Work

Group (CEWG), the Drug

Enforcement Administration (DEA),

and numerous local law enforcement

and public health agencies. The

growth of the problem, particularly

the proliferation of “ecstasy” 

(methylenedioxymethamphetamine or

MDMA), has warranted further

scrutiny by Pulse Check, and so this

issue once again devotes a special

focus to this broad category of drugs,

which includes the following:

! Ecstasy, a synthetic, psychoactive

substance with stimulant and mild

hallucinogenic properties, is most

often used in pill form. 

! Gamma hydroxybutyrate (GHB) is a

central nervous system depressant

usually sold as an odorless, colorless

liquid in spring water bottles or as a

powder and mixed with beverages.

GHB precursors, gamma butyrolatone (GBL) (a chemical used in

many industrial cleaners) and 1,4-

butanediol (BDL), convert into GHB

in the body and have been sold as

nutritional supplements in health

food stores and over the Internet,

often in powder or capsule form.

! Ketamine is a prescription anesthetic

with hallucinogenic and dissociative

properties and marketed for human

use, but primarily for veterinary use.

Ketamine can be used in liquid or

powder form.

! Rohypnol (flunitrazepam) is a 

benzodiazepine, no longer marketed

in the United States, that is obtained

by prescription in Mexico (and

sometimes Colombia) and smuggled

across the border. It has been

involved in numerous drug rapes,

but its most common abuse pattern

is episodic use by teenagers and

young adults as an “alcohol extender” and disinhibitory agent, most

often in combination with beer.

! Methamphetamine is a stimulant

(discussed in the previous section).

! Nitrous oxide is an inhalant often

referred to as laughing gas.

! Lysergic acid diethylamide (LSD)

(“acid”) is a hallucinogen, most

commonly distributed on blotter

paper and taken orally.

The club or rave experience typically

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

night. Club drugs are commonly 

combined with one another and with

other illicit drugs and alcohol.

For this issue, all four categories of

Pulse Check sources were asked about

club drug use and activity in their

areas. The law enforcement, epidemiologic, and ethnographic sources 

provided most of the information,

whereas treatment sources had little

first-hand knowledge of club drug

use, suggesting that club drug users

have not yet entered the treatment

system in large numbers. 

Pulse Check discussions suggest that

club drug availability and use are

increasing, corresponding to reports

from the sources listed above. For

example, according to DAWN, emergency department mentions for GHB

and MDMA increased significantly

between 1998 and 1999 (from 1,282

GHB mentions in 1998 to 2,973 in

1999, and from 1,143 MDMA 

mentions in 1998 to 2,850 in 1999),

whereas other club drugs did not

increase significantly during this time

period. Additionally, emergency

department episodes involving club

drugs usually involve multiple substances, such as marijuana, cocaine,

and other club drugs. Alcohol is a

common factor in these episodes.

Similarly, MTF data showed that

ecstasy use (both lifetime and 

past-30-day use) continued to rise

sharply between 1999 and 2000

among 8th, 10th, and 12th graders.

Furthermore, perceived ecstasy 

availability among 12th graders 

(the only grade for which perceived

ecstasy availability was reported) also

increased markedly during that time

period. The other club drugs included

in the survey are LSD, Rohypnol, and

methamphetamine, use of which

declined among 8th, 10th, and 12th

graders. GHB, ketamine, nitrous

oxide use were not specifically 

surveyed. 

Pulse Check discussions in 2000 

further indicate that club drug activity

may be expanding from nightclubs

and raves to high schools, streets, and

SPECIAL TOPIC: “ECSTASY” AND OTHER CLUB DRUGS
CLUB DRUGS

Pulse Check: Mid-Year 2000 page 57

open venues; further, they suggest

that whites are no longer the 

exclusive users and sellers, which now

include more blacks and Hispanics.

Pulse Check sources corroborate the

DAWN reports of the continuing

practice of combining club drugs with

one another, with other illicit drugs,

and with alcohol.

ECSTASY AND OTHER CLUB

DRUGS: THE PERCEPTION

How serious a problem are club

drugs in Pulse Check communities in 2000? Club drugs (including

ecstasy) or ecstasy alone were perceived as the emerging drugs in their

communities by 27 sources in 18 of

the 20 Pulse Check cities (52 percent

of 52 responding enforcement, 

epidemiologic, ethnographic, and

treatment sources). Billings and

Birmingham were the only two cities

where these drugs were not named as

an emerging problem. While no

sources reported club drugs or ecstasy

as their communities’ most serious

drug problem in 2000, three did

report club drugs as the 

second most serious drug problem:

the non-methadone treatment source

in Boston, the law enforcement

source in Miami, and the law

enforcement source in New Orleans. 

ECSTASY AND OTHER CLUB

DRUGS:

Availability, Form, Price, and Purity

How available are club drugs in

Pulse Check communities?

(Exhibits 1 and 2) Ecstasy is the most

available of club drugs, with more

than 90 percent of epidemiologic,

ethnographic, and law enforcement

respondents reporting it as somewhat

or widely available, followed by GHB

(and its precursors). Interestingly, all

respondents reporting wide GHB

availability are from cities in the West

or South: Denver, Los Angeles,

Miami, New Orleans, and Seattle.

Similarly, Rohypnol is considered

widely available by respondents only

in western and southern cities:

Denver, El Paso, and Los Angeles.

The most common type of ecstasy

available in Pulse Check cities, by far,

is the pressed pill (tablet), followed by

powder and liquid forms. In Brooklyn,

New York, a street gang is reportedly

selling a powder form of ecstasy that,

like heroin, may be snorted or injected. In Los Angeles, homemade ecstasy

is reportedly increasing, albeit not

widely available, according to the 

epidemiologic source.

Has club drug availability

changed? (Exhibit 3) More 

than 80 percent of epidemiologic,

ethnographic, and law enforcement

respondents report that ecstasy availability increased between 1999 and

2000; only one source (in Portland,

Maine) reports that ecstasy availability

declined. Ketamine availability

increased or remained stable according

to most respondents, whereas GHB

availability was mixed, with 48 percent

of sources from all four U.S. regions

reporting increases, and 18 percent

reporting declines (in El Paso, Los

Angeles, and Miami). Rohypnol 

availability trends are also mixed,

with increases in Denver, El Paso, Los

Angeles, Memphis, New Orleans, and

St. Louis and declines in Los Angeles

and Miami.

How are club drugs and their

combinations referred to across

the United States? (Exhibit 4)

Slang terms for ecstasy are similar

across the Nation. It is generally

Exhibit 2. 

How available are the different

forms of ecstasy?

In general Pill Powder Liquid

(N=36) (N=32) (N=19) (N=23)

Percent

Exhibit 1. 

How available are club

drugs across the United States?

Sources: Law enforcement, epidemiologic, ethnographic respondents

100

90

80

70

60

50

40

30

20

10

0

Not Available

or Not Very

Available

Widely

Available

Percent

Somewhat

Available

Not Available

or Not Very

Available

Widely

Available

Somewhat

Available

100

90

80

70

60

50

40

30

20

10

0

Miami, FL: According to the law

enforcement source, ecstasy availability

and use are surging. The drug is 

replacing crack, GHB, and Rohypnol.

Ecstasy GHB Ketamine Rohypnol

(N=36)(N=33) (N=35) (N=33)
CLUB DRUGS

page 58 Pulse Check: Mid-Year 2000

referred to as “X,” although “E,”

“roll,” and “the hug drug” are more

recent names. The practice of taking

ecstasy is referred to as “rolling.” 

Ketamine is referred to as “K” or

“special K” in most cities, with 

additional terms by locality. Where

available, Rohypnol is referred to by

many names, including “roofies,”

“roches,” and “R-2.” Slang for other

club drug and drug combinations are

national or vary by city. The numerous

terms for club drug combinations (for

example, LSD combined with ecstasy

is referred to as “candy flipping”

across the Nation) highlight the 

practice of using club drugs with other

club drugs, hallucinogens, heroin, and

cocaine, particularly in eastern cities.

What are street-level ecstasy

prices across the country and

have they changed? (Exhibit 5)

Ecstasy ranges from $10 to $45 per

pill in Pulse Check cities, according to

law enforcement, epidemiologic, and

ethnographic sources. Price ranges in

the Midwest seem to start at higher

levels than elsewhere, while the lowest

prices are reported in southern cities.

Little information is available on the

purity of ecstasy or any club drug.

What adulterants are added to

ecstasy across the country?

According to law enforcement, 

epidemiologic, and ethnographic

sources, ecstasy may contain many

substances other than MDMA, and

adulterants include mostly stimulants.

Miami: The epidemiologic source notes

that users have stopped referring to

ecstasy as MDMA or ‘X’ and are now

calling it ‘E.’ Also, fewer users think of

it as a drug and more as a feeling, a 

pick-me-up, a fantasy.

Exhibit 4. 

Slang terms for club drugs and club drug combinations across the

United States

Drug or drug combinations Slang term City 

GHB, GBL, 1,4-BD date rape drug Birmingham, AL

liquid X, liquid E Boston, MA

liquid G, G Chicago, IL

wonder stuff Columbia, SC

liquid E, liquid X, G, scoop, water Detroit, MI 

shot (liquid), hit (powder), G Los Angeles, CA 

Blue Nitro, ReNewtrient (GBL 

“nutritional supplement” brand names) Miami, FL

G, gamma New Orleans, LA 

G, liquid X, verve New York, NY

Georgia home boy St. Louis, MO

liquid ecstasy Seattle, WA 

Ketamine cat Denver, CO

super K Los Angeles, CA

bump (one dose), cat valium New York, NY

been rowing Columbia, SC

Nitrous Oxide nitrous, N-2, hippie crack Los Angeles, CA 

Ecstasy + LSD trolling Miami, FL 

Ecstasy + LSD (in pill form) nexus Washington, DC 

Ecstasy + psilocybin 

mushrooms hippie flipping Boston, MA 

Ecstasy + powder cocaine bump Miami, FL 

Ecstasy + heroin down ecstasy Washington, DC 

Ecstasy + methamphetamine up ecstasy Washington, DC 

Ketamine + LSD the matrix Chicago, IL

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

Exhibit 3. 

Has club drug availability changed between 1999 and 2000?

Sources: Law enforcement, epidemiologic, and ethnographic respondents

100

90

80

70

60

50

40

30

20

10

0

Up Stable

Percent

Down

Ecstasy

(N=22)

Ketamine

(N=25)

GHB

(N=21)

Rohypnol

(N=22)
CLUB DRUGS

Pulse Check: Mid-Year 2000 page 59

According to a law enforcement

source, very weak, home-pressed

ecstasy pills were seized in Columbia,

South Carolina, where the seller

reportedly “sold as many as he 

wanted to for $25 each.”

ECSTASY: THE USERS

Who, Where, How and With What?

Who uses ecstasy? According to

all responding epidemiologic and

ethnographic sources, ecstasy users

are predominantly adolescents and

young adults, with many sources

mentioning high school and college

students (in Boston, Los Angeles,

Philadelphia, St. Louis, and

Washington, DC). Of 14 epidemiologic and ethnographic respondents,

half report that ecstasy users are 

predominantly male, and half report

that they are evenly divided between

the genders. Nearly all epidemiologic 

and ethnographic respondents (87

percent) report that ecstasy users are

predominantly whites. In El Paso,

however, both Hispanics and whites

are reportedly the predominant users,

and in Sioux Falls, users represent a

cross-section of the general population. Most ecstasy users range from

middle to upper socioeconomic status, although in New York, users

reportedly fall into all socioeconomic

groups. Treatment sources who 

provided information on club drug

use concur that the groups most likely

to use ecstasy are adolescents (in

Honolulu and Portland) and young

adults (in Denver, El Paso, and Los

Angeles).

City Adulterants

Boston, MA amphetamine, caffeine

Chicago, IL caffeine, vitamins, 

heroin (anecdotal) 

Los Angeles, caffeine, 

CA methamphetamine 

Memphis, TN ephedrine

New York, NY amphetamine, caffeine,

ephedrine, heroin 

(anecdotal)

Washington, DC heroin (anecdotal)

Seattle, WA: According to the law

enforcement source, what is being sold

as GHB and ecstasy may be methamphetamine, and this practice seems to

be increasing substantially.

Seattle, WA: According to a treatment

respondent, ecstasy users are becoming

more prevalent across all income levels. 

Then and Now:

How have ecstasy users changed across the country between 1999 and

2000?

Ecstasy user groups

and settings seem to be

shifting or expanding

according to 

epidemiologic sources:

" New Orleans, LA: In the recent past, ecstasy was used only

in underground, private settings, but in the last 2 months a

New York promoter publicly advertised raves and concerts,

where club drugs are used fairly openly.

" New York, NY: As ecstasy availability has increased on the

street, Hispanics and blacks are starting to use the drug.

" St. Louis, MO: “Ecstasy use has become more noticeable in

the past 6 months.”

Do some ecstasy tablets contain

heroin? 

Heroin is mentioned anecdotally as an

adulterant in Chicago, New York, and

Washington, DC. However, two Miami

sources (both law enforcement and 

epidemiologic) suggest that sellers 

falsely claim that their ecstasy pills 

contain heroin as a marketing scheme:

if ecstasy users believe that they have

tried heroin once, they might be willing

to use heroin (with or without ecstasy)

at a later time.

Sources: Law enforcement, epidemiologic,

and ethnographic respondents

Exhibit 5. 

Ecstasy prices per pill by region

and city

CITY PRICE

Denver, CO $22

Honolulu, HI $25–$45

Los Angeles, CA $20–$30

Seattle, WA $15–$20

Chicago, IL $25–$35

St. Louis, MO $35

Sioux Falls, SD $30

Columbia, SC $25–$35 

El Paso, TX $10–$30 

Miami, FL $14–$30 

New Orleans, LA $30

Washington, DC $20–$30 

Boston, MA $20–$40 

New York, NY $20–$25 

Philadelphia, PA $20–$35 

Portland, ME $20–$30 

Sources: Law enforcement and epidemiologic/

ethnographic respondents

West Northeast South Midwest

Have ecstasy prices changed?

The few 1999-to-2000 changes reported show mixed trends:

Los Angeles, CA

Miami, FL

New Orleans, LA

Denver, CO

Portland, ME
CLUB DRUGS

page 60 Pulse Check: Mid-Year 2000

Where do ecstasy users tend to

reside? (Exhibit 6) Suburban and

urban areas are equally mentioned by

Pulse Check epidemiologic and ethnographic sources as areas where ecstasy

users reside, with sources in Chicago,

St. Louis, and Seattle mentioning

both suburbia and the central city as

areas where ecstasy users live.

Additionally, users tend to reside in

affluent areas in Los Angeles and in

college apartments and dorms in

Philadelphia. In New Orleans, most

ecstasy users are young out-of-towners who visit the city.

Where and how is ecstasy used?

Ecstasy is used at social settings

(mostly nightclubs and dance clubs,

raves, and private parties), although it

is also reportedly used in private

homes, on college campuses (including dorms), and at bars. Ecstasy is

almost exclusively taken orally in pill

or powder form, although it has also

been reportedly used anally in Miami

(only one case reported), snorted in

Philadelphia, and diluted with water

and drunk in St. Louis.

What other drugs do ecstasy

users take? According to law

enforcement, epidemiologic, ethnographic, and treatment sources, ecstasy—and all club drugs, for that matter—is often used in combination

with many other drugs, most commonly alcohol, other club drugs

(including GHB and ketamine), marijuana, methamphetamine, psilocybin

mushrooms, and LSD. Other combinations vary geographically:

Rohypnol in El Paso; antidepressants

or sildenafil citrate (Viagra®) in Los

Angeles (to gain a “better bump”);

powder cocaine in Miami; benzodiazepines in Miami, New York, and

Philadelphia; powder heroin or cough

syrup in Philadelphia; opiates other

than heroin in Portland, Maine; and

heroin and diverted pharmaceuticals

in Washington, DC. 

ECSTASY: THE SELLERS

Who, How, Where, and With What?

Who sells ecstasy? According to

law enforcement, epidemiologic, and

ethnographic sources, ecstasy sellers,

like ecstasy users, are predominantly

white, male, middle-class young adults,

whose ages range from 14 to 32 years.

In Miami, rave operators, nightclub

personnel, and security guards at raves

also sell ecstasy, and in St. Louis, 

sellers are predominantly high school

and college students. In Birmingham,

sellers are often “regular” nightclub

patrons who may or may not know

the owners of the clubs. Similarly, in

Billings, sellers are often nightclub frequenters and rave partygoers. In New

York, street gangs and organized crime

are becoming involved in ecstasy sales.

Then and now:

How have street-level ecstasy sales changed in the last year?

Ecstasy sales 

settings are shifting or expanding

in several Pulse

Check cities:

" Miami, FL: According to the law enforcement source, the 

settings for club drug sales seem to be changing constantly:

from raves to homes and nightclubs. Legitimate nightclubs are

now sponsoring “electronights” and “technonights,” which are

profitable rave-like parties. Club drugs are everywhere, even 

at ice skating rinks.

" New York, NY: Ecstasy is more available on the street partially

due to the involvement of organized crime and street gangs in

sales and the involvement of Long Island youth in sales via the

Internet and in malls.

" Portland, ME: According to a law enforcement source, rave

activity has increased dramatically.

" Seattle, WA: The law enforcement source states that ecstasy,

GHB, and ketamine are finding their way into high schools 

and colleges.

Drug Use Among Ecstasy Sellers

Law enforcement, epidemiologic, and

ethnographic sources overwhelmingly

report that ecstasy dealers use their

drug. Only in Billings and Los Angeles

do some sources report that dealers do

not tend to use ecstasy.

Miami, FL: The law enforcement source

reports a new phenomenon in club drug

combinations: the practice of placing

five to nine “lines” of drugs (including

marijuana and powder cocaine) on a

tray and taking one after the other.

Exhibit 6. 

Where do ecstasy users tend to

live?

Suburban Urban 

City Areas Areas

Seattle, WA # #

Chicago, IL # #

Detroit, MI #

Birmingham, AL #

El Paso, TX #

St. Louis, MO # #

Miami, FL #

Washington, DC #

Boston, MA #

Sources: Epidemiologic and ethnographic

providers West Northeast South Midwest
CLUB DRUGS

Pulse Check: Mid-Year 2000 page 61

Where is ecstasy sold? (Exhibit 7)

Similar to ecstasy user settings, Pulse

Check law enforcement, epidemiologic, and ethnographic sources overwhelmingly mention nightclubs and

raves as the settings for ecstasy sales,

with nightclubs or bars mentioned in

17 of 20 Pulse Check cities (by 24

sources), raves in 16 cities (by 19

sources), followed by private parties,

private residences, college campuses,

streets, and high schools. Other settings for ecstasy sales include dealers’

homes in Los Angeles, sex and strip

clubs in Miami, shopping malls in

New York, and coffee shops in

Washington, DC. Law enforcement

sources in New York and Philadelphia

also report use of the Internet by 

promoters to advertise nightly raves

and by rave goers to locate them.

How is ecstasy sold? According to

law enforcement, epidemiologic, and

ethnographic sources, the way that

ecstasy is sold often depends on the

setting. For example, in Birmingham

and Chicago nightclubs, buyers are

referred to and approach sellers. At

Los Angeles raves, buyers may ask

users who seem “high” to refer them

to an on-site dealer. At Miami raves

and nightclubs, “runners” on dance

floors are used as liaisons between

ecstasy dealers and buyers, and rave

operators, security guards, and bar

personnel may sell the drug. At raves

in Columbia, South Carolina, young,

female heroin addicts sell ecstasy and

other club drugs for male dealers

(“hustling”), so that they can support

their heroin habits. In settings other

than nightclubs and raves, ecstasy is

most often sold hand-to-hand among

friends and associates or through

introductions and referrals by friends

(as reported in Billings, Boston,

Columbia, Detroit, and Seattle). In

Philadelphia, ecstasy is sold from user

to user, and in Washington, DC, it is

sold through contacts and beepers.

How is ecstasy packaged and

marketed? (Exhibit 8) All law

enforcement, epidemiologic, and

ethnographic respondents reporting

on packaging state that ecstasy is sold

as loose pills. Additionally, the pills

are packaged in various ways: in

small, plastic zipper bags in

Honolulu, Los Angeles, Miami, and

New Orleans; in plastic pill bottles in

Memphis; and in bottles in New

Orleans and St. Louis. Liquid ecstasy

in New Orleans is packaged in 

Exhibit 7. 

Where is street-level ecstasy sold?

Nightclubs/ Private Private College High

City Bars Raves parties residences campuses Streets schools

Billings, MT # #

Denver, CO #

Honolulu, HI # #

Los Angeles, CA # ##

Seattle, WA # ## # # #

Chicago, IL # #

Detroit, MI #

St. Louis, MO # #

Sioux Falls, SD # #

Birmingham, AL # #

Columbia, SC # #

El Paso, TX # ## #

Memphis, TN # #

Miami, FL # ## #

New Orleans, LA # #

Washington, DC # #

Boston, MA ## #

New York, NY ## #

Philadelphia, PA # #

Portland, ME # ## #

West South Northeast Midwest

Sources: Law enforcement, epidemiologic, and ethnographic respondents

Exhibit 8. 

How are ecstasy pills labeled in reporting Pulse Check cities?

City Label

Los Angeles, CA Nike and other logos 

Chicago, IL Ferrari and other logos 

Detroit, MI cartoon characters, colored pills 

Sioux Falls, ND buddha 

Columbia, SC double dip diamond, double dip, democrat, republican 

El Paso, TX “E” 

Washington, DC Star of David, Versace, Mitsubishi

Boston, MA rabbits, race car logos 

Portland, ME “E” 

Sources: Law enforcement, epidemiologic, and ethnographic respondents West Northeast South Midwest
CLUB DRUGS

page 62 Pulse Check: Mid-Year 2000

Exhibit 9. 

Club drug user and seller characteristics

Club drugs Who uses? Where reside? Where used? Who sells? Where sold?

GHB, GBL, "$White middle-class "$Suburban areas "$Raves "$White, male, middle-class "$Raves

1,4-BDL youth "$Nightclubs "$Companies (many interna- "$Nightclubs

"$Males "$Private residences tional) over the Internet "$College campuses

"$Young adult "$Health clubs and gyms

body builders "$Health food stores

"$Internet

Ketamine "$White middle class "$Suburban areas "$Raves "$White middle-class youth "$Raves

youth "$Gay communities "$Nightclubs who divert them from "$Nightclubs "$Urban areas "$Private residences pharmacies or veterinary "$Private parties

"$Private parties offices "$College campuses

Rohypnol "$Hispanic and white "$Urban areas "$Raves "$Hispanic and white male "$Raves

youth "$Suburban areas "$Private parties youth from legal "$Nightclubs

"$Urban high schools prescription drug sales "$Private parties

in Mexico "$College campuses

"$High schools

"$Gyms

Nitrous "$White adolescents "$Suburban areas "$Raves "$Raves

oxide "$Outdoor concerts "$Outdoor concerts

Sources: Law enforcement, epidemiologic, and ethnographic respondents

bottles. Most sources report that

ecstasy pills are stamped or

impressed with a wide variety of

designs and logos and that new

designs and logos emerge often. 

Only in Memphis and St. Louis are

pills reportedly unlabeled.

OTHER CLUB DRUGS: THE USERS

AND SELLERS

Who uses and sells ketamine,

GHB, and Rohypnol? (Exhibit 9)

Regardless of the specific drug, club

drug user and seller characteristics 

are usually similar with a few key 

differences. For example, Internet

sales are mentioned primarily in 

conjunction with GHB, veterinary

break-ins and pharmacy diversions are

mainly associated with ketamine, and

Hispanic involvement in use and sales

is mentioned only for Rohypnol.

Miami, FL: According to the 

epidemiologic respondent, 20–40-

year-old, middle-class whites of both

genders who use GBL at home have

become a problematic user subgroup.

Indications of addiction in this group

increased during 2000, probably due 

to the supply cutoff when GBL was

banned from health food stores. 

These users are now being treated in

emergency departments for depression

and suicides.

Treatment sources report that 

the number of clients in treatment

for club drugs is small but 

warrants watching:

Boston, MA: Treatment sources 

identified ketamine users as white suburban adolescents and preadolescents.

Referrals to treatment in these cases

were generally made by school 

professionals.

Birmingham, AL: Young adults are

using GHB due to its easy access.

Denver, CO: GHB is easily obtained

and available, according to some young

adults in treatment.
Pulse Check: Mid-Year 2000 page 63

APPENDIX 1: METHODOLOGY

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. 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,

Maine—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 ONDCPdesignated High Intensity Drug

Trafficking Area (HIDTA). 

Portland is Maine’s most populous

metropolitan area.

! Region II (South): Columbia, South

Carolina—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,

South Dakota—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,

Montana—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:

Billings, Montana

Birmingham, Alabama

Boston, Massachusetts

Chicago, Illinois

Columbia, South Carolina

Denver, Colorado

Detroit, Michigan

El Paso, Texas

Honolulu, Hawaii

Los Angeles, California

Miami, Florida

Memphis, Tennessee

New Orleans, Louisiana

New York City, New York

Philadelphia, Pennsylvania

Portland, Maine

St. Louis, Missouri

Seattle, Washington

Sioux Falls, South Dakota 

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 18.4

in Billings, Montana, to a crowded

2,897.4 in New York City (1997 

estimates). Their unemployment rates

range from a 2.7 low in Columbia,

South Carolina, to an 11.2 high in 

El Paso, Texas. The racial/ethnic

breakdowns in the 20 sites further

exemplify their diversity: white 

representation ranges from 31.4 

percent in Honolulu, Hawaii, to 96.7

percent in Sioux Falls, South Dakota;

black representation ranges from 0.5

percent in Billings, Montana, to 42.1

percent in Memphis, Tennessee.
page 64 Pulse Check: Mid-Year 2000

APPENDIX 1: METHODOLOGY

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 

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. 

To identify treatment sources, 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 non-methadone 

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,

Montana, has no UFDS-listed

methadone treatment facilities, we

selected two non-methadone facilities

in this site. Despite several attempts, 

in a few sites we were unable to

recruit a second treatment provider, 

so we solicited a referral from the 

one treatment provider successfully 

recruited from the UFDS data file.

Of the 80 sources identified and

recruited, we successfully obtained

information for this Pulse Check

issue from 74: a response rate of 93

percent. The nonresponding individuals included a law enforcement official

in Detroit, the methadone treatment

providers in Denver, Miami, and

Honolulu, and the non-methadone

treatment providers in Philadelphia 

and St. Louis. 

What kind of data were collected,

and how? For each of the 74 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 1999 and

2000, reflecting back on the first 6

months of 1999 compared with the

same 6 months in 2000. In general, we

discussed the following topic areas

with Pulse Check sources, noting

source opinions about the drug use

problem in 2000 compared with the

previous year:

! An overall snapshot of the 

community’s drug use situation,

including the perceived seriousness

of the problem and the relative concern about specific major drugs of

abuse—heroin, cocaine, marijuana,

methamphetamine, club drugs, and

any emerging drug abuse problems

! Population groups in the site most

likely to use major drugs of abuse,

user characteristics (such as age, 

gender, race/ethnicity, socioeconomic status, and residence), 

and patterns of use (such as route of

administration, concomitance, setting, and context)

! Availability of major drugs of use

(such as drug forms, supply levels,

quantities, prices, and purity)

! Trafficking patterns (such as how

drugs are manufactured or grown,

where drugs originate, where they

are transshipped, how they enter

local areas, and where they 

ultimately end up) 

! Seller characteristics (such as gang

or organized crime affiliation, age,

gender, race/ethnicity, seller drug

use patterns, and drug-associated

violence)

! Sales practices (such as where drugs

are sold, settings, street names,

packaging, adulterants, marketing

strategies)

! Other activities associated with

drug sales or use (such as gang

activity, prostitution, violence)
Pulse Check: Mid-Year 2000 page 65

APPENDIX 1: METHODOLOGY

! Community context issues that

might have impacted on the drug

use situation during the study 

periods (such as treatment 

availability, medical consequences,

large Seizures, law enforcement 

policy initiatives, policing and 

sentencing practices, legislation,

task forces, media campaigns, or

major news events)

Not surprisingly, ethnographic and

epidemiologic sources seemed to be

very knowledgeable about users and

patterns of use; they were somewhat

knowledgeable about drug availability;

and they were less informed about

sellers, distribution, and trafficking

patterns. Treatment providers had a

similar range of knowledge, but they

generally focused on the specific populations targeted by their programs.

Some providers, however, were able

to provide a broader perspective

about the communities extending

beyond their individual programs.

Among the three Pulse Check source

types, law enforcement officials

appeared to be most knowledgeable

about drug availability, trafficking

patterns, seller characteristics, sales

practices, and other associated 

activities; they were, understandably,

less knowledgeable about user groups

and characteristics.
page 66 Pulse Check: Mid-Year 2000

APPENDIX 2: SITE DEMOGRAPHICS

*Small = <150,000 persons; Medium =

250,000–999,999 persons; Large = >1 million

persons (NOTE: None of the sites are in the

150,000–249,000 category.)

1

Includes Los Angeles-Long Beach

2

Includes Seattle, Bellevue-Everett, WA

3

Includes Washington, DC-MD-VA-WVA

4

Includes Worcester, Lawrence, Lowell,

Brockton MA-NH

a

1997

b

1990–1997 

c

1996 

d

1995 

Race Percenta

American Asian Violent Percent

MSA Indian and Population Percent Crime/ Persons Under

Size* Eskimo Pacific Percent Density/ Population 100,000 18 Below UnemployProposed Site (S, M, L) White Black Aleut. Islander Hispanica Square KMa Changeb Populationc Poverty Leveld ment Ratea

Billings, MT S 95.8 0.5 3.1 0.6 3.1 18.4 10.9 NA 17.0 4.5

Denver, CO M 90.0 6.2 0.8 2.9 14.4 195.4 17.1 460 13.1 2.8

Honolulu, HI M 31.4 3.8 0.5 64.3 7.4 559.8 4.0 313 12.6 5.3

Los Angeles, CA1 L 75.3 11.1 0.6 13.0 43.7 869.7 3.2 1,278 33.7 6.8

Seattle, WA2 M 85.4 4.6 1.2 8.7 3.9 197.9 11.6 421 11.7 3.3

Chicago, IL L 76.0 19.4 0.2 4.4 14.1 592.6 4.9 NA 19.0 4.5

Detroit, MI L 75.3 22.5 0.4 1.9 2.4 442.3 4.6 957 22.5 3.9

Sioux Falls, SD S 96.7 0.8 1.7 0.8 0.8 44.7 15.4 385 11.2 2.0

St. Louis, MO-IL M 80.9 17.6 0.2 1.2 1.4 154.5 2.6 745 17.9 4.1

Birmingham, AL M 70.3 29.0 0.2 0.5 0.7 109.0 7.2 782 22.1 3.4

Columbia, SC M 68.3 30.1 0.2 1.4 1.8 133.5 11.0 999 19.8 2.7

El Paso, TX M 94.5 3.5 0.5 1.5 74.4 267.4 18.6 811 41.9 11.2

Memphis, TN M 56.6 42.1 0.2 1.1 1.2 139.0 7.5 1,419 27.7 4.6

Miami, FL M 77.1 21.0 0.2 1.7 55.7 406.0 5.5 NA 36.0 7.1

New Orleans, LA M 62.7 34.9 0.3 2.1 4.9 148.5 1.8 1,355 32.6 5.5

Washington, DC3 M 67.9 25.4 0.3 6.3 7.0 273.0 9.0 678 11.5 3.7

Boston, MA4 M 90.5 5.8 0.2 3.5 5.3 348.0 2.5 560 13.1 3.8

New York City, NY L 61.7 29.1 0.4 8.7 25.0 2,897.4 0.8 1,195 36.1 8.5

Philadelphia, PA-NJ L 76.8 20.0 0.2 3.0 4.4 494.8 0.4 NA 18.0 4.9

Portland, ME S 97.9 0.7 0.2 1.1 0.8 116.2 3.4 249 12.3 2.9

West South Northeast Midwest

Source: 1999 County and City Extra: Annual Metro, City, and County Data Book, Eighth Edition. Eds: Gaquin, D.A., and Littman, M.S. 

Washington, DC: Bernan Press

APPENDIX 2: POPULATION DEMOGRAPHICS IN THE 20 PULSE CHECK SITES
Pulse Check: Mid-Year 2000 page 67

APPENDIX 3: OTHER DATA SOURCES

Billings, MT

Denver, CO # # # ##

Los Angeles, CA # # # ##

Honolulu, HI ###

Seattle, WA # # # ##

Chicago, IL # # # ##

Detroit, MI # # ##

Sioux Falls, SD #

St. Louis, MO # ##

Birmingham, AL #

Columbia, SC

El Paso, TX ###

Memphis, TN #

Miami, FL # # # ##

New Orleans, LA # # ##

Washington, DC # # # ##

Boston, MA ### #

New York, NY # # # ##

Philadelphia, PA # # ##

Portland, ME #

Site HIDTA1 Past Pulse CEWG2 DAWN3 ADAM4

State Check

APPENDIX 3: NATIONAL-LEVEL DATA SOURCES AVAILABLE IN THE 20 PULSE CHECK SITES West Northeast South Midwest

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 cities are in a rural area.
page 68 Pulse Check: Mid-Year 2000

APPENDIX 4: PULSE CHECK SOURCES

Epidemiology/Ethnography Law Enforcement

Billings, MT Roland Mena Scott Forshee

Department of Health/Substance Abuse City/County Special Investigations Unit

Birmingham, AL Sergeant T.E. (Thomas) Thrash

Birmingham Police Department

Vice and Narcotics Division

Boston, MA Thomas W. Clark Lieutenant Francis Armstrong

Health and Addictions Research, Inc. Drug Control Division

Boston Police Department

Chicago, IL Larry Ouellet, Ph.D. Prefers anonymity

University of Illinois at Chicago 

School of Public Health

Columbia, SC Prefers anonymity Prefers anonymity

Denver, CO Bruce Mendelson, M.P.A. Prefers anonymity

State Treatment Needs Assessment Contract

Colorado Department of Human Services

Alcohol and Drug Abuse Division

Stephen Koester, Ph.D.

Urban Links

Detroit, MI Richard F. Calkins Nonrespondent

Michigan Department of Community Health

Division of Substance Abuse Quality and Planning

El Paso, TX Alviane, Inc. Prefers anonymity

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

University of Hawaii Narcotics, Vice Division

Department of Sociology Hawaii Police Department

Los Angeles, CA Richard Rawson, Ph.D. Prefers anonymity

University of California, Los Angeles

Integrated Substance Abuse Programs (ISAP)

Memphis, TN Randy Dupont, Ph.D. Sergeant Richard Parker

University of Tennessee Memphis Police Department

Department of Psychiatry Vice Narcotics Unit

Miami, FL James N. Hall Prefers anonymity

Up Front Drug Information Center

New Orleans, LA Gail Thornton-Collins Lieutenant Commander Bruce Adams

New Orleans Health Department Narcotics Major Case Section

New Orleans Police Department

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

New York State Office of Alcoholism New York Division

and Substance Abuse Services

Street Studies Unit

Philadelphia, PA Philadelphia Behavioral Health System Drug Enforcement Administration

Coordinating Office for Drug Philadelphia Field Division

and Alcohol Abuse Programs Divisional Intelligence Group

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

Public Health Division Augusta Field Office/

Maine Drug Enforcement Agency

Department of Health and Human Services

City of Portland

Seattle, WA Thomas R. Jackson, M.S.W. Steve Freng

Evergreen Treatment Services High Intensity Drug Trafficking Area

Sioux Falls, SD Darcy Jensen, CCDCIII, CPS Lieutenant Mark Moberly

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, D.C. Alfred Pach, Ph.D., M.P.H. Sergeant John Brennan

National Opinion Research Center Washington, D.C., Police Department
Pulse Check: Mid-Year 2000 page 69

APPENDIX 4: PULSE CHECK SOURCES

Non-Methadone Treatment Methadone Treatment

Billings, MT Deena Vandersloot Illegal in the State of Montana

South Central Mental Health Center

Journey Recovery Program

Mona Sumner

Rimrock Foundation

Birmingham, AL Eleanor Powers Bill Garrett, M.P.H.

Alcohol and Drug Treatment Centers, Inc. University of Alabama

Substance Abuse Program

Boston, MA Prefers anonymity Jayne Wilson, LICSW

CAB Health and Recovery Services

Chicago, IL Del Larkin Cornell Interventions

Association House of Chicago

Columbia, SC Carolyn Flemming Columbia Metro Treatment Center

Lexington/Richland Alcohol 

and Drug Abuse Council

Denver, CO Beth Leighton, R.N., M.S.N. Nonrespondent

Addiction Treatment Service

Presbyterian St. Luke’s Medical Center

Detroit, MI Prefers anonymity Octavius Sapp, CAC

City of Detroit

Detroit Department of Human Services

Drug Treatment

El Paso, TX Casa Blanca Therapeutic Communities James Sabal, M.D.

El Paso Methadone Maintenance and 

Detox Treatment Center

Honolulu, HI Prefers anonymity Nonrespondent

Los Angeles, CA Mari Radvik, M.D. Sandy MacNicoll

Substance Abuse Treatment Program, West LA Treatment Program

Division of Adolescent Medicine

Children’s Hospital of Los Angeles

Memphis, TN Prefers anonymity Prefers anonymity

Miami, FL Prefers anonymity Nonrespondent

New Orleans, LA Eleanor Glapion Letetia Nelson, BA, LPN, LSBCSAC, RCS

New Orleans Substance Abuse Clinic Metropolitan Treatment Center, Inc.

New York, NY (Prefers anonymity) Eugenia Curet, M.D.

The New York Presbyterian Hospital

Adult Service Clinic

Philadelphia, PA Nonrespondent Peter A. Demaria, Jr., M.D., FASAM

Department of Psychiatry and Human Behavior

Jefferson Medical College

Portland, ME Stephen Leary Prefers anonymity

Milestone Foundation, Inc.

Seattle, WA Prefers anonymity Therapeutic Health Services

Sioux Falls, SD Prefers anonymity Robin Erz, CCDCIII

Avera McKennan - Turning Point

Heisler Adolescent Treatment Program

St. Louis, MO Nonrespondent Prefers anonymity

Washington, D.C. Prefers anonymity LaTonya Sullivan

Umoja Treatment Center