Drug report shows shifting trends in use and abuse in Texas

Heroin users are younger, and a growing proportion of crack cocaine users are Anglo or Hispanic, according to a recent report on drug abuse trends in Texas.

The shifting demographics highlight why treatment, prevention and education programs must be flexible to respond to new addiction patterns, the report’s author said.

"The type of person using a drug 10 years ago is often not the same person using it today," said Dr. Jane Maxwell of the University of Texas Addiction Research Institute. "It is always evolving. You have to target new groups."

The report, Substance Abuse Trends in Texas, relied on data from multiple agencies, law enforcement and drug-treatment centers.

Among the more important trends noted is a new generation of younger, Hispanic heroin users.

Of those admitted to treatment centers funded by the Department of State Health Services, the average age of a heroin user has fallen from 37 in 1996 to 34 in 2007. Meanwhile, the proportion that is Hispanics has more than doubled, from 23 percent in 1996 to 55 percent in 2007.

"What we’re seeing is more people starting heroin when they are younger," Maxwell said. "One day they’ll use a needle. We need more effective treatment to target a younger population."

Dealers marketing the drug more to youths plays a major role in the increase, experts say.

In Dallas, for example, the "cheese heroin" epidemic involved dealers cutting heroin with Tylenol PM and selling it for as little as $3 a dose. Of 174 cases in which heroin users were age 19 and under in Dallas in 2007, 52 percent were male, 92 percent were Hispanic, and 96 percent inhaled their heroin, according to the report.

Tarrant County treatment centers saw a much smaller increase in young heroin users.

"We have seen more cases but still not anything like they saw in Dallas," said Stevie Hansen, chief of addiction services for Mental Health Mental Retardation of Tarrant County. "We’re ready for this epidemic to spread this way, but it just really hasn’t happened here. That’s a good thing."

Changing demographics

Statewide, the face of crack cocaine is also changing. It was originally a drug thought to primarily affect African-American communities, but the proportion of African-American addicts in treatment centers has dropped from 75 percent in 1993 to 46 percent in 2007.

The proportion of Anglos in treatment for crack cocaine increased from 20 percent in 1993 to 35 percent in 2007, while the numbers for Hispanics increased from 5 percent to 18 percent.

In Tarrant County, the majority of males treated for crack addiction are still African-American, but white women have surpassed African-American women, according to Fort Worth’s Recovery Resource Council, which screens potential patients.

"That’s how drugs evolve," said Suzanne Lofton, clinical director for the council. "They start in one community, one ethnicity or one age group. Word spreads, and the drug spreads into others."

Other trends noticed in Tarrant County treatment centers are more adults hooked on pain medications and fewer on methamphetamine. More patients seem to have longtime addictions, said Daryl Dulany, a licensed clinical social worker for Volunteers of America.

"I don’t know if it’s because they’re waiting longer to get treatment," Dulany said. "But I do know that the line to get in is longer."

Texas trends

Trends in drug and alcohol use among Texans, according to Substance Abuse Trends in Texas: June 2008, conducted by the Gulf Coast Addiction Technology Transfer Center and University of Texas Addiction Research Institute:

Cocaine/crack In 2007, 13 percent of high-school students reported having used cocaine/crack, compared with 12 percent in 2005. Between 1987 and 2007, the proportion of people using powder cocaine admitted for treatment increased from 23 percent to 48 percent for Hispanics, while it dropped for Anglos (from 48 percent to 33 percent) and African-Americans (from 28 percent to 18 percent).

The number of deaths statewide in which cocaine was mentioned increased from 223 in 1992 to 795 in 2006.

Heroin was the drug of choice for 10 percent of users admitted to state treatment centers. The majority of addicts inject the drug, but the proportion inhaling it has increased from 4 percent in 1996 to 20 percent in 2007.

Those in treatment were younger and more likely to be Hispanic. "This increase in inhalers and decrease in age at admission is evidence of the emergence of younger heroin users," the report found.

Cheese heroin — a mixture of heroin and Tylenol PM — continues to be a problem in Dallas County, the report stated. However, an analysis of overdose deaths there found only one death that involved cheese heroin alone.

The other deaths also involved drugs like cocaine, Xanax or hydrocodone, "which shows that this is not a population of novice users but a growing problem among very young, experienced heroin users."

Prescription drugs Abuse of alprazolam — the anti-anxiety drug in Xanax — and muscle relaxers appears to be growing.

The number of calls to poison-control centers involving alprazolam has grown, and the drug was mentioned on 216 death certificates in 2006, the report found.

Misuse and abuse of the muscle relaxer carisoprodol have also grown. Poison centers reported 83 calls in 1998 and 510 in 2007.

In 2006, carisoprodol was mentioned on 146 death certificates, up from 51 in 2003.

Methamphetamine
There are some signs that the rate of methamphetamine abuse is slowing. Deaths involving amphetamines or methamphetamines dropped from 2005 to 2006 (the most recent year available), and authorities busted fewer meth labs in 2007 than in 2006.

The Drug Enforcement Agency in Dallas reported that the availability of meth is stable but the price is rising because of tighter border security and increasing difficulty in obtaining the needed chemicals in Mexico.

However, less of the Mexican product could lead to more local labs, Maxwell said.

Alcohol
Alcohol continues to be the drug of choice for Texans. In 2007, 78 percent of high-school students reported having drunk alcohol.

Almost 50 percent had drunk in the past month, and 29 had drunk five or more drinks in a row in the last month.

Binge drinking has increased among girls and decreased among boys. In 2005, 26 percent of girls and 33 percent of boys reported binge drinking. In 2007, 28 percent of girls and 30 percent of boys reported doing it.

A 2005 Texas college survey found that 84 percent of students had drunk alcohol in their lifetime and almost 30 percent reported binge drinking.

Marijuana
Reported marijuana use among Texas high school students was down. Thirty-eight percent of students admitted to having smoked it in 2007, a decrease of 4 percent since 2005.

Marijuana was the primary problem for 23 percent of those admitted to treatment programs in 2007, with the average age being 23. Of those admitted, 42 percent were Hispanic, 30 percent were Anglo, and 27 percent were African-American.
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source: Star-Telegram, http://www.star-telegram.com