Detroit, Wayne County, and Michigan

Drug Abuse Patterns and Trends in Detroit, Wayne County, and Michigan—Update: January 2014

Cynthia L. Arfken, Ph.D.

Overview of Findings: The continuing problems in Detroit, Wayne County, and the State of Michigan with heroin and the increase in stimulants other than cocaine were the two most important findings for this reporting period. Drug use patterns in Detroit differ from those across the rest of the State of Michigan. In Detroit, heroin and cocaine are the two major drugs of abuse, based on treatment admissions, while heroin and prescription opioids/opiates other than heroin are the major drugs of abuse in the rest of the State. However, mari­juana indicators were widespread in both Detroit and across the State. In Detroit, primary cocaine treatment admissions declined as a proportion of total admissions from fiscal year (FY) 2012 to FY 2013, and crack cocaine continued to be the dominant form of cocaine for these admissions. In 2013, numbers of drug-related deaths in Detroit declined. The most striking trend for heroin admissions in Michigan was the continued influx of young, White, and injecting treatment clients. However, in Detroit, for the first time, an increase in the proportion of African-Americans in treatment admissions data was observed. Treatment admissions for marijuana as the primary drug of abuse have been stable with minor fluctuations for the past 7 years. The top four drugs identified in drug reports among drug items seized and analyzed by National Forensic Laboratory Information System (NFLIS) laboratories for Wayne County and the State of Michigan in the first half of 2013 were marijuana, cocaine, heroin, and hydrocodone. The number of synthetic cannabinoids identified in NFLIS data declined sharply in both Wayne County and the State, but no similar decline for synthetic cathinones was identified in NFLIS drug reports for either geographic area.

Updated Drug Abuse Trends and Emerging Patterns

Cocaine: Treatment admissions with cocaine as the primary drug accounted for 15.7 percent of total Detroit publicly funded admissions in FY 2013, continuing cocaine's decline from its height of 33.8 percent in both FY 2000 and FY 2003. The proportion of publicly funded admissions in the rest of the State with cocaine reported as the primary drug was much lower (6 percent) from a height of 19 percent in FY 2006. However, in the rest of the State, the proportion of cocaine admissions that involved crack was lower (67.7 percent) than the proportion in Detroit (90.7 percent). Of the cocaine admissions in Detroit, 64.3 percent were male, compared with 57.7 percent in FY 2009; 91.7 percent were African-American; and 88.4 percent were older than 35. Cocaine continued to rank second among drug reports identified in items seized and analyzed for Wayne County and the State of Michigan, according to NFLIS, in the first half of 2013.

Heroin: In FY 2013, treatment admissions in Detroit with heroin as the primary drug constituted 33.3 percent of all admissions, relatively stable from FY2012, when the proportion of such admissions was 34.5 percent. The proportion of publicly funded admissions in the rest of the State with heroin as the primary drug was much lower (at 20.4 percent), but it continued to increase (the proportion was 13.8 percent in FY 2010). In Detroit, 64.6 percent of primary heroin treatment admissions were male; 82.3 percent were African-American (compared with 78.7 percent in FY 2011); and 85.8 percent were older than 35. In FY 2013, White heroin treatment clients in Detroit continued to be younger (with a lower mean age) than African-American heroin treatment clients (39.2 versus 53.6 years, respectively), and they were more likely to inject heroin (71.5 versus 33.1 percent, respectively). In Detroit, White injecting heroin users constituted 10.5 percent of treatment admissions for heroin during FY 2013, compared with 13.1 percent during FY 2012. Admissions among noninjecting African-Americans climbed to 55.1 percent of heroin admissions in FY 2013, reversing a steadily declining proportion since FY 2006. Heroin continued to rank third among drug reports from items seized and analyzed by NFLIS laboratories for Wayne County and the State of Michigan in the first half of 2013.

Prescription Opioids/Opiates Other Than Heroin: Treatment admissions with prescription opioids/opiates other than heroin as the primary drug in Detroit accounted for 2.8 percent in FY 2012, compared with 15.6 percent for the rest of the State. Hydrocodone continued to be the prescription opioid most frequently identified in drug reports among items analyzed by NFLIS laboratories for both Wayne County and the State of Michigan in the first half of 2013.

Methamphetamine indicators in Detroit remained low. Only 5 treatment admissions cited methamphetamine as the primary drug of abuse in Detroit during FY 2013 (constituting 0.1 percent of total admissions), compared with 891 in the rest of the State (representing 1.4 percent of the total treatment admissions for the rest of the State). For the first time, in the first half of 2013, methamphetamine was among the top 10 drug reports identified among drug items seized and analyzed in NFLIS laboratories for Wayne County; the drug ranked fifth among drug reports for the State of Michigan.

Marijuana/Cannabis: Treatment admissions with marijuana as the primary drug in Detroit accounted for 15.3 percent in FY 2013; this was similar to the 15.0 percent of primary marijuana admissions reported in FY 2011. Of these recent admissions, males represented 60.5 percent; 91.1 percent were African-American; and the proportion younger than 18 was 21.5 percent (this represented a sustained decline from 28.9 percent in FY 2011). The percentage of publicly funded admissions in the rest of the State with marijuana as the primary drug was similar (at 16 percent) in FY 2013. Marijuana/cannabis continued to rank first among drug reports from items seized and analyzed by NFLIS laboratories for both Wayne County and the State of Michigan in the first half of 2013. A focus group of law enforcement officials reported that marijuana use was widespread in Detroit.

Other Drugs: Both synthetic (substituted) cathinones (and cathinones) and synthetic cannabinoids (cannabimimetics) were reported among drug reports from items seized and analyzed by NFLIS laboratories for Wayne County and the State of Michigan in the reporting period. However, while the number of  drug reports dropped for synthetic cannabinoids in the State (from 135 synthetic cannabinoid drug reports in 2012 to 35 in the first half of 2013), the combined numbers of  synthetic (substituted) cathinones and cathinones in drug reports increased (from n=154 in 2012 to n=168 in the first 6 months of 2013). Interviews with users suggested less interest in synthetic cannabinoids but did not support increased interest in synthetic (substituted) cathinones.

HIV (human immunodeficiency virus)/AIDS (acquired immunodeficiency syndrome)  Update: From January to October 2013, people with newly diagnosed HIV infection continued to be disproportionately living in the six-county metropolitan Detroit area; 60 percent were from metropolitan Detroit, an area that constitutes only 43 percent of Michigan’s total population. Newly diagnosed HIV cases were also disproportionately male (81 percent) and African-American (60 percent); African-Americans represent 43 percent of the State’s total population. Seven percent of the people newly diagnosed with HIV infection reported injection drug use, either alone or combined with other high-risk sexual behaviors, as a risk factor in 2013.

Data Sources: Mortality data came from the Wayne County Medical Examiner for 2013. Drug-related crime data came from a law enforcement officials' focus group conducted by Cynthia L. Arfken, Ph.D.Users’ perspectives data came from a research study (Emerging Drugs of Abuse, Principal Investigator C. Arfken). Treatment admissions data were provided by the Bureau of Substance Abuse and Addiction Services, Division of Substance Abuse and Gambling Services, Michigan Department of Community Health for FY 2013. Forensic laboratory data for the first half of 2013 were provided by NFLIS. HIV data came from the Michigan Department of Community Health for January–October 2013.