New York City, New York

Drug Abuse Patterns and Trends in New York City—Update: January 2014

Gregory Rainone, Ph.D., and Rozanne Marel, Ph.D.

Overview of Findings: The two most important findings in New York City in this reporting period were the continuing predominance of cocaine, heroin, and marijuana in indicators (based on proportions of treatment admissions and drug reports among drug items analyzed by National Forensic Laboratory [NLFIS] laboratories in the first half of 2013) and an increase in indicators and consequences for prescription opioids/opiates other than heroin. Cocaine remained a major problem in New York City, according to the area representative but cocaine indica­tors were mixed for this reporting period. New York City is considered the most important heroin market and distribution center in the country; in this reporting period, heroin indicators were stable in New York City. Mari­juana indicators were at a high level, and most marijuana indicators were also stable in the first half of 2013. More clients in treatment had a primary, secondary, or tertiary problem with marijuana than with any other drug. Many kinds of prescription drugs were available on the street. Opioid analgesic poisoning death rates per 100,000 population in New York City increased by 50 percent between 2005 and 2012. Methamphetamine indicators in New York City remained low. Most indicators for other drugs remained low, but PCP (phen­cyclidine) and ketamine were among the top 10 drug reports identified among drug items analyzed by NFLIS laboratories in the first half of 2013.

Updated Drug Abuse Trends and Emerging Patterns

Cocaine indicators were mixed in this reporting period, with some remaining stable and some decreasing. Primary cocaine treatment admissions, as a proportion of the total, decreased slightly to 13 percent in the first half of 2013, compared with 14 percent in the first half of 2012, but they still represented the lowest first half-year number in more than two decades. Many clients in treatment had a primary, secondary, or tertiary problem with cocaine. Cocaine reports were the second most common identified among seized drug items analyzed in NFLIS laboratories. In the first half of 2013, 32.2 percent of all drug reports among items analyzed in NFLIS laboratories were identified as cocaine, compared with 34.5 percent of the total in the first half of 2012.

Heroin remained a major problem in New York City based on all available indicators. Primary heroin treatment admissions were relatively stable, constituting more than one-quarter of all primary treatment admissions (26 percent of total admissions in the first half of 2013, compared with 24 percent of the total in the first half of 2012). Among primary heroin treat­ment admissions, the proportion of injectors was 43 percent, slightly lower than the 44 percent who cited injection as their primary route of administration in the first half of 2012; this proportion was higher, however, than the proportion from 1996 through 2011. For the first time since 2009, the average age at admission to substance abuse treatment decreased. In the first half of 2013, 11.6 percent of drug reports among items analyzed in NFLIS laboratories were identified as heroin; this represented a slight increase over 10.4 percent of the total in the first half of 2012.

Marijuana/Cannabis indicators remained at a high level. Primary marijuana treatment admissions were stable and represented 25 percent of all treatment admissions. More clients in treatment had a primary, secondary, or tertiary problem with marijuana than with any other drug. More than one-third of drug reports among items analyzed by NFLIS laboratories (33.6 percent) in the first half of 2013 were identified as marijuana/cannabis, the highest proportion for any drug. This proportion was the same as in the first half of 2012.

Methamphetamine indicators remained low relative to other drugs. Numbers of primary methamphetamine treatment admissions and of NFLIS methamphetamine drug reports among analyzed drug items were at very low levels. In the first half of 2013, methamphetamine ranked 11th among all NFLIS drug reports, with 197 reports identified as methamphetamine. In 2012, methamphetamine ranked 16th among total drug reports from analyzed items, with 131 reports identified as methamphetamine.

MDMA (3,4-methylenedioxymethamphetamine) indicators were stable during this reporting period. NFLIS data from forensic laboratories showed that MDMA fell to 16th among all drug reports from analyzed drug items in the first half of 2013 (n=93 reports) in the five boroughs of New York City, compared with 13th (n=171 reports) in the first half of 2012 .

Prescription Opioids/Opiates Other Than Heroin indicators showed an increase from previous reporting periods. While unintentional drug poisoning death rates in New York City decreased by 12 percent overall between 2005 and 2012, opioid analgesic poisoning death rates increased by 50 percent. Opioid analgesic poisoning death rates increased by 233 percent among Staten Islanders during this period. Preliminary data for 2012 may suggest stabilization in these death rates. Primary treatment admissions for prescription opioids/opiates other than heroin and for benzodiazepines remained low, but both increased in proportion to other drugs in recent years. Although prescription drugs represented only a small number of drug reports among items analyzed by NFLIS laboratories, the specific drugs that accounted for more than 150 drug reports each in the first half of 2013 were oxycodone (n=1,094, ranking 4th among the top 10 drugs), alprazolam (n=1,071, ranking 5th), buprenorphine (n=418, ranking 7th), methadone (n=358, ranking 8th), clonazepam (n=341, ranking 9th), and hydrocodone (n=161, not ranking within the top 10 but placing 12th among all drug reports from analyzed items). These numbers represented increases for all of these specific drugs since the first half of 2012 except hydrocodone, which declined very slightly in number from the first half of 2012.

Other Drugs: PCP and ketamine were among the top 10 drug reports identified among drug items analyzed by NFLIS laboratories in the first half of 2013. PCP ranked 6th, with 1.7 percent of total drug reports, and ketamine ranked 10th, with 1.0 percent of the total. These rankings and percentages were stable from the first half of 2012, when PCP also represented 1.7 percent of the total drug reports from NFLIS laboratories, and ketamine represented 0.7 percent.

HIV (human immunodeficiency virus)/AIDS (acquired immunodeficiency syndrome) Update: As of December 31, 2012, 114,926 persons had been diagnosed with HIV/AIDS and reported in New York City and were presumed to be living. In 2012, there were 3,141 new HIV diagnoses, 1,889 new AIDS diagnoses, and 1,578 deaths among persons with HIV. Important disparities in HIV by gender, race/ethnicity, HIV transmission risk, geography, and poverty level continued from previous reporting periods. Men having sex with men remained the major transmission risk factor. Among the new HIV diagnoses, only 4.4 percent had a transmission risk factor of injection drug use history.

Data Sources: Treatment admissions data were provided by New York State Office of Alcoholism and Sub­stance Abuse Services for 1991 through the first half of 2013 and included both State-funded and nonfunded admissions. Demographic data were for the first half of 2013. Data were extracted on November 18, 2013. Forensic laboratory testing data for New York City were provided by the Drug Enforcement Administration (DEA)’s NFLIS for the first half of 2013. The data include New York Police Department laboratory data for the five boroughs of New York City, as well as data from New York State and DEA laboratories. Data were extracted on December 30, 2013. Drug price and trafficking data were provided by the DEA New York Division: Drug Trends, July 2013. Prescription drug data for New York City were provided by Paone, D., Tuazon, E., Nolan, M., & Bradley O’Brien, D., Unintentional Drug Poisoning (Overdose) Deaths in New York City, 2000–2012, New York City Department of Health and Mental Hygiene, Epi Data Brief, (33), September 2013, updated January 2014. AIDS and HIV data were provided by the New York City Department of Health and Mental Hygiene, HIV Surveillance Annual Report, 2012, published December 2013.