Texas

January 2014 Update to Drug Trends in Texas

Jane C. Maxwell, Ph.D.

Updated Drug Abuse Trends and Emerging Patterns

The key findings for 2013 are 1) an increase in young heroin users and 2) increasing presence of the more potent P2P methamphetamine made in Mexico.

Heroin: The primary types of heroin in Texas are Mexican black tar and powdered brown, which is black tar turned into a powder by combining it with diphenhydramine or other ingredients. The age of persons of persons dying from a heroin overdose has been decreasing, with the average age declining from 41 years in 2005 to 36 years in 2012. There are more reports of suburban youth using heroin, according to key informants, and the number of young clients entering treatment with a primary problem of heroin has increased. The proportion of primary heroin treatment admissions who were younger than 30 went from 41 percent in 2005 to 54 percent in 2012, while the proportion of older clients entering treatment with heroin as the primary problem decreased correspondingly. The number of calls to the Texas Poison Center Network involving exposures to heroin ranged from 181 in 1998 to a high of 307 in 2012. The mean age of the cases in 2012 was 30 years. The demand for heroin in Texas also increased in the current reporting period, with supplies up and costs down, based on Drug Enforcement Administration (DEA) field division reports. The proportion of seized drugs identified as heroin among drug items analyzed by laboratories reporting to NFLIS remained low at 4 percent.

Methamphetamine: Beginning in 2008, the decrease in methamphetamine indicators that followed the 2006 ban on the sale of large quantities of pseudoephedrine to produce the illicit drug reversed. Methamphetamine indicators were at higher levels in this reporting period than ever seen in Texas. The higher purity and potency of the current supply is due to the P2P (phenyl­2-propanone) version of the drug made in Mexico, based on data from the DEA’s Methamphetamine Profiling Program. The number of calls to Texas poison control centers involving human exposure to methamphetamine increased from 279 in 2012 to 503 in 2013. To aid in smuggling supplies into Texas, liquid methamphetamine is imported into Texas and then converting it to “ice.” Street outreach workers report that more psychotic episodes were occurring among methamphetamine users recently. They also report the old term for methamphetamine, “Tina,” or “T,” was again being used by those seeking anonymous sex partners through social media channels. The proportion of methamphetamine items seized, analyzed, and reported to NFLIS in Texas increased from 16.8 percent of all drugs in 2012 to 21.8 percent in 2013. 

Synthetic Cannabinoids (Cannabimimetics): It appears that the popularity of cannabimimetics in Texas is dropping. Texas poison control center calls for synthetic cannabinoids peaked in 2011 at 588; these calls dropped to 474 in 2012 and then to 464 in 2013. Seventy-one percent of the cases involved males, with the average age being 23 years. The 2013 data reported to NFLIS show changes in the different varieties of cannabinoids for Texas: the JWH varieties have almost disappeared, and XLR varieties were dominant in 2013.

Synthetic (substituted) cathinones also peaked in 2011 in Texas poison control center data. In Texas, there were 340 calls to poison control centers for synthetic (substituted) cathinones in 2011; they declined to 160 in 2012 and 53 in 2013. Some 73 percent of the 2013 cases involved males, with the average age being 29 years.

MDMA (3,4-methylenedioxymethamphetamine) calls to Texas poison control centers peaked in 2009 at 310 and declined to 184 in 2013. Items reported in NFLIS as MDMA peaked in 2007 at 1,758 and declined to 91 in 2013. The scientific literature has reported that mephedrone and methylone, two stimulants commonly found in synthetic cathinones, act on the brain much like MDMA. The MDMA drought continues, and users may be replacing MDMA with the synthetic cathinones.

Cocaine indicators (poison control center calls, primary treatment admissions, forensic findings, and deaths) continued to decrease, with fewer seizures at the border, more diversion to Europe, use of levamisole as a filler, and increased prices. Some users on the street report the available cocaine is so weak that it is not worth the cost.

Marijuana/Cannabis: Demand indicators for marijuana/cannabis (poison control center calls, primary treatment admissions, and forensic laboratory items identified) were level or increasing. However, supply indicators are down. The quality of Mexican cannabis is poor, and availability is down due to a drought in Mexico. Indoor and hydroponic grows in Texas provide large quantities of high-quality cannabis. Due to the situation in Mexico, there may be an emerging domestic supply source.

Prescription Opioids/Opiates Other Than Heroin: Indicators were increasing for prescription opioids/opiates other than heroin, with users of street methadone becoming more similar to users of other opioids in terms of gender and race/ethnicity. Drinking codeine cough syrup continued to be driven by music promoting “sippin’ syrup” and recent cases of singers getting in trouble because of their use of “Syrup.” Abuse of prescription narcotic drugs is seen in two groups: teenagers/young adults seeking euphoria and older Baby Boomers seeking pain relief. Hydrocodone continued to be the most prevalent prescription opioid used for nonmedical purposes in Texas in this reporting period.

Benzodiazepines: Alprazolam continued to be the most frequently identified benzodiazepine among drug reports from Texas forensic laboratories reporting to NFLIS in 2013. Alprazolam is one of the ingredients in the “Houston Cocktail” or “Holy Trinity,” along with hydrocodone and carisoprodol.

HIV (human immunodeficiency virus)/AIDS (acquired immunodeficiency syndrome)/HCV (hepatitis C) data show decreases over time in Texas in the proportions of cases related to injection drug use (from 6 percent of all AIDS cases reported in 2008 to 4 percent in 2012). Reports of “Krokodil” (the street name for desomorphine, a synthetic morphine analog) highlight the need to expand the focus of outreach initiatives to include information about the dangers of dirty needles in terms of MRSA (Methicillin-resistant Staphylococcus aureus) and wound infections, according to the area representative. Increases in methamphetamine use among men who have sex with men illustrate the need to increase emphasis on the dangers of anonymous unprotected sex involving the use of social media to find partners. Additionally, outreach needs to emphasize not only the dangers of HIV/AIDS, but also the problems confronted in receiving and maintaining treatment after HIV infection. New drugs approved by the Food and Drug Administration are now available to treat those with HCV.

Data Sources: Poison control center cases through December 31, 2013, were received from the Texas Poison Center Net­work, Department of State Health Services (DSHS), and the American Association of Poison Control Centers. HIV/AIDS/HCV reports were received from 14 DSHS-funded street outreach programs. Forensic laboratory data are for drugs seized by Texas law enforcement agencies, identified by toxicological laboratories, and reported to NFLIS, Drug Enforcement Administration (DEA), for 2013. NFLIS data in this report for 2013 will differ from the data shown for Texas in the January 2014 Highlights and Executive Summary Report, where NFLIS data are for the first half of 2013 (January–June), because more complete NFLIS data for all of 2013 were downloaded on February 19, 2014. Even these numbers are preliminary due to the lag in identifying some of the new synthetic drugs.  Intelligence reports for the first half of 2013 came from the Dallas, El Paso, and Houston DEA Field Divi­sions. Methamphetamine data came from the DEA’s Methamphetamine Profiling Program through the third quarter of 2013. Treatment data were provided by the DSHS data system on clients admitted to treatment in DSHS-funded facilities from January 1, 1987, through December 31, 2012; data for 2013 will be included in the June 2014 report.