Abuse

Cocaine, heroin, and marijuana are abused at high levels in the PC HIDTA region. Cocaine, especially crack, is the primary cause of drug-related deaths, emergency department visits, and treatment admissions to publicly funded facilities in Philadelphia. Heroin abuse is rising in the HIDTA region. Declining heroin purity has contributed to local abusers' alternative methods of abuse such as injecting greater doses, injecting more frequently, or abusing heroin in combination with other drugs such as fentanyl, a synthetic opioid significantly more potent than heroin. From late April through August 2006, clandestinely produced fentanyl was linked to approximately 500 overdoses and 200 deaths in the tristate area (southeastern Pennsylvania, southern New Jersey, and northern Delaware). Most of these incidents occurred in Philadelphia; officials report approximately 300 overdoses and 170 deaths. Clandestinely produced fentanyl powder, heroin/fentanyl combinations, and cocaine/fentanyl combinations have been periodically distributed throughout the region; however, the availability of fentanyl and fentanyl combinations appears to have decreased since the fall of 2006. Compounding the heroin problem in the region, the drug is gaining popularity among teens and young adults, who initially inhale the drug but progress to injection as addiction sets in. Marijuana is the most widely available and commonly abused illicit drug in the region. Additionally, the availability of high-potency marijuana, both Canadian and locally produced, is increasing, drawing new users to the drug.

Methadone abuse is a developing problem. In the Philadelphia metropolitan area, the availability of diverted methadone is due, in part, to patients in opioid treatment programs selling their take-home doses of the drug. According to treatment providers, many methadone abusers are using the drug in combination with benzodiazepines in an attempt to achieve a heroin-like effect. Many methadone abusers are acquiring benzodiazepines from treatment patients who obtain the drugs by prescription, keep some for themselves, and sell the rest at or near treatment sites.

The abuse of benzodiazepines is an increasing problem in the PC HIDTA region. As a group, benzodiazepines are the second most frequently detected drugs (after cocaine) in drug-related deaths in Philadelphia. The two most frequently abused benzodiazepines in Philadelphia are alprazolam (marketed as Xanax and Niravan) and diazepam (marketed as Valium), although others are also abused. The abuse of prescription opiates such as oxycodone and hydrocodone also is increasing in the region, especially among adolescents and young adults. These abusers typically initiate opiate abuse with prescription drugs, rather than heroin, to avoid the stigma associated with heroin; however, once addicted to prescription drugs, they often switch to heroin because of the drug's higher availability and lower price.

Diverted pharmaceutical abuse among teenagers and young adults is rising in the region. Such abuse often occurs in social settings such as "pharming parties," which typically involve teenagers taking medications from their relatives or those prescribed for them, mixing them in a bowl with pharmaceutical drugs obtained by other teenagers, and then ingesting several drugs that they indiscriminately retrieve from the bowl. This trend is especially dangerous for young girls whose lower body weight exacerbates the effects of the combined drugs. An increasing percentage of teens do not regard pharmaceutical drug abuse as dangerous; they believe that drugs prescribed by doctors are less harmful than illegal drugs such as cocaine, heroin, and methamphetamine.

Ice methamphetamine abuse may be rising in the HIDTA region. According to law enforcement officials and treatment providers, ice methamphetamine abuse typically has been concentrated within the homosexual male population, but it now may be spreading beyond this community to young rural and suburban users. Some officials also report an increase in ice methamphetamine abuse in the downtown Philadelphia nightclub scene.

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