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NCJ 197242


Since 1992, the Office of National Drug Control Policy (ONDCP) has published the Pulse Check, a source for timely information on drug abuse and drug markets. The report aims to describe chronic drug users, emerging drugs, new routes of administration, varying use patterns, changing demand for treatment, drug-related criminal activity, drug markets and shifts in supply and distribution patterns. Pulse Check regularly addresses four drugs of serious concern: heroin, crack cocaine/powder cocaine, marijuana, and methamphetamine. Additionally, due to their spread across the country, Pulse Check continues to monitor the problems of "ecstasy" (methylenedioxymethamphetamine or MDMA), the diversion and abuse of OxyContin® (a controlled- release formulation of the pharmaceutical opiate oxycodone), and other drugs of concern.

The Pulse Check is not designed to be used as a law enforcement tool but rather to be a research report presenting findings on drug use patterns and drug markets as reported by ethnographers, epidemiologists, treatment providers and law enforcement officials. The intent of the Pulse Check has been and continues to be merely to describe patterns in illicit drug use and illicit drug markets that are emerging in local communities.

Several key features characterize the illicit drug situation:

  • Heroin continues to surpass crack as the drug associated with the most serious consequences, as perceived by 31 sources in 15 cities, particularly in the Northeast and Midwest.
  • Crack remains a serious problem, according to 21 sources in 14 cities, particularly in the South. One source in Memphis suggests that crack has overtaken marijuana as the most commonly abused drug.
  • Marijuana remains the most widely abused illicit drug, as reported by 34 sources in 17 cities.
  • Methamphetamine is reported as an emerging or intensifying problem in 10 cities. Furthermore, sources in eight cities, particularly in the West, consider it the drug contributing to the most serious consequences.
  • Some signs indicate that diversion of OxyContin® (oxycodone hydrochloride controlled-released) might have peaked during the last reporting period. However, it continues to be reported as an emerging problem by sources in 14 Pulse Check cities.
  • Ecstasy (methylenedioxymethamphetamine or MDMA) continues to emerge or intensify as a problem in all but five Pulse Check cities: in Detroit, Miami, New Orleans, New York, and Portland (ME), it has now either leveled off or has become an established drug of abuse.
  • Marijuana is the illicit drug most easily purchased by both users and undercover police, followed by crack.
  • Users find it a bit more difficult than undercover police to purchase powder cocaine.
  • Heroin is also relatively easy to purchase on the street. Undercover police generally find it slightly more difficult to purchase than crack or powder cocaine. Users, on average, purchase heroin with more difficulty than crack but with less difficulty than powder cocaine.
  • Of the five drugs discussed, methamphetamine is the most difficult to purchase overall. It is easiest to purchase the drug in Honolulu, Los Angeles, Memphis and Sioux Falls.
  • Only a few sources report that users or undercover police had a hard time buying drugs at any specific times during this reporting period.
  • Drug markets in several Pulse Check cities appear more active when users receive paychecks or Government checks, on or before weekends and holidays, when police presence is low and when supply is up.
  • Beepers and cell phones are the most common means of communication between dealers and their buyers, suppliers and fellow dealers.
  • Motor vehicles, usually personal cars, are the most frequently mentioned means of moving drugs.
  • Dealers generally accept mostly cash in payment for drugs. They do, however, occasionally accept other modes of payment, such as sex, property or merchandise, other drugs, drug transport and other items or services.
  • Dealers dispose of cash from drug sales in many ways, including money laundering in various forms, "re-upping" supplies, spending on entertainment and passing money up the supply ladder.
  • An intense and visible police presence is, by far, the most effective, albeit short-term, deterrent to street drug buys.

 Highlights of Treatment Issues

  • Epidemiologic/ethnographic and treatment sources discuss various treatment issues, such as methadone maintenance capacity, treatment referral sources, adverse health consequences, barriers to treatment and diagnoses of psychiatric comorbidity:
  • Since the last Pulse Check, public methadone maintenance capacity has decreased somewhat in Chicago. Private capacity, however, has increased in Memphis, Miami, New Orleans, and Portland (ME), although waiting lists are reported by six sources.
  • Drug users, particularly those who use marijuana or crack, are predominantly referred to treatment through courts or the criminal justice system. Referral sources have remained generally stable since the last reporting period.
  • The impact of drug use on AIDS and HIV seems to have stabilized in the majority of treatment programs. Reported hepatitis C cases, however, continue to increase, usually because of increased screening and awareness.
  • The most reported barriers to drug treatment (in descending order) are limited slot capacity, lack of trained staff to treat comorbid mental health disorders and violent behavior among presenting clients.
  • Mood and conduct disorders are the most commonly reported mental health diagnoses among drug treatment clients, according to treatment respondents.

(Excerpted from information in Pulse Check: Trends in Drug Abuse, November 2002; Executive Office of the President, Office of National Drug Control Policy, http://www.whitehousedrugpolicy.gov/)


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Free To Grow is a national program supported by the Robert Wood Johnson Foundation and the Doris Duke Charitable Foundation with direction and technical assistance provided by the Mailman School of Public Health of Columbia University.