Professor Jane Maxwell from the Addiction Research Institute has released the 2018 report to the National Drug Early Warning System (NDWES), Drug Use Patterns and Trends in Texas (pdf). Main findings include:
- Methamphetamine is the No. 1 drug threat ranked by the Dallas, El Paso, and Houston DEA Field Divisions. Indicators of drug use (poison control calls, treatment admissions, deaths, and toxicology reports on substances seized and identified) all show methamphetamine is a larger problem than heroin. Methamphetamine continues to be made using phenyl-2-proponone, not cold medicines, and major drug seizures of large quantities imported from Mexico are more commonly reported..
- Cocaine is ranked the No. 2 to No. 3 threat by the DEA Field Divisions. Poison center calls and treatment admissions for cocaine continue to decrease while deaths and toxicological data are increasing. Use is more common among the marginalized and people experiencing homelessness. The expected flood of cocaine from Colombia is beginning to be seen.
- Pharmaceuticals, benzodiazepines, hydrocodone, and muscle relaxants remain problematic. Compared to other NDEWS sites, the number of fentanyl items seized and identified is increasing, but the number of cases involving heroin and fentanyl in combination is low, while the number of cases involving fentanyl and other opiates is high. The recent increase in the number of tramadol cases involved with other opiates is also a concern.
- Heroin in Texas is either black tar heroin or powdered brown heroin (diluted with diphenhydramine or other filler), with some white Mexican/South American heroin seen. In Texas, “tar” is sold in small balloons and the user than extracts the tar from the balloon, mixes it with water over heat, and then draws it up and injects it. In states north of Texas, the heroin tends to be powdered when it reaches the dealer, who then packages it (with or without powdered fentanyl) in cellophane envelopes to sell to the user. To prevent an overdose, fentanyl test strips should be used to determine if the package contains fentanyl. In Texas, of the top 25 items seized and identified in Texas laboratories reporting to the National Forensic Laboratory Information System (NFLIS), heroin ranks No. 4, at 5.2 percent of all items identified, and fentanyl ranks No. 21 (0.21 percent of all items identified).
- Cannabis indicators remain steady, with problems most often seen in the trafficking of decriminalized cannabis products from Colorado through Texas. Additional research is needed to analyze the problems from the use of these products and the effects of potency.
- Synthetic cannabinoid and cathinone poison calls have decreased but recent research by the author looking at treatment admissions and poison center call data has found statistically significant trends over time. The user population has changed from younger males hoping to use a cannabinoid that would not show positive in drug tests to an older population who are more likely to be experiencing homelessness and comorbid psychological problems.
- Texas needs an enlarged harm reduction campaign beyond the heroin+fentanyl emphasis. It needs to target people who are using a variety of prescription opiates, and their pharmacists and physicians. It should not only provide naloxone but to also train users and their family members on the signs of overdose.