- Methamphetamine is the #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 #2-#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 #4, at 5.2% of all items identified, and fentanyl ranks #21 (0.21% 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.
Previous trends (all in PDF): October 2017, August 2016, June 2015, June 2014, June 2013, June 2012, June 2011, June 2010, June 2009, June 2008, June 2007, January 2006, June 2006, January 2005, June 2005, June 2004, June 2003, December 2003, June 2002, December 2002, June 2001, December 2001, June 2000, December 2000, June 1999, December 1999, June 1998, December 1998, June 1997, December 1997, June 1996, December 1996, June 1995, December 1995.
Substance Use Reports and Trainings
- Brief report on the current epidemic of drug poisoning deaths, 2014 (PDF)
- MDMA/Molly/Ecstasy–Warning, 2014: “Molly” initially referred to ecstasy pills with high quality MDMA powder. After the MDMA shortage several years ago, the capsules were more likely to contain caffeine, methamphetamine, & methylone with little MDMA. The European Monitoring Centre for Drugs and Drug Addiction issued a warning in February 2014 that “dangerously high” levels of MDMA were appearing in Europe. MDMA tablets in the Europe in 2012 contained 60 – 100 mg of MDMA, but tablets containing 150 and 200 mg of MDMA are were available in February 2014 and the warning stated they could contain even higher amounts, e.g. 240 mg. Deaths due to potent levels of MDMA have been reported in New York City at a music festival last summer and a recent death in Austin involved MDMA.
- Training: “Will they turn you into a zombie?” What clinicians need to know about synthetic drugs (second edition), 2013. Download the Trainer Guide (PDF), Slide presentation (PPTX), and Reference List (PDF).
- Synthetic Drug Training Package, 2013
- Leaning on Syrup: The Misuse of Opioid Cough Syrup in Houston, 1999 (PDF): With the increased recent interest in this form of substance abuse, Leaning on Syrup is one of the earliest publications that describes the phenomenon. The original purple color came from the color of promethazine cough syrup. Variations of “syrup” are avaialble at liquor stores and “relaxation” soft drinks (purple colored, without alcohol but containing ingredients such as melatonin, valerian root, rose hips) are available, without age restrictions, at some drug stores and convenience stores.
- Information on Cheese Heroin in Dallas, 2007 (PDF)
- Abuse of Prescription Drugs, 2006 (PDF)
- Patterns of Club Drug Use in the U.S., 2004 (PDF)
- Implications of Research for Treatment: Methamphetamine, 2005 (PDF)
- Links to Methamphetamine Treatment Materials (PDF)
- Implications of Research for Treatment: Ecstasy (PDF)
- Implications of Research for Treatment: GHB (PDF)
- Implications of Research for Treatment: Ketamine (PDF)
- Implications of Research for Treatment: Rohypnol (PDF)