- Methamphetamine remains the major drug threat, according to half of the 18 DEA offices in Texas. There were 715 deaths due to methamphetamine in Texas in 2017, as compared to 539 due to heroin. Key indicators are far higher than when the drug was made from pseudoephedrine, and with the phenyl-2-proponone method, the drug is now 95% potent. Seizures at the Texas-Mexico border have increased by 103% since 2014. Methamphetamine in solution (“Liquid Meth”), which is easier to transport into the U.S., is increasing and the price of methamphetamine has dropped by half. The relationship between methamphetamine and HIV is increasing, with the proportion of HIV cases due to men having sex with men higher in Texas than it was in 1987 when HIV data were first reported.
- Heroin indicators are increasing, except for heroin admissions to treatment. Seizures along the Texas–Mexico border decreased 2%, although DEA reported Mexican opium production is increasing to sustain the increasingly high levels of demand in the United States. Texas has not yet suffered the epidemic of overdoses seen in the northeast because the heroin in Texas is Mexican Black Tar, which cannot easily be mixed with fentanyl. However, new potent “white” heroin made in Mexico is becoming increasingly available.
- “Other opiate” death rate in Texas between 2010 and 2015, when adjusted for age, has remained level. While the number of cases has grown, the population has also grown; Indicators are trending downward as a result of rescheduling of hydrocodone. Previously, fentanyl abuse and misuse in Texas had involved transdermal patches, but rogue fentanyl powder began appearing in spring 2016 and more events are being reported. In addition, the pattern of drinking codeine cough syrup, which was popular years ago, has returned recently with mentions of drinking not only codeine cough syrup (“Drank”) but also of drinking promethazine syrup.
- Benzodiazepine comprises less than 5 percent of all items seized and identified, but the number of persons admitted to treatment with a primary problem with benzodiazepines is increasing. Alprazolam (Xanax) is the most abused benzodiazepine, and in combination with hydrocodone and carisprodol, is known as the Houston Cocktail or Holy Trinity.
- Cocaine indicators are mixed, with the number of toxicology items identified increasing but the amount seized on the border and treatment admissions have decreased. Crack cocaine and synthetic cannabinoids remain drugs of choice among the homeless and those living in tent cities, but outreach workers report increased popularity of powder cocaine. Cocaine availability is expected to increase in the future due to increased acreage planted, decreased use of herbicides, and the FARC peace treaty in South America.
- Cannabis is ranked as the #1 threat by the other half of DEA offices in Texas because of the trafficking not only north-south, but also east-west. Seizures at the Texas-Mexico border are down 125% since 2014 but there is more domestic indoor and outdoor growing as well as the supply from states where the drug is legal or decriminalized. The demand for the drug has been influenced by changes in patterns of use with blunts and electronic cigarettes and the “vaping” of hash oil and “shatter”.
- Synthetic Cannabis and Synthetic Cathinone situation has changed: poison center cases involving both cannabinoids and cathinones have decreased while toxicology and treatment cases involving these synthetic are increasing. The chemical formulations and characteristics of persons using cannabinoids continue to change, with more cases occurring among the homeless population.
- PCP remains a problem. The number of PCP items identified by forensic labs has increased but poison center calls and treatment admissions are down. The pattern of dipping small cigarillos filled with synthetic cannabinoids into bottles of PCP continues, and may be exacerbating the severity of the cases involving the use of synthetic cannabinoids.
- Novel psychoactive substances including MDMA and the 2 C-xx Phenethylamines change depending on availability of the drug and perceived effects. Use of these drugs was lower in 2016 than in previous years.
- Drug patterns on the Texas Border continue to show high levels of use of cannabis, steady level of heroin since around 2004, slight increases in methamphetamine, and decreasing admissions for cocaine. In comparison, treatment admissions in the non-border area show increases in methamphetamine and heroin, level use of cannabis, and the same decrease in cocaine use.
Previous trends (all in PDF): 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)