Substance Use

Cocaine, methamphetamine, and spice are addictive, non-opioid substances that negatively impact a person's health through direct and indirect means. Direct health concerns of non-opioid substance use include anxiety, paranoia, seizure, heart attack, stroke, and potentially death while indirect health concerns include the acquisition of disease and infections, particularly sexually transmitted infections (STIs). Substance users experience an increased risk of acquiring STIs since they may exchange sex for substances, use substances within a social setting that may lead to sexual activity, or engage in risky sexual behavior as a result of impaired judgement associated with substance use. The current study evaluated the use of multiple data sources to monitor changes in the rate of cocaine, methamphetamine, and spice related emergency department visits as well as cocaine- and methamphetamine-related death rates, within Marion County, Indiana between 2013 and 2017.

Objective: To assess the prevalence of non-opioid substance use ”including cocaine, methamphetamine and spice within Marion County, Indiana and propose response recommendations utilizing a current opioid response plan.

The rate of drug overdose deaths in the United States has increased steadily since 2000. Injection drug use, a practice associated with infectious disease transmission, has likely increased along with this upward trend in drug overdoses. Injection drug use surveillance is difficult to conduct at a public health department because there are no specific Internal Classification of Diseases codes to identify this risk behavior in hospital discharge or vital registration data. Maricopa County Department of Public Health Office of Epidemiology aimed to identify indications of injection drug use within data from the Office of the Medical Examiner.

Objective: To determine whether data from the Office of the Medical Examiner are useful for conducting injection drug use surveillance in Maricopa County, Arizona, and to describe the characteristics of decedents who died from a drug overdose, were investigated by the county's medical examiner, and had an indication of injection drug use.

Drug overdose deaths are increasing nationally and in Minnesota (MN). This is only a fraction of the overall burden that recreational drug use exacts on emergency departments (ED) and hospitals. In addition to opioids and other drugs, three outbreaks of synthetic cannabinoids and cathinones have occurred in MN recently. ICD codes do not adequately identify patients treated for drug use. Also, toxicology data for these patients are limited: routine toxicology testing is not performed at hospitals as results are not timely enough to be useful for clinical care. Even when such testing is performed, hospital laboratories are unable to detect newer synthetic drugs. In order to more quickly respond to clusters of substance use, identify substances causing atypical symptoms or severe illness, and understand the burden of overdoses and substance use in MN, the MN Department of Health (MDH) developed the MN Drug Overdose and Substance Abuse Pilot Surveillance System (MNDOSA). MNDOSA data collection began in November 2017 and includes two pilot sites in Northeastern MN, and one in the Twin Cities Metropolitan Area.

Objective: Implement a novel surveillance system for recreational substance use, including toxicology testing, to enable situational awareness and more accurately assess the health care burden related to recreational substance use.