HEROIN NOW KILLING MORE SOUTH FLORIDIANS

Rate of deaths from cocaine falls behind

Heroin, blamed for a death a week, has moved ahead of cocaine as a killer
narcotic in Miami-Dade County, according to a report delivered Tuesday to
the National Institute on Drug Abuse.

The local report was one of 21 from major U.S. cities whose representatives
update one another twice a year on drug-abuse patterns and trends, which
often vary from one metropolitan area to another. The meetings are projects
of the U.S. Department of Health and Human Services. A subgroup, the
Community Epidemiology Work Group, is meeting this week in Miami at the
Wyndham Hotel.

South Florida's heroin problem is not new, but the news is that it's
growing worse.

The authors of the Miami report, James N. Hall and Dr. Michael Whitman,
called the heroin problem an epidemic "now characterized by dramatic
increases in hospital emergency department visits, heroin-induced deaths,
the highest street purity in local history and novice, noninjecting
abusers. . . . The number of casualties in Miami's heroin epidemic of the
1990s rivals the consequences of the local cocaine and crack epidemic at
its peak a decade ago."

Besides the growing heroin problem, Hall and Whitman reported on changes in
the so-called "club drugs" like XTC and the newest hit, GHB, which is known
by the nicknames Liquid X, Scoop and Grievous Bodily Harm. GHB had been
used mostly by people in their 20s and 30s. People younger than 20 are
using it now, but the date-rape drug Rohypnol, called roofies, has gone out
of style.

The dark outlook reflects the danger of heroin more than its popularity
compared to cocaine, Hall explained:

"This does not mean more people are using heroin than cocaine. It means
more people are dying from heroin. It's more risky than cocaine."

Hall directs Up Front, a drug information center, and is information and
research director of The Miami Coalition for a Safe and Drug-Free
Community. Whitman has a drug research fellowship at the University of
Miami. Their report suggests that heroin abuse -- even if not at an
epidemic level -- has a capacity for harm out of proportion to its share of
the market in dangerous drugs.

Deaths directly caused by cocaine have leveled off in the 1990s, with fewer
than 40 deaths a year except for 1994 and 1997, with 41 and 42 deaths. In
the same period, heroin deaths have leaped. Based on the first nine months
of 1998, Hall and Whitman project 31 deaths from cocaine and 52 deaths from
heroin -- an average of one a week -- by the end of the year.

"Heroin has now moved into the expansion phase," Hall said. "Further
evidence of that is hospital medical emergencies related to heroin."

At the start of the decade, he said, Miami-Dade's rate of nonfatal heroin
emergencies was one person in 100,000. The national average was four in
100,000. Now the national rate is 14 in 100,000 and Miami-Dade matches it,
he said.

One reason may be stronger heroin. Based on a small number of police
seizures, too limited to be conclusive, it looks as if the heroin available
now is 30 percent pure. Two years ago, it was typically 12 to 14 percent,
Hall said.

The apparent leveling-off of cocaine use nationally is not equaled locally.
Even though cocaine-induced deaths have decreased here, the drug is still
listed as a factor in nearly 80 medical emergencies for every 100,000
people in the population. The average in other cities has stabilized in the
mid-20s.

Checked-by: Mike Gogulski