U.S. Department of Justice
National Drug Intelligence Center
New England HIDTA Drug Market Analysis 2010
June 2010
Opioid abuse, particularly abuse of SA heroin and diverted controlled prescription opioids, is the most significant drug concern in the HIDTA region, according to various drug abuse indicators. Opioid-related inquiries accounted for the highest percentage of substance abuse-related, nonemergency information calls from healthcare professionals and the general public to the Northern New England Poison Center (NNEPC) hotline from 2005 through 2009. Most of the opioid-related calls to the hotline, which serves Maine, New Hampshire, and Vermont, involved oxycodone; hydrocodone products accounted for the second-highest number of calls.
Treatment Episode Data Set (TEDS) reporting indicates that the number of heroin-related treatment admissions to publicly funded facilities in New England exceeded admissions related to all other illicit substances combined from 2003 through 2008, the latest year for which such data are available. Heroin and other opiate-related treatment admissions increased during that time frame, peaking in 2008, when they accounted for approximately 70 percent of all illicit drug-related treatment admissions. Other opiate-related treatment admissions increased by more than 76 percent from 2004 (8,591) through 2008 (15,134), and heroin-related admissions rose from 50,246 to 53,688, or nearly 7 percent. (See Figure 3.)
Figure 3. Drug-Related Treatment Admissions to Publicly Funded Facilities in New England, 2004-2008
Source: Treatment Episode Data Set.
Opioids are mentioned in the majority of the drug-related deaths reported in New England, and most of these deaths occurred in HIDTA counties. (See Table 3; see Appendix A.) There is also a distinct relationship between the abuse of heroin and controlled prescription opioids and addiction treatment drugs such as methadone and buprenorphine in New England. According to substance abuse treatment providers in the region, in addition to controlled prescription opioid abusers switching to heroin use, former heroin abusers are abusing the synthetic opioids methadone and buprenorphine, which are addiction treatment drugs. Some heroin abusers self-medicate with drugs such as Suboxone to avoid the withdrawal symptoms commonly associated with heroin abuse. These individuals are then able to resume using heroin more quickly than heroin addicts who did not use Suboxone. In 2009, methadone was mentioned in approximately 25 percent of all drug-related deaths in New Hampshire, 6 percent in Connecticut,c and 19 percent in Vermont. The number of opioid-related deaths that occurred in New England is likely underreported, since not all decedents are autopsied and specific drugs are not always identified in deaths involving multiple drug mentions. Moreover, a significant number of potentially fatal opioid overdoses were reversed because first responders administered Narcan.d
Table 3. Drug-Related Deaths in New England States
State | Year (Most Current Available Data) |
Total Number of Drug-Related Deaths | Total Number of Opioid Mentions (Heroin and/or Controlled Prescription Opioids) | Top Illicit Drug Mentions and Number (Excludes Alcohol) |
---|---|---|---|---|
Connecticut | 2009 | 515 | 192 | Heroin (98), multiple drugs (88), cocaine (48), methadone (31), opiate (25), oxycodone (21), fentanyl (11) |
Maine | 2008 | 168 | Not available | Not available |
Massachusetts | 2007 | 906 | 633 | Not available |
New Hampshire | 2009 | 164 | 124 | Methadone (41), oxycodone (29), cocaine (25), heroin (22), citalopram (11), fentanyl (16), morphine (15), alprazolam (14), diazepam (13), clonazepam (11), opiate (9) |
Rhode Island | 2009 | 537* | Not available | Not available |
Vermont | 2009 | 93 | 52 | Methadone (18), oxycodone (13), hydrocodone (10), morphine (10) |
Source: State Medical Examiner Offices.
* Data provided by DAWN Live!
Heroin was mentioned in an increasing percentage of drug-related deaths in Connecticut from 2006 through 2009--approximately 22 percent of drug-related deaths in 2006, 23 percent in 2007, 29 percent in 2008, and 38 percent in 2009, according to the Connecticut Medical Examiner's Office.e The ages of the heroin-related overdose decedents ranged from 19 to 65 during 2009.
Many heroin abusers in the region are "functional abusers"--they hold jobs, have families, attend school, and participate in community events. Moreover, many abusers from the northern New England states are commonly viewed by law enforcement and public health officials as "day trippers" because they drive to the Lowell/Lawrence and Hartford/Springfield areas to purchase heroin on a daily basis. They often ingest or inject a portion of the heroin while driving back to their home state and typically sell a portion of their purchase to other abusers to defray costs associated with their addiction. Canadian law enforcement officials have reported that SWA heroin has replaced Southeast Asian heroin as the primary heroin type available in Canada. Other types of heroin may become more available in New England if the demand for heroin remains high.
Some cocaine abusers in the region have been unwittingly exposed to illicit substances, such as levamisole, used by distributors as cutting agents to stretch cocaine supplies and increase profits. (See text box.)
Tens of millions of dollars in illicit drug proceeds are generated in the NE HIDTA region each year. New England HIDTA initiatives seized more than $61.8 million in drugs and drug assets in 2009, including drugs valued at more than $42.1 million and more than $19.6 million in cash and other assets. Illicit drug proceeds generated in the NE HIDTA region are typically transported by traffickers through bulk cash and monetary instrument smuggling or laundered through money services businesses (MSBs), depository institutions, front companies, casinos, securities and futures instruments, and the purchase of real property and expensive consumer goods. Wholesale-level traffickers transport drug proceeds in bulk, either in the form of cash (U.S. and foreign currency) or monetary instruments, to New York City, Canada, the Dominican Republic, Mexico, and other source areas for eventual repatriation; they generally transport the proceeds in private vehicles and tractor-trailers and aboard commercial aircraft. They also ship drug proceeds through the U.S. mail and via package delivery services.
Wholesale-level traffickers operating in the HIDTA region use personal and business accounts to launder drug proceeds through depository institutions, a segment of the New England financial industry that ranked first in the number of Suspicious Activity Reports filed in the region in 2008 (the latest available data) after ranking second annually from 2004 through 2007. (See Figure 4.)
Wholesale-level traffickers also launder drug proceeds through MSBs, typically by electronic wire transfers of funds to associates outside the HIDTA region or to domestic and international bank accounts owned by the trafficker or money brokers. Law enforcement officials seized approximately $2.4 million in U.S. currency in 46 incidents linked to New England during 2009, according to National Seizure System data. U.S. postal inspectors seized 71 parcels and nearly $1.8 million in cash that had been mailed from New England to various locations from 2007 through 2009; most of the seized currency parcels were destined for California and Puerto Rico.
Midlevel and retail traffickers operating in the region often launder proceeds by commingling them with legitimate funds generated from cash-intensive area businesses such as clothing, music, and convenience stores; restaurants; tanning and nail salons; travel agencies; and used car dealerships. Retail distributors also use drug proceeds to purchase real estate and high-value personal items such as expensive clothing, jewelry, consumer electronics products, and automobiles. In addition, drug traffickers use prepaid cards--often referred to as stored value cards--to anonymously move monies associated with all types of illicit activity. Some traffickers use unscrupulous members of the financial and legal professions to launder drug proceeds in the New England region.
Source: U.S. Department of the Treasury, Financial Crimes Enforcement Network.
c.
Multiple unidentified drugs were mentioned as having contributed to
approximately 17 percent of the drug-related deaths reported in Connecticut
during 2009.
d. Narcan (naloxone), also marketed as Nalone and Narcanti, is an injectable narcotic antagonist that immediately reverses respiratory arrest caused by a heroin or other opiate overdose.
e.
The mortality percentages listed may be understated because they include only
incidents in which heroin was mentioned as contributing to a drug-related death;
the percentages may exclude incidents in which heroin was involved and the
pathologist listed the cause of death as multiple drug toxicity.
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