Miami Metro Area Addiction Treatment

The city of Miami is located in Miami-Dade County, FL, in the southern part of the state. It contains the largest population in the state.² In Florida, according to a report by the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2018, an estimated 1.8 million people in Florida needed substance use disorder treatment, but only 447,000 received it. Meaning an additional 75% could have benefited from treatment for substance use disorders.³

According to SAMHSA, an estimated 7.9% of the populated aged 12 or older in the Miami-Dade area had a substance use disorders in the past year. This represents approximately 233,000 individuals.³

Substance use disorders often co-occur with mental health disorders.⁵ It is estimated that up to 50% of individuals who seek treatment for addiction also have some sort of co-occurring mental illness. In 2018, according to SAMHSA, an estimated 377,000 adults in Florida had a serious mental illness.³ Mental health and addiction treatment in the Miami area ranges from public programs to privately funded options, and there are many different forms and levels of care available.

Miami in a High Intensity Drug Trafficking Area (HIDTA)

Miami-Dade, Broward, Palm Beach, and Monroe Counties are part of the South Florida HIDTA as classified by the U.S. Department of Justice, or DOJ.⁷ Miami has one of the largest international airports in the country, in addition to a large and bustling seaport, highly developed roadways and interstates, massive cruise ship traffic, and miles of coastline in close proximity to South America, Central America, and the Caribbean. All of these features make it easily accessible to tourists and drug traffickers alike. Large quantities of cocaine, heroin, and marijuana may be imported in for both distribution around the country as well as sale and use within the area itself.⁸

In addition to drug smuggling, Miami is also home to a large amount of prescription drug diversion and retail pill mills, marijuana grow houses, and methamphetamine labs. In 2010, Florida doctors were dispensing oxycodone directly from their offices, and 98 out of 100 of those who dispensed the highest amounts of the powerful and highly addictive narcotic were in Florida.⁹

In 2011, almost 50 Floridians were dying each week as the result of a prescription drug overdose.¹⁰ The Prescription Drug Monitoring Program (PDMP) was set up in 2009 and activated in 2011. Along with the institution of other laws, regulations, and preventative measures, as well as the enactment of Operation Pill Mill, which was set up in 2010 as a joint operation between Florida’s law enforcement agencies and the Drug Enforcement Administration (DEA), Miami and Florida as a whole saw a decrease in prescription drug overdoses deaths and drug diversion.¹¹

The rate of prescription overdose fatalities decreased 17.7 percent between 2010 and 2012. For the first half of 2014, drug-related deaths as a whole were down 3.4 percent in the state of Florida.^12,13 This may be the result of stricter regulations, laws, and prevention techniques regarding drug abuse and diversion, particularly in relation to prescription drugs.

Drug Trends in South Florida and Miami

According to the University of Miami’s Community Health Needs Assessment, a total of 4.1% of the adults in Miami-Dade county sought treatment for a substance use disorder. Among these, people rated the following as the most problematic

• Alcohol – 48%
• Heroin or other opioids – 20%
• Prescription medications – 8%
• Marijuana – 8%
• Cocaine or crack – 8%
• Methamphetamines (or other amphetamines) – 4%
• OTC medications – 4%

In Miami-Dade County, addiction treatment admission rates for the following substances were:

• Prescription opioids – 1279 people.
• Heroin – 2201 people.
• Cocaine – 1472.
• Methamphetamines – 85 people.
• Marijuana – 3108 people.

Heroin

As prescription drugs become more heavily controlled and harder to alter to inject, snort, or smoke due to tamper-resistant packaging and manufacturing of the tablets themselves, people who previously abused prescription opioid narcotics may be turning to heroin as a cheaper and more accessible alternative. Both prescription pain killers and heroin are opioids and produce similar effects. Heroin has a high risk for overdose. According to FLHealthCharts.gov, in 2021, 8093 people in Florida died as the result of drug overdose, and 436 of those individuals were in Miami-Dade county. According to the Florida Department of Law Enforcement Medical Examiner’s Office, heroin was the cause of 234 of overdose deaths in Miami-Dade county — 19 of those in Miami alone.

Cocaine

Within Miami, cocaine has traditionally been the drug of choice for many drug abusers, and it remains the most commonly seized and analyzed drug by the local crime laboratories in Miami-Dade County.²⁰ Cocaine was involved in 237 deaths in Miami-Dade County in the first half of 2021, the highest number in any of the 24 Medical Examiner’s Districts in Florida. Another drug was present in each of these deaths, however. Cocaine use as the primary drug for admittance into a substance use disorder treatment program in Miami-Dade County accounted for 2.27% of admissions.²²

Marijuana

Marijuana is the drug most often cited as the primary substance of abuse behind only alcohol in Miami-Dade County. Close to half of all admissions to treatment facilities are for individuals under age 18.²³ In 2021, in Miami-Dade County, there were 2108 people admitted to an addiction treatment facility that reported marijuana as their primary drug of use.²⁴ Current use is measured by use within the 30 days prior to the survey.

Alcohol

Alcohol is the most commonly used substance in Miami-Dade County. In 2020, 35.8% of the adults in Miami-Dade reported binge drinking in the past month. Five percent of Miami-Dade County residents over the age of 12 were estimated to battle alcohol abuse or dependency between 2010 and 2012.²⁹

Prescription drugs

In 2011, controlled prescription drugs, often shortened to CPDs, were estimated by 90 percent of Florida NDTS jurisdictions to be readily and easily accessible to the population.³⁰ This number dropped to 70 percent in 2013 presumably after the noticeable changes in state legislature.³¹ That being said, in 2021, there were still over 4740 deaths from a drug overdose in which a prescription drug was present in the state of Florida.³² Prescription opioids include drugs such as Vicodin (hydrocodone), oxycodone (OxyContin), morphine, codeine, methadone, and fentanyl. Substance use disorder treatment admissions noting prescription drugs as the primary substance of use were 2.95%  in Miami-Dade County.³⁴

Another class of prescription drugs causing death from overdoses in Florida in large numbers are benzodiazepines, which include drugs like Xanax (alprazolam), Valium (diazepam), Ativan (lorazepam), and Klonopin (clonazepam). Aside from alcohol, benzodiazepines were one of the most discovered drugs in drug-related overdoses in 2020 in the state of Florida, with almost over 2,000 fatalities.

Designer Drugs

New and designer, or synthetic, drugs are becoming more prevalent around the country and may be particularly common in the Miami drug scene. Synthetic drugs are man-made, typically in illegal laboratories, and usually provide some sort of high or mind-altering effect. These drugs may be difficult to quantify as they are constantly changing. They are also potentially dangerous, as users may never be exactly clear what is in the drug and how it may interact with their bodies or other substances. Toxic chemicals may even be used to cut these drugs or increase the psychoactive properties. For example, one of the newer drugs on the South Florida drug scene is one called “budder,” which is essentially marijuana plant parts soaked in a noxious chemical, such as butane, to produce a synthetic cannabinoid wax with high levels of THC, which is the active ingredient in marijuana.³⁷ The remaining wax may then be added to e-cigarettes and smoked. Not only can this drug be toxic for a user, it can also be hazardous to produce as it is highly flammable and unstable, and it can cause explosions.

For the first half of 2013, the National Forensic Laboratory Information System (NFLIS) identified 37 new psychoactive drugs in the drug seizures made in South Florida.³⁸ These drugs included new formulations of synthetic cathinones (bath salts) and synthetic cannabinoids (fake weed).

The third most seized drug during the first six months of 2013 was another synthetic and designer drug called Molly.³⁹ Many people may believe that Molly pills are actually pure ecstasy, or MDMA; however, this is actually not the case, as 611 of the Molly drugs seized and analyzed in the first half of 2013 also contained methylone, or 3,4-methylenedioxymethcathinone.⁴⁰ Instances of drug reports involving actual MDMA were almost cut in half between January and June of 2013 from that same time in 2012.⁴¹

Another new synthetic cathinone-type drug resembling bath salts, bursting onto the South Florida streets, is one called flakka, or alpha-PVP. This drug may cause drastic hallucinations, bizarre behavior, and be highly addictive. It may have been a contributor in around 29 deaths in neighboring Broward County in the past year.⁴² It may be smoked or “vaped” with e-cigarettes, and most recently a version of flakka may be produced to resemble candy.⁴³ These drugs are highly unpredictable and have potentially deadly consequences.

Causes of Youth Drug Use

Drug and alcohol use among young people continues to be an area of concern across the nation and in the state of Florida. According to the 2022 Monitoring the Future Survey, rates of substance use among youth are still at alarming rates.

Alcohol

• 23% of surveyed 8th graders reported alcohol use.
• 41% of surveyed 10th graders reported alcohol use.
• 61.6% of surveyed 12th graders reported alcohol use.

Any Illicit Drug Use

• 17% of surveyed 8th graders reported prescription drug use.
• 28% of surveyed 10th graders reported prescription drug use.
• 41% of surveyed 12th graders reported prescription drug use.

Marijuana

• 11% of surveyed 8th graders reported marijuana use.
• 24% of surveyed 10th graders reported marijuana use.
• 41% of surveyed 12th graders reported marijuana use.

Cocaine

• 0.8% of surveyed 8th graders reported cocaine use.
• 0.8% of surveyed 10th graders reported cocaine use.
• 2.4% of surveyed 12th graders reported cocaine use.

Amphetamines

• 3% of surveyed 8th graders reported amphetamine use.
• 3% of surveyed 10th graders reported amphetamine use.
• 3% of surveyed 12th graders reported amphetamine use.

Miami Music Festival a Hotspot for Designer Drugs

The Ultra Music Festival is held in downtown Miami’s Bayfront Park. It is notoriously a scene for not only electronic dance music, but also for psychotropic drugs.⁴⁴ A federal study was undertaken to find out exactly what types of drugs the attendees were actually taking, and 145 festival goers agreed to the voluntary screening. Over 70 percent said they had taken marijuana, Molly, ecstasy, or cocaine in the past week. Of the 100 who also submitted to a urine sample, 80 percent tested positive for a synthetic drug like Molly or alpha-PVP, known more commonly as flakka or gravel.⁴⁵ The festival has a drug-free policy, and the results of the study may not show the whole picture as it only represents a small percentage of the thousands of people attending Ultra overall.

MDMA (Molly)

MDMA, or ecstasy, is a club drug that is often taken at places like night clubs, musical festivals, and parties. It produces a euphoric effect that many people feel boosts their energy and enhances their mood. Many people believe that this substance is relatively safe, but it can have potentially life-threatening consequences to users — especially in environments, like the Ultra Music Festival, where dehydration and overheating can occur easily.

LSD (Acid)

Hallucinogens, like LSD (acid), are popular among people attending festivals and concerts, as this substance alters perception. Despite the zero tolerance policy for drugs at the Ultra Music Festival, some attendees reported use of LSD or other hallucinogens.

Mushrooms (Shrooms)

Like LSD, certain types of mushrooms produce a hallucinogenic effect. People may think “shrooms” are safer than LSD, but they also carry a risk when taken — especially at outdoor music festivals where overheating and dehydration can occur.

Drugs, Mental Health, and Incarceration

Addiction is considered a disease of the brain that can be chronic and relapsing. There are many programs and facilities throughout the Miami metro area and around the state of Florida dedicated to helping families and individuals battling substance abuse and addiction. Mental health is just as vital as physical health, and an individual’s emotional well being greatly contributes to quality of life.

An estimated 40 percent of people who battle mental illness in their lives will have some form of contact with the criminal justice system, which is in much greater proportions to that of the general population.⁴⁶ Nationally, around 800,000 people with mental illnesses are incarcerated annually, and 72 percent of them also battle a co-occurring substance use disorder.⁴⁷ Locally, 70,000 Floridians with a serious mental illness are booked into jails after being arrested each year.⁴⁸

Crime and drugs also often go hand in hand. The change to civil charges for marijuana-related offenses may be overall decreasing the number of adolescents in treatment for marijuana dependency or abuse in Southern Florida.⁴⁹ In the fiscal year 2019-2020, a reported 2,626 felonies were filed for drug-related crimes in Miami-Dade County.⁵⁰ This is not even taking into account how many offenders may have had drugs or alcohol in their system when they committed a non-drug-related crime.

Instead of criminal action, much of the time, behavioral health services may instead be more effective long-term. Hence, the institution of drug courts, of which Miami-Dade was one of the pioneers with the fourth largest drug court in the country and biggest in the state of Florida.⁵¹ Drug courts strive to help get individuals the treatment they need and provide incentive for staying drug-free and completing a substance abuse program.

Regardless of the reason for entering into a drug or alcohol treatment program, whether court-mandated or voluntarily, addiction and mental health services can help individuals and their loved ones obtain the necessary tools for healthy, happy and productive lives.