Orlando Metro Drug Habits & Health Services

20 percent of the city’s population is below the poverty level.¹ Located in central Florida, Orlando is in Orange County, and it is in an at-risk area for drug trafficking and smuggling. The United States Department of Justice (DOJ) places Orlando inside the Central Florida High Intensity Drug Trafficking Area (HIDTA), which includes the counties of Orange, Seminole, Osceola, Polk, Volusia, Pinellas, and Hillsborough.² Orlando may be a shipment hub for cash and drugs, especially marijuana coming from Mexico.³ Controlled prescription drug trafficking, diversion, and abuse, as well as cocaine use, are also concerns in this region of Central Florida.⁴

With the increased presence of drugs may also come drug abuse. Within Florida, an estimated 8 percent of the population are considered current drug abusers (according to a survey done on past-month drug abuse in 2008).⁵ While this is similar to the national drug abuse average, the drug overdose rate for Floridians is higher than the rest of the country; Florida ranks 11th in drug overdose mortality rates in the United States.⁶ More than 4,000 Florida residents had one or more drugs in their system at their time of death in just the first six months of 2014.⁷ In many of these cases, a drug overdose was the cause of death.

Addiction is another potential side effect to drug abuse, and it often co-occurs with mental illness as well. An estimated 660,000 adults and 181,000 children in Florida suffered from mental illness at the time of the national survey in 2010.⁸ Mental health and substance abuse both fall into the category of behavioral health, and both conditions are highly treatable with the proper type and level of care.

The Rise and Fall of Pill Mills

Opioid pain pills like OxyContin (oxycodone) and Vicodin (hydrocodone) effectively block pain sensors in the brain. Perhaps an unintended consequence, they also activate the reward and pleasure centers by increasing dopamine levels. When abused a rush of euphoria, or high, occurs, thereby increasing the abuse potential of these drugs. As the demand for these drugs rose, retail pill mill outlets began springing up all over Florida. Due to its easy access to the rest of the country, Orlando became a hub for the diversion of controlled prescription drugs (CPDs).

In 2009, the Orlando Metropolitan Bureau of Investigation (MBI) reported a big jump of CPD-related investigations since 2007, from 10 percent to 70 percent of their cases.⁹ In 2011, there were over 850 pain clinics and only seven of the top 100 oxycodone prescribing doctors in the US were not located in Florida in 2010.¹⁰

Prescription drug overdose deaths skyrocketed 61 percent as well from 2003 to 2009, as almost 3,000 Floridians died in 2009 from a fatal prescription overdose.¹¹ Many of these deaths were also related to the abuse of prescription benzodiazepines, or sedatives and tranquilizers, such as alprazolam (Xanax) and diazepam (Valium).¹²

The state government enacted the Florida Prescription Drug Monitoring Program (PDMP) to better control the epidemic and keep track of these controlled substances. Local law enforcement paired with the Drug Enforcement Administration (DEA) to crack down on these pill mills and doctors engaging in CPD diversion.¹³ Perhaps as a direct result, prescription drug overdose fatalities fell over 17 percent from 2010 to 2012 and the number continues to decline.¹⁴

Oxycodone deaths dropped another 20.1 percent and alprazolam-relate deaths fell 13.5 percent from the first six months of 2013 to the first six months of 2014.¹⁵ While this is good news, unfortunately, other drugs have stepped in as cheaper and more attractive alternatives. Heroin is another opioid drug that may produce a similar high to opioid narcotics; heroin incidents increased almost 120 percent and overdose fatalities related to heroin rose by close to 103 percent from January to June of 2014 compared to the same time period in 2013 in Florida.¹⁶ In Orange County, there were 90 reported drug overdoses related to heroin in 2014, and 36 of them were fatal, representing a 58 percent increase in heroin overdose incidents and a 40 percent increase in heroin-related deaths since 2013.¹⁷

New Drugs Appear on the Scene

Synthetic drugs are rising in popularity. This category includes both synthetic, or man-made, cannabinoids and cathinones. Synthetic cannabinoids have extremely high and potent levels of THC, or tetrahydrocannabinol, the active ingredient in marijuana. Often marketed in smoke shops as incense, these synthetic drugs include Spice, K2, and a hash oil or wax called Budder. These drugs are highly dangerous. Individuals may never be exactly sure how their bodies will react to even one dose of the drug. Florida Poison Information Centers received 537 calls related to synthetic cannabinoids in 2012.¹⁸

Other synthetic drugs that are usually made in illegal laboratories around the state include methamphetamine, MDMA (ecstasy), and an equivalent called Molly. Molly may be heralded and marketed underground as pure MDMA, a stimulant, but it is usually cut with a variety of other agents and may have many different fillers in the tablets. In Central Florida, Molly may be imported and shipped from China, and it is popular in the local club scene.¹⁹ Molly can increase body temperature and heart rate to dangerous levels as well as cause confusion and an altered state of mind.

Incidents involving the stimulant drug methamphetamine, or meth for short, increased in the first half of 2014 over the first half of 2013 almost 35 percent, although overall meth cases only represented a small percentage of the abused drugs in Florida.²⁰

A relatively new drug Alpha-PVP also called flakka or gravel, is also making its way onto the streets of Florida. The popularity of this mind-altering drug seems to be increasing within the Sunshine State. A designer drug that comes in crystal form and can be smoked, snorted, swallowed, injected, or vaped in an e-cigarette, flakka is similar in context to other stimulant drugs labeled bath salts, which are synthetic cathinones. This particular designer drug can cause drastic hallucinations, delusions, mood swings, and high temperature spikes when taken. There were 670 reported cases around the country in 2014, with many of those reports coming from Florida.²¹

Dangerous Drugs Commonly Abused in Orange County

In 2013, approximately 50,025 people were admitted to a substance abuse treatment program in the state of Florida.²² According to national data, close to 89 percent of individuals needing treatment for a drug or alcohol abuse or dependency problem in 2013 did not receive care a specialized treatment facility.²³ This means that there are a large number of people who may benefit from treatment, but are not actively receiving it.

Within Florida, substance abuse treatment admissions listing the primary substance of abuse and the number of individuals for each substance during 2013 were as follows:

• Opioids (not including heroin and primarily referring to prescription pain relievers): 12,787
• Alcohol (on its own): 12,552
• Marijuana: 9,824
• Alcohol including a secondary drug: 4,361
• Heroin: 2,597
• Cocaine (smoked, generally “crack”): 2,044
• Unknown and other drugs not listed: 1,796
• Cocaine (any other route of administration): 1,233
• Amphetamines: 1,377
• Tranquilizers: 925
• Sedatives: 368
• Hallucinogens: 99
• Stimulants (not already listed): 30
• Inhalants: 30
• PCP: 2²⁴

Marijuana surpassed alcohol in treatment admissions for the year 2013 in Florida, as it is fairly easily accessible and available within the state, trafficked in across the border from Mexico, and also grown locally.²⁵ According to a 2012 survey, almost 18 percent of high school students in Florida’s Orange County had used marijuana in the past month.²⁶
Alcohol is cheap, legal to those over the age of 21, and easy to find. Alcohol dependency and abuse issues may be compounded by mental health disorders, history of addiction, and the use of other drugs as well. Across the entire country, alcohol is the most frequently used addictive substance, and one in every 12 adults may be battling alcohol dependence or abuse.²⁷

Cocaine has long been a scourge in Central Florida, and in 2011, out of the 30 law enforcement regions in the area, 11 of them listed cocaine as the number one drug threat in their jurisdiction.²⁸ Interstate-4, which runs through Orlando, may be frequently used for trafficking illicit drugs in private and commercial vehicles through the state and beyond into the rest of the country.