FLORIDA DEPARTMENT OF LAW ENFORCEMENT November 2002 Identi?ed in Deceased Persons by Florida Medical Examiners Data Collection During January through June 2002, there were 2,657 toxicology reports received by the Medical Examiners Commission at the time of the issuance of this report. Although not all the cases from this timeframe have been ?nalized, these cases represent approximately 95% of all cases. The Of?ce of Vital Statistics reports approximately 87,5 00 deaths occurred in Florida during this six-month period. The state?s medical examiners were asked to collect information from autopsies performed in their districts on the following drugs: Ethyl Alcohol, Benzodiazepine, Cannabinoids, Cocaine, Gamma-hydroxybutyric acid (GHB), Heroin, Hydrocodone, Oxycodone, Ketamine, Methadone, Methylated Amphetamines, Nitrous Oxide (N20), (PCP) and Rohypnol. Report Summary Some general statewide trends in the ?rst half of 2002 when compared with the last half of 2001 are listed below: 1/ Table 2A reveals decreased incidences (both lethal and non?lethal levels) of ethyl alcohol, cannabinoids, heroin and methylated amphetamines occurred in the ?rst half of 2002. Notable are the 15% decrease in heroin deaths, and the 29% decrease in the incidence of methylated amphetamine deaths. 1/ Increased incidences (both lethal and non-lethal levels) are noted with cocaine, hydrocodone, oxycodone and methadone as shown in Table 2A. Methadone?related deaths rose during the ?rst half of 2002 by 31%, and hydrocodone deaths increased by 19% during this period as well. These drugs with minimal or no signi?cant change statewide were benzodiazepine, GHB, ketamine, nitrous oxide, PCP and rohypnol. When lethal dosages are examined speci?cally, Table 2B reveals signi?cant decreases in heroin, hydrocodone, oxycodone, and methylated amphetamines, with the only signi?cant increase in methadone. Tables 4 and 6 reveal high levels of oxycodone and hydrocodone continue along the southeastern coast of Florida, from Broward up through Brevard counties, as well as in the St. Petersburg and Pensacola areas. Methadone re?ects high occurrences throughout this same geographic area of Florida, with high levels also present in the Jacksonville and Daytona Beach areas. Herein and cocaine continue to decline in the Miami area, while Jacksonville and Daytona Beach have experienced an increase in cocaine-related deaths. I 2002 Interim ME Drug Report a i Tables and Charts This report differentiates between when a drug was found to be at lethal levels and contributed to the cause of death (?Cause?) or merely present in the body (?Present?). Table 1 shows that summary of the drug?related deaths for the ?rst six months of 2002. This information is broken out by ?Cause? or ?Present? for the period. Chart 1 is a graphical representation of the frequency of occurrences (both lethal and non-lethal) for each drug reported from January 2002 through June 2002. Table 2A shows a comparison of drqurelated deaths (lethal and non-lethal) for last six?months of 2001 and the ?rst six?months of 2002. Table 2B shows a comparison of deaths in which lethal levels of drugs were found for the last six-months of 2001 and the ?rst six?months of 2002. Chart 2 is a graphical representation of the frequency of lethal amounts for the speci?ed drug for each six?month period beginning with January 2001 through June 2002. Map 1 is a geographical representation of Florida that displays the 24 Medical Examiner Districts, and provides a listing of counties for each district. Table 3 shows data for heroin and cocaine deaths during January June 2002 by medical examiner district and statewide totals. The information is broken out to indicate the number of cases in which heroin or cocaine was the cause of death (lethal) and the number of cases in which heroin or cocaine was found in the body, whether or not the drug contributed to the death (both lethal and non-lethal cases). Table 4 shows information on Oxycodone deaths during January June 2002 by medical examiner district and statewide totals. Also provided is the number of deaths indicating Oxycodone only in the body and the number of deaths with Oxycodone in combination with other drugs. Table 5 shows information concerning the age of decedents in which Oxycodone was identi?ed in the body for the ?rst six?months of 2002 by medical examiner district and statewide totals. The data is presented for both cases where the drug contributed to the death (lethal) and cases where the drug was merely present (non-lethal). Table 6 shows information on Hydrocodone deaths during January June 2002 by medical examiner district and statewide totals. Also provided is the number of deaths indicating Hydrocodone only in the body and the number of deaths with Hydrocodone in combination with other drugs. 2002 Interim ME Report Page. ii Table 7 shows information concerning the age of decedents in which Hydrocodone was identi?ed in the body for the ?rst six?months of 2002 by medical examiner district and statewide totals. The data is presented for both cases where the drug contributed to the death (lethal) and cases where the drug was merely present (non-lethal). . .- Table 8 shows information on Methadone deaths during January June 2002 by medical examiner district and statewide totals. Also provided is the number of deaths indicating Methadone only in the body and the number of deaths with Methadone in combination with other drugs. Table 9 shows information concerning the age of decedents in which Methadone was identi?ed in the body for the ?rst six-months of 2002 by medical examiner district and statewide totals. The data is presented for both cases where the drug contributed to the death (lethal) and cases where the drug was merely present (non?lethal). Table 10 shows information on Cocaine deaths during January June 2002 by medical examiner district and statewide totals. Also provided is the number of deaths indicating Cocaine only in the body and the number of deaths with Cocaine in combination with other drugs. Table 11 shows information concerning the age of decedents in which Cocaine was identified in the body for the ?rst six-months of 2002 by medical examiner district and statewide totals. The data is presented for both cases where the drug contributed to the death (lethal) and cases where the drug was merely present (non-lethal). Table 12 shows information on Heroin deaths during January June 2002 by medical examiner district and statewide totals. Also provided is the number of deaths indicating Heroin only in the body and the number of deaths with Heroin in combination with other drugs. Table 13 shows information concerning the age of decedents in which Heroin was identi?ed in the body for the ?rst six-months of 2002 by medical examiner district and statewide totals. The data is presented for both cases where the drug contributed to the death (lethal) and cases where the drug was merely present (non-lethal). Table 14 shows information on Methylated Amphetamine deaths during January June 2002 by medical examiner district and statewide totals. Also provided is the number of deaths indicating Methylated Amphetamine only in the body and the number of deaths with Methylated Amphetamine in combination with other drugs. Table .15 shows information concerning the age of decedents in which Methylated Amphetamine was identi?ed in the body for the ?rst six-months of 2002 by medical examiner district and statewide totals. The data is presented for both cases where the drug contributed to the death (lethal) and cases where the drug was merely present (non?lethal). Table 16 shows the information concerning the speci?c isomers of Methylated Amphetamines identi?ed through toxicology tests Chart 3 depicts data concerning the percentages of cases where the respective drug was found to be either the ?cause? of death or ?present? in the body for the ?rst six-months of 2002. 2002 Interim ME Drug Report Page Chart 4 depicts data concerning the percentages of ages of decedents in cases where the respective drug was found in the body, whether lethal or not. Chart 5 depicts data concerning percentages of the Manners of Death (accidental, homicide, suicide, natural, undetermined) for cases where the respective drug was found in the body, whether lethal or not. Medical Examiners Commission Members Stephen J. Nelson, M.A., M.D. Chairman District Ten Medical Examiner (863) 687?1160 Valerie J. Rao, MD. Honorable Robert H. Dillinger, J.D. District Five Medical Examiner Public Defender, Sixth Judicial Circuit Honorable Harrell Reid Honorable Bruce H. Colton, .D. Sheriff, Hamilton County State Attorney, Nineteenth Judicial Circuit Mrs. Mariana Caballero Robert J. Krauss, J.D. Stewart Enterprises Of?ce of the Attorney General Ms. Robin Giddens Sheppard Honorable Lane C. Rees Of?ce of Vital Statistics Walton County Commission 2002 Interim MEC Drug Report Page iv Table 1 of Drug Related Deaths January June 2002 Drug Found in Body Total Cause Present Ethyl Alcohol 1,487 123 1,3 64 Benzodiazepine 734 150 84 Cannabinoids 3 3 1 0 33 1 Cocaine 579 Heroin 141 121 20 Hydrocodone 248 6 1 1 87 Oxyoodone 267 112 155 Ketamine 1 0 1 Methadone 254 13 3 121 Methylated Amphetamines Rohypnol 0 0 0 2002 Interim MEC Drug Report Page I Chart 1 Frequency of Occurrence of Drugs January June 2002 Methylated Amphetamines 1% Benzodiazepine 7/0 . 13% Cannabinoids Hydrocodone 6% Note: GHB, Ketamine, N20, PCP, and Rohypnol constituted less than 0.5% of the drug frequencies. 2002 Interim MEC Drug Report Page 2 Drug Found in Body Table 2A Comparison of Dr July December 2001 January June 2002 July December 2001 -Related Deaths January June 2002 Percentage Change Ethyl Alcohol 1,574 1,487 Benzodiazepine 7 1 7 734 2% Cannabinoids 363 331 Cocaine 555 579 4% GHB 8 8 None Heroin 165 141 -15% Hydrocodone 209 248 19% Oxycodcne 249 267 7% Ketamine 5 1 Not signi?cant Methadone 194 254 31% Methylated Amphetamines 73 52 -29% N20 2 0 Not signi?cant PCP 0 0 None 0 0 None 2002 Interim ME Drug Report Page 3 Table 2B Comparison of Deaths in Which Lethal Levels of Drugs Were Found July - December 2001 January June 2002 Drug Causing Death July December 2001 January June 2002 Percentage Change Ethyl Alcohol 1 20 1 23 3 Benzodiazepine 155 150 Cannabinoids 0 None Cocaine 195 180 GHB 2 1 Not signi?cant Heroin 135 121 -10% Hydrocodone 7 1 6 1 - 14% Oxycodone 140 1 12 -20% Ketarnine 2 0 Not signi?cant Methadone 98 1 33 36% Methylated Amphetamines 1 6 8 -50% N20 2 0 Not signi?cant PCP 0 0 None Rohypnol 0 0 None 2002 Interim ME Drug Report Page 4 2002 Interim ME Drug Report Page 5 January - June 2001 I July - December 2001 ElJanuary - June 2002 200? 180- 160? 140? 120- 100? z?ix??ii? ??ffrgi?rfJanuary 2001 Deaths in ?Mich Drugs Caused Death June 2002 Chart 2 DISTRICT ONE Escambla Okaloosa Santa Rosa Walton DISTRICT TWO Franklin Gadsden Leon Liberty Jefferson Taylor Wakulla DISTRICT THREE Colum bia Dixie Hamilton Lafayette Madison uwan nee DISTRICT F0 UR we] Nassau Clay DISTRICT FIVE Citrus Hernando Lake Marion Sumter DISTRICT SIX Pinellas Pasco DISTRICT SE YEN Volosia 2002 Interim MEG Drug Report Florida Medical Examiner Districts DISTRICT EIGHT Alachua Baker Bradford Gilchrist Levy Union DISTRICT NINE Orange Osceola DISTRICT TEN Hardee Highlands Polk DISTRICT ELEVEN Dade DISTRICT TWELVE eSoto an atee Sarasota DISTRICT THIRTEEN illsborou gh DISTRICT F0 URTEEN Bay Calhoun Gulf Jackson Washington Holmes DISTRICT FIFTEEN Palm Beach DIS TRICT SIXTEEN on roe Map 1 DISTRICT SEVEN TEEN Brow ard DISTRICT EIG HTEEN Brevard DISTRICT NINETEEN Indian River Martin Okeechobee St. Lucie DISTRICT TWENTY Collier DISTRICT WENT Y-ONE Glades Hen dry Lee DISTRICT TWENTY-TWO Charlotte DISTRICT Flagler Putnam St. Johns DISTRICT TWENTY-F0 UR Seminole Page 6 Medical Examiner Districts and Areas of Florida Table 3 Heroin and Cocaine Deaths January June 2002 District Area of Florida 1 Pensacola 2 Tallahassee 3 Live Oak 4 Jacksonville 5 Leesbur 6 St. Petersburg 7 Daytona Beach 8 Gainesville 9 Orlando 10 Lakeland 1 1 Miami 12 Sarasota 1 3 Tampa 14 Panama City 15 West Palm 16 Florida Keys 17 Ft. Lauderdale 18 Melbourne 19 Ft. Pierce 20 Naples 21 Ft. Myers 22 Port Charlotte 23 St. Augustine 24 Sanford Statewide Totals Deaths with Lethal Amounts of Heroin or Cocaine Heroin Toxicity Cocaine Toxicity 121 180 2002 Interim MEC Drug Report All Deaths with Heroin or Cocaine (both lethal and non lethal amounts) Heroin Found in Body Cocaine Found in Body 141 579 Page 7 Table 4 Oxycodone Deaths January J1me 2-002 Medical Examiner Total Deaths with Oxycodone Deaths with Oxycodone Only Deaths with Oxycodone in District Area of Florida Combination with Other Drugs District Area of Florida Total Cause Present Total Cause Present Total Cause Present 1 Pensacola 1Tallahassee Live Oak Jacksonville Leesburg St. Petersburg Daytona Beach Gainesville Orlando Lakeland Miami Sarasota Tampa Panama City West Palm Florida Keys Ft. Lauderdale Melbourne Ft. Pierce Naples Ft. Myers Port Charlotte St. Augustine Sanford Statewide Totals 267 112 155 55 20 35 212 92 120 2002 Interim ME Drug Report Page 8 Oxycodone Deaths by Age Table 5 January June 2002 Medical Examiner District and Area Oxycodone Found at Lethal Levels Oxycodone Present (Non?Lethal) of Florida Age of Age of District. Area of Florida Total Total 18 18?25 26?34 35-50 >5 0 Total <18 18-25 26?34 35 -50 >50 1 Pensacola Tallahassee Live Oak Jacksonville Leesburg St. Petersburg Daytona Beach Gainesville Orlando Lakeland Miami Sarasota Tampa Panama City West Palm Florida Keys Ft. Lauderdale Melbourne Ft. Pierce Naples Ft. Myers Port Charlotte St. Augustine Sanford Statewide Totals 267 112 2002 Interim ME Drug Report Page 9 Table 6 Hydrocodone Deaths January 11110 2002 Medical Examiner Total Deaths with Deaths with Hydrocodone Deaths with Hydrocodone in District Area of Florida Hydrocodone Only Combination with Other Drugs District Area of Florida Total Cause Present Total Cause Present Total Cause Present 1 Pensacola Tallahassee Live Oak Jacksonville Leesburg St. Petersburg Daytona Beach Gainesville Orlando Lakeland Miami Sarasota Tampa Panama City West Palm Florida Keys Ft. Lauderdale Melbourne Ft. Pierce Naples Ft. Myers Port Charlotte St. Augustine Sanford Statewide Totals 248 140 2002 Interim MEG Drug Report Page 10 Hydrocodone Deaths by Age Table 7 January June 2002 Medical Examiner District and Area Hydrocodone Found at Lethal Levels Hydroeodone Present (Non?Lethal) of Florida Age of Decedent Age of Decedent District Area of Florida Total Total 18 18?25 26-34 35-50- >50 Total <18 18-25 26?34 35-50 >50 1 Pensacola Tallahassee Live Oak Jacksonville Leesburg St. Petersburg Daytona Beach Gainesville Orlando Lakeland Miami Sarasota Tampa Panama City West Palm Bob Florida Keys Ft. Lauderdale Melbourne Ft. Pierce Naples Ft. Myers Port Charlotte St. Aggustine S'anford Statewide Totals 248 2002 Interim MEC Report Page 11 Table 8 Methadone Deaths January June 2002 Medical Examiner Total Deaths with Methadone Deaths with Methadone Only Deaths with Methadone in District Area of Florida Combination with Other Drugs District Area of Florida Total Cause Present Total Cause Present Total Cause Present 1 Pensacola Tallahassee LiVe Oak Jacksonville Leesburg St. Petersburg_ Daytona Beach Gainesville Orlando Lakeland Miami Sarasota Tampa Panama City West Palm Florida Keys Ft. Lauderdale Melbourne Ft. Pierce Naples Ft. Myers Port Charlotte St. Augustine Sanford Statewide Totals 254 133 121 44 23 21 210 110 100 2002 Interim ME Drug Report Page 12 Methadone Deaths by Age Table 9 January June 2002 Medical Examiner District and Area Methadone Found at Lethal Levels Methadone Present (N on-Lethal) of Florida Age of Decedent Age of Decedent District Area of Florida Total Total 18 18?25 26?34 3 5?50 >50 Total <18 18?25 26?34 3 5?50 >50 1 Pensacola Tallahassee Live Oak Jacksonville Leesburg St. Petersburg Daytona Beach Gainesville Orlando Lakeland Miami Sarasota Tampa Panama City West Palm Beh Florida Keys Ft. Lauderdale Melbourne Ft. Pierce Naples Ft. Myers Port Charlotte St. Augustine 24. Sanford Statewide Totals 254 133 2002 Interim MEC Drug Report Page 1.3 Table 10 Cocaine Deaths January June 2002 Medical Examiner Total Deaths with Cocaine Deaths with Cocaine Only Deaths with Cocaine in District Area of Florida Combination with Other Drugs District Area of Florida Total Cause Present Total Cause Present Total Cause Present 1 Pensacola Tallahassee Live Oak Jacksonville Leesburg St. Petersburg . Daytona Beach Gainesville Orlando Lakeland Miami Sarasota Tampa Panama City West Palm Florida Keys Ft. Lauderdale Melbourne Ft. Pierce Naples Ft. Myers Port Charlotte St. Augustine Sanford Statewide Totals 579 180 399 170 49 121 409 131 278 2002 Interim MEC Drug Report Page 14 Cocaine Deaths by Age January June 2002 Table 11 Medical Examiner District and Area Cocaine Found at Lethal Levels Cocaine Present (Non?Lethal) of Florida Age of Decedent Age of Decedent District Area of Florida Total 18 18?25 26?34 35-50 >50 Total <18 18-25 26-34 35-50 >50 1 Pensacola Tallahassee Live Oak Jacksonville Leesburg St. Petersburg Daytona Beach Gainesville Orlando Lakeland Miami Sarasota Tampa Panama City West Palm Florida Keys Ft. Lauderdale Melbourne Ft. Pierce Naples 'Ft. Myers Port Charlotte St. Augustine Sanford Statewide Totals 579 2002 Interim MEC Drug Report Page 15 Table 12 Heroin Deaths January June 2002 Medical Examiner Total Deaths with Heroin Deaths with Heroin Only Deaths with Heroin in District Area of Florida Combination with Other Drugs District Area of Florida Total Cause Present Total Cause Present Total Cause Present 1 Pensacola Tallahassee Live Oak Jacksonville Leesburg St. Petersburg Daytona Beach Gainesville Orlando Lakeland Miami Sarasota Tampa Panama City West Palm Bob Florida Keys Ft. Lauderdale Melbourne Ft. Pierce Naples Ft. Myers Port Charlotte St. Augustine Sanford Statewide Totals 141 121 2002 Interim MEC Drug Report Page 16 Table 13 Heroin Deaths by Age January June 2002 Medical Examiner District and Area Heroin Found at Lethal Levels Heroin Present (Non-Lethal) of Florida Age of Decedent Age of Decedent District Area of Florida Total 18 18?25 26-34 35?50 >50 <18 18-25 26?34 35?50 >50 1 Pensacola Tallahassee Live Oak Jacksonville Leesburg St. Petersburg Daytona Beach Gainesville Orlando Lakeland Miami Sarasota Tampa Panama City West Palm Florida Keys Ft. Lauderdale Melbourne Ft. Pierce Naples Ft. Myers Port Charlotte St. Augustine Sanford Statewide Totals 141 121 2002 Interim MEG Drug Report Page I 7 Table 14 Methylated Amphetamine Deaths January June 2002 Medical Examiner Total Deaths with Methylated Deaths with Methylated Deaths with Methylated District Area of Florida Amphetamines Amphetamines Only Amphetamines in Combination with Other Drugs District Area of Florida Total Cause Present Total Cause Present Total Cause Present 1 Pensacola Tallahassee Live Oak Jacksonville Leesburg St. Petersburg Daytona Beach Gainesville Orlando Lakeland Miami Sarasota Tampa Panama City West Palm Bob Florida Keys Ft. Lauderdale Melbourne Ft. Pierce Naples Ft. Myers Port Charlotte St. Augustine Sanford Statewide Totals 2002 Interim ME Drug Report Page 18 Methylated Amphetamine Deaths by Age Table 15 January June 2002 Medical Examiner District and Area Methylated Amphetamines Found at Lethal Methylated Amphetamines Present (Non- of Florida Levels Lethal) Age of Decedent Age of Decedent District Area of Florida Total Total 18 18-?25 26-34 35-50 >50 Total <18 18?25 26-34 35?50 >50 1 Pensacola Tallahassee Live Oak Jacksonville Leesburg St. Petersburg Daytona Beach Gainesville Orlando Lakeland Miami Sarasota Tampa Panama City West Palm Bob Florida Keys Ft. Lauderdale Melbourne Ft. Pierce Naples Ft. Myers Port Charlotte St. Augustine Sanford Statewide Totals 2002 Interim ME Drug Report Page 19 Table 16 Type of Methylated Amphetamine Compound Occurrences January June 2002 Number of Deaths Methylated Amphetamine Present Lethal and Non-Lethal) 7 (MDMA) I (MDMA) d-methamphetamine 1-methamphetamine 14 (MDDIA) 3,4-methylenedioxyamphetamine 1 3,4-methylenedi0xyamphetamine d-Inethamphetamine 9 d?methamphetamine l-methamphetamine 4 d-methamphetamine 1 1?methamphetamine 2,5-dimethoxyamphetamine 14 Not Determined 52 Total 2002 Interim MEC Drug Report Page 20 Chart 3 Drugs Detected at Death: Lethal vs. Non-Lethal Cocaine Deaths Heroin Deaths Present 69% Hyrdocodone Deaths Oxycodone Deaths Present Present 58% 75% Methadone Deaths Methylated Amphetamine Deaths Present 4 8 A Present 85% 2002 Interim ME Drug Report Page 2] Chart 4 Ages of Decedent's Cocaine Deaths <18 Heroin Deaths 1% >50 8% Hydrocodone Deaths Oxycodone Deaths 18 1% 18 - 25 8% Methylated Amphetamine Deaths Methadone Deaths >50 >50 .2002 Interim ME Drug Report Page 22 Chart 5 Manners of Death for Cases Reported Undet. Cocaine Deaths 2% Natural 8% Methylated Amphetamine Deaths Natural 4% Hamletde 10% 2002 Interim ME Drug Report Heroin Deaths 3% Natural 1% Oxycodone Deaths Undet 5% Homicide 1% Natural 17% Methadone Deaths Undet 6% Suicide 9% Homicide. 0% Page 23