When it comes to drug and alcohol abuse in the State of Florida, there is some good news and some not-so-good news. Mirroring national trends, the rates of cigarette smoking, alcohol consumption, and binge drinking have shown historic declines in recent years (2017 figures). But new problems related to addiction have emerged. For instance, vaping has become popular among students with 1 out of 13 students reporting the use of electronic cigarettes or similar devices within the past 30 days. This is three times the frequency of cigarette smoking among high school students, many of whom are unaware that the aerosol produced by vaping devices contains fine particles of toxic chemicals.

There is good news on another front. The use of synthetic cathinones like Molly and flakka has declined considerably with a resultant 42% reduction in deaths caused by these drugs (2017 figures).

The opioid crisis, however, continues to rage in Florida. There has been a rapid spread of illegally manufactured non-pharmaceutical opioids that primarily make their way into Florida from illicit overseas laboratories. Of particular concern are fentanyl analogs like carfentanil which is 10,000 times more powerful than morphine and has 100 times the potency of fentanyl. As a result, even tiny amounts of these fentanyl analog drugs can be lethal. Unfortunately, they are increasingly being detected as adulterants in heroin and cocaine sold on Florida streets. Perhaps reflecting the use of such deadly adulterants, the number of deaths related to cocaine increased by 83% from 2016 to 2017 per the Florida Medical Examiner’s report. [1]

Alcohol Use by Adults in Florida

The two main areas of concern in Florida related to alcohol use are heavy drinking and underage drinking. In the adult population, excessive alcohol use continues to be a problem in Florida. Alcohol was found in 44% of all drug-related deaths in Florida (2016 figures), indicating that many Floridians combine the use of alcohol and illicit drugs, often with fatal consequences.

Overall, roughly 18% of Floridians (21% of men and 15% of women) report heavy alcohol use or binge drinking. Heavy alcohol use is the highest among non-Hispanic Whites (19%) and Hispanics (17%). Approximately 23% of non-Hispanic White men are heavy alcohol drinkers. Alcohol use is highest in young adults in the 18-44 age group. In terms of education level and income, 19% of heavy drinkers in Florida have more than a high school education and 22% have an annual income of more than $50,000. [2]

Binge drinking is a behavior associated with a range of health problems as well as injuries and accidents. The National Survey on Drug Use found that 22% of Floridians above the age of 21 report binge alcohol use (having 5 or more drinks at a time within a couple of hours).

Excessive drinking in Florida not only leads to health problems and premature deaths but also has a substantial economic cost to the state. It is estimated that Florida loses a whopping $15.3 billion each year ($815 per Floridian) due to lost workplace productivity, healthcare expenses, motor vehicle crashes, property damage, and criminal justice costs related to alcohol use.

Alcohol Use by Youth in Florida

Among Floridian youth, there are some promising trends in terms of alcohol consumption. There continues to be a decline in underage drinking according to multiple surveys on youth risk behaviors. Yet, 1 in 5 high school students in Florida report alcohol use within the past 30 days and binge drinking within the past 2 weeks. Even more worrisome, 1 out of 8 high school students report at least one episode of blacking out after drinking.

Roughly 1 out of 5 middle and high school students have their first drink of alcohol by age 13 or younger in Florida, underlining the need for more intensive education about the great risk of harm associated with underage drinking. Interestingly, nearly 80% of youth report that they consumed alcohol in their own home or at a friend’s home. [3]

Marijuana Use in Florida

The use of marijuana in Florida peaked in the 2010-2014 period and has shown a decline since then. A 2017 survey found that 23% of high school students and 52% of middle school students in Florida understand that regular use of marijuana can be harmful. Encouragingly, 89% of middle schoolers and 61% of high schoolers felt it was wrong or very wrong for someone of their age to be smoking marijuana regularly. However, early initiation of marijuana continues to be a problem in Florida. Approximately 1 out of 8 high school students and 1 out of 16 middle school students first use marijuana by age 13 or younger.

Among Floridian adults, 7% report current use of marijuana or the use of marijuana within the past 30 days. Surveys also show that a larger number of middle-aged and older adults in Florida have begun using marijuana in recent years.

Prescription Opioid Abuse in Florida

In around the year 2007, Florida became notorious for the proliferation of clinics prescribing opioid pain pills with little to no medically valid reason. The opioid analgesics prescribed at these pain clinics were being abused or diverted. In 2010, 98 out of the top 100 physicians in the United States prescribing oxycodone from their offices were located in Florida.

In response to this prescription opioid crisis, the state undertook several measures such as Operation Pill Nation to ensure opioid analgesic prescriptions were in line with best practices. Pain clinics that prescribe controlled substances were required to register with the state. Also, the authorities conducted statewide raids and made several arrests and seizures.

As a result of these measures, drug overdose deaths decreased by 16% from 2010 to 2012, largely attributed to a decrease in prescription drug-related deaths. Specifically, the number of oxycodone prescriptions declined by 24% and the rate of opioid analgesic overdose deaths decreased by 27%. [4]

Fentanyl Analogs in Florida

Like the rest of the United States, Florida continues to grapple with an opioid crisis. In particular, the rising abuse of fentanyl analogs has raised red flags. Fentanyl analogs are some of the most lethal opioid drugs and include carfentanil, which was originally developed as a tranquilizer for elephants and other large animals. Weight for weight, this fentanyl analog is 100 times more potent than the same amount of fentanyl. These illicitly manufactured, non-pharmaceutical drugs led to a spike in heroin-related deaths in Florida in around 2014. (Fentanyl analogs are often added as adulterants to heroin and cocaine).

In response, the Florida Medical Examiners began tracking fentanyl analogs separately in 2016 and found there was an 80% increase in deaths related to these drugs in the state. This dramatic escalation in deaths resulted in more than 1,000 lives lost in one year alone.

Also of concern is the number of heroin deaths in Florida (1,023 in 2016). This was 18 times more compared to 2011 and a fivefold increase compared to 2013. What’s more, nearly half of the people who died from heroin abuse were below the age of 35.

Methamphetamine Use in Florida

Methamphetamine is a highly addictive stimulant drug that comes to the United States primarily from clandestine labs in Mexico. Methamphetamine-related deaths in Florida have shown a worrisome increase in recent years. In 2011, meth deaths escalated a staggering 540% compared to the previous six years. In 2016, more than 600 Floridians died from meth use, a number that was five times higher than meth-related deaths in 2011.

Cocaine Abuse in Florida

There has been a steady decline in cocaine use among Floridians from 2014 onwards. Although there is a low prevalence of cocaine use in Florida, the drug causes great harm to users. After showing a decline for some years from 2007 to 2010, cocaine deaths began increasing at a faster rate in Florida, causing nearly 2,900 deaths in the state in 2016. Roughly 60% of cocaine deaths occurred in individuals above the age of 35, 26% in people of ages 26-34, and 11% in young adults ages 18-25.

In 2017, more than 6,500 Floridians sought treatment for drug addiction where cocaine was the primary drug of use. The majority of users reported smoking cocaine, with a smaller number citing intranasal sniffing as the method of use.

Benzodiazepine Abuse in Florida

Benzodiazepines like Xanax continue to be a significant problem in Florida. Benzo-related deaths peaked in 2010 with close to 6,200 Floridians dying from this drug. Among the various benzos, most deaths were caused by alprazolam, followed by diazepam, nordiazepam, and temazepam.

Novel Psychoactive Substance Abuse in Florida

One of the more recent critical issues impacting substance abuse in Florida has been the use of novel psychoactive substances (NPS). These synthetic drugs are laboratory-made and mimic the effects of natural psychoactive substances like mushrooms and opium. They include tryptamines (LSD and psilocybin or psychedelic mushrooms), piperazines (Molly’s and ecstasy), and cathinones (sold as Molly’s or flakkas).

In 2014, a flakka epidemic erupted in Southeastern Florida leading to 63 deaths and thousands of emergency hospitalizations. Flakkas are highly profitable for drug dealers because they are sold in micro-quantities of 1/10th of a gram for under $5, making them affordable and ensuring repeat business, especially in low-income communities, in the homeless population, and among crack-cocaine abusers.

Last updated: January 8, 2021

References

1 Patterns and Trends of Substance Use Within and Across the Regions of Florida, May 2018. Florida Alcohol and Drug Abuse Association. Available online. Accessed on January 3, 2021.
2 2019 Florida Behavior Risk Factor Surveillance System (BRFSS) Data Book. Available online. Accessed on January 3, 2021.
3 Patterns and Trends of Substance Use Within and Across the Regions of Florida, May 2018. Florida Alcohol and Drug Abuse Association. Available online. Accessed on January 3, 2021.
4 Decline in Drug Overdose Deaths After State Policy Changes Florida 2010-2012. Available online. Accessed on January 3, 2021.