International Journal of the Addictions
ISSN: 0020-773X (Print) (Online) Journal homepage: http://www.tandfonline.com/loi/isum19
Estimating Heroin Use in an Urban Area June Morrison, Allen D. Putt & Robert Zmud To cite this article: June Morrison, Allen D. Putt & Robert Zmud (1975) Estimating Heroin Use in an Urban Area, International Journal of the Addictions, 10:4, 589-598, DOI: 10.3109/10826087509026736 To link to this article: http://dx.doi.org/10.3109/10826087509026736
Published online: 03 Jul 2009.
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Date: 03 April 2016, At: 02:40
The International Journal of the Addictions, 10(4), pp. 589-598, 1975
Downloaded by [New York University] at 02:40 03 April 2016
Estimating Heroin Use in an Urban Area June Morrison, Ph.D. Allen D. Putt, Ph.D. Robert Zmud, Ph.D. College of Business and Public Administration University of Arizona Tucson, Arizona
Abstract
The purpose of this pilot project was to develop a verifiable method of empirically estimating heroin usage in a defined geographic area. If such a methodology could be constructed, appropriate officials could employ the procedure to promote planning, prevention, and education projects, and to evaluate on-going programs. Thus, should such a technique be developed, it could replace more traditional and empirically unconfirmed methods. Employing data furnished by local law-enforcement, social, and medical agencies, a questionnaire was developed, pretested, and applied to a selected sample of the stipulated population. This study was made possible in part by the Law Enforcement Assistance Administration, Grant No. 72-136-2. 589 Copyright 0 1975 by Marcel Dekker, Inc. All Rights Reserved. Neither this work nor any part may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, microfilming, and recording, or by any information storage and retrieval system, without permission in writing from the publisher.
590
MORRISON, PUTT, AND ZMUD
Downloaded by [New York University] at 02:40 03 April 2016
Cluster sampling was the specific statistical method utilized. Based on this methodology, estimates of heroin use were derived for the population. Given the constraints of the study, if appears that this technique has the potential of providing the methodology for estimating the extent of heroin use in a given geographic area. The problem to which this pilot project addressed itself was one of attempting to determine a reliable and verifiable method of estimating the extent of heroin use in a given geographic area. The availability of such a methodology would make possible the planning of realistic education, prevention, and treatment programs. In addition, the ability to project heroin usage with a reasonable expectation of accuracy would enable law enforcement and drug treatment agencies to evaluate programs designed to reduce the number of opiate users. Few will argue that heroin usage is not a serious social/legal/medical problem. It has been estimated that the cost of heroin-related crime is in excess of $3 billion a year (Crime Control Digest, 1972), and a LEAAfunded study in the New York area designed primarily to determine the characteristics of heroin users was entitled “Heroin Spreads Like Epidemic” (LEAA Newsletter, 1972). Another project devoted to reducing the incidence and prevalence of narcotic addiction was patterned after the medical model of venereal disease control; however, the project was not statistically oriented and no effort was made to develop a base for estimating the extent of the problem (Hughes, Crawford, and Barker, 1971). Although there is agreement that a serious problem exists, there is much disagreement about the extent of the problem. The Baden method (Holahan, 1972) of predicting heroin usage (200 addicts for each death caused by an overdose of the opiate) has not been empirically confirmed. It has been used mainly because no objective method has been generally accepted. The primary purpose of this research project was to develop reliable analytical tools that would allow various public and private sector officials to estimate more accurately the extent of heroin use in a given area. During the first phase of the 3-month project in 1972, an interviewer contacted social and medical facility personnel presently involved in prevention and treatment programs for heroin users in Tucson, Arizona. The interviewer requested information concerning: (I) an estimate of the extent of heroin usage and an explanation of how the estimate was derived; (2) the kinds of records maintained on patients or clients; (3) service boundaries; and (4) plans for the future.
Downloaded by [New York University] at 02:40 03 April 2016
ESTIMATING HEROIN USE I N AN URBAN AREA
59 1
Only three hospitals maintained retrievable records of addicts admitted for treatment. These were the detoxification centers available to the community in crisis situations. Only one hospital would estimate the extent of usage in the area, and it set the figures at approximately 2,000. The County Hospital can be utilized for voluntary detoxification only for those persons eligible for county medical care, and detoxification patients in another facility come from a specific catchment area. There are only two large social facilities designed primarily for the treatment of heroin addicts. A spokesman for a nonchemical program that offered counseling services on an outpatient basis would not issue a public statement concerning the extent of the problem. Another facility, which provides the only public methadone maintenance program, estimated there were approximately 7,000 heroin users in the greater metropolitan area. No basis was given for this estimate. Detailed records were kept for all persons receiving treatment. Future plans in all agencies and facilities were stated to be dependent upon receipt or nonreceipt of an approximately $1 million federal grant that would provide additional services in the area of drug abuse. Included were an expansion of an existing methadone maintenance program, detoxification beds in two hospitals, a crisis intervention program, a therapeutic community, and postrelease supervision of detoxified addicts. Although all the law enforcement agencies in the community cooperated in this research effort, none would estimate the extent of usage. Law enforcement agencies provide information for public consumption only when they are able to produce actual supporting statistics. It would appear that law enforcement departments are highly vulnerable to public opinion and to bureaucratic repercussions. No one was willing to hazard an estimate. The second phase of the study involved developing the questionnaire t o be used in the research. In order to establish the validity and reliability of this instrument and to test our beliefs regarding the extent and location of heroin usage, a pretest was conducted. We discovered that an original concept of a student/ex-addict interviewing team was invalid. The presence of the student made it impossible for the team to establish a rapport with people in the areas of heaviest usage. We re-formed the interviewing teams using ex-addict teams in those areas of heaviest usage and student teams in the remaining areas. A second pretest utilizing the new format was productive, and this method was used for the actual research. The ex-addicts were paraprofessionals selected from the nonchemical store front treatment centers. The students were selected because of their awareness of the drug problem in Tucson. Both students and paraprofes-
Downloaded by [New York University] at 02:40 03 April 2016
592
MORRISON, PUTT,AND ZMUD
sionals were trained prior to the pretest and supervised during the pretests and the actual data collection phase by the authors. Cluster sampling was chosen as the method of sampling because it appeared t o be the technique best suited to the population we were sampling (a large urban area) and the constraints of the study (limited time and budget). Cluster sampling is the favored method of sampling when either the costs of obtaining a list of all population elements is high or if the costs of obtaining observations increases at a faster rate than the distance separating elements in the population. As both of these factors were present in our study, we decided to adopt the cluster sampling approacha less accurate but efficient technique for our purposes. There are three major steps in determining an interviewing sample: (1) identifying the specific population to be sampled, (2) determining the sample size, and (3) selecting those population elements to be sampled. Even if these steps are carried out in an effective manner, the researcher must realize that he will arrive at estimates that reflect the precise population he defines-i.e., all of the assumptions knowingly or unknowingly made by the researcher will influence his results. Our first assumption concerned the population that was to be sampled. We felt that by collecting information from law enforcement agencies we could narrow the geographic area (with which we could be concerned). We assumed that heroin usage in an area was linearly related to the number of inhabitants arrested for heroin-related offense. If this was true, we could then limit our study to an area of high arrest incidence and use an estimate of usage in this area to obtain the estimate for the entire urban area. Given the above assumption, arrest figures for a 3-month period were obtained from the Metropolitan Narcotics Division and the County Sheriff’s Office. This information concerned residence addresses of those persons arrested for a heroin-related offense or those who had a history of heroin use even though the offense was not a drug offense. These residences were charted on a map of the community, and this map was then studied to detect patterns in arrests. In this way, high arrest areas were located. We found that the numerical and geographical extent of heroin use was much more widespread than had initially been visualized. Five geographical regions of increasing size were specified. Table 1 gives the information used in selecting both the population to be sampled and the sample size needed. As we desired to determine the number of known heroin users per household, 1970 Census Tract data were used to obtain estimates of the number of households in each block in the community. The pretest supplied the required estimate of variance needed in
ESTIMATING HEROIN USE IN AN URBAN AREA
593
Table 1
A
B
150 2,300
400 6,400
C
D
E
650 10,500
1,500 33,400
4,500 91,300
Areas Blocks Households
Downloaded by [New York University] at 02:40 03 April 2016
Sample Sizes for 95 % Confidence Bounds Bounds 100 150 200 250 300 400 500 150 1,000 1,250 1,500 1,750 2,000
95 62 38 28 22 14 9 4 2 -
-
333 200
80 57 25 15 II
8 5 4
166 75 40 27 19 14 13
195 137 94 72 55
122
determining sample size. The decision criteria in selecting the sample size were: (1) we would accept 95 ”/, confidence bounds up to a range of f800; (2) given our time and funding constraints, we felt we could effectively sample around 25 blocks. Consequently. Area B was selected as the population of interests and the sample size was set at 25 blocks. Determining which particular blocks would be used for the interviewing was accomplished by listing the 400 blocks in Area B and using a random number table to select a random set of 25 blocks. The approach used in the interviews and the questions asked have been previously discussed. However, two additional points will be mentioned as they effect the estimates which were made. Both items would bias our estimates upward if they were not adequately handled. First, we were faced with the problem of the general population not knowing what or who a “heroin user” was. We did not want our responses biased with references to individuals using other depressants or stimulants. We could think of no way to eliminate this problem except by the interviewers volunteering information concerning signs of heroin usage whenever an interviewee seemed perplexed. Second, we felt that the same user might be known by more than one person. We attempted to solve this problem by
MORRISON, PUTT, AND ZMUD
Downloaded by [New York University] at 02:40 03 April 2016
594
asking questions concerning demographic characteristics of the user and then deleting seemingly duplicate responses. More females (170) than males (160) were interviewed. The majority of those interviewed felt that heroin was an increasing problem, and of the 330 persons interviewed, only 19 refused to talk with the interviewer. This is a promising result if the technique is to be used in larger studies, but may be partially explained by the relatively high age of those interviewed, as seen in Table 2. Sex and age were the only demographic data obtained from the interviewees. In addition to providing a means of locating duplications in responses, the descriptive information was interesting in its own right. The number of male users totaled 142 and the number of female users was 71. Table 3 shows the age groups of the reported users, who in general were quite younger than the individuals interviewed. The data in ethnic background given in Table 4 reflects the ethnic composition of the area in which the interviewing was done. Table 5 shows the marital status of users and Tables 6 and 7 depict their educational attainments. An overwhelming majority (178) of the 236 reported users had not served in the military. Table 8 shows the employment status of the users. Finally, the ratio of users known Table 2 Age Group of lnterviewees
Absolute frequency
No response 16 and under 17 to 21 22 to 30 31 to 45 46 and over
11
5 34 105 110 65
Table 3 Age Group of Reported Users
Absolute frequency 14 and under 15 to 20
8 27
21 to 25 26 to 30 31 and over
63 79 49
ESTIMATING HEROIN USE IN AN URBAN AREA
595
Table 4 Ethnic Background of Reported Users
Downloaded by [New York University] at 02:40 03 April 2016
Absolute frequency 2
No response White Black Brown Red Other
45 72 100 4 3
Table 5 Marital Status of Reported Users Absolute frequency N o response Single Separated Divorced Married Widow
16 65 78 32 31 4
Table 6 Educational Level of Reported Users
Absolute frequency
No response Elementary High School College Graduate
35 85 92 8 6
596
MORRISON, PUTT, AND ZMUD
Table 7 Diploma Received by Reported Users
Downloaded by [New York University] at 02:40 03 April 2016
Absolute frequency
No response High School Bachelor Master GED
161 52 2 1 10
Table 8 Employment Status of Reported Users
Absolute frequency
No response Unemployed Irregular Part-time Full-time Welfare
4 I09 39 31 12 30
Table 9 Estimate of Heroin Use in the Urban Area
1975
Estimate 95 % confidence bounds
1980
1972
High
Low
High
Low
10,685
12,309
12,245
14,243
13,784
15,089
&5,863
15,832
&6,784
16,565
Arrests in Area B : 47 Total arrests in urban area: 133 Average number of users per block in Area B : 9.44 Estimated number of users in Area B: 3776 95 % confidence bounds for Area 8 estimate: 1798
Downloaded by [New York University] at 02:40 03 April 2016
ESTIMATING HEROIN USE IN AN URBAN AREA
597
t o have been arrested was 3:1, and only 26 of those interviewed would not give information concerning the user's arrest record. The actual number of households interviewed was less than the number estimated with the Census Tract data. Further, the number of known users per block varied considerably (due in part t o a large fluctuation in the number of households per block). Both of these factors contributed to the rather large bounds we were forced t o use with our final estimates, which are given in Table 9. The estimated number of heroin users in the urban area was derived from our estimate of known users in the sample population by multiplying that estimate by the ratio:* number of arrests in entire urban area number of arrests in Area B The estimates for 1975 and 1980 were obtained by multiplying the 1972 estimate by growth rate figures. These projections called for a second assumption t o be made: the use of heroin would vary linearly with changes in population. Summarizing our findings, our best estimate of the number of heroin users in the urban area is 10,685, the midpoint between our confidence bounds of 5,596 and 15,774. We can predict with only a 50/, probability of being wrong that the actual number of users will fall somewhere between these two extremes. During the first 8 months of 1972, the County Health Department reported 16 deaths caused by overdoses of opiates. This is a n average of two per month, o r 24 projected for 1972. According to the Baden method, tlus represents 4,800 addicts. I t should be pointed out that this present study was concerned with usage and not restricted t o addicts. The methodology presented in this study, if conducted county-wide and over a period of at least 1 year, would provide a broad data base and some objective procedures for evaluation of the results of drug programs. It could also be of assistance to law enforcement agencies as it would provide an index of increase o r decrease in opiate use in their jurisdictions.
* Accepting the assumption that heroin usage is linearly related to the number of heroin related arrests of the inhabitants of an urban area, then thc ratio: number of heroin users in urban area number of heroin users in Area B should be proportional to the ratio: number of heroin related arrests in urban area number of heroin related arrests of inhabitants from Area B
Downloaded by [New York University] at 02:40 03 April 2016
598
MORRISON, PUTT, AND ZMUD
The technique described herein seems to be a viable procedure for estimating the extent of heroin use in an urban area. The assumptions which were made have been specified. They appear to be realistic. Two procedural weaknesses should be noted. First, the method of identifying duplicate “users” is subject to further refinement. Second, some difficulty was encountered in developing an operational definition of heroin usage as distinct from other forms of drug abuse. The major restriction of the study is that it was necessary to increase our confidence bounds beyond an ideal width in order to retain a reasonable probability of including the actual number. If more time and money were available for an in-depth study, the effects of the problems which were encountered could be lessened. The total amount of the grant was $10,505. There were 330 interviews, resulting in a cost of approximately $32 per interview; however, it is estimated that about one-half of the dollar amount of the project was devoted to research design. Taking this into consideration, the per interview cost was reduced to $16.00. REFERENCES Crime Control Digest, May 5 , 1972, p. 10. HOLAHAN, J.F. The economics of heroin, Staff Paper #4. In Dealing With Drug Abuse: A Report to the Ford Foundation. New York: Praeger, 1972, p. 297, footnote #29. HUGHES, P.H., CRAWFORD, G.A., and BARKER, N.W. Developing an epidemiologic field team for drug dependence. Arch. Gen. Psychiat. 24: 389-393, May 1971. LEAA Newsletter 2(8): 2, August 1972.
ISSN: 0020-773X (Print) (Online) Journal homepage: http://www.tandfonline.com/loi/isum19
Estimating Heroin Use in an Urban Area June Morrison, Allen D. Putt & Robert Zmud To cite this article: June Morrison, Allen D. Putt & Robert Zmud (1975) Estimating Heroin Use in an Urban Area, International Journal of the Addictions, 10:4, 589-598, DOI: 10.3109/10826087509026736 To link to this article: http://dx.doi.org/10.3109/10826087509026736
Published online: 03 Jul 2009.
Submit your article to this journal
Article views: 1
View related articles
Citing articles: 1 View citing articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=isum19 Download by: [New York University]
Date: 03 April 2016, At: 02:40
The International Journal of the Addictions, 10(4), pp. 589-598, 1975
Downloaded by [New York University] at 02:40 03 April 2016
Estimating Heroin Use in an Urban Area June Morrison, Ph.D. Allen D. Putt, Ph.D. Robert Zmud, Ph.D. College of Business and Public Administration University of Arizona Tucson, Arizona
Abstract
The purpose of this pilot project was to develop a verifiable method of empirically estimating heroin usage in a defined geographic area. If such a methodology could be constructed, appropriate officials could employ the procedure to promote planning, prevention, and education projects, and to evaluate on-going programs. Thus, should such a technique be developed, it could replace more traditional and empirically unconfirmed methods. Employing data furnished by local law-enforcement, social, and medical agencies, a questionnaire was developed, pretested, and applied to a selected sample of the stipulated population. This study was made possible in part by the Law Enforcement Assistance Administration, Grant No. 72-136-2. 589 Copyright 0 1975 by Marcel Dekker, Inc. All Rights Reserved. Neither this work nor any part may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, microfilming, and recording, or by any information storage and retrieval system, without permission in writing from the publisher.
590
MORRISON, PUTT, AND ZMUD
Downloaded by [New York University] at 02:40 03 April 2016
Cluster sampling was the specific statistical method utilized. Based on this methodology, estimates of heroin use were derived for the population. Given the constraints of the study, if appears that this technique has the potential of providing the methodology for estimating the extent of heroin use in a given geographic area. The problem to which this pilot project addressed itself was one of attempting to determine a reliable and verifiable method of estimating the extent of heroin use in a given geographic area. The availability of such a methodology would make possible the planning of realistic education, prevention, and treatment programs. In addition, the ability to project heroin usage with a reasonable expectation of accuracy would enable law enforcement and drug treatment agencies to evaluate programs designed to reduce the number of opiate users. Few will argue that heroin usage is not a serious social/legal/medical problem. It has been estimated that the cost of heroin-related crime is in excess of $3 billion a year (Crime Control Digest, 1972), and a LEAAfunded study in the New York area designed primarily to determine the characteristics of heroin users was entitled “Heroin Spreads Like Epidemic” (LEAA Newsletter, 1972). Another project devoted to reducing the incidence and prevalence of narcotic addiction was patterned after the medical model of venereal disease control; however, the project was not statistically oriented and no effort was made to develop a base for estimating the extent of the problem (Hughes, Crawford, and Barker, 1971). Although there is agreement that a serious problem exists, there is much disagreement about the extent of the problem. The Baden method (Holahan, 1972) of predicting heroin usage (200 addicts for each death caused by an overdose of the opiate) has not been empirically confirmed. It has been used mainly because no objective method has been generally accepted. The primary purpose of this research project was to develop reliable analytical tools that would allow various public and private sector officials to estimate more accurately the extent of heroin use in a given area. During the first phase of the 3-month project in 1972, an interviewer contacted social and medical facility personnel presently involved in prevention and treatment programs for heroin users in Tucson, Arizona. The interviewer requested information concerning: (I) an estimate of the extent of heroin usage and an explanation of how the estimate was derived; (2) the kinds of records maintained on patients or clients; (3) service boundaries; and (4) plans for the future.
Downloaded by [New York University] at 02:40 03 April 2016
ESTIMATING HEROIN USE I N AN URBAN AREA
59 1
Only three hospitals maintained retrievable records of addicts admitted for treatment. These were the detoxification centers available to the community in crisis situations. Only one hospital would estimate the extent of usage in the area, and it set the figures at approximately 2,000. The County Hospital can be utilized for voluntary detoxification only for those persons eligible for county medical care, and detoxification patients in another facility come from a specific catchment area. There are only two large social facilities designed primarily for the treatment of heroin addicts. A spokesman for a nonchemical program that offered counseling services on an outpatient basis would not issue a public statement concerning the extent of the problem. Another facility, which provides the only public methadone maintenance program, estimated there were approximately 7,000 heroin users in the greater metropolitan area. No basis was given for this estimate. Detailed records were kept for all persons receiving treatment. Future plans in all agencies and facilities were stated to be dependent upon receipt or nonreceipt of an approximately $1 million federal grant that would provide additional services in the area of drug abuse. Included were an expansion of an existing methadone maintenance program, detoxification beds in two hospitals, a crisis intervention program, a therapeutic community, and postrelease supervision of detoxified addicts. Although all the law enforcement agencies in the community cooperated in this research effort, none would estimate the extent of usage. Law enforcement agencies provide information for public consumption only when they are able to produce actual supporting statistics. It would appear that law enforcement departments are highly vulnerable to public opinion and to bureaucratic repercussions. No one was willing to hazard an estimate. The second phase of the study involved developing the questionnaire t o be used in the research. In order to establish the validity and reliability of this instrument and to test our beliefs regarding the extent and location of heroin usage, a pretest was conducted. We discovered that an original concept of a student/ex-addict interviewing team was invalid. The presence of the student made it impossible for the team to establish a rapport with people in the areas of heaviest usage. We re-formed the interviewing teams using ex-addict teams in those areas of heaviest usage and student teams in the remaining areas. A second pretest utilizing the new format was productive, and this method was used for the actual research. The ex-addicts were paraprofessionals selected from the nonchemical store front treatment centers. The students were selected because of their awareness of the drug problem in Tucson. Both students and paraprofes-
Downloaded by [New York University] at 02:40 03 April 2016
592
MORRISON, PUTT,AND ZMUD
sionals were trained prior to the pretest and supervised during the pretests and the actual data collection phase by the authors. Cluster sampling was chosen as the method of sampling because it appeared t o be the technique best suited to the population we were sampling (a large urban area) and the constraints of the study (limited time and budget). Cluster sampling is the favored method of sampling when either the costs of obtaining a list of all population elements is high or if the costs of obtaining observations increases at a faster rate than the distance separating elements in the population. As both of these factors were present in our study, we decided to adopt the cluster sampling approacha less accurate but efficient technique for our purposes. There are three major steps in determining an interviewing sample: (1) identifying the specific population to be sampled, (2) determining the sample size, and (3) selecting those population elements to be sampled. Even if these steps are carried out in an effective manner, the researcher must realize that he will arrive at estimates that reflect the precise population he defines-i.e., all of the assumptions knowingly or unknowingly made by the researcher will influence his results. Our first assumption concerned the population that was to be sampled. We felt that by collecting information from law enforcement agencies we could narrow the geographic area (with which we could be concerned). We assumed that heroin usage in an area was linearly related to the number of inhabitants arrested for heroin-related offense. If this was true, we could then limit our study to an area of high arrest incidence and use an estimate of usage in this area to obtain the estimate for the entire urban area. Given the above assumption, arrest figures for a 3-month period were obtained from the Metropolitan Narcotics Division and the County Sheriff’s Office. This information concerned residence addresses of those persons arrested for a heroin-related offense or those who had a history of heroin use even though the offense was not a drug offense. These residences were charted on a map of the community, and this map was then studied to detect patterns in arrests. In this way, high arrest areas were located. We found that the numerical and geographical extent of heroin use was much more widespread than had initially been visualized. Five geographical regions of increasing size were specified. Table 1 gives the information used in selecting both the population to be sampled and the sample size needed. As we desired to determine the number of known heroin users per household, 1970 Census Tract data were used to obtain estimates of the number of households in each block in the community. The pretest supplied the required estimate of variance needed in
ESTIMATING HEROIN USE IN AN URBAN AREA
593
Table 1
A
B
150 2,300
400 6,400
C
D
E
650 10,500
1,500 33,400
4,500 91,300
Areas Blocks Households
Downloaded by [New York University] at 02:40 03 April 2016
Sample Sizes for 95 % Confidence Bounds Bounds 100 150 200 250 300 400 500 150 1,000 1,250 1,500 1,750 2,000
95 62 38 28 22 14 9 4 2 -
-
333 200
80 57 25 15 II
8 5 4
166 75 40 27 19 14 13
195 137 94 72 55
122
determining sample size. The decision criteria in selecting the sample size were: (1) we would accept 95 ”/, confidence bounds up to a range of f800; (2) given our time and funding constraints, we felt we could effectively sample around 25 blocks. Consequently. Area B was selected as the population of interests and the sample size was set at 25 blocks. Determining which particular blocks would be used for the interviewing was accomplished by listing the 400 blocks in Area B and using a random number table to select a random set of 25 blocks. The approach used in the interviews and the questions asked have been previously discussed. However, two additional points will be mentioned as they effect the estimates which were made. Both items would bias our estimates upward if they were not adequately handled. First, we were faced with the problem of the general population not knowing what or who a “heroin user” was. We did not want our responses biased with references to individuals using other depressants or stimulants. We could think of no way to eliminate this problem except by the interviewers volunteering information concerning signs of heroin usage whenever an interviewee seemed perplexed. Second, we felt that the same user might be known by more than one person. We attempted to solve this problem by
MORRISON, PUTT, AND ZMUD
Downloaded by [New York University] at 02:40 03 April 2016
594
asking questions concerning demographic characteristics of the user and then deleting seemingly duplicate responses. More females (170) than males (160) were interviewed. The majority of those interviewed felt that heroin was an increasing problem, and of the 330 persons interviewed, only 19 refused to talk with the interviewer. This is a promising result if the technique is to be used in larger studies, but may be partially explained by the relatively high age of those interviewed, as seen in Table 2. Sex and age were the only demographic data obtained from the interviewees. In addition to providing a means of locating duplications in responses, the descriptive information was interesting in its own right. The number of male users totaled 142 and the number of female users was 71. Table 3 shows the age groups of the reported users, who in general were quite younger than the individuals interviewed. The data in ethnic background given in Table 4 reflects the ethnic composition of the area in which the interviewing was done. Table 5 shows the marital status of users and Tables 6 and 7 depict their educational attainments. An overwhelming majority (178) of the 236 reported users had not served in the military. Table 8 shows the employment status of the users. Finally, the ratio of users known Table 2 Age Group of lnterviewees
Absolute frequency
No response 16 and under 17 to 21 22 to 30 31 to 45 46 and over
11
5 34 105 110 65
Table 3 Age Group of Reported Users
Absolute frequency 14 and under 15 to 20
8 27
21 to 25 26 to 30 31 and over
63 79 49
ESTIMATING HEROIN USE IN AN URBAN AREA
595
Table 4 Ethnic Background of Reported Users
Downloaded by [New York University] at 02:40 03 April 2016
Absolute frequency 2
No response White Black Brown Red Other
45 72 100 4 3
Table 5 Marital Status of Reported Users Absolute frequency N o response Single Separated Divorced Married Widow
16 65 78 32 31 4
Table 6 Educational Level of Reported Users
Absolute frequency
No response Elementary High School College Graduate
35 85 92 8 6
596
MORRISON, PUTT, AND ZMUD
Table 7 Diploma Received by Reported Users
Downloaded by [New York University] at 02:40 03 April 2016
Absolute frequency
No response High School Bachelor Master GED
161 52 2 1 10
Table 8 Employment Status of Reported Users
Absolute frequency
No response Unemployed Irregular Part-time Full-time Welfare
4 I09 39 31 12 30
Table 9 Estimate of Heroin Use in the Urban Area
1975
Estimate 95 % confidence bounds
1980
1972
High
Low
High
Low
10,685
12,309
12,245
14,243
13,784
15,089
&5,863
15,832
&6,784
16,565
Arrests in Area B : 47 Total arrests in urban area: 133 Average number of users per block in Area B : 9.44 Estimated number of users in Area B: 3776 95 % confidence bounds for Area 8 estimate: 1798
Downloaded by [New York University] at 02:40 03 April 2016
ESTIMATING HEROIN USE IN AN URBAN AREA
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t o have been arrested was 3:1, and only 26 of those interviewed would not give information concerning the user's arrest record. The actual number of households interviewed was less than the number estimated with the Census Tract data. Further, the number of known users per block varied considerably (due in part t o a large fluctuation in the number of households per block). Both of these factors contributed to the rather large bounds we were forced t o use with our final estimates, which are given in Table 9. The estimated number of heroin users in the urban area was derived from our estimate of known users in the sample population by multiplying that estimate by the ratio:* number of arrests in entire urban area number of arrests in Area B The estimates for 1975 and 1980 were obtained by multiplying the 1972 estimate by growth rate figures. These projections called for a second assumption t o be made: the use of heroin would vary linearly with changes in population. Summarizing our findings, our best estimate of the number of heroin users in the urban area is 10,685, the midpoint between our confidence bounds of 5,596 and 15,774. We can predict with only a 50/, probability of being wrong that the actual number of users will fall somewhere between these two extremes. During the first 8 months of 1972, the County Health Department reported 16 deaths caused by overdoses of opiates. This is a n average of two per month, o r 24 projected for 1972. According to the Baden method, tlus represents 4,800 addicts. I t should be pointed out that this present study was concerned with usage and not restricted t o addicts. The methodology presented in this study, if conducted county-wide and over a period of at least 1 year, would provide a broad data base and some objective procedures for evaluation of the results of drug programs. It could also be of assistance to law enforcement agencies as it would provide an index of increase o r decrease in opiate use in their jurisdictions.
* Accepting the assumption that heroin usage is linearly related to the number of heroin related arrests of the inhabitants of an urban area, then thc ratio: number of heroin users in urban area number of heroin users in Area B should be proportional to the ratio: number of heroin related arrests in urban area number of heroin related arrests of inhabitants from Area B
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The technique described herein seems to be a viable procedure for estimating the extent of heroin use in an urban area. The assumptions which were made have been specified. They appear to be realistic. Two procedural weaknesses should be noted. First, the method of identifying duplicate “users” is subject to further refinement. Second, some difficulty was encountered in developing an operational definition of heroin usage as distinct from other forms of drug abuse. The major restriction of the study is that it was necessary to increase our confidence bounds beyond an ideal width in order to retain a reasonable probability of including the actual number. If more time and money were available for an in-depth study, the effects of the problems which were encountered could be lessened. The total amount of the grant was $10,505. There were 330 interviews, resulting in a cost of approximately $32 per interview; however, it is estimated that about one-half of the dollar amount of the project was devoted to research design. Taking this into consideration, the per interview cost was reduced to $16.00. REFERENCES Crime Control Digest, May 5 , 1972, p. 10. HOLAHAN, J.F. The economics of heroin, Staff Paper #4. In Dealing With Drug Abuse: A Report to the Ford Foundation. New York: Praeger, 1972, p. 297, footnote #29. HUGHES, P.H., CRAWFORD, G.A., and BARKER, N.W. Developing an epidemiologic field team for drug dependence. Arch. Gen. Psychiat. 24: 389-393, May 1971. LEAA Newsletter 2(8): 2, August 1972.
