title: Impact of South American heroin on the US heroin market 1993-2004.
abstract: BACKGROUND
  The past two decades have seen an increase in heroin-related morbidity and mortality in the United States. We report on trends in US heroin retail price and purity, including the effect of entry of Colombian-sourced heroin on the US heroin market.
  
  
  METHODS
  The average standardized price ($/mg-pure) and purity (% by weight) of heroin from 1993 to 2004 was from obtained from US Drug Enforcement Agency retail purchase data for 20 metropolitan statistical areas. Univariate statistics, robust Ordinary Least Squares regression and mixed fixed and random effect growth curve models were used to predict the price and purity data in each metropolitan statistical area over time.
  
  
  RESULTS
  Over the 12 study years, heroin price decreased 62%. The median percentage of all heroin samples that are of South American origin increased an absolute 7% per year. Multivariate models suggest percent South American heroin is a significant predictor of lower heroin price and higher purity adjusting for time and demographics.
  
  
  CONCLUSIONS
  These analyses reveal trends to historically low-cost heroin in many US cities. These changes correspond to the entrance into and rapid domination of the US heroin market by Colombian-sourced heroin. The implications of these changes are discussed.
authors.affiliation: University of California San Francisco, Department of Family and Community Medicine, San Francisco, CA 94143-0900, USA. Ciccaron@fcm.ucsf.edu
authors.forename: Daniel
authors.initials: D
authors.lastname: Ciccarone
authors.forename: George J
authors.initials: GJ
authors.lastname: Unick
authors.forename: Allison
authors.initials: A
authors.lastname: Kraus
mesh_terms: D003132:Commerce / Q000706:statistics & numerical data* / Q000639:trends; D004340:Drug Contamination / Q000706:statistics & numerical data*; D004335:Drug and Narcotic Control / Q000191:economics / Q000331:legislation & jurisprudence; D003932:Heroin / Q000191:economics* / Q000600:supply & distribution*; D006801:Humans; D015233:Models, Statistical; D013020:South America; D014481:United States
chemical_list: D003932:Heroin