In 2003, Texas boasted a population of 21,828,569. Its shared border with Mexico presents problems in terms of illicit drug smuggling into the State. Drug trafficking also occurs via commercial cargo vessels and the international airports in Houston and Dallas/Fort Worth. Legal prescription drugs are also presenting a problem as Mexican pharmacies sell controlled substances to United States citizens who can then legally bring up to 50 dosage units into the country. This report presents summary information on the use of 15 categories of drugs in Texas. Information about each drug contains the following components: data about student substance abuse from two statewide school surveys; data about adult substance abuse from a statewide survey conducted in 2000; data from the Substance Abuse and Mental Health Services Administration; data from the Texas Poison Control Centers; data from Dallas area emergency departments; treatment admission data; overdose death data from the Bureau of Vital Statistics; drug use data from arrestees; drugs identified by laboratory tests; data on prices, purity, and trafficking, distribution, and supply; data from drug users and outreach workers; and data about AIDS and hepatitis C. Highlights include that the fact that 30 percent of treatment admissions in Texas report a primary problem with cocaine. School survey and arrestee data indicate that cocaine remains a threat to Texas, especially in border towns around Mexico. Alcohol, however, is the most prevalent drug of abuse in Texas. Alcohol continues to be the primary mention in terms of dependence, deaths, treatment admissions, and arrests. Marijuana is also a significant problem in Texas, with 75 percent of youth treatment admissions reporting marijuana as the primary problem drug. Ecstasy treatment admissions are rising and drugs such as GHB and GBL continue to be a problem, particularly in the Dallas/Forth Worth Metroplex area. Xanax is a widely abused prescription drug in Texas and the use of codeine cough syrup is increasing. AIDS cases among females and persons of color are rising in Texas. In 2003, more new AIDS cases were due to heterosexual transmission than injection drug use. The report is published every 6 months as an on-going effort to understand drug trends in Texas. Charts, exhibits