Increases in cocaine-related deaths were reported by Minneapolis, New Orleans, Philadelphia, the District of Columbia, and most western cities, while New York and Detroit reported declines. Miami reported an increasing number of deaths preceded by a syndrome characterized by hyperactivity, stupor, tachycardia, and hyperthermia. Cocaine ranked highest in emergency room mentions in most cities and accounted for a sizable portion of treatment clients. Crack-related crime and violence escalated, particularly in Atlanta, Miami, New Orleans, Philadelphia, and the District of Columbia. Heroin-related deaths increased in northeastern cities, while western cities reported declines or stable trends. Methadone ranked first in emergency room mentions among opiates other than heroin, followed by propoxyphene, oxycodone, codeine, hydromorphone, pentazocine, and merperidine. Seven cities reported increases of over 100 percent in marijuana emergency room mentions, while all other cities reported smaller increases or level trends. San Diego exceeded other cities in the number of stimulant emergency room mentions for amphetamines, methamphetamines, and speed. The percentage of clients reporting barbituates and sedatives/hypnotics as primary drugs of abuse remained low. Hallucinogens showed dramatic increases in St. Louis, San Francisco, and the District of Columbia and more moderate increases in Chicago; declines were reported in Los Angeles, New York, and New Orleans. Regional and city summaries of drug abuse trends are included. 26 tables.