The CEWG is a network of epidemiologists and researchers who meet biannually to discuss current and emerging problems of substance abuse. CEWG members present indicator data obtained from a variety of city, State, Federal, and other sources. These data are enhanced with information collected through ethnographic research, focus groups, interviews, and other qualitative data. This report contains CEWG general observations on the most significant substance abuse trends. It documents increases in heroin use and a change in the route of administration from injection to intranasal use. It contains an alert to a possible new problem: injection of crack cocaine, first reported by the Chicago CEWG. It also shows an increase in indicators of methamphetamine abuse and provides a follow-up (including a detoxification protocol) on flunitrazepam abuse, first identified at the June 1993 CEWG meeting. An overview of drug abuse internationally focuses on Toronto, Canada; Mexico; England; Singapore; Thailand; Lebanon; issues discussed are managed care and marketing. A section on advances in drug use surveillance methodology considers the reporting of multiple drug use, resource-driven indicators, the timeliness of indicators, and reporting criteria.