In December 2002, the author conducted a comprehensive review of indicators of use of illicit substances in the San Francisco Bay Area. Cocaine use prevalence appears to be rising again, after a significant decline in the late 1990s. The shift away from smoking crack and toward snorting powder cocaine persists. The former predominance of Blacks among users continues to ebb. Heroin use indicators consistently show a peak in 1999, followed by a significant decline. The average age of users keeps increasing. Local street prices of heroin have risen considerably since 2001. Marijuana indicators suggest a continued increase in prevalence. Methamphetamine indicators are mixed. Usage is still widespread, and risky injection practices among gay/bisexual men remain a major factor for HIV incidence. Incidence of new HIV infection declined between 1997 and 2001 for heterosexual drug injectors, but increased for gay male and transsexual injectors.