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APRIL 2004
Highlights From DAWN: Miami, 2002 Top 5 drugs in drug abuse-related ED visits in Miami, 2002 6,000
5,055 5,000
Number of visits
This special report presents findings based on data submitted by 14 hospitals in the Miami metropolitan area for 2002. ■ Of the 655,000 visits to Miami area emergency departments (EDs) in 2002, about 1.4 percent (9,213) were related to drug abuse. ■ During 2002, the most common drugs involved in these ED visits were cocaine, alcohol in combination with other drugs, marijuana, heroin, and benzodiazepines. ■ Between 1995 and 2002, heroin-related ED visits in Miami increased 366 percent (from 18 to 85 mentions per 100,000 population). ■ Among the 21 DAWN areas, Miami ranked in the top 5 in terms of ED visits involving cocaine and marijuana.
3,863
4,000
3,000
2,337 2,000
1,784 1,029
1,000
0
Cocaine
Alcohol-in- Marijuana combination
Heroin
Benzodiazepines
DAWN: The Warning Network Local information is essential to Seattle support local action, and drugs, drug use, and drug-related morbidity can Detroit Minneapolis differ dramatically across communities. Buffalo DAWN focuses on metropolitan areas Chicago Baltimore to reveal emerging drug problems Denver San Francisco Washington St. Louis before they become widespread. DAWN detects new drugs, new drug Los Angeles combinations, new health consequences Atlanta Phoenix Dallas of drug use, and changing patterns involving San old drugs. Facilities participating in DAWN Diego can use this information to train staff and New improve patient care. Communities can use this Orleans Miami information to plan, target resources, and act more effectively. Today, hospitals in Miami and 20 other metropolitan areas serve their communities by participating in DAWN. Expansion to other areas is underway.
Boston New York Newark Philadelphia
DAWN serves a diverse audience. In addition to participating facilities, users include researchers and policy analysts; pharmaceutical firms; State and local substance abuse agencies; community coalitions; and Federal agencies, including the White House Office of National Drug Control Policy, the Food and Drug Administration, and the National Institute on Drug Abuse. For more information, go to http://DAWNinfo.samhsa.gov/.
2
H I G H L I G H T S F R O M DA W N :
MIAMI 2002
Trends in Top 4 Drugs, 1995-2002 Cocaine
■
■
In 2002, Miami had 240 cocaine-related ED visits per 100,000 population, an increase of 43 percent since 1995. By contrast, the rate for the U.S. was 78 per 100,000 in 2002. Nearly three-quarters (74%) of cocaine-related ED visits in Miami also involved other drugs. More than one-third (37%) of cocaine-related ED visits in Miami were attributed to "crack."
300
Miami Rate per 100,000 population
■
200
100
U.S. 0
1995
1996
1997
1998
1999
2000
2001
2002
Marijuana
■
From 1995 to 2002, marijuana-related ED visits in Miami grew 111 percent (from 53 to 111 visits per 100,000 population). In percentage terms, the growth in the national rate was similar (139%), but the national level (47 visits per 100,000) remained less than half that in Miami. Marijuana was reported in 25 percent of all drug abuse-related ED visits in Miami, and most of these visits (76%) involved other drugs as well.
300
Rate per 100,000 population
■
200
Miami 100
U.S.
0
1995
1996
1997
1998
1999
2000
2001
2002
Heroin
■
■
Heroin-related ED visits in Miami increased more than four-fold between 1995 and 2002 (from 18 to 85 visits per 100,000 population). Over the same period, the national rate increased only 22 percent (from 30 to 36 visits per 100,000). By 2002, heroin-related ED visits in Miami were more than double the national rate. More than 60 percent of heroin-related ED visits in Miami also involved other drugs.
100
Rate per 100,000 population
■
Miami
75
50
U.S.
25
0
1995
1996
1997
1998
1999
2000
2001
2002
Benzodiazepines
■
From 1995 to 2002, mentions of benzodiazepines in drug abuse-related ED visits in Miami increased 21 percent (from 41 to 49 mentions per 100,000 population). The increase nationally was 25 percent. Alprazolam was the most frequently named benzodiazepine in drug-related ED visits in Miami in 2002. Alprazolam accounted for 40 percent of benzodiazepine mentions in Miami.
100
Rate per 100,000 population
■
75
Miami 50
U.S. 25
0
1995
1996
1997
1998
1999
2000
2001
2002
H I G H L I G H T S F R O M DA W N :
??? Comparisons
MIAMI 2002
3
Across 21 Metropolitan Areas
The following figures show Miami in relation to the Nation and 20 other metropolitan areas represented in DAWN for selected drugs in 2002. Comparisons across areas are possible because the number of visits for each drug is represented in terms of a rate per 100,000 population. Not all differences in rates are statistically significant.
Cocaine visits
Marijuana visits
Rate per 100,000 population, 2002
Rate per 100,000 population, 2002
78
Total U.S.
47
Total U.S.
Chicago
275
Philadelphia
Philadelphia
274
Detroit
257
Baltimore
96
Atlanta
182
Detroit
111
Miami
186
88
Baltimore
171
Buffalo
119
Boston
239
Atlanta Newark
124
St. Louis
240
Miami
150 146
78
Chicago
New York
166
New Orleans
Seattle
164
Seattle
72 65 64
Boston
156
Los Angeles
St. Louis
153
Buffalo
150
Washington, DC
55
Newark
54
San Francisco
145
New Orleans 108
Los Angeles 82
Denver
71
Washington, DC
59
Phoenix
55
Minneapolis
46
Dallas
32
San Diego
56
New York
47
Minneapolis
47
San Diego
46
Phoenix
46
San Francisco
39
Denver
38 27
Dallas
0
300
0
160
Heroin visits
Benzodiazepines visits
Rate per 100,000 population, 2002
Rate per 100,000 population, 2002
36
Total U.S.
41
Total U.S. 220
Chicago
214
Newark
203
Baltimore 171
San Francisco
95
Philadelphia 82
New Orleans
78
St. Louis
128
Seattle
69
Detroit
123
New York
102
Boston
60
Baltimore
Boston
111
Newark
Philadelphia
109
Phoenix
57 53
Buffalo
93
Seattle
50
Detroit
93
Miami
49
85
Miami New Orleans St. Louis
San Diego
51
San Francisco
43
Denver
22
New York
10 0
26
Denver
16
Dallas
26
Minneapolis
20
Atlanta Minneapolis
28
Los Angeles
23
Phoenix
34 30
Dallas
28
San Diego
42 35
Atlanta
29
Los Angeles
45
Buffalo
38
Washington, DC
47
Chicago
53
21
Washington, DC 225
0
130
4
H I G H L I G H T S F R O M DA W N :
??? About
MIAMI 2002
DAWN
The Drug Abuse Warning Network (DAWN) is a national surveillance system that monitors drug-related morbidity and mortality. Section 505 of the Public Health Service Act assigns this responsibility to the Substance Abuse and Mental Health Services Administration (SAMHSA), an agency of the U.S. Department of Health and Human Services. The Act requires SAMHSA to report annually on drug-related visits to hospital emergency departments and on drug-related deaths reviewed by medical examiners and coroners. SAMHSA has a contract with Westat, a private research firm based in Rockville, MD, to operate the DAWN system. DAWN collects data from a scientific sample of hospital emergency departments and a set of medical examiners and coroners from across the U.S., with concentrations in selected metropolitan areas. Each participating facility has a DAWN Reporter who is specially trained to identify DAWN cases by retrospectively reviewing emergency department medical records or death investigation case files. No patient, family member, or physician is ever interviewed. No direct identifiers for individual patients or decedents are collected. Beginning in 2003, DAWN cases include any emergency department visit or death that was related to drug use. Reportable cases include drug abuse, misuse, overmedication, accidental and malicious poisonings, and adverse drug reactions. For each case, the DAWN Reporter submits a case report detailing the specific drugs involved, and characteristics of the patient or decedent and event (visit or death). Patient and decedent characteristics include demographics (age, gender, race/ethnicity) and ZIP code. Other data items include date/time, chief complaint, diagnoses, and disposition for each emergency department visit; and date, cause, manner, and place of death for each decedent.
U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES
Highlights From DAWN: Miami, 2002 Top 5 drugs in drug abuse-related ED visits in Miami, 2002 6,000
5,055 5,000
Number of visits
This special report presents findings based on data submitted by 14 hospitals in the Miami metropolitan area for 2002. ■ Of the 655,000 visits to Miami area emergency departments (EDs) in 2002, about 1.4 percent (9,213) were related to drug abuse. ■ During 2002, the most common drugs involved in these ED visits were cocaine, alcohol in combination with other drugs, marijuana, heroin, and benzodiazepines. ■ Between 1995 and 2002, heroin-related ED visits in Miami increased 366 percent (from 18 to 85 mentions per 100,000 population). ■ Among the 21 DAWN areas, Miami ranked in the top 5 in terms of ED visits involving cocaine and marijuana.
3,863
4,000
3,000
2,337 2,000
1,784 1,029
1,000
0
Cocaine
Alcohol-in- Marijuana combination
Heroin
Benzodiazepines
DAWN: The Warning Network Local information is essential to Seattle support local action, and drugs, drug use, and drug-related morbidity can Detroit Minneapolis differ dramatically across communities. Buffalo DAWN focuses on metropolitan areas Chicago Baltimore to reveal emerging drug problems Denver San Francisco Washington St. Louis before they become widespread. DAWN detects new drugs, new drug Los Angeles combinations, new health consequences Atlanta Phoenix Dallas of drug use, and changing patterns involving San old drugs. Facilities participating in DAWN Diego can use this information to train staff and New improve patient care. Communities can use this Orleans Miami information to plan, target resources, and act more effectively. Today, hospitals in Miami and 20 other metropolitan areas serve their communities by participating in DAWN. Expansion to other areas is underway.
Boston New York Newark Philadelphia
DAWN serves a diverse audience. In addition to participating facilities, users include researchers and policy analysts; pharmaceutical firms; State and local substance abuse agencies; community coalitions; and Federal agencies, including the White House Office of National Drug Control Policy, the Food and Drug Administration, and the National Institute on Drug Abuse. For more information, go to http://DAWNinfo.samhsa.gov/.
2
H I G H L I G H T S F R O M DA W N :
MIAMI 2002
Trends in Top 4 Drugs, 1995-2002 Cocaine
■
■
In 2002, Miami had 240 cocaine-related ED visits per 100,000 population, an increase of 43 percent since 1995. By contrast, the rate for the U.S. was 78 per 100,000 in 2002. Nearly three-quarters (74%) of cocaine-related ED visits in Miami also involved other drugs. More than one-third (37%) of cocaine-related ED visits in Miami were attributed to "crack."
300
Miami Rate per 100,000 population
■
200
100
U.S. 0
1995
1996
1997
1998
1999
2000
2001
2002
Marijuana
■
From 1995 to 2002, marijuana-related ED visits in Miami grew 111 percent (from 53 to 111 visits per 100,000 population). In percentage terms, the growth in the national rate was similar (139%), but the national level (47 visits per 100,000) remained less than half that in Miami. Marijuana was reported in 25 percent of all drug abuse-related ED visits in Miami, and most of these visits (76%) involved other drugs as well.
300
Rate per 100,000 population
■
200
Miami 100
U.S.
0
1995
1996
1997
1998
1999
2000
2001
2002
Heroin
■
■
Heroin-related ED visits in Miami increased more than four-fold between 1995 and 2002 (from 18 to 85 visits per 100,000 population). Over the same period, the national rate increased only 22 percent (from 30 to 36 visits per 100,000). By 2002, heroin-related ED visits in Miami were more than double the national rate. More than 60 percent of heroin-related ED visits in Miami also involved other drugs.
100
Rate per 100,000 population
■
Miami
75
50
U.S.
25
0
1995
1996
1997
1998
1999
2000
2001
2002
Benzodiazepines
■
From 1995 to 2002, mentions of benzodiazepines in drug abuse-related ED visits in Miami increased 21 percent (from 41 to 49 mentions per 100,000 population). The increase nationally was 25 percent. Alprazolam was the most frequently named benzodiazepine in drug-related ED visits in Miami in 2002. Alprazolam accounted for 40 percent of benzodiazepine mentions in Miami.
100
Rate per 100,000 population
■
75
Miami 50
U.S. 25
0
1995
1996
1997
1998
1999
2000
2001
2002
H I G H L I G H T S F R O M DA W N :
??? Comparisons
MIAMI 2002
3
Across 21 Metropolitan Areas
The following figures show Miami in relation to the Nation and 20 other metropolitan areas represented in DAWN for selected drugs in 2002. Comparisons across areas are possible because the number of visits for each drug is represented in terms of a rate per 100,000 population. Not all differences in rates are statistically significant.
Cocaine visits
Marijuana visits
Rate per 100,000 population, 2002
Rate per 100,000 population, 2002
78
Total U.S.
47
Total U.S.
Chicago
275
Philadelphia
Philadelphia
274
Detroit
257
Baltimore
96
Atlanta
182
Detroit
111
Miami
186
88
Baltimore
171
Buffalo
119
Boston
239
Atlanta Newark
124
St. Louis
240
Miami
150 146
78
Chicago
New York
166
New Orleans
Seattle
164
Seattle
72 65 64
Boston
156
Los Angeles
St. Louis
153
Buffalo
150
Washington, DC
55
Newark
54
San Francisco
145
New Orleans 108
Los Angeles 82
Denver
71
Washington, DC
59
Phoenix
55
Minneapolis
46
Dallas
32
San Diego
56
New York
47
Minneapolis
47
San Diego
46
Phoenix
46
San Francisco
39
Denver
38 27
Dallas
0
300
0
160
Heroin visits
Benzodiazepines visits
Rate per 100,000 population, 2002
Rate per 100,000 population, 2002
36
Total U.S.
41
Total U.S. 220
Chicago
214
Newark
203
Baltimore 171
San Francisco
95
Philadelphia 82
New Orleans
78
St. Louis
128
Seattle
69
Detroit
123
New York
102
Boston
60
Baltimore
Boston
111
Newark
Philadelphia
109
Phoenix
57 53
Buffalo
93
Seattle
50
Detroit
93
Miami
49
85
Miami New Orleans St. Louis
San Diego
51
San Francisco
43
Denver
22
New York
10 0
26
Denver
16
Dallas
26
Minneapolis
20
Atlanta Minneapolis
28
Los Angeles
23
Phoenix
34 30
Dallas
28
San Diego
42 35
Atlanta
29
Los Angeles
45
Buffalo
38
Washington, DC
47
Chicago
53
21
Washington, DC 225
0
130
4
H I G H L I G H T S F R O M DA W N :
??? About
MIAMI 2002
DAWN
The Drug Abuse Warning Network (DAWN) is a national surveillance system that monitors drug-related morbidity and mortality. Section 505 of the Public Health Service Act assigns this responsibility to the Substance Abuse and Mental Health Services Administration (SAMHSA), an agency of the U.S. Department of Health and Human Services. The Act requires SAMHSA to report annually on drug-related visits to hospital emergency departments and on drug-related deaths reviewed by medical examiners and coroners. SAMHSA has a contract with Westat, a private research firm based in Rockville, MD, to operate the DAWN system. DAWN collects data from a scientific sample of hospital emergency departments and a set of medical examiners and coroners from across the U.S., with concentrations in selected metropolitan areas. Each participating facility has a DAWN Reporter who is specially trained to identify DAWN cases by retrospectively reviewing emergency department medical records or death investigation case files. No patient, family member, or physician is ever interviewed. No direct identifiers for individual patients or decedents are collected. Beginning in 2003, DAWN cases include any emergency department visit or death that was related to drug use. Reportable cases include drug abuse, misuse, overmedication, accidental and malicious poisonings, and adverse drug reactions. For each case, the DAWN Reporter submits a case report detailing the specific drugs involved, and characteristics of the patient or decedent and event (visit or death). Patient and decedent characteristics include demographics (age, gender, race/ethnicity) and ZIP code. Other data items include date/time, chief complaint, diagnoses, and disposition for each emergency department visit; and date, cause, manner, and place of death for each decedent.
U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES
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