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MARCH 2004
Highlights From DAWN: Baltimore, 2002 Top 5 drugs in drug abuse-related ED visits in Baltimore, 2002 10,000
7,500 Number of visits
This special report presents findings based on data submitted by 20 hospitals in the Baltimore metropolitan area for 2002. ■ Of the 1.1 million visits to Baltimore area emergency departments (EDs) in 2002, about one percent (12,904) were related to drug abuse. ■ During 2002, the most common drugs involved in these ED visits were cocaine, heroin, narcotic analgesics (pain relievers), alcohol in combination with other drugs, and marijuana. ■ Heroin-related ED visits in Baltimore increased 4 percent between 2001 and 2002, but have decreased 45 percent since 1995. ■ Among the 21 DAWN areas, Baltimore ranked in the top 3 in terms of ED visits involving heroin, cocaine, and pain relievers.
5,969 4,715
5,000
3,848 3,189 2,500
2,044
0 Cocaine
Heroin
Narcotic Alcohol-in- Marijuana analgesics combination (pain relievers)
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 information to Orleans Miami plan, target resources, and act more effectively. Today, hospitals in Baltimore 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/.
Cocaine
Rate perRate 100,000 per 100,000 population population
400 300 H I G H L I G H T S F R O M DA W N : BA LT I M O R E 2 0 0 2
2
Baltimore
300 200
Baltimore
Cocaine ■
■
■
Cocaine-related ED visits in Baltimore increased 20 percent (to 257 visits per 100,000 population) between 2001 and 2002, but decreased 33 percent since 1995. Cocaine More than 80 percent of cocaine-related ED visits in Baltimore also involved other drugs. Marijuana Less than 5 percent of cocaine-related ED visits were attributedMarijuana to "crack" in Baltimore.
Rate perRate 100,000 per 100,000 Rate per 100,000 population population population
Trends inCocaine Top 4 Drugs, 1995-2002
Heroin-related ED visits in Baltimore increased 4 percent (to 203 visits per 100,000 population) between 2001 and 2002, but decreased 45 Marijuana percent since 1995 heroin (from 366 visits per 100,000). More than half (55 percent) of the heroinrelated ED visits inheroin Baltimore also involved other drugs.
Rate perRate 100,000 perRate 100,000 per 100,000 population population population
■
Marijuana ■
■
From 1995 to 2002, marijuana-related ED visits in Baltimore rose over 100 percent (from 42 to 88 visits per 100,000 population). The national rate (47 visits per 100,000 in 2002) increased Marijuana almost 140 percent over the same 8-year period. Marijuana was reported in about 16 percent of all drug abuse-related ED visits in Baltimore and was usually reported in combination with other drugs.
Rate per 100,000 population
Narcotic analgesics...
Rate per 100,000 population
From 1995 implicated in drug abuse-related ED visits increased more Narcotic than 400 percent in analgesics... Baltimore (from 30 to 165 mentions per 100,000 population). The increase nationally was 139 percent (from 19 to 46 mentions per 100,000). Cocaine Oxycodone and methadone were the most frequently named pain relievers in drug-related ED visits in Baltimore in 2002.
400 0 200 300
U.S. U.S.
1995
1996
1997
1998
1999
2000
2001
2002
1995
1996
1997
1998
1999
2000
2001
2002
Baltimore
200 150 200 150 100 100 100 50 0 50 0
Baltimore U.S. U.S. Baltimore 1995
1996
1997
1998
1999
2000
2001
2002 U.S.
1995
1996
1997
1998
1999
2000
2001
2002
1995
1996
1997
1998
1999
2000
2001
2002
400 150 400 300 100
Baltimore Baltimore U.S.
300 200 50
Baltimore 200 100 0 100 0 400 0 200 300
1995
1996
1997
1998
1999
2000
2001
U.S. 2002
1995
1996
1997
1998
1999
2000
2001
U.S. 2002
1995
1996
1997
1998
1999
2000
2001
2002
Baltimore Baltimore Baltimore
200 150 200 400 150 100 100 300 100 50 0 200 50 0 200 100 0 150 0
U.S. U.S. Baltimore 1995
1996
1997
1998
1999
2000
2001
2002 U.S.
1995
1996
1997
1998
1999
2000
2001
2002
1995
1996
1997
1998
1999
2000
2001
1995
1996
1997
1998
1999
2000
2001
U.S. Baltimore 2002
2002
100 200
U.S.
50 150 0
1995
1996
1997
1998
1999
2000
100
2001
2002
Baltimore U.S.
50
0
400
00
■
toNarcotic 2002,heroin pain relievers analgesics...
Rate per 100,000 Rate perRate 100,000 per 100,000 Rate per 100,000 population population population population
Pain Relievers ■
100 0
200 0
Heroin ■
200 100
300
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
BA LT I M O R E 2 0 0 2
3
Across 21 Metropolitan Areas
The following figures show Baltimore 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 Cocaine visits
Cocaine visits Rate perHeroin 100,000 population, 2002 Heroin visits visits
Rate perRate 100,000 population, 2002 2002 per 100,000 population,
Rate perRate 100,000 population, 2002 2002 per 100,000 population,
171
Miami
78
Total U.S.Total U.S. 36 Chicago
Atlanta Atlanta 186
Newark Newark
275
Chicago Chicago Philadelphia
274
274
Newark Newark Baltimore
257
240
240
239
239
274220 257 214 240 203
Baltimore MiamiBaltimore
171 239
New YorkNew York
166
166
Buffalo Seattle Buffalo
93
93 164
Seattle Seattle
164
164
Detroit Detroit Boston
93
93 156
Boston Boston
156
156
153
153
New Orleans New Orleans San Francisco
150
LouisSt. Louis NewSt. Orleans
150
San Francisco San Francisco
145
New Orleans New Orleans 108
Los Angeles Los Angeles 82
Denver Denver
Dallas 46
Dallas
San Diego San Diego32 225 0 0
108
53 51 38
85 153
53
N
150
51
43
Washington, DC Washington, DC Denver
145
43 108
Was
8238
Los Angeles Los Washington, DC Angeles 29 7129 San Diego San Diego 28 59 28 Phoenix 23 55 23 Phoenix Phoenix Minneapolis 20 46 20 Atlanta Dallas Atlanta
59
55
85
Miami
Denver Denver Los Angeles
71
59
Phoenix Phoenix Minneapolis Minneapolis
145
82
71
Washington, DC Washington, DC
St.Miami Louis
55 46
1632 Minneapolis Minneapolis San Diego 10 Dallas 0 Dallas
32 300
0
300
16 10
300 225
0
Pain Reliever visits Rate per 100,000 population, Marijuana visits Marijuana visits2002
Marijuana visits Rate perBenzodiazepines 100,000 population, 2002 visits Benzodiazepines visits
Rate perRate 100,000 population, 2002 2002 per 100,000 population,
Rate perRate 100,000 population, 2002 2002 per 100,000 population,
46
Total U.S. Total U.S.Total U.S. Baltimore
102
47
106
Detroit Detroit New Orleans
98
St. LouisSt.Detroit Louis
97
Boston Boston Boston
97
Seattle Chicago Seattle
65 61
65 64
San Francisco San Francisco Newark Buffalo New York Buffalo
47 34
47 47
San Diego San Diego Los Angeles
28 46
46
130
Dallas 0 27
Dallas 0
0
Miami
46 28
39
38 22
38
45 55
San Dallas Diego
225 160
Minneapolis Minneapolis San Francisco
2639
Denver Denver
2638
22 27 Washington, DC 0 Washington, DC 21 0
St. Louis
50
Newark
49
Phoenix
Chicago
47
New YorkN Sa San Francisco San F
45
San Diego Sa
Minneapolis Min
Denver
Atlanta
28 46 28
New YorkNew York Dallas
160
Seattle
Philadelphia Phil
34 34 47 30 46 30
Dallas
Los Phoenix Angeles Los Angeles
27
Boston
42 42 54 35 35 47
Atlanta Atlanta Minneapolis
46
39 26
47 56
Chicago Buffalo Chicago
55
Detroit
78 111
88 60
50 65 49 64
Seattle Seattle
54
Buffalo N New Orleans New
95124 95 82 119
5778 57 5372 53
Newark Newark Chicago New Phoenix Orleans Phoenix
46 55
30 47
60
BaltimoreBaltimore
Miami Los Angeles
BaltimoreB
102 146
69 96 69
Detroit Detroit Atlanta
40 54
Minneapolis Minneapolis Atlanta
82 78
St.Miami LouisSt. Louis
96
Total U.S.T
150 102
New Orleans New Orleans Boston
111
Rate perRate 100,0 p
41
Philadelphia Philadelphia St. Louis
San Diego San Diego Washington, DC
Buffalo Buffalo San Francisco
Denver Denver Miami
124 119
225
B PainPain Re Ra
Boston Detroit Boston
56
Washington, DC Washington, DC San Diego Newark Newark Minneapolis
146
72
64 55 5652
150
78
62 72
Los Angeles LosNew Angeles York
Phoenix Phoenix Dallas
111
Total U.S.Total U.S. Philadelphia
88
6478
New Orleans New Orleans Phoenix
San Francisco San Francisco Washington, DC
124
68 88
BaltimoreBaltimore St. Louis
New YorkNew York Denver
146
81 96
Atlanta Atlanta Philadelphia
150
119
95
Miami Seattle
Chicago Chicago Newark
47 41
Total U.S. 165
47
Philadelphia Philadelphia Buffalo
Miami
S
111171 111 109166 109
Philadelphia Philadelphia New York
St. LouisSt. Louis
203
171
123 182 123
Boston Boston Buffalo
171
220 214
128 186 128
Seattle Seattle Newark New YorkNew York Detroit
182
171
275
36
San Francisco San Francisco Atlanta
186
182
Detroit Detroit Buffalo Buffalo
95
275 257
Miami
Ra
78
Total U.S. 78
Total U.S.Total U.S. 220 Chicago Chicago 214 Philadelphia Philadelphia 203 BaltimoreBaltimore
H
0
Los Angeles Los
26
Dallas
26
Washington, DC Washin Was Miami
22 21
160 130
130
4
H I G H L I G H T S F R O M DA W N :
??? About
BA LT I M O R E 2 0 0 2
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: Baltimore, 2002 Top 5 drugs in drug abuse-related ED visits in Baltimore, 2002 10,000
7,500 Number of visits
This special report presents findings based on data submitted by 20 hospitals in the Baltimore metropolitan area for 2002. ■ Of the 1.1 million visits to Baltimore area emergency departments (EDs) in 2002, about one percent (12,904) were related to drug abuse. ■ During 2002, the most common drugs involved in these ED visits were cocaine, heroin, narcotic analgesics (pain relievers), alcohol in combination with other drugs, and marijuana. ■ Heroin-related ED visits in Baltimore increased 4 percent between 2001 and 2002, but have decreased 45 percent since 1995. ■ Among the 21 DAWN areas, Baltimore ranked in the top 3 in terms of ED visits involving heroin, cocaine, and pain relievers.
5,969 4,715
5,000
3,848 3,189 2,500
2,044
0 Cocaine
Heroin
Narcotic Alcohol-in- Marijuana analgesics combination (pain relievers)
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 information to Orleans Miami plan, target resources, and act more effectively. Today, hospitals in Baltimore 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/.
Cocaine
Rate perRate 100,000 per 100,000 population population
400 300 H I G H L I G H T S F R O M DA W N : BA LT I M O R E 2 0 0 2
2
Baltimore
300 200
Baltimore
Cocaine ■
■
■
Cocaine-related ED visits in Baltimore increased 20 percent (to 257 visits per 100,000 population) between 2001 and 2002, but decreased 33 percent since 1995. Cocaine More than 80 percent of cocaine-related ED visits in Baltimore also involved other drugs. Marijuana Less than 5 percent of cocaine-related ED visits were attributedMarijuana to "crack" in Baltimore.
Rate perRate 100,000 per 100,000 Rate per 100,000 population population population
Trends inCocaine Top 4 Drugs, 1995-2002
Heroin-related ED visits in Baltimore increased 4 percent (to 203 visits per 100,000 population) between 2001 and 2002, but decreased 45 Marijuana percent since 1995 heroin (from 366 visits per 100,000). More than half (55 percent) of the heroinrelated ED visits inheroin Baltimore also involved other drugs.
Rate perRate 100,000 perRate 100,000 per 100,000 population population population
■
Marijuana ■
■
From 1995 to 2002, marijuana-related ED visits in Baltimore rose over 100 percent (from 42 to 88 visits per 100,000 population). The national rate (47 visits per 100,000 in 2002) increased Marijuana almost 140 percent over the same 8-year period. Marijuana was reported in about 16 percent of all drug abuse-related ED visits in Baltimore and was usually reported in combination with other drugs.
Rate per 100,000 population
Narcotic analgesics...
Rate per 100,000 population
From 1995 implicated in drug abuse-related ED visits increased more Narcotic than 400 percent in analgesics... Baltimore (from 30 to 165 mentions per 100,000 population). The increase nationally was 139 percent (from 19 to 46 mentions per 100,000). Cocaine Oxycodone and methadone were the most frequently named pain relievers in drug-related ED visits in Baltimore in 2002.
400 0 200 300
U.S. U.S.
1995
1996
1997
1998
1999
2000
2001
2002
1995
1996
1997
1998
1999
2000
2001
2002
Baltimore
200 150 200 150 100 100 100 50 0 50 0
Baltimore U.S. U.S. Baltimore 1995
1996
1997
1998
1999
2000
2001
2002 U.S.
1995
1996
1997
1998
1999
2000
2001
2002
1995
1996
1997
1998
1999
2000
2001
2002
400 150 400 300 100
Baltimore Baltimore U.S.
300 200 50
Baltimore 200 100 0 100 0 400 0 200 300
1995
1996
1997
1998
1999
2000
2001
U.S. 2002
1995
1996
1997
1998
1999
2000
2001
U.S. 2002
1995
1996
1997
1998
1999
2000
2001
2002
Baltimore Baltimore Baltimore
200 150 200 400 150 100 100 300 100 50 0 200 50 0 200 100 0 150 0
U.S. U.S. Baltimore 1995
1996
1997
1998
1999
2000
2001
2002 U.S.
1995
1996
1997
1998
1999
2000
2001
2002
1995
1996
1997
1998
1999
2000
2001
1995
1996
1997
1998
1999
2000
2001
U.S. Baltimore 2002
2002
100 200
U.S.
50 150 0
1995
1996
1997
1998
1999
2000
100
2001
2002
Baltimore U.S.
50
0
400
00
■
toNarcotic 2002,heroin pain relievers analgesics...
Rate per 100,000 Rate perRate 100,000 per 100,000 Rate per 100,000 population population population population
Pain Relievers ■
100 0
200 0
Heroin ■
200 100
300
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
BA LT I M O R E 2 0 0 2
3
Across 21 Metropolitan Areas
The following figures show Baltimore 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 Cocaine visits
Cocaine visits Rate perHeroin 100,000 population, 2002 Heroin visits visits
Rate perRate 100,000 population, 2002 2002 per 100,000 population,
Rate perRate 100,000 population, 2002 2002 per 100,000 population,
171
Miami
78
Total U.S.Total U.S. 36 Chicago
Atlanta Atlanta 186
Newark Newark
275
Chicago Chicago Philadelphia
274
274
Newark Newark Baltimore
257
240
240
239
239
274220 257 214 240 203
Baltimore MiamiBaltimore
171 239
New YorkNew York
166
166
Buffalo Seattle Buffalo
93
93 164
Seattle Seattle
164
164
Detroit Detroit Boston
93
93 156
Boston Boston
156
156
153
153
New Orleans New Orleans San Francisco
150
LouisSt. Louis NewSt. Orleans
150
San Francisco San Francisco
145
New Orleans New Orleans 108
Los Angeles Los Angeles 82
Denver Denver
Dallas 46
Dallas
San Diego San Diego32 225 0 0
108
53 51 38
85 153
53
N
150
51
43
Washington, DC Washington, DC Denver
145
43 108
Was
8238
Los Angeles Los Washington, DC Angeles 29 7129 San Diego San Diego 28 59 28 Phoenix 23 55 23 Phoenix Phoenix Minneapolis 20 46 20 Atlanta Dallas Atlanta
59
55
85
Miami
Denver Denver Los Angeles
71
59
Phoenix Phoenix Minneapolis Minneapolis
145
82
71
Washington, DC Washington, DC
St.Miami Louis
55 46
1632 Minneapolis Minneapolis San Diego 10 Dallas 0 Dallas
32 300
0
300
16 10
300 225
0
Pain Reliever visits Rate per 100,000 population, Marijuana visits Marijuana visits2002
Marijuana visits Rate perBenzodiazepines 100,000 population, 2002 visits Benzodiazepines visits
Rate perRate 100,000 population, 2002 2002 per 100,000 population,
Rate perRate 100,000 population, 2002 2002 per 100,000 population,
46
Total U.S. Total U.S.Total U.S. Baltimore
102
47
106
Detroit Detroit New Orleans
98
St. LouisSt.Detroit Louis
97
Boston Boston Boston
97
Seattle Chicago Seattle
65 61
65 64
San Francisco San Francisco Newark Buffalo New York Buffalo
47 34
47 47
San Diego San Diego Los Angeles
28 46
46
130
Dallas 0 27
Dallas 0
0
Miami
46 28
39
38 22
38
45 55
San Dallas Diego
225 160
Minneapolis Minneapolis San Francisco
2639
Denver Denver
2638
22 27 Washington, DC 0 Washington, DC 21 0
St. Louis
50
Newark
49
Phoenix
Chicago
47
New YorkN Sa San Francisco San F
45
San Diego Sa
Minneapolis Min
Denver
Atlanta
28 46 28
New YorkNew York Dallas
160
Seattle
Philadelphia Phil
34 34 47 30 46 30
Dallas
Los Phoenix Angeles Los Angeles
27
Boston
42 42 54 35 35 47
Atlanta Atlanta Minneapolis
46
39 26
47 56
Chicago Buffalo Chicago
55
Detroit
78 111
88 60
50 65 49 64
Seattle Seattle
54
Buffalo N New Orleans New
95124 95 82 119
5778 57 5372 53
Newark Newark Chicago New Phoenix Orleans Phoenix
46 55
30 47
60
BaltimoreBaltimore
Miami Los Angeles
BaltimoreB
102 146
69 96 69
Detroit Detroit Atlanta
40 54
Minneapolis Minneapolis Atlanta
82 78
St.Miami LouisSt. Louis
96
Total U.S.T
150 102
New Orleans New Orleans Boston
111
Rate perRate 100,0 p
41
Philadelphia Philadelphia St. Louis
San Diego San Diego Washington, DC
Buffalo Buffalo San Francisco
Denver Denver Miami
124 119
225
B PainPain Re Ra
Boston Detroit Boston
56
Washington, DC Washington, DC San Diego Newark Newark Minneapolis
146
72
64 55 5652
150
78
62 72
Los Angeles LosNew Angeles York
Phoenix Phoenix Dallas
111
Total U.S.Total U.S. Philadelphia
88
6478
New Orleans New Orleans Phoenix
San Francisco San Francisco Washington, DC
124
68 88
BaltimoreBaltimore St. Louis
New YorkNew York Denver
146
81 96
Atlanta Atlanta Philadelphia
150
119
95
Miami Seattle
Chicago Chicago Newark
47 41
Total U.S. 165
47
Philadelphia Philadelphia Buffalo
Miami
S
111171 111 109166 109
Philadelphia Philadelphia New York
St. LouisSt. Louis
203
171
123 182 123
Boston Boston Buffalo
171
220 214
128 186 128
Seattle Seattle Newark New YorkNew York Detroit
182
171
275
36
San Francisco San Francisco Atlanta
186
182
Detroit Detroit Buffalo Buffalo
95
275 257
Miami
Ra
78
Total U.S. 78
Total U.S.Total U.S. 220 Chicago Chicago 214 Philadelphia Philadelphia 203 BaltimoreBaltimore
H
0
Los Angeles Los
26
Dallas
26
Washington, DC Washin Was Miami
22 21
160 130
130
4
H I G H L I G H T S F R O M DA W N :
??? About
BA LT I M O R E 2 0 0 2
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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