MAY 2004

Major Drugs of Abuse in ED Visits, 2002 Update
This issue of The DAWN Report examines geographic variation1 in emergency department (ED) visits related to 4 drugs2—cocaine, marijuana, heroin, and methamphetamine. The map (inside) displays the rates of drug abuse-related ED visits per 100,000 population for these 4 drugs for the
Cocaine visits Cocaine EDED visits per per 100,000 population 100,000 population Cocaine EDED visits Cocaine visits
Chicago Chicago 78 78 Total Total U.S. U.S. Philadelphia Philadelphia Chicago Chicago Baltimore Baltimore Philadelphia Philadelphia Miami Miami Baltimore Baltimore Atlanta Atlanta Miami Miami Newark Newark Atlanta Atlanta Detroit Detroit Newark Newark Buffalo Buffalo Detroit Detroit New New York York Buffalo Buffalo Seattle Seattle New York York New Boston Boston Seattle Seattle St. St. LouisLouis Boston Boston San Francisco San FranciscoLouis St. Louis St. New New Orleans Orleans San Francisco San Francisco Los Angeles 108 Los New Orleans New Angeles Orleans 82 Denver 82 108 Denver Los Angeles Los Angeles 71 Washington, 71 Washington, DC DC 82 82 Denver Denver 59 Phoenix 59 Phoenix 71 71 Washington, DC DC Washington, 55 Minneapolis 55 Minneapolis 59 59 Phoenix Phoenix 46 Dallas 46 Dallas 55 55 Minneapolis Minneapolis San Diego 32 32 San Dallas Diego 46 46 Dallas 0 San Diego 0 San Diego 32 32
0 0

21 metropolitan areas3 oversampled by the Drug Abuse Warning Network (DAWN) and for the coterminous U.S. To allow for easier comparisons across metropolitan areas for a particular drug, the bar charts shown below rank the metropolitan areas for each of the 4 drugs.
Heroin visits Heroin EDED visits per per 100,000 population 100,000 visits Heroin EDED visits Heroin population

per Total Total U.S. population 100,000 per U.S. population 78 100,000 78

274 274 275 275 257 257 274 274 240 240 257 257 239 239 240 240 186 186 239 239 182 182 186 186 171 171 182 182 166 166 171 171 164 164 166 166 156 156 164 164 153 153 156 156 150 150 153 153 145 145 150 150 108 145 145 108

275

275

300 300

300 300

220 Chicago 220 Chicago 36 36 Total Total U.S. U.S. 214 Newark 214 220 Newark 220 Chicago Chicago 203 Baltimore 203 Baltimore 214 214 Newark Newark 171 San Francisco 171 San Baltimore Francisco 203 203 Baltimore 128 Seattle 128 Seattle 171 171 San Francisco San Francisco 123 New York 123 128 New York 128 Seattle Seattle 111 Boston 111 Boston 123 123 New York York New 109 Philadelphia 109 111 Philadelphia 111 Boston Boston 93 Buffalo 93 109 109 Buffalo Philadelphia Philadelphia 93 Detroit 93 93 Detroit 93 Buffalo Buffalo 85 Miami 85 Miami 93 93 Detroit Detroit 53 New Orleans 53 New Orleans 85 85 Miami Miami 51 St. Louis 51 53 53 NewSt. Louis Orleans New Orleans 43 Denver 43 DenverLouis 51 51 St. Louis St. 38 Washington, 38 Washington, DC DC 43 43 Denver Denver Los Angeles 29 29 Los Angeles DC 38 38 Washington, DC Washington, 28 San Diego San Diego 29 29 Los Angeles Los Angeles 28 23 Phoenix 23 Phoenix 28 San Diego San Diego 28 20 Atlanta Atlanta 23 Phoenix Phoenix 20 23 16 Minneapolis16 Minneapolis Atlanta Atlanta 201020 Dallas 10 Dallas Minneapolis Minneapolis16 16 0 225 225 Dallas 0 10 10 Dallas
0 0 225 225

36 perTotal Total U.S. 100,000 population perU.S. 100,000 population 36

Marijuana visits Marijuana EDED visits per per 100,000 population 100,000 population Marijuana EDED visits Marijuana visits
Total U.S. Philadelphia Philadelphia U.S. Total Total U.S. Detroit Detroit Philadelphia Philadelphia St. St. LouisLouis Detroit Detroit Boston Boston St. LouisLouis St. Miami Miami Boston Boston Atlanta Atlanta Miami Miami Baltimore Baltimore Atlanta Atlanta Chicago Chicago Baltimore Baltimore New Orleans New Chicago Orleans Chicago Seattle Seattle New New Orleans Orleans Los Angeles Los Angeles Seattle Seattle Buffalo Buffalo Los Angeles Los Angeles Washington, Washington, DC DC Buffalo Buffalo Newark Newark Washington, DC DC Washington, Minneapolis Minneapolis Newark Newark New New York York Minneapolis Minneapolis Phoenix Phoenix New York York New San Diego San Diego Phoenix Phoenix San Francisco SanSan Diego Francisco San Diego Denver Denver San Francisco San Francisco Dallas Dallas Denver Denver 0 Dallas 0 Dallas
0 0

per per Total U.S. population 100,000 population 47 100,000 47
47 47

150 150 146 146 150 150 124 124 146 146 119 119 124 124 111 111 119 119 96 96 111 111 88 8896 96 78 78 88 88 72 72 78 78 65 65 72 72 64 64 65 65 56 5664 64 55 55 56 56 54 54 55 55 47 47 54 54 47 47 47 47 46 46 47 47 46 46 46 46 39 39 46 46 38 38 39 39 27 27 38 38 160 27 27 160
160 160

perTotal Total U.S. 100,000 population perU.S. 7 100,000 population 46 San Francisco San Total Total U.S. 7 46 Francisco 7 U.S. Seattle 25 25 Seattle 46 46 San Francisco San Francisco San Diego 23 23 San Diego Seattle Seattle 25 25 Los Angeles 20 20 Los Angeles San Diego San Diego 23 23 17 Phoenix Phoenix 20 20 Los Angeles Los Angeles 17 12 Minneapolis 12 Minneapolis Phoenix Phoenix17 7 17 Atlanta Atlanta Minneapolis 712 12 Minneapolis 7 St. St. LouisLouis 7 7 Atlanta 7 Atlanta Denver 5 Denver 5 7 St. LouisLouis 7 St. New Orleans 5 New Orleans 5 Denver 5 Denver 5 Dallas 3 Dallas 5 New New Orleans 5 Orleans 3 Philadelphia 1 Philadelphia 1 Dallas 3 Dallas 3 1 New 1 New York York 1 Philadelphia 1 Philadelphia 1 Washington, 1 DC Washington, DC York 1 New York 1 New Miami 1 Miami DC 1 Washington, DC 1 Washington, 1 Chicago 1 Chicago 1 Miami 1 Miami 1 Boston 0 Boston 1 Chicago 0 1 Chicago 0 Baltimore Baltimore 0 Boston 0 Boston 0 Detroit 0 Detroit 0 Baltimore 0 Baltimore 0 Buffalo 0 Buffalo 0 Detroit 0 Detroit 0 Newark 0 Newark 0 Buffalo 0 Buffalo 0 0 Newark 0 0 Newark 0
7
0 0

Methamphetamine visits Methamphetamine EDED visits per per 100,000 population 100,000 population Methamphetamine EDED visits Methamphetamine visits

225 225

225 225

2

THE DAWN REPORT • M A J O R D R U G S O F A B U S E I N E D V I S I T S , 2 0 0 2 U P DAT E

3

Major drugs of abuse by metropolitan area
Drug abuse-related ED visits per 100,000 population, 2002
164 128 65 25 Seattle

182 93

146

156

111 119
0

0

55 16

47

Detroit

12

171

Boston

Minneapolis

93

56
0

275

Buffalo

220

257

166

203
78
150 171

123 47

82
39 46

153

1
124

88
0
New York
186

1

43

38

5

51 7 St. Louis

Chicago
Baltimore

214

San Francisco

Denver

71
108 29 64 20
59 23 46

54

38

55

0

1
274

Newark

239
17

Washington, DC

Los Angeles
32 28 46 23

46 10

27

Phoenix

3

96

109

150

Dallas
San Diego

145
53 72
5

20 Atlanta

7

1

Highlights for the Nation, 2002

Philadelphia

According to DAWN, in 2002, there were an estimated 670,307 ED visits related to drug abuse in the coterminous U.S.—about 261 visits per 100,000 population. Four illicit drugs—cocaine, marijuana, heroin, and methamphetamine—accounted for 36 percent of the drugs involved in these visits. Cocaine was the most frequent illicit drug involved in drug abuse-related ED visits in 2002 with an estimated 199,198 visits nationally. Marijuanarelated ED visits were next with 119,472 visits; heroin was involved in 93,519 ED visits nationally; and methamphetamine was involved in 17,696 drug abuse-related ED visits in 2002. From 1995 to 2002, the rate of drug abuse-related ED visits involving marijuana rose 139 percent nationally (from 19 to 47 visits per 100,000). During the same period, the rate of cocaine-related ED visits increased 33 percent (from 58 to 78 visits per 100,000) and heroin-related ED visits increased 22 percent (from 30 to 36 visits per 100,000). The national rate of methamphetamine-related ED visits remained stable.

New Orleans

240

85

111
1

Rates for coterminous U.S., 2002
78

Miami

Highlights for 21 metropolitan areas

36

47

7
Marijuana

The rate of ED visits involving cocaine exceeded that for any other illicit drug in 18 of the 21 metropolitan areas monitored by DAWN. Only in San Diego was the rate of marijuana-related ED visits higher than the rates of heroin or cocainerelated visits. In 2 metropolitan areas—Detroit and Philadelphia— the rate of marijuana-related ED visits was more than 3 times the national rate. The highest rates of methamphetamine ED visits were found in western metropolitan areas, including San Francisco, Seattle, San Diego, Los Angeles, and Phoenix.

Cocaine

Heroin

Methamphetamine


1 As patterns in availability, purity, and use of illicit drugs differ across the country, the consequences of drug abuse can exhibit local variations. In order to compare visits across

metropolitan areas, it is essential to adjust for population size. DAWN does this by calculating the rate of drug abuse-related ED visits per 100,000 population.
2 This report focuses only on 4 major drugs of abuse; however, thousands of drugs are reported to DAWN each year. For a more extensive list of drug estimates for the Nation and

the 21 metropolitan areas, see ED Trends From DAWN, Final Estimates 1995-2002 online at http://DAWNinfo.samhsa.gov/.
3 In DAWN, metropolitan-level estimates pertain to the entire metropolitan area, not just the city for which the metropolitan area is named. For example, the 2002 estimates

presented for the San Francisco metropolitan area include San Mateo, San Francisco, and Marin Counties in California.

T H E DAWN REPORT • MAJOR DRUGS OF ABUSE IN ED VISITS, 2002 UPDATE

4

About DAWN
The Drug Abuse Warning Network (DAWN) is a national public health surveillance system that collects data on drug abuse-related visits to emergency departments (EDs) and drug abuse-related deaths reviewed by medical examiners and coroners. Data on ED visits are collected from a national probability sample of non-Federal, short-stay hospitals, with oversampling in 21 major metropolitan areas. Data from the sample are used to generate estimates for the coterminous U.S. and the 21 metropolitan areas. ED visits are reportable to DAWN if a patient between the ages of 6 and 97 was treated for a condition associated with intentional drug abuse, including recreation use, dependence, or a suicide attempt. Visits involving chronic health conditions resulting from drug abuse are reportable. Abuse of prescription and over-thecounter medications is reportable. Adverse reactions associated with appropriate use of these drugs and accidental ingestion or inhalation of any drug are not reportable. In DAWN, drugs are described by their generic names. An index linking brand (trade) names with generic drug names is available at http://DAWNinfo.samhsa.gov/. The classification of drugs is derived from the Multum Lexicon, Copyright © 2003 Multum Information Services, Inc. The Multum Licensing Agreement governing use of the Lexicon can be found on the Internet at http://www.multum.com/, on the DAWN website at http://DAWNinfo.samhsa.gov/, and in DAWN publications.

Rates of ED visits per 100,000 for the coterminous U.S., 2002
78 36 47 7 Marijuana Heroin Methamphetamine

Cocaine

The DAWN Report is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). This issue was written by Dana Lehder Roberts (OAS/SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Citation of the source is appreciated.

U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES