DECEMBER  2003

Highlights From DAWN: Chicago, 2002

This special report presents findings based on data submitted by 27 hospitals in the Chicago metropolitan area for 2002. ■ Of the nearly 2.4 million visits to Chicago area emergency departments (EDs) in 2002, about one percent (32,454) were related to drug abuse. ■ During 2002, the most common drugs involved in these ED visits were cocaine, heroin, alcohol, marijuana, and narcotic analgesics (pain relievers). ■ Between 1995 and 2002, the rate of heroin­related ED visits increased 167 percent (from 83 to 220 visits per 100,000 population). ■ Among the 21 DAWN areas, Chicago ranked in the top three in terms of ED visits involving cocaine and heroin in 2002. Top 5 drugs in drug abuse­related ED visits in Chicago, 2002
20,000

16,227
15,000

12,982
Number of visits

10,056
10,000

5,000

4,588 3,599

0
Cocaine Heroin Alcohol­in­ Marijuana Narcotic analgesics combination (pain relievers)

DAWN: The Warning Network
Local information is essential to Seattle support local action, so DAWN  focuses on metropolitan areas to  Detroit Minneapolis reveal emerging drug problems Buffalo before they become widespread. Chicago Baltimore DAWN detects new drugs, new  Denver San Francisco Washington St. Louis drug combinations, new health consequences of drug use, and changing Los Angeles patterns involving old drugs. Facilities Atlanta Phoenix Dallas participating in DAWN can use this information to train staff and improve patient San� Diego care. Communities can use this information New� to plan, target resources, and act more effectively. Orleans
Miami

Boston New Y ork Newark Philadelphia

Today, hospitals in Chicago and 20 other metropolitan areas serve their communities by participating in DAWN. Expansion to other areas is underway.
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/.

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T H E   DA W N   R E P O RT   • RT

DECEMBER 2003

Trends in Top 4 Drugs, 1995­2002
Cocaine

Cocaine­related ED visits in Chicago rose 47
percent from 1995 to 2002 (from 188 to 275
per 100,000 population). In 2002, Chicago
had 275 cocaine­related visits per 100,000
population, which was more than three
times the national rate of 78 visits.
More than three­quarters (76%) of cocaine­ related ED visits involved other drugs.

300
250

Rate per 100,000 population

Chicago

200
150
100
50
0
1995 1996 1997 1998 1999 2000 2001 2002

U.S.

Heroin

Between 1995 and 2002, the rate of heroin­
related ED visits in Chicago increased 167
percent (from 83 to 220 visits per 100,000
population). Over the same period, the national
rate rose only 22 percent (from 30 to 36).
In 2002, the rate of heroin­related ED visits in Chicago was more than six times the national rate of 36 visits per 100,000 population.

300
250

Rate per 100,000 population

Chicago

200
150
100
50
0
1995 1996 1997 1998 1999 2000 2001

U.S.

2002

Marijuana

The rate of marijuana­related ED visits in
Chicago rose 52 percent from 1995 to 2002 
(from 51 to 78 visits per 100,000 population),
but declined 12 percent from 2001 to 2002 
(from 89).
In Chicago, almost three­quarters (74%)  of marijuana­related ED visits in 2002 also involved other drugs.

120
100

Rate per 100,000 population

Chicago
80
60
40
20
0
1995 1996 1997 1998 1999 2000 2001 2002

U.S.

Pain Relievers

From 1995 to 2002, ED mentions of pain
relievers in Chicago rose 96 percent (from 31
to 61 mentions per 100,000 population) with
an increase of 56 percent from 2000 to 2002
(from 39). Nationally, the increase was 139
percent from 1995 to 2002 and 39 percent
from 2000 to 2002.
During 2002, methadone, hydrocodone, and codeine were the most frequently named pain relievers in drug abuse­related ED visits in Chicago.

120
100

Rate per 100,000 population

80
60
40
20
0
1995 1996 1997 1998 1999 2000 2001

Chicago U.S.

2002

T H E   DA W N   R E P O R T     •

DECEMBER 2003

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??? Comparisons Across 21 Metropolitan Areas

The following figures show Chicago 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�
Rate per 100,000 population, 2002
Total U.S. Chicago Philadelphia
Baltimore Miami Atlanta 240 78 275 274

Heroin visits�
Rate per 100,000 population, 2002
Total U.S.
Chicago Newark

36
220 214 203

257 239
186 182 171

Baltimore San Francisco
Seattle 128

171 123
111 109 93� � 93� � 85 53 51 43 38 29 28 23 20 16 10

Newark Detroit
Buffalo

New York
Boston Philadelphia

New York
Seattle Boston

166� � 164� � 156
153 150 145 108

Buffalo
Detroit Miami New Orleans St. Louis

St. Louis San Francisco
New Orleans Los Angeles Denver

Denver Washington, DC Los Angeles
San Diego Phoenix Atlanta Minneapolis Dallas

Washington, DC
Phoenix Minneapolis Dallas San Diego0 0 32 55 46

82� � 71
59

0

0

300

0

225

Marijuana visits�
Rate per 100,000 population, 2002
Total U.S.
Philadelphia Detroit St. Louis Boston Miami Atlanta Baltimore Chicago New Orleans Seattle Los Angeles Buffalo 78 72� � 65� � 64 56 55 54 47 47� � 46 46 39 38 27 96 88 124 119 111 47 150 146

Pain Reliever visits�
Rate per 100,000 population, 2002
Total U.S.
Baltimore Buffalo New Orleans Detroit Boston Seattle Philadelphia St. Louis Newark Phoenix Chicago 64� � 62 61 55 52 46 40 34 30 28 28 26 22 81 68 106 98 97 97 95 46 165

New York
San Francisco San Diego Minneapolis Denver Atlanta Los Angeles Dallas

Washington, DC
Newark

New York
Minneapolis San Diego Phoenix San Francisco Denver Dallas

Washington, DC
Miami

0

160

0

225

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T H E   DA W N   R E P O RT     •

DECEMBER 2003

??? About DAWN

The Drug Abuse Warning Network (DAWN) is a national surveillance system that monitors drug­related 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 drug­related visits to hospital emergency departments and on drug­related 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 the use of any drug. These include events related to prescription and over­the­counter medications, as well as the  illicit drugs of abuse. 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