APRIL 2004

Highlights From DAWN: Phoenix, 2002
This special report presents findings based on data submitted by 14 hospitals in the Phoenix metropolitan area for 2002. ■ Of the 880,000 visits to Phoenix area emergency departments (EDs) in 2002, slightly more than 1 percent (10,292) were related to drug abuse. ■ During 2002, the most common drugs involved in these ED visits were alcohol in combination with other drugs, narcotic analgesics (pain relievers), cocaine, benzodiazepines, amphetamines, and marijuana. ■ Between 1995 and 2002, ED mentions of pain relievers in Phoenix increased 156 percent (from 24 to 62 mentions per 100,000 population). ■ Among the DAWN areas, Phoenix ranked in the top 5 in terms of ED visits involving amphetamines and methamphetamine in 2002. Top 5 drugs in drug abuse-related ED visits in Phoenix, 2002
2500

2,239
2000

1,838 1,727 1,548

Number of visits

1500

1,436

1000

500

0
Alcohol-in- Narcotic Cocaine combination analgesics (pain relievers) Benzodiazepines Amphetamines

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 Phoenix and 20 other metropolitan areas serve their communities by participating in DAWN. Expansion to other areas is underway.

Boston New Y ork 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/.

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PHOENIX 2002

Trends in Top 4 Drugs, 1995-2002
Pain Relievers

From 1995 to 2002, pain relievers implicated in drug abuse-related ED visits in Phoenix rose 156 percent (from 24 to 62 ED mentions per 100,000 population). The national rate increased similarly in percentage terms over the 8-year period (from 19 to 46 mentions per 100,000 population). Oxycodone, hydrocodone, and methadone were the most frequently named pain relievers in drug abuse-related ED visits in Phoenix in 2002.

100

Rate per 100,000 population

75

Phoenix

50

U.S.
25

0

1995

1996

1997

1998

1999

2000

2001

2002

Cocaine

From 1995 to 1999, the rate of cocaine-related ED visits in Phoenix rose (from 59 to 91 visits per 100,000), but by 2002 had returned to 1995 levels. Almost two-thirds (62%) of cocaine-related ED visits in Phoenix also involved other drugs. About one-sixth (16%) of the cocaine-related ED visits in Phoenix in 2002 were attributed to “crack.”

100

U.S.
Rate per 100,000 population

75

50

Phoenix

25

0

1995

1996

1997

1998

1999

2000

2001

2002

Benzodiazepines

From 1995 to 2002, benzodiazepines implicated in drug abuse-related ED visits in Phoenix remained relatively stable. Nationally, the rate increased 25 percent during this time (from 33 to 41 visits). Clonazepam, alprazolam, lorazepam, and diazepam were the most frequently named benzodiazepines in drug abuse-related ED visits in Phoenix in 2002.

100

Rate per 100,000 population

75

Phoenix
50

U.S.
25

0

1995

1996

1997

1998

1999

2000

2001

2002

Amphetamines

The rate of amphetamine-related ED visits in Phoenix increased by 56 percent between 2001 and 2002 alone (from 31 to 49 visits per 100,000 population). In 2002, the rate of amphetamine-related ED visits in Phoenix stood at more than 6 times the national rate (8 visits per 100,000). In Phoenix, ED visits involving amphetamines usually involved other drugs as well (57%).

100

Rate per 100,000 population

75

Phoenix
50

25

U.S.
1995 1996 1997 1998 1999 2000 2001 2002

0

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PHOENIX 2002

3

??? Comparisons

Across 21 Metropolitan Areas

The following figures show Phoenix 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.

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 New York San Francisco San Diego Minneapolis Denver Atlanta Los Angeles Dallas Washington, DC Miami 0 34 30 28 28 26 22 225 40 64 62 61 55 52 46 81 68 106 98 97 97 95 46 165

Cocaine visits
Rate per 100,000 population, 2002
Total U.S. Chicago Philadelphia Baltimore Miami Atlanta Newark Detroit Buffalo New York Seattle Boston St. Louis San Francisco New Orleans Los Angeles Denver Washington, DC Phoenix Minneapolis Dallas San Diego 0 32 300 55 46 59 82 71 108 186 182 171 166 164 156 153 150 145 240 239 78 275 274 257

Benzodiazepines visits
Rate per 100,000 population, 2002
Total U.S. Boston Philadelphia New Orleans St. Louis Detroit Baltimore Newark Phoenix Seattle Miami Chicago San Diego San Francisco Buffalo Atlanta Dallas Los Angeles Minneapolis Denver New York Washington, DC 0 34 30 28 26 26 22 21 130 35 50 49 47 45 42 60 57 53 69 82 78 41 102 95

Amphetamine visits
Rate per 100,000 population, 2002
Total U.S. Phoenix San Francisco San Diego Denver Seattle Los Angeles St. Louis Atlanta Boston Detroit New Orleans Baltimore Dallas Newark Minneapolis Philadelphia Chicago Miami Buffalo 24 21 19 18 16 15 11 11 10 9 9 8 7 7 3 3 8 49 45 45

New York 1 0 160

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PHOENIX 2002

??? About

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