MARCH 2004

Highlights From DAWN: Atlanta, 2002
This special report presents findings based on data submitted by 14 hospitals in the Atlanta metropolitan area for 2002. s Of the 1.3 million visits to Atlanta area emergency departments (EDs) in 2002, about one percent (14,211) were related to drug abuse. s During 2002, the most common drugs involved in these ED visits were cocaine, alcohol in combination with other drugs, marijuana, benzodiazepines, and narcotic analgesics (pain relievers). s Between 1995 and 2002, the rate of ED visits involving marijuana in Atlanta increased 53 percent (from 63 to 96 visits per 100,000 population). s Among the 21 DAWN areas, Atlanta ranked in the top 6 in terms of ED visits involving cocaine and marijuana. Top 5 drugs in drug abuse-related ED visits in Atlanta, 2002
10,000

8,947
8,000

6,743
Number of visits 6,000

4,000

3,602

2,000

1,267

1,143

0
Cocaine Alcohol-in- Marijuana combination Benzodiazepines Narcotic analgesics (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 Washington St. Louis before they become widespread. DAWN San Francisco detects new drugs, new drug Los Angeles combinations, new health consequences Atlanta Phoenix Dallas of drug use, and changing patterns involving old drugs. Facilities participating in DAWN can San use this information to train staff and improve Diego New patient care. Communities can use this information to plan, target Orleans Miami resources, and act more effectively. Today, hospitals in Atlanta 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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Trends in Top 4 Drugs, 1995-2002
Cocaine
s

Rate per Rate per 100,000 per 100,000 100,000 Rate per 100,000 Rate population population population population

s

s

Atlanta had 239 cocaine-related ED visits per 100,000 population in 2002, a rate similar to that in 1995. By contrast, the rate for the U.S. was 78 per 100,000 in 2002. Cocaine More than two-thirds (71%) of cocaine-related Cocaine ED visits in Atlanta also involved other drugs. Almost one-half (46%) of cocaine-related ED Cocaine visits were attributed to "crack."
Cocaine

300

Atlanta
300 200 300 200 300 100 200 100 200 0 100 0 100 150 0 150 0 100 150 100 150 50 100 50 100 0 50 0 50 100 0 100 75 0 100 75 50 100 75 50 25 75 50 25 0 50 25 0 100 25 0 100 75 0 100 75 50 100 75 50 25 75 50 25 0 50 25 0 25 0

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

U.S. 2002
2002

Marijuana
s

U.S.

2002

Rate per Rate per 100,000 per 100,000 100,000 Rate per 100,000 Rate population population population population

s

Since 1995, marijuana-related ED visits in Atlanta have risen 53 percent (from 63 to 96 visits per 100,000 population in 2002). The national rate Marijuana increased 139 percent (from 19 to 47 visits per Marijuana 100,000) over the same 8-year period. Marijuana was Marijuana in one-fourth of all reported drug abuse-related ED visits in Atlanta; more than 80 percent of the time, these visits involved Marijuana other drugs as well.

Atlanta
1995 1996 1997 1998 1999 2000 2001 2002

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

U.S. 2002
2002

Benzodiazepines
Rate per Rate per 100,000 per 100,000 100,000 Rate per 100,000 Rate population population population population

s

s

Benzio... From 1995 to 2002, mentions of benzodiazepines in drug abuse-related ED visits Benzio... in Atlanta remained relatively stable. Over the same period, the national rate rose 25 percent Benzio... (from 33 to 41 visits per 100,000). Benzio... Alprazolam was the most frequently named benzodiazepine in drug-related ED visits in Atlanta in 2002.

1995

1996

1997

1998

1999

2000

2001

2002

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

Atlanta U.S.
2002

2002

Atlanta
2002

Rate per Rate per 100,000 per 100,000 100,000 Rate per 100,000 Rate population population population population

Narcotic analgesics...

Pain Relievers analgesics... Narcotic
s

1995

1996

1997

1998

1999

2000

2001

2002

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

s

Narcotic pain relievers implicated From 1995 to 2002, analgesics... in drug abuse-related ED visits increased 27 Narcotic analgesics... percent in Atlanta (from 24 to 30 mentions per 100,000 population). The increase nationally during this time was 139 percent. Hydrocodone and oxycodone were the most frequently named pain relievers in drug-related ED visits in Atlanta in 2002.

Atlanta
2002

0

1995

1996

1997

1998

1999

2000

2001

2002

St. Louis San Francisco

153 150 145 108 82

S

H I G H L I G H T S F R O M DA W N : AT L A N TA 2 0 0 2 New Orleans
Los Angeles Denver

3

??? Comparisons

71 Washington, DC Across 21 Metropolitan Areas 59 Phoenix Minneapolis 55

The following figures show Atlanta in relation to the Nation and 20 other metropolitan areas represented in DAWN 46 Dallas 32 for selected drugs in 2002. Comparisons across areas are possible because the number of visits for each drug San Diego 0 300 is represented in terms of a rate per 100,000 population. Not all differences in rates are statistically significant.

Was

Pain Reliever visits Rate per 100,000 population, Cocaine visits 2002
Rate per 100,000 population, 2002
Total U.S. Total U.S. Baltimore Chicago Buffalo Philadelphia New Orleans Baltimore Detroit Miami Boston Atlanta Seattle Newark Philadelphia Detroit St. Louis Buffalo Newark New York Phoenix Seattle Chicago Boston New York St. Louis San Francisco SanSan Diego Francisco New Orleans Minneapolis Los Angeles Denver Denver Atlanta Washington, DC Los Angeles Phoenix Dallas Minneapolis Washington, DC Dallas Miami San Diego 0 0 34 30 28 26 55 22 46 32 225 300 28 59 82 71 40 108 64 62 61 55 52 46 81 68 46 78 106 98 97 97 95 186 182 171 166 164 156 153 150 145 240 239 165 275 274 257

Marijuana visits visits Pain Reliever
Rate per Rate per population, 2002 100,000 100,000 population, 2002
Total U.S. Total U.S. Baltimore Philadelphia Detroit Buffalo New St. Louis Orleans Boston Detroit Miami Boston Atlanta Seattle Philadelphia Baltimore Chicago St. Louis New Orleans Newark Seattle Phoenix Los Angeles Chicago New York Buffalo San Francisco Washington, DC San Newark Diego Minneapolis New York Minneapolis Denver San Diego Atlanta Los Phoenix Angeles San Francisco Dallas 0 Dallas Miami 0 Washington, DC Denver 64 72 62 65 61 64 5655 52 55 46 54 40 47 34 47 30 46 28 46 28 39 38 26 27 22 160 225 68 78 106 98 97 97 95 96 81 88 124 119 111 47 46 165 150 146

B

Ra

75

74

N

Sa

300

Was

Benzodiazepines visits Cocaine visits Rate perRate per population,visits 100,000 100,000 population, Marijuana 2002 2002
Rate per 100,000 population, 2002
Total U.S. Total U.S. Chicago Boston Total U.S. Philadelphia Philadelphia New Detroit Baltimore Orleans Miami St. Louis Detroit Atlanta Boston Baltimore Newark Miami Detroit Newark Atlanta Buffalo Phoenix Baltimore Seattle New York Chicago Seattle Orleans New Miami Boston Chicago Seattle San St. Louis Angeles Los Diego San Francisco San Francisco Buffalo New Orleans Buffalo Washington, DC Atlanta Los Angeles Newark Denver Dallas New York Los Angeles Washington,Minneapolis DC Minneapolis Phoenix Diego San Denver Minneapolis Phoenix 32 Washington, DC San Diego Denver 0 Dallas 0 0 55 59 82 71 69 60 186 57 182 53 171 50 166 78 49 72 164 4765 156 45 64 153 42 150 56 35 145 55 34 54 108 30 47 28 47 26 26 46 46 96 88 78240 78 41 47 275 102 95 274 82 257 124 239 119 111 150 146

Pain Reliever visits Rate per 100,000 population, 2002 Benzodiazepines visits
Rate per 100,000 population, 2002
Total U.S. Total U.S. Baltimore Buffalo Boston Philadelphia New Orleans New Detroit Orleans Boston St. Louis Seattle Detroit Baltimore Philadelphia St. Louis Newark Newark Phoenix Phoenix Seattle Chicago Miami New York Chicago San San Francisco Diego San Francisco San Diego Minneapolis Buffalo Atlanta Denver Atlanta 34 Dallas30 28 Los Los Angeles Angeles 28 Minneapolis Dallas 26 Washington, DC Denver 22 New York Miami 300 130 160 Washington, DC 0 0 40 64 62 61 55 52 46 34 30 28 26 26 22 21 225 130 35 81 68 50 49 47 45 42 46 41 106 98 97 97 95 60 57 53 69 82 78 165 102 95

150

46

Dallas San New York 46 Francisco

22 39 21 38 27

160

Marijuana visits
Rate per 100,000 population, 2002

Benzodiazepines visits
Rate per 100,000 population, 2002

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??? 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