APRIL 2004

Highlights From DAWN: Buffalo, 2002

This special report presents findings based on data submitted by 8 hospitals in the Buffalo metropolitan area for 2002. ■ Of the 310,000 visits to Buffalo area emergency departments (EDs) in 2002, about 1 percent (3,844) were related to drug abuse. ■ During 2002, the most common drugs involved in these ED visits were alcohol in combination with other drugs, cocaine, narcotic analgesics (pain relievers), heroin, and marijuana. ■ Between 1995 and 2002, the rate of ED mentions of pain relievers increased 372 percent (from 22 to 106 mentions per 100,000 population) with a 50 percent increase from 2000 to 2002 (from 70). ■ Among the 21 DAWN areas, Buffalo was one of the top 5 in the rate of ED mentions of pain relievers in 2002. Top 5 drugs in drug abuse-related ED visits in Buffalo, 2002
3,000

2,120
Number of visits 2,000

1,441

1,000

892

785 474

0

Alcohol-incombination

Cocaine

Narcotic Heroin analgesics (pain relievers)

Marijuana

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 Buffalo 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

At 171 visits per 100,000 population in 2002,
Buffalo's rate of cocaine-related ED visits was
more than double the national rate of 78. From
2000 to 2002, the rate of cocaine-related ED visits
rose 63 percent (from 104 to 171 visits per 100,000
population) with an 18 percent increase from
2001 to 2002 (from 145).
Close to half (41%) of cocaine-related ED visits in Buffalo were attributed to "crack."

300

Rate per 100,000 population

200

Buffalo

100

U.S.
0 1995 1996 1997 1998 1999 2000 2001 2002

Pain Relievers

From 1995 to 2002, the rate of ED mentions of pain relievers increased 372 percent (from 22 to 106 mentions per 100,000 population), with an increase from 2000 to 2002 of 50 percent (from 70). From 1995 to 2002, the increase nationally was 139 percent; from 2000 to 2002, the increase nationally was 39 percent. During 2002, hydrocodone was the most frequently named pain reliever in drug abuserelated ED visits in Buffalo.

200

Rate per 100,000 population

150

Buffalo
100

50

U.S.
0
1995 1996 1997 1998 1999 2000 2001 2002

Heroin

Between 1995 and 2002, heroin-related ED visits
in Buffalo increased 125 percent (from 41 to 93
visits per 100,000 population) with a 29 percent
increase from 2001 to 2002 (from 72). Nationally,
heroin-related ED visits only increased 22 percent
from 1995 to 2002 and have remained relatively
stable in recent years.
Almost three-quarters (74%) of heroin-related ED visits involved other drugs.

200

Rate per 100,000 population

150

Buffalo
100

50

U.S.
0
1995 1996 1997 1998 1999 2000 2001 2002

Marijuana

Rate per 100,000 population

From 1995 to 2002, marijuana-related ED visits in Buffalo rose by 74 percent (from 32 to 56 visits per 100,000 population), less than the national increase of 139 percent. In Buffalo, marijuana was usually reported in combination with other drugs (77% of visits).

200

150

100

Buffalo
50

U.S.
0
1995 1996 1997 1998 1999 2000 2001 2002

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??? Comparisons

Across 21 Metropolitan Areas

The following figures show Buffalo 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 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

Pain Reliever visits
Rate per 100,000 population, 2002
Total U.S.

46 165 106 98 97 97 95 81 68 64 62 61 55 52 46 40 34 30 28 28 26 22
0 225

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

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

Marijuana visits
Rate per 100,000 population, 2002
Total U.S. 47 150 146 124 119 111 96 88 78 72 65 64 56 55 54 47 47 46 46 39 38 27 0 160

36 220 214 203 171 128 123 111 109 93 93 85 53 51 43 38 29 28 23 20 16 10
0 225

Chicago
Newark

Philadelphia Detroit St. Louis Boston Miami Atlanta Baltimore Chicago New Orleans Seattle Los Angeles Buffalo Washington, DC Newark New York Minneapolis San Diego Phoenix San Francisco Denver Dallas

Baltimore
San Francisco Seattle New York

Boston Philadelphia
Buffalo

Detroit Miami New Orleans
St. Louis Denver Washington, DC Los Angeles San Diego

Phoenix Atlanta Minneapolis Dallas

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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