MARCH 2004

Highlights From DAWN: Newark, 2002
This special report presents findings based on data submitted by 16 hospitals in the Newark metropolitan area for 2002. ■ Of the 818,000 visits to Newark area emergency departments (EDs) in 2002, about one percent (7,677) were related to drug abuse. ■ In 2002, the most common drugs involved in these ED visits were heroin, cocaine, alcohol in combination with other drugs, narcotic analgesics (pain relievers), benzodiazepines, and marijuana. ■ From 2000 to 2002, mentions of pain relievers doubled in drug abuse-related ED visits in Newark (from 31 to 64 per 100,000 population). ■ Among the 21 DAWN areas, Newark ranked in the top 5 in ED visits involving heroin. Top 5 drugs in drug abuse-related ED visits in Newark, 2002
5,000

4,000

3,731 3,242

Number of visits

3,000

2,000

2,008

1,115
1,000

991

0

Heroin

Cocaine

Alcohol-in- Narcotic Benzocombination analgesics diazepines (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 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 Newark 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
Heroin

In 2002, Newark’s rate of heroin-related ED visits was 214 per 100,000, almost 6 times the national rate of 36 visits per 100,000. Between 1995 and 2002, Newark’s rate of heroin-related ED visits was stable, while the national rate rose 22 percent (from 30 to 36). In Newark, over 60 percent of heroin-related ED visits also involved other drugs.

500 400
Rate per 100,000 population

300

Newark
200 100 0

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

Cocaine

Cocaine-related ED visits in Newark remained stable between 1995 and 2002. In 2002, the rate of cocaine-related ED visits in Newark (186) was 2.4 times the national rate (78). In Newark, over 80 percent of cocaine-related ED visits also involved other drugs. Only 2 percent of cocaine-related visits were attributable to crack.

500 400
Rate per 100,000 population

300

Newark
200

U.S.
100 0

1995

1996

1997

1998

1999

2000

2001

2002

Pain Relievers

From 2000 to 2002, pain relievers implicated in drug abuse-related ED visits doubled in Newark (from 31 to 64 mentions per 100,000 population). During the same period, the increase nationally was 39 percent. Methadone and oxycodone/combinations were the most frequently named pain relievers in Newark ED visits in 2002.

100

Rate per 100,000 population

75

Newark

50

U.S.
25

0

1995

1996

1997

1998

1999

2000

2001

2002

Benzodiazepines

In Newark, mentions of benzodiazepines in drug abuse-related ED visits increased 63 percent between 1995 and 2002 (from 35 to 57 mentions per 100,000). Nationally, ED mentions of benzodiazepines rose 25 percent during the same period (from 33 to 41 mentions per 100,000). Alprazolam was the most frequently named benzodiazepine in Newark ED visits in 2002.

100

Rate per 100,000 population

75

Newark
50

U.S.
25

0

1995

1996

1997

1998

1999

2000

2001

2002

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??? Comparisons

Across 21 Metropolitan Areas

The following figures show Newark 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.

Heroin visits
Rate per 100,000 population, 2002
Total U.S. Chicago Newark 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 0 29 28 23 20 16 10 225 38 53 51 43 93 93 85 128 123 111 109 171 36 220 214 203

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. 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

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

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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