***DAWN Drug Reference Vocabulary***

The DAWN drug reference vocabulary (DRV) is a system of tables that DAWN
uses to record, code, and classify reportable substances. It includes
brand (trade) names, generic names, chemical names, metabolites,
nonspecific drug terms, and street terms for legal and illegal
substances, including prescription and over-the-counter pharmaceuticals
and selected nonpharmaceuticals that are abused by inhalation. Because
it is so comprehensive, the DAWN DRV is not only useful for DAWN, but is
available also as a resource for other purposes and other organizations
that require such a tool.

In 2000, DAWN adopted the Multum Lexicon, a drug vocabulary and
classification tool developed and maintained by [Multum Information
Services, Inc.,](http://www.multum.com/) a private sector firm, as the
basis for the DAWN drug vocabulary. Multum distributes the Lexicon (a
complete database in Microsoft Access format) and regular updates
through its website. At the time of its adoption, Multum permitted use
of its Lexicon free of charge; a [license
agreement](http://www.multum.com/lexidownload.htm) specifies the terms
required of users. In accordance with the license agreement, DAWN
publications, tabulations, and software applications cite the Multum
Lexicon as the source and basis for the DAWN drug vocabulary. (A
detailed overview of the Multum Lexicon is available for review in the
file Lexicon.pdf.) DAWN actually uses only a fraction of the Multum
Lexicon because DAWN case reports typically lack the most precise drug
product information. For example, DAWN case reports supply drug names,
but not strength or dosage, so it is not feasible to code drugs at the
granularity of National Drug Codes (NDCs), even though the Multum
Lexicon includes such detail. On the other hand, the specificity of drug
information reported to DAWN varies depending on the detail available in
the source documents, that is, ED medical records or death investigation
files. The Multum Lexicon not only accommodates such variability but it
provides a consistent method for aggregating very detailed information
(such as brands) into consistent generic drug categories. One reason for
choosing the Multum Lexicon for DAWN is that the Lexicon structure was
robust enough to accommodate the many illicit substances and
nonpharmaceutical inhalants reported to DAWN each year. By adopting the
Multum Lexicon structure, DAWN has designed a drug database that
incorporates Multum Lexicon content for generic names (e.g., naproxen),
brand or trade names (e.g., Aleve), and 3-level nested categories (e.g.,
for naproxen: central nervous system agents \[level 1\]; analgesics
\[level 2\]; nonsteroidal anti-inflammatory agents \[level 3\]). Illicit
drugs and other DAWN-reportable substances are added and maintained in a
compatible structure. The result of this combination of the Multum
Lexicon and DAWN-specific substances is referred to as the DAWN Drug
Reference Vocabulary.

There are several ways to retrieve information from the DAWN DRV. A user
familiar with Microsoft Access can refer to the file available via this
website named DAWN_DRV.mdb. The user would write queries that would join
tables using the established table relationships. Anyone not familiar
with Access who requires information at the brand (trade) name or higher
can reference the excel file DAWN_Final.xls. This file contains the same
information as the Access table DAWN\_\_Final_Table. All Access tables
in the database can be exported to other file types such as excel and
dBase. Each table has a descriptive label as seen in the following
screen print.

![](media/image1.png){width="7.5in" height="5.86875in"}

The example of naproxen discussed earlier will be used to show how the
various tables can be used to retrieve information. By starting with the
DAWN\_\_Final_Table, the terminology in the DRV might become more
familiar. Let\'s say that you are interested in the generic product
naproxen. Start by sorting the DAWN\_\_Final_Table by drug_name. Scroll
down until you see naproxen in the drug_name field. Naproxen is drug_id
d00019 and has 13 brand/trade names and generic names associated with
it. Scroll to the right to see the 3-level categorization assigned to
this drug. The DAWN_Final.xls file contains the same information and
sorting can be done within excel.

The relationships table below shows the table linkage for the DAWN DRV.

![](media/image2.png){width="7.2in" height="3.5in"}

The tables and important data elements are defined below. The list is
not exhaustive; rather it lists key items that would be useful to most
users.

-   DAWN\_\_Final_table A complete list of all brands, drugs, and
    corresponding categories.

-   DAWN_Active_Ingredient Map of active ingredient code to name.

-   DAWN_Active_Ingredient_List Map of active ingredient code to main
    Multum drug code.

-   DAWN_Brand_Name Map of brand code to brand code prefix and brand
    (trade, generic, or street) name

-   DAWN_Category_Drug_Xref Maps drug ID to category.

-   DAWN_Category_Sub_Xref Maps the nesting of the categories

-   DAWN_Combination_Drug Identifies combination drugs

-   DAWN_Core_Description Maps brand code to main Multum drug code

-   DAWN_Drug_Categories Maps the category to category name

-   DAWN_Drug_ID Maps drug ID to drug name - remainder of table is
    related to reporting

-   DAWN_Legend A list of terms and definitions used in the DRV

-   DAWN_Main_Multum_Drug_Code Maps main Multum drug code to drug ID

-   DAWN_SDL_x_Placement A static table that demonstrates how Multum\'s
    drug categorization is used in DAWN ED reports.

-   DAWN_SDLme_Detail A static table that demonstrates how Multum\'s
    drug categorization is used in DAWN ME reports.

There are 2 reports included with the database. The reports show the
nested, 3-level Multum category scheme. The ED version shows the row
placement for each category in the standard drug list (SDL) reports.
There are 71 row placements. Please view the static table
DAWN_SDLed_X_Detail, columns SDL_row_number and
corresponding_Multum_category. The number in parenthesis from the report
will match the row number placement in the table. For example, the first
category in the report is anti-infectives. It is Multum category 1 and
is reported in row 65. The ME report has a similar function, but the ME
reports have only a few report rows.