# Presentation: 791630

## Findings from theDrug Abuse Warning Network

**Narcotic Analgesics**

- Judy K. Ball, Ph.D., M.P.A.
- Office of Applied Studies, Substance Abuse and Mental Health Services Administration
- 31 January 2002

## DAWN ED Sample

- Stratified probability sample
- Short-term, general, non-Federal hospitals operating 24-hour emergency departments
- Representative estimates for:
- Coterminous U.S.
- 21 major metropolitan areas

## DAWN Cases

- Age 6-97 treated in ED
- ED visit related to drug abuse
- Illicit drugs
- Non-medical use of R*x*/OTCs
- Motive for drug use
- Dependence
- Psychic effects
- Suicide attempt/gesture

**Notes:**
Retrospective chart review

## Drug Detail in DAWN

- Varies, based on detail in source record
- Brand (trade) names – MSContin
- Chemical names – morphine sulfate
- Generic names – morphine
- Nonspecific names – opiates
- Street names
- No estimates by brand (trade) name

## DAWN National Estimates, 2000

- Drug-related ED visits
- Drug "_mentions_"
- Drugs per visit
- ED visits, any reason
- Responding hospitals

- 601,563
- 1,099,306
- 1.8
- 96,163,000
- 466

## Drugs with High Abuse Potential

**Cocaine**

**Heroin**

**Marijuana**

**Benzodiazepines**

**Antidepressants**

**Narcotic**

**Alcohol-in-combination**

**Other**

**Analgesics**

- Source:  Drug Abuse Warning Network

- Mentions

## ED Mentions of Narcotic Analgesics

- Mentions

- Source:  Drug Abuse Warning Network

## Narcotic Analgesics, 2000

- NOS
- Hydrocodone
- Oxycodone
- Propoxyphene
- Codeine
- Morphine

- 25,935
- 20,098
- 10,825
- 5,485
- 5,295
- 2,483

- +40%
- +48%
- +108%
- n.s.
- -20%
- n.s.

- _ED Mentions_

- _1998_

- Source:  Drug Abuse Warning Network

- n.s.
- +32%
- +68%
- n.s.
- n.s.
- n.s.

- _1999_

- _% change from_

## Rising Trends, Narcotic Analgesics

**Oxycodone**

**Hydrocodone**

**Narcotic analgesic, NOS**

- Source:  Drug Abuse Warning Network

- Mentions

## Trends, Narcotic Analgesics

**Morphine**

**Propoxyphene**

- Source:  Drug Abuse Warning Network

- Mentions

**Codeine**

## DAWN Mortality Component

- Data from medical examiners/coroners
- Drug-induced deaths (overdoses)
- Drug-related deaths
- Not a probability sample
- No statistical estimates
- Partial/full participation in 40 metropolitan areas
- Review criteria vary across jurisdictions
- No national estimates

## Metropolitan Areas, ED & Mortality

- Baltimore
- Boston
- Denver
- Los Angeles

- Miami
- San Diego
- San Francisco

-   Consistent DAWN coverage in 2000:

-   Rates/100,000 population for comparisons

## Narcotics NOS (rates per 100,000 population)

- Narcotics NOS (rates per 100,000 population)

- Source:  Drug Abuse Warning Network

## Oxycodone (rates per 100,000 population)

- Oxycodone (rates per 100,000 population)

- Source:  Drug Abuse Warning Network

## Hydrocodone (rates per 100,000 population)

- Hydrocodone (rates per 100,000 population)

- Source:  Drug Abuse Warning Network

## Limitations of DAWN

- Intent to _abuse_ drug must be documented in source record
- Cannot distinguish diversion vs. abuse of legitimate prescriptions
- Variable reporting of nonspecific terms
- No information on health status, presenting complaint, diagnoses

## Strengths of DAWN

- Extensive drug detail
- Illicit, prescription, and over-the-counter
- High and low frequency events
- New and old drugs
- Statistically valid ED estimates, trends
- Timely
- Major changes planned for next 5 years