Year-End 1998 ED DAWN Data

OFFICE OF APPLIED STUDIES

Year-End 1998

Emergency Department Data

from the

Drug Abuse Warning Network

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration
ii Year-End 1998 ED DAWN Data

ACKNOWLEDGMENTS

This report is based on data developed for the Substance Abuse and Mental Health Services

Administration (SAMHSA), Office of Applied Studies (OAS), by Johnson, Bassin, and Shaw, Inc.

under Contract No. 283-98-9010 and Westat under Contract No. 282-98-0003. Drs. Wendy

Kissin (Westat) and Judy Ball (SAMHSA/OAS Project Officer) wrote the report. Other significant

contributors at Westat include Josefina Moran (Project Director), Pat Stouffer, and A. Joseph

Stribling. We thank Carolyn Travers of the Drug Enforcement Administration for her insights

into the methamphetamine/speed findings.

PUBLIC DOMAIN NOTICE

All material appearing in this report is in the public domain and may be reproduced or copied

without permission from the Substance Abuse and Mental Health Services Administration.

Citation of the source is appreciated.

OBTAINING ADDITIONAL COPIES OF PUBLICATION

Copies may be obtained, free of charge, from the National Clearinghouse for Alcohol and Drug

Information (NCADI). The NCADI is a service of the Substance Abuse and Mental Health

Services Administration (SAMHSA). Write or call NCADI at:

National Clearinghouse for Alcohol and Drug Information (NCADI)

P.O. Box 2345

Rockville, MD 20847-2345

301-468-2600, 800-729-6686, or TDD 800-487-4889

ELECTRONIC ACCESS TO PUBLICATION

This publication can be accessed electronically through the Internet World Wide Web

connections listed below.

World Wide Web Internet Connections: http://www.samhsa.gov

http://www.health.org

ORIGINATING OFFICE:

SAMHSA, Office of Applied Studies

5600 Fishers Lane, Room 16-105

Rockville, MD 20857

DECEMBER 1999
Year-End 1998 ED DAWN Data iii

CONTENTS

Section Page

ACKNOWLEDGEMENTS................................................................... ii

HIGHLIGHTS...................................................................................... 1

INTRODUCTION ................................................................................ 5

ANNUAL TRENDS IN TOTAL DRUG EPISODES.............................. 11

ANNUAL TRENDS IN COCAINE MENTIONS.................................... 15

ANNUAL TRENDS IN HEROIN/MORPHINE MENTIONS .................. 17

ANNUAL TRENDS IN MARIJUANA/HASHISH MENTIONS .............. 19

ANNUAL TRENDS IN OTHER ILLICIT DRUG MENTIONS ............... 21

ANNUAL TRENDS IN PRESCRIPTION AND OVER-THE-COUNTER

DRUG-RELATED EPISODES ............................................................ 23

ANNUAL TRENDS IN SELECTED METROPOLITAN

AREAS ............................................................................................... 25

ESTIMATED RATES OF EMERGENCY DEPARTMENT EPISODES

AND MENTIONS ................................................................................ 27

DISCUSSION OF RESULTS .............................................................. 29

DETAILED TABLES........................................................................... 55

APPENDIXES

Appendix

A Detailed Description of DAWN ......................................................... 37

B Limitations of the DAWN Data.......................................................... 41

C Explanation of Tables ....................................................................... 43

D Glossary of Terms............................................................................. 45
iv Year-End 1998 ED DAWN Data

CONTENTS

LIST OF TABLES

Table Page

1 Estimated number of emergency department drug episodes, drug

mentions, mentions of selected drugs, and total visits for total

coterminous U.S. by half year: First half 1993 - second half 1998...... 57

2 Estimated number of emergency department drug episodes,

drug mentions, mentions of selected drugs, and total visits, for

total coterminous U.S. by year: 1991-1998 ........................................ 58

3 Estimated number of emergency department drug episodes, by

metropolitan area by half year: First half 1993 - second half 1998...... 59

4 Estimated number of emergency department drug episodes,

by metropolitan area by year: 1991-1998........................................... 60

5 Estimated number of emergency department drug episodes, by

metropolitan area by half year: First half 1993 - second half 1998...... 61

6 Estimated number of emergency department drug episodes,

by metropolitan area by year: 1991-1998........................................... 62

7 Estimated number of emergency department cocaine mentions, by

metropolitan area by half year: First half 1993 - second half 1998...... 63

8 Estimated number of emergency department cocaine mentions,

by metropolitan area by year: 1991-1998........................................... 64

9 Estimated number of emergency department heroin/morphine

mentions, by metropolitan area by half year: First half 1993 - second

half 1998............................................................................................. 65

10 Estimated number of emergency department heroin/morphine

mentions, by metropolitan area by year: 1991-1998........................... 66

11 Estimated number of emergency department marijuana/hashish

mentions, by metropolitan area by half year: First half 1993 - second

half 1998............................................................................................. 67

12 Estimated number of emergency department marijuana/hashish

mentions, by metropolitan area by year: 1991-1998........................... 68

13 Estimated number of emergency department methamphetamine/speed

mentions, by metropolitan area by half year: First half 1993 - second

half 1998............................................................................................. 69
Year-End 1998 ED DAWN Data v

CONTENTS

LIST OF TABLES (CONTINUED)

Table Page

14 Estimated number of emergency department methamphetamine/speed

mentions, by metropolitan area by year: 1991-1998........................... 70

15 Estimated number of total emergency department visits, by

metropolitan area by half year: First half 1993 - second half 1998...... 71

16 Estimated number of total emergency department visits, by

metropolitan area by year: 1991-1998................................................ 72

17 Estimated number of emergency department drug episodes,

by age, gender, race/ethnicity, hospital location, drug use motive,

and reason for emergency department contact: First half 1993 - second

half 1998............................................................................................. 73

18 Estimated number of emergency department drug episodes,

by age, gender, race/ethnicity, hospital location, drug use motive,

and reason for emergency department contact: 1991-1998 ............... 74

19 Estimated number of emergency department drug mentions,

by age, gender, race/ethnicity, hospital location, drug use motive,

and reason for emergency department contact: First half 1993 –

second half 1998................................................................................. 75

20 Estimated number of emergency department drug mentions,

by age, gender, race/ethnicity, hospital location, drug use motive,

and reason for emergency department contact: 1991-1998 ............... 76

21 Estimated number of emergency department cocaine mentions,

by age, gender, race/ethnicity, hospital location, drug use motive,

and reason for emergency department contact: First half 1993 –

second half 1998................................................................................. 77

22 Estimated number of emergency department cocaine mentions,

by age, gender, race/ethnicity, hospital location, drug use motive,

and reason for emergency department contact: 1991-1998 ............... 78

23 Estimated number of emergency department heroin/morphine

mentions, by age, gender, race/ethnicity, hospital location, drug use

motive, and reason for emergency department contact:

First half 1993 - second half 1998 ....................................................... 79
vi Year-End 1998 ED DAWN Data

CONTENTS

LIST OF TABLES (CONTINUED)

Table Page

24 Estimated number of emergency department heroin/morphine

mentions, by age, gender, race/ethnicity, hospital location, drug use

motive, and reason for emergency department contact: 1991-1998 ... 80

25 Estimated number of emergency department marijuana/hashish

mentions, by age, gender, race/ethnicity, hospital location, drug use

motive, and reason for emergency department contact: First half

1993 - second half 1998...................................................................... 81

26 Estimated number of emergency department marijuana/hashish mentions,

by age, gender, race/ethnicity, hospital location, drug use motive, and

reason for emergency department contact: 1991-1998 ...................... 82

27 Estimated number of emergency department methamphetamine/

speed mentions, by age, gender, race/ethnicity, hospital location, drug

use motive, and reason for emergency department contact: First half

1993 - second half 1998...................................................................... 83

28 Estimated number of emergency department methamphetamine/

speed mentions, by age, gender, race/ethnicity, hospital location,

drug use motive, and reason for emergency department contact:

1991-1998........................................................................................... 84

29 Estimated rate of emergency department drug episodes,

drug mentions, mentions of selected drugs, and total visits

per 100,000 population for total coterminous U.S. by half year:

First half 1993 - second half 1998 ....................................................... 85

30 Estimated rate of emergency department drug episodes, drug

mentions, mentions of selected drugs, and total visits per 100,000

population for total coterminous U.S. by year: 1991-1998 .................. 86

31 Estimated rate of emergency department drug episodes per

100,000 population, by metropolitan area by half year: First half

1993 - second half 1998...................................................................... 87

32 Estimated rate of emergency department drug episodes per

100,000 population, by metropolitan area by year: 1991-1998 ........... 88

33 Estimated rate of emergency department drug mentions per

100,000 population, by metropolitan area by half year: First half

1993 - second half 1998...................................................................... 89
Year-End 1998 ED DAWN Data vii

CONTENTS

LIST OF TABLES (CONTINUED)

Table Page

34 Estimated rate of emergency department drug mentions per

100,000 population, by metropolitan area by year: 1991-1998 ........... 90

35 Estimated rate of emergency department cocaine mentions

per 100,000 population, by metropolitan area by half year:

First half 1993 - second half 1998 ....................................................... 91

36 Estimated rate of emergency department cocaine mentions

per 100,000 population, by metropolitan area by year: 1991-1998..... 92

37 Estimated rate of emergency department heroin/morphine

mentions per 100,000 population, by metropolitan area by half

year: First half 1993 - second half 1998 ............................................. 93

38 Estimated rate of emergency department heroin/morphine

mentions per 100,000 population, by metropolitan area by year:

1991-1998........................................................................................... 94

39 Estimated rate of emergency department marijuana/hashish

mentions per 100,000 population, by metropolitan area by half year:

First half 1993 - second half 1998 ....................................................... 95

40 Estimated rate of emergency department marijuana/hashish

mentions per 100,000 population, by metropolitan area by year:

1991-1998........................................................................................... 96

41 Estimated rate of emergency department methamphetamine/

speed mentions per 100,000 population, by metropolitan

area by half year: First half 1993 - second half 1998.......................... 97

42 Estimated rate of emergency department methamphetamine/

speed mentions per 100,000 population, by metropolitan area

by year: 1991-1998 ............................................................................ 98

43 Estimated rate of total emergency department visits per 100,000

population, by metropolitan area by half year: First half 1993 -

second half 1998................................................................................. 99

44 Estimated rate of total emergency department visits per 100,000

population, by metropolitan area by year: 1991-1998......................... 100

45 Estimated rate of emergency department drug episodes per 100,000

population by age, gender: First half 1993 - second half 1998 ........... 101
viii Year-End 1998 ED DAWN Data

CONTENTS

LIST OF TABLES (CONTINUED)

Table Page

46 Estimated rate of emergency department drug episodes,

per 100,000 population by age, gender: 1991-1998 ........................... 102

47 Estimated rate of emergency department drug mentions per

100,000 population by age, gender: First half 1993 - second

half 1998............................................................................................. 103

48 Estimated rate of emergency department drug mentions

per 100,000 population by age, gender: 1991-1998 ........................... 104

49 Estimated rate of emergency department cocaine mentions

per 100,000 population, by age, gender: First half 1993 –

second half 1998................................................................................. 105

50 Estimated rate of emergency department cocaine mentions

per 100,000 population by age, gender: 1991-1998 ........................... 106

51 Estimated rate of emergency department heroin/morphine mentions

per 100,000 population by age, gender: First half 1993 - second

half 1998............................................................................................. 107

52 Estimated rate of emergency department heroin/morphine

mentions per 100,000 population by age, gender: 1991-1998............ 108

53 Estimated rate of emergency department marijuana/hashish

mentions per 100,000 population by age, gender: First half 1993 -

second half 1998................................................................................. 109

54 Estimated rate of emergency department marijuana/hashish

mentions per 100,000 population by age, gender: 1991-1998............ 110

55 Estimated rate of emergency department methamphetamine/

speed mentions per 100,000 population by age, gender: First half

1993 - second half 1998...................................................................... 111

56 Estimated rate of emergency department methamphetamine/

speed mentions per 100,000 population by age, gender:

1991-1998........................................................................................... 112
Year-End 1998 ED DAWN Data ix

CONTENTS

LIST OF FIGURES

Figure Page

1 Number of total drug-related episodes, cocaine mentions, and

heroin/morphine mentions: 1990 through 1998 ................................. 13

2 Number of illicit drug-related episodes by selected drugs:

1990 through 1998.............................................................................. 13

3 Number of cocaine mentions by age: 1990 through 1998 .................. 16

4 Number of cocaine mentions by race/ethnicity: 1990 through 1998.... 16

5 Number of heroin/morphine mentions by age: 1990 through 1998 ..... 18

6 Number of heroin/morphine mentions by race/ethnicity:

1990 through 1998.............................................................................. 18

7 Number of marijuana/hashish mentions by age: 1990 through 1998 .. 20

8 Number of marijuana/hashish mentions by race/ethnicity:

1990 through 1998.............................................................................. 20

9 Number of methamphetamine/speed mentions by location: 1998 ...... 22

10 Number of methamphetamine/speed and amphetamine

mentions: 1990 through 1998.............................................................. 22

11 Number of methamphetamine/speed mentions by selected

metropolitan area: 1990 through 1998 ............................................... 34

12 Number of illicit drug-related episodes age 12 to 17:

1990 through 1998.............................................................................. 34

13 Number of illicit drug-related episodes age 35 and older:

1990 through 1998.............................................................................. 35
x Year-End 1998 ED DAWN Data
Year-End 1998 ED DAWN Data 1

Drug Episodes vs.

Drug Mentions

Drug-Related Episode: A

drug episode is an ED visit

that was induced by or

related to the use of an illegal

drug(s) or the nonmedical

use of a legal drug for

patients age 6 years and

older.

Drug Mention: A drug

mention refers to a substance

that was mentioned during a

drug-related ED episode.

Because up to 4 drugs can be

reported for each drug abuse

episode, there are more

mentions than episodes cited

in this report.

HIGHLIGHTS

he Drug Abuse Warning Network (DAWN) is a national

probability survey of hospitals with emergency

departments (EDs) conducted annually by the Substance

Abuse and Mental Health Services Administration (SAMHSA).

The survey is designed to capture data on ED episodes that

are induced by or related to the use of an illegal drug or the

nonmedical use of a legal drug. Therefore, DAWN data do

not measure prevalence of drug use in the population.

Analyses in this report focus on comparisons between 1998

estimates and estimates for the previous 2 years, as well as

long-term trends in drug mentions between 1991 and 1998.

Data from 1995 onward reflect improvements that were made

recently to the estimation system. Findings reported here

are statistically significant unless stated otherwise.

The following trends were observed between 1998 and

earlier years:

TOTAL DRUG-RELATED EPISODES

 In 1998, there were an estimated 542,544 drug-related ED episodes and 982,856 ED

drug mentions in the coterminous United States. Nationally, the number of ED

episodes and mentions remained relatively stable between 1997 and 1998 (Table 2).

 Among the drugs mentioned most frequently in ED reports, alcohol-in-combination

(185,002), cocaine (172,014), and heroin/morphine (77,645) were statistically

unchanged from 1997 to 1998, while marijuana/hashish mentions increased 19 percent

(from 64,744 to 76,870) (Table 2).

 From 1997 to 1998, total drug-related ED episodes were stable for gender and

race/ethnicity subgroups (Table 18).

 For patients age 12 to 17, total drug-related episodes in 1998 (59,086, Table 18) were

statistically unchanged from 1997 levels (61,437), but 8 percent lower than in 1996

(63,949). For the same age group, mentions of cocaine were stable from 1997 to 1998

(3,630 to 4,309, Table 22) and from 1996 (2,581) to 1998. Mentions of heroin/

morphine and marijuana/hashish were stable from 1997 to 1998, but this followed

significant increases from 1996 to 1998 – heroin/morphine (63%, from 559 to 909,

Table 24) and marijuana/hashish (32%, 9,982 to 13,135, Table 26).

 Total ED episodes for patients age 35 and older increased 9 percent (from 218,630 to

239,172) between 1997 and 1998 (Table 18). Mentions of other drugs also increased

for this age group: marijuana/hashish (22%, from 17,043 to 20,796, Table 26); cocaine

(12%, from 74,602 to 83,729, Table 22); and heroin/morphine (10%, from 39,914 to

43,714, Table 24).

T
2 Year-End 1998 ED DAWN Data

 In drug-related ED episodes, overdose (245,164) was the most frequently cited reason

for the drug-related ED visit and suicide (189,897) and dependence (189,094) were the

most frequently cited motives for taking the substances (Table 18). These were

unchanged from 1997 to 1998.

 Among the 21 metropolitan areas oversampled in DAWN, only Dallas had a significant

change – an increase of 16 percent (from 6,195 to 7,198) – in total drug-related ED

episodes from 1997 to 1998 (Table 4).

COCAINE

 Cocaine-related episodes constituted 32 percent (172,014) of all ED drug episodes in

1998; more than any other illicit substance measured by DAWN (Table 2).

 Cocaine mentions were relatively unchanged between 1997 (161,087 mentions) and

1998 (Table 22).

 ED episodes involving cocaine increased between 1997 and 1998 among adults age

35 and over (12%, from 74,602 to 83,729). No changes were evident for any other

age, gender, or race/ethnicity subgroup (Table 22).

 Among the metropolitan areas oversampled in DAWN, cocaine mentions increased

between 1997 and 1998 in Dallas (45%, from 1,778 to 2,586); Los Angeles (23%, from

4,707 to 5,783); Philadelphia (16%, from 11,202 to 13,049); Washington, DC (15%,

from 3,223 to 3,718); and Phoenix (11%, from 1,334 to 1,486) (Table 8).

HEROIN/MORPHINE

 Heroin/morphine-related episodes were relatively stable between 1997 (72,010

mentions) and 1998 (77,645) (Table 2).

 From 1997 to 1998, heroin/morphine mentions increased 10 percent (from 39,914 to

43,714) among patients age 35 and older. No changes in heroin/morphine mentions

occurred for other age, gender, or race/ethnicity subgroups between 1997 and 1998

(Table 24).

 Among the metropolitan areas oversampled in DAWN, heroin/morphine mentions

increased between 1997 and 1998 in Miami (29%, from 599 to 772); Washington, DC

(25%, from 1,691 to 2,112); New Orleans (24%, from 431 to 534); Newark (16%, from

4,367 to 5,080); and Buffalo (16%, from 471 to 545). Heroin/morphine mentions

decreased only in San Francisco (13%, from 2,751 to 2,386) (Table 10).

MARIJUANA/HASHISH

 Marijuana/hashish-related episodes increased 19 percent from 64,744 in 1997 to

76,870 in 1998 (Table 2).

 From 1997 to 1998, statistically significant increases in marijuana/hashish mentions

were found for both genders, black patients, and all age subgroups, with the exception

of youth age 12 to 17 whose increase from 11,056 to 13,135 mentions was not

statistically significant. However, marijuana/hashish mentions among youth age 12 to

17 increased 31 percent from 9,982 in 1996 to 13,135 in 1998, and 517 percent from

1991 (2,130 mentions) to 1998 (Table 26).
Year-End 1998 ED DAWN Data 3

 Among the 21 metropolitan areas represented in DAWN, marijuana/hashish mentions

increased from 1997 to 1998 in Dallas (65%, from 916 to 1,513); Philadelphia (17%,

from 4,556 to 5,310); and San Diego (16%, from 970 to 1,127). Marijuana/hashish

mentions decreased only in New Orleans (11%, from 1,345 to 1,196) (Table 12).

METHAMPHETAMINE/SPEED

 Overall, methamphetamine/speed mentions decreased 33 percent from 17,154

mentions in 1997 to 11,491 in 1998, to return to 1996 levels (11,002) (Table 2).

 Looking across the 21 DAWN metropolitan areas, the vast majority (over 80%) of

estimated ED mentions of methamphetamine/speed in 1998 came from six cities in the

western United States: Los Angeles (786 mentions), San Diego (721), San Francisco

(616), Phoenix (446), Seattle (266), and Dallas (186) (Table 14).

 From 1997 to 1998, mentions of methamphetamine/speed declined significantly in

Denver (59%, from 292 to 120); Phoenix (45%, from 800 to 446); Seattle (44%, from

479 to 266); San Francisco (39%, from 1,012 to 616); Los Angeles (36%, from 1,229 to

786); San Diego (26%, from 976 to 721). Methamphetamine/speed mentions

increased only in Dallas (17%, from 159 to 186) (Table 14).

PCP/PCP COMBINATIONS

 ED mentions of PCP/PCP combinations did not change significantly from 1997 (4,195)

to 1998 (4,033) (Table 2).

LSD

 No significant changes occurred in LSD mentions from 1997 (5,219) to 1998 (4,982)

(Table 2).

NON-MEDICAL USES OF LICIT DRUGS

Not all cases involving prescription or over-the-counter (OTC) drugs are reportable to

DAWN. DAWN cases do not include accidental ingestion or inhalation of a substance with no

intent of abuse, or adverse reactions to prescription or OTC medications taken as prescribed.

Accidental overdoses of OTC or prescription drugs taken as directed are reportable when used

in combination with an illicit drug. Alcohol is reportable only when used in combination with

another drug.

 Mentions of alcohol-in-combination occurred in 34 percent (185,002) of ED drug

episodes in 1998. Mentions of alcohol-in-combination were stable from 1997 to 1998

(Table 2).

 Between 1997 and 1998, significant decreases were noted for several prescription and

OTC drugs, including acetaminophen with codeine (from 6,589 to 5,045); amitriptyline

(from 8,445 to 6,710); diphenhydramine (from 8,804 to 6,110); and imipramine (from

1,383 to 717). Only carisoprodol increased significantly from 6,133 mentions in 1997

to 8,454 in 1998 (Table 2).
4 Year-End 1998 ED DAWN Data
Year-End 1998 ED DAWN Data 5

INTRODUCTION

his report presents information on drug-related emergency department (ED) episodes

collected through the Drug Abuse Warning Network (DAWN) through December of 1998.

Since late 1992, DAWN data collection and reports publication have been the responsibility

of the Office of Applied Studies (OAS) at the Substance Abuse and Mental Health Services

Administration (SAMHSA). Earlier operation of DAWN and periodic reports from the data

system were provided by the National Institute on Drug Abuse (NIDA) and, before that, by the

Drug Enforcement Administration (DEA).

This report contains final estimates of drug-related ED episodes and specific drug mentions

for full years from 1991 through 1998. Final estimates for each half-year period for 1993

through 1998 are provided for reference. Final 1998 estimates are presented in this report for

the first time.

This Year-End Report is similar in format to the Mid-Year 1998 Preliminary ED Report

published in August 1999. Although both include estimates for the first 6 months of 1998,

estimates shown in this report may differ slightly from those presented in the Mid-Year Report

due to late reporting hospitals and revisions to the data weights for the present report (see

Appendix A, Section III). In 1998, a thorough review of the DAWN estimation system by Westat

produced more accurate 1995 and 1996 estimates (se Appendix A, Section IV for more

information).

This introduction includes a brief overview of DAWN data collection and highlights issues

for the reader to consider in interpreting DAWN data. This is followed by sections with specific

focuses on trends in drug abuse episodes overall; trends in cocaine mentions; trends in

heroin/morphine mentions; trends in marijuana/hashish mentions; trends in mentions of other

illicit drugs, including methamphetamine/ speed, PCP, and LSD. A separate section

summarizes trends in prescription and over-the-counter (OTC) drug-related episodes reported

to DAWN. This is followed by highlights in drug episode trends from the 21 metropolitan areas

oversampled in DAWN.

The DAWN system also collects data on drug-related deaths from a nonrandom sample of

medical examiners. Medical examiner data are published annually in separate reports; [i.e.,

Drug Abuse Warning Network Annual Medical Examiner Data].

OVERVIEW OF DAWN ED DATA

The DAWN system provides information on the health consequences of drug use in the

United States as manifested by drug-related visits to hospital EDs. Hospitals eligible for DAWN

are non-Federal, short-stay, general hospitals that have a 24-hour emergency department in the

coterminous U.S. Since 1988, DAWN ED data have been collected from a representative

sample of eligible hospitals located throughout the coterminous U.S., with oversampling in 21

metropolitan areas and a National Panel of hospitals sampled from locations outside these

areas.

T
6 Year-End 1998 ED DAWN Data

In 1998, the DAWN sample consisted of 595 eligible hospitals. Of these, 471 (79%)

participated in the DAWN ED survey. The 1998 sample of hospitals submitted information on

172,258 drug abuse episodes with an average of 1.75 drug mentions per episode.

For this report, data have been weighted to produce estimates representing all ED drug

episodes and drug mentions in the total coterminous U.S.1

 and in the 21 metropolitan areas

(see Appendix A). For analysis, hospitals in the 21 metropolitan areas are sometimes classified

by location -- inside or outside the central city portion of those areas. The National Panel

represents hospitals outside of the 21 metropolitan areas. Data for the 21 metropolitan areas

are pooled with data from the National Panel to produce the national estimates.

DATA COLLECTION METHODOLOGY

Within each facility that participates in DAWN, a designated DAWN reporter, who is usually

a member of the ED or medical records staff, is responsible for reviewing medical charts to

identify drug abuse episodes eligible for inclusion in DAWN. DAWN reporters rely on

information from medical charts that originates with hospital staff who treated the patient.

Ultimately, the accuracy and completeness of DAWN reports depend on the careful recording of

information by the medical staff and on the accuracy and completeness of the information

provided to the medical staff by the patient.

The DAWN reporter submits an episode report to the DAWN system for each drug abuse

patient who visits a DAWN ED and meets certain criteria. To be included in DAWN, the patient

presenting to the ED must be between age 6 and 97 and meet all 4 of the following criteria:

 The patient was treated in the hospital's ED;

 The patient's presenting problem(s) – i.e., the reason for the ED visit – was induced by

or related to drug use, regardless of when the drug use occurred;

 The episode involved the use of an illegal drug or the use a legal drug or other

chemical substance contrary to directions; and

 The patient's reason for using the substance(s) was dependence, suicide attempt or

gesture, and/or psychic effects.

In addition to drug overdoses, reportable ED episodes may result from the chronic effects of

habitual drug use or from unexpected reactions. Unexpected reactions reflect cases where the

drug's effect was different than anticipated (e.g., caused hallucinations). DAWN cases do not

include accidental ingestion or inhalation of a substance with no intent of abuse, or adverse

reactions to prescription or over-the-counter medications taken as prescribed.

A single drug abuse episode may have multiple drug mentions. Up to 4 different

substances can be recorded for each ED episode. Therefore, not every reported substance is,

by itself, necessarily a cause of the medical emergency. On the other hand, substances that

contributed to a drug abuse episode may occasionally go unreported or undetected. Even when

only one substance is reported for an episode, an allowance should be made for reportable

drugs not mentioned or for other contributory factors.

 

1

 The total conterminous U.S. consists of 48 contiguous states and the District of Columbia. Alaska and Hawaii are excluded.
Year-End 1998 ED DAWN Data 7

Alcohol use is reported to DAWN only when consumed in combination with a reportable

substance.

In addition, each report of a drug-related ED episode includes demographic information

about the patient and information about the circumstances of the episode (e.g., the date and

time of the ED visit, the reason the patient came to the ED). For each drug mentioned, the

DAWN report includes the form in which the drug was acquired (e.g., liquid, pieces), its source

(e.g., street buy, patient's own legal prescription), and its route of administration (e.g., oral,

injection). Only one reason for the ED contact and one reason for taking substances is

recorded, regardless of the number of substances involved.

CONSIDERATIONS WHEN INTERPRETING DAWN DATA

When reporting and interpreting findings from this report, the reader needs to recognize

what DAWN data are and what they are not. DAWN data do not measure the frequency or

prevalence of drug use in the population, but rather the health consequences of drug use that

are reflected in visits to hospital EDs. Moreover, estimates of drug episodes and mentions may

increase or decrease for reasons unrelated to the size or characteristics of the drug-using

population. The reader should consider the following when interpreting DAWN data estimates.

 The number of ED episodes reported to DAWN is not equivalent to the number of

individual patients, because one person may make repeated visits to an ED. DAWN

data contain no personal identifiers, which would be required to estimate repeat visits.

 DAWN data may be affected by data collection procedures and thereby reflect changes

in hospital services or operations. A hospital in one city may open a new detoxification

unit that diverts drug-related episodes away from the ED. Conversely, in another city,

people may go to the ED to seek care for detoxification because they are unable to

gain admission to a drug treatment facility or because they need medical certification

before entering treatment.

 Estimates of drug-related ED episodes or mentions may be affected by reporting

patterns. For example, a change to computer-based recordkeeping systems in a

hospital ED could increase or decrease the number of ED visits identified as drug

related.

 Greater awareness and knowledge of drug-related problems may result in a greater

propensity for ED staff to record drug use in the ED record. Alternatively, the

sensitivity of drug-related problems may reduce patients' willingness to disclose drug

use and providers' willingness to record it in the permanent medical record.

 Estimates of drug-related ED episodes or mentions are affected if the weights applied

to the data change in an irregular way. We routinely investigate irregular weights and

data, and review of the weights and data used in this report did not reveal any factors

that are unduly responsible for the trends reported.

 Trends may be affected by additional factors concerning the sample composition. See

Appendix B for more information regarding sampling.
8 Year-End 1998 ED DAWN Data

 Graphs illustrating trends in drug mentions often use different scales for the vertical

axis.

INTERPRETATION OF STATISTICAL SIGNIFICANCE

The estimated numbers of episodes and mentions reported in detailed tables in this report

are accompanied by p-values of statistical tests for differences between time periods. In tables

presenting estimates for half years, the first half of 1998 is compared to the second half of 1998,

then the second halves of 1997 and 1998 are compared. In tables presenting estimates for full

years, 1998 is compared to 1997 and also to 1996. However, the purpose of this report is to

release final estimates for 1998, with a focus on the full year. Estimates for half years are

presented in this report primarily for reference.

In describing statistically significant differences in this report, the traditional level of

statistical significance (p less than 0.05) is used. The tables show both p-values and the

direction of difference indicated by "+" and "-" signs for statistically significant comparisons. The

statistical test used to determine the significance levels are t-tests (with infinite degrees of

freedom). That is, the change score, or the difference between the 2 estimates, is divided by

the standard error of the estimate. A value of zero is expected under the null hypothesis.

Although tests for statistical significance are important tools in interpreting data, significance

does not always imply that the difference is large or important. Small changes that are

statistically significant may occur frequently at the metropolitan area level in DAWN due to the

selection of all eligible hospitals (which constitutes a census) in Baltimore, Buffalo, Denver, San

Diego, and San Francisco [see the 1994 Annual ED Data, Series I, Number 14-A, DHHS Pub.

No. (SMA) 96-3104, page 10], along with sampling many other metropolitan areas at a high

frequency. The closer the sample is to a census, the higher is the likelihood that a change will

be statistically significant, no matter how small it may be. While technically there is no sampling

variability in the 5 areas noted, some variability is due to the hospitals' nonresponse, which is

treated as sampling error in the variance calculations.

Nonsampling errors such as nonresponse and reporting errors may affect the outcome of

significance tests. While p less than 0.05 significance level is used to determine statistical

significance in the DAWN ED sample, large differences associated with slightly higher p-values

(specifically those between 0.05 and 0.10) may be worth noting. On the other hand, statistically

significant differences are not always meaningful, because the size of the difference may be

small or because the significance may have occurred simply by chance. In a series of 20

independent tests, it is to be expected that one test will indicate a significant difference merely

by chance even if there is no real difference in the populations compared. The text often

discusses more than one comparison within a given table (e.g., comparing percentages for

different subgroups). However, we have made no attempt to adjust the level of significance to

account for these multiple comparisons. Therefore, the probability of falsely rejecting the null

hypothesis at least once in a family of comparisons is higher than the significance level given for

individual comparisons (in this report, 0.05).

CONSIDERATIONS WHEN READING DETAILED DATA TABLES

For many of the trends described in the text bullets of this report, the actual numbers cited

are found in the cited source table. In other instances, typically when the trend is described as

a percentage change, the statistic was derived from the cited source table.
Year-End 1998 ED DAWN Data 9

In this report, estimates with relative standard errors (RSEs) of 50 percent or higher are

regarded as too imprecise and are not published. With an RSE of 50 percent, the 95-percent

confidence interval for an estimate ranges from 2 to 198 percent of the estimate's value. In the

tables, the symbol "..." is substituted for estimates with an RSE of 50 percent or higher. The 3-

dot symbol identifies cells in which the estimates do not meet the standard of precision required

for publication.

In addition, estimates of less than 10 are not shown. Although many estimates in this range

may have RSEs of less than 50 percent, the reliability of the RSE estimates themselves is

suspect. The 3-dot symbol "..." is also printed in the table cells where these values would have

appeared. Percentages and population-based rates corresponding to these numbers are

shown or suppressed according to the same rules and using the same symbols.

As described in Appendix A, the DAWN ED data for 1995 and 1996 were reweighted,

reprogrammed, and data presentations improved during 1998. This report often summarizes

changes between 1996 and 1998, especially when a consistent trend prevailed over this 2-year

period. In addition, the graphic presentations emphasize changes across the decade from 1990

through 1998.
10 Year-End 1998 ED DAWN Data
Year-End 1998 ED DAWN Data 11

What is Statistically

Significant?

DAWN reports consider a

difference to be statistically

significant if the associated

p-value is less than 0.05.

This indicates a 95 percent

chance that the difference did

not occur by chance alone.

ANNUAL TRENDS

IN TOTAL DRUG EPISODES

his section presents annual estimates from the DAWN survey

on the number of total drug-related ED episodes and mentions

of particular drugs. The following discussion focuses on

comparisons of estimates from 1997 and 1998. Tables also

show statistical tests comparing 1998 estimates with those for

1996. Long-term trends in drug-related ED episodes overall and

for those involving the most frequently mentioned illicit drugs are

shown in Figures 1 and 2.

TOTAL DRUG-RELATED EPISODES

 In 1998, there were 542,544 drug-related ED episodes in the coterminous U.S. with

982,856 drug mentions. The number of ED episodes and ED drug mentions remained

stable between 1997 and 1998 (Table 2 and Figure 1).

 Cocaine continued to be the most frequently mentioned illicit drug (32% of episodes) in

1998. Cocaine was followed in frequency by heroin/morphine (14%), marijuana/

hashish (14%), and methamphetamine/speed (2%) (Table 2). This rank ordering of

illicit drug mentions has been constant since 1990 and is illustrated in Figure 2.

 Alcohol-in-combination was mentioned in 34 percent (185,002) of ED drug episodes in

1998 (Table 2). Note that alcohol is only reported to DAWN when present in

combination with another reportable drug.

CHANGES FROM 1997 TO 1998

 A comparison of 1997 and 1998 revealed:

- No significant changes for amphetamine, cocaine, heroin/morphine, LSD, or

PCP/PCP combinations (Table 2);

- A 19 percent increase in marijuana/hashish mentions (from 64,744 to 76,870)

(Table 2); and

- Methamphetamine/speed mentions dropped 33 percent, returning to 1996 levels

(Table 2).

DEMOGRAPHIC CHARACTERISTICS OF PATIENTS

 Total drug-related ED episodes were stable across gender, race/ethnicity, and most

age subgroups, based on comparisons of 1997 and 1998. However, total episodes

increased 9 percent (from 218,630 to 239,172) among patients age 35 and older

(Table 18).

T
12 Year-End 1998 ED DAWN Data

 Total drug-related ED episodes for the 12 to 17 age group were stable between 1997

and 1998 (Table 18). Mentions of cocaine (Table 22), heroin/morphine (Table 24), and

marijuana/hashish (Table 26) were also stable for this age group from 1997 to 1998.

However, this followed significant increases in heroin/morphine (63%) and

marijuana/hashish (32%) from 1996 to 1998.

EPISODE CHARACTERISTICS

 Motives for taking substances

- In drug-related ED episodes during 1998, suicide and dependence were the most

frequently cited motives for taking substances (Table 18).

- Between 1997 and 1998, the number of drug episodes citing these motives was

unchanged (Table 18).

- However, 20 percent of episodes had other or unknown motives reported during

1998 (Table 18).

 Reasons for ED contact

- Overdose was the most frequently cited reason for the drug-related ED contacts

(245,164 episodes) in 1998 (Table 18).

- Between 1997 and 1998, reasons for ED contacts were unchanged, except

episodes citing withdrawal as the reason for the visit increased 18 percent (from

15,176 to 17,979) (Table 18).

- However, 16 percent of ED episodes had other or unknown reasons for the ED

visit (Table 18).
Year-End 1998 ED DAWN Data 13

Figure 1

Number of total drug-related episodes, 

cocaine mentions, and heroin/morphine mentions: 

1990 through 1998

0

100

200

300

400

500

600

1990 1991 1992 1993 1994 1995 1996 1997 1998

NOTE: Reports prior to 1997 included figures presenting trends in drugrelated episodes beginning in 1979 or earlier. Data are presented 

beginning with 1990 due to changes in the sampling and data weighting 

which produce these estimates.

Thousands

Total Episodes Cocaine Heroin/morphine

Figure 2

Number of illicit drug-related episodes by selected drugs: 

1990 through 1998

0

20

40

60

80

100

120

140

160

180

1990 1991 1992 1993 1994 1995 1996 1997 1998

NOTE: Reports prior to 1997 included figures presenting trends in drugrelated episodes beginning in 1979 or earlier. Data are presented 

beginning with 1990 due to changes in the sampling and data weighting 

which produce these estimates.

Thousands

Cocaine Heroin/morphine Marijuana/hashish Methamphetamine/speed
14 Year-End 1998 ED DAWN Data
Year-End 1998 ED DAWN Data 15

ANNUAL TRENDS

IN COCAINE MENTIONS

his section presents annual estimates of the number of cocaine mentions in drug-related

ED episodes. Cocaine is sometimes used in combination with other drugs. Therefore, one

ED episode can include mentions of one or more drugs. Long-term trends in cocaine

mentions for subgroups of patients, based on age and race/ethnicity, are shown in Figures 3

and 4.

 In 1998, cocaine was mentioned in 32 percent of all drug-related ED episodes (Table

2). Cocaine mentions have increased 70 percent from 1991 (101,189 mentions) to

1998 (172,014 mentions) but were unchanged from 1997 to 1998 (Table 22 and Figure

2).

 In 1998, 49 percent of cocaine mentions occurred in ED episodes of patients age 35

and older (Table 22). Cocaine mentions for this age group increased 12 percent

between 1997 and 1998 and 174 percent since 1991 (Table 22 and Figure 3). There

were no statistically significant changes in cocaine mentions among the other age

groups between 1997 and 1998.

 In 1998, 65 percent of cocaine mentions occurred among ED episodes of males.

There were no significant changes in cocaine mentions for either gender between 1997

and 1998 (Table 22).

 In 1998, 49 percent of cocaine mentions occurred in ED episodes of black patients, 31

percent of white patients, and 12 percent of Hispanic patients (Table 22). Between

1997 and 1998, cocaine mentions were stable for all race/ethnicity subgroups (Table

22 and Figure 4).

 Within the 21 metropolitan areas oversampled in DAWN, cocaine mentions increased

18 percent outside the central cities from 1997 to 1998, returning to 1996 levels (Table

22). Cocaine mentions were relatively stable inside those central cities.

 Among cocaine-related episodes, dependence (61% of episodes) was the most

commonly reported motive for drug use in 1998. Recreational use and suicide attempt

accounted for 13 and 9 percent of reported motives, respectively. Sixteen percent of

cocaine mentions had motives reported as unknown or "other" (Table 22).

 In 1998, the most frequently reported reasons for ED episodes in which cocaine was

mentioned were seeking detoxification (29%) and unexpected reaction (20%). Another

19 percent had "other" or unknown reasons reported (Table 22).

T
16 Year-End 1998 ED DAWN Data

Figure 3

Number of cocaine mentions by age: 

1990 through 1998

0

10

20

30

40

50

60

70

80

90

1990 1991 1992 1993 1994 1995 1996 1997 1998

Thousands

12-17 18-25 26-34 35+

Figure 4

Number of cocaine mentions by race/ethnicity:

1990 through 1998

0

10

20

30

40

50

60

70

80

90

1990 1991 1992 1993 1994 1995 1996 1997 1998

Thousands

White Black Hispanic
Year-End 1998 ED DAWN Data 17

ANNUAL TRENDS

IN HEROIN/MORPHINE MENTIONS

his section presents annual estimates of the number of heroin/morphine mentions in drugrelated ED episodes. Heroin/morphine is sometimes used in combination with other drugs.

Therefore, one ED episode can include mentions of one or more drugs. Figures 5 and 6

illustrate long-term trends in heroin/morphine mentions among subgroups of patients, based on

their age and race/ethnicity.

 In 1998, 14 percent (77,645) of all drug-related episodes had mentions of

heroin/morphine (Table 2). From 1991 to 1996, the number of heroin/morphine

mentions more than doubled (from 35,898 to 73,846), but heroin/morphine mentions

remained relatively stable from 1996 through 1998.

 Heroin/morphine mentions among those age 12 to 17 were stable from 1997 to 1998

(Table 24). Patients age 12 to 17 accounted for only 1 percent of heroin/morphine

mentions in 1998, but heroin/morphine mentions for this age group increased 399

percent from 1991 and 1998 and 63 percent from 1996 to 1998. (Table 24).

 Patients age 35 and older accounted for the majority (56% in 1998) of heroin/morphine

mentions, which have risen 153 percent from 1991 to 1998 (Table 24 and Figure 5).

Mentions among this age group increased 10 percent from 1997 to 1998, returning to

1996 levels.

 In 1998, 68 percent of heroin/morphine mentions occurred among males (Table 24).

Since 1991, heroin/morphine mentions in drug-related ED episodes have increased

122 percent for males and 106 percent for females. However, heroin/morphine

mentions were stable from 1997 to 1998 for both genders.

 In 1998, white and black patients constituted 38 and 36 percent of heroin/morphine

mentions, respectively (Table 24). Hispanic patients were represented in 15 percent of

heroin/morphine mentions. Between 1997 and 1998, heroin/morphine mentions were

relatively stable for all race/ethnicity subgroups. However, these findings for

race/ethnicity subgroups need to be interpreted cautiously, since race/ethnicity was

reported as "other" or unknown in 11 percent of mentions.

 Within the 21 metropolitan areas oversampled in DAWN, the majority (57%) of

heroin/morphine mentions in 1998 occurred inside the central cities (Table 24).

Mentions of heroin/morphine outside these central cities increased 11 percent between

1997 and 1998, returning to 1996 levels.

 Among ED episodes involving heroin/morphine in 1998, dependence accounted for 80

percent of the reported motives (Table 24). Another 10 percent of patients had motive

reported as unknown or "other." No statistically significant change occurred between

1997 and 1998 for drug use motive.

 In 1998, the most frequently reported reasons for ED visits with heroin/morphine

mentions were seeking detoxification (28%), chronic effects (20%), and overdose

(20%) (Table 24). Withdrawal increased 23 percent between 1997 and 1998, and

unexpected reaction increased 19 percent from 1997 to 1998. Nine percent of

heroin/morphine-related ED visits had "other" or unknown reasons reported.

T
18 Year-End 1998 ED DAWN Data

Figure 5

Number of heroin/morphine mentions by age: 

1990 through 1998

0

5

10

15

20

25

30

35

40

45

1990 1991 1992 1993 1994 1995 1996 1997 1998

12-17 18-25 26-34 35+

Thousands

Figure 6

Number of heroin/morphine mentions by race/ethnicity:

1990 through 1998

0

5

10

15

20

25

30

35

40

45

1990 1991 1992 1993 1994 1995 1996 1997 1998

Thousands

White Black Hispanic
Year-End 1998 ED DAWN Data 19

ANNUAL TRENDS IN MARIJUANA/HASHISH

MENTIONS

hen reported as DAWN ED mentions, marijuana/hashish is likely to be mentioned in

combination with other substances, particularly alcohol and cocaine. The following

reports the number of marijuana/hashish mentions based on annual data from the

DAWN survey. Figures 7 and 8 show the long-term trends in marijuana/hashish mentions by

patient subgroups, based on age and race/ethnicity.

 Total marijuana/hashish mentions increased 19 percent (from 64,744 to 76,870) from

1997 to 1998, and 373 percent from 1991 (16,251 mentions) to 1998 (Table 26 and

Figure 2).

 Marijuana/hashish mentions have increased steadily since 1991 for all age groups

(Table 26 and Figure 7). Between 1997 and 1998, the number of marijuana/hashish

mentions increased for all age groups except for those age 12 to 17. Statistically

significant increases were found among patients age 18 to 25 (30%), 35 and older

(22%), and 26 to 34 (26%).

 Marijuana/hashish mentions among ED patients age 12 to 17 were relatively stable

from 1997 (11,056 mentions) to 1998 (13,135), following a 31 percent increase from

1996 (9,982) to 1998 (Table 26). Marijuana/ hashish mentions for patients age 12 to

17 have increased dramatically (517%) from 1991 (2,130) to 1998 (Table 26 and

Figure 2).

 In 1998, 50 percent of ED marijuana/hashish mentions occurred among white ED

patients, 32 percent among black ED patients, and 10 percent among Hispanic ED

patients (Table 26). Between 1991 and 1998, the number of marijuana/hashish

mentions increased 4-fold or more for all 3 of these race/ethnicity subgroups. From

1997 to 1998, marijuana/hashish mentions increased (16%) only for black patients.

Race/ethnicity was reported as "other" or was unknown in 8 percent of mentions (Table

26).

 Statistically significant increases in marijuana/hashish-related episodes between 1997

and 1998 occurred for females (20%) and males (18%) (Table 26).

 From 1997 to 1998, within the 21 metropolitan areas oversampled in DAWN,

marijuana/hashish mentions increased outside the central cities (25%) and inside those

central cities (10%) (Table 26).

 Marijuana/hashish mentions related to all motives and most reasons were stable from

1997 to 1998 (Table 26). Although episodes due to overdose increased 30 percent

from 1997 to 1998, two important caveats must be kept in mind: first, the reason for

ED contact and the drug use motive were frequently unknown or reported as "other"

(32% and 28% of mentions, respectively). Second, drug use motive and reason for ED

contact were coded for the episode, not a particular drug. Since marijuana/hashish is

frequently present in combination with other drugs, the reason for the ED contact may

be more relevant to the other drug(s) involved in the episode.

W
20 Year-End 1998 ED DAWN Data

Figure 7

Number of marijuana/hashish mentions by age: 

1990 through 1998

0

2

4

6

8

10

12

14

16

18

20

22

24

1990 1991 1992 1993 1994 1995 1996 1997 1998

Thousands

12-17 18-25 26-34 35+

Figure 8

Number of marijuana/hashish mentions by 

race/ethnicity: 1990 through 1998

0

5

10

15

20

25

30

35

40

45

1990 1991 1992 1993 1994 1995 1996 1997 1998

Thousands

White Black Hispanic
Year-End 1998 ED DAWN Data 21

ANNUAL TRENDS IN OTHER ILLICIT DRUG

MENTIONS

his section presents estimates for selected other illicit drugs not previously addressed.

These drugs are sometimes used in combination with other drugs. Therefore, one ED

episode can include mentions of one or more drugs.

METHAMPHETAMINE/SPEED

 Mentions of methamphetamine/speed decreased 33 percent (from 17,154 to 11,491)

between 1997 and 1998 (Tables 14 and 28), returning to 1996 levels (11,002).

 More than two-thirds (68%) of methamphetamine/speed mentions in 1998 were

attributed to the National Panel, which represents hospitals outside the 21 DAWN

metropolitan areas (Table 14). Figure 9 shows that fluctuations in the trend observed

since 1993 are due in large part to fluctuations in the methamphetamine/speed

mentions estimated for the National Panel. It is important to note that the apparent

changes in methamphetamine/ speed mentions for the National Panel from 1997 to

1998 were not statistically significant. Similarly, apparent changes from 1996 to 1997,

from 1995 to 1996, and from 1994 to 1995 were not statistically significant.

 Figure 10 compares methamphetamine/speed and amphetamine mentions. This figure

highlights the spikes in the methamphetamine/speed mentions. Otherwise, the two

drugs exhibit parallel trends.

 Methamphetamine/speed mentions continue to be concentrated in relatively few of the

21 metropolitan areas covered by DAWN (Table 14). From 1997 to 1998, significant

decreases in methamphetamine/speed mentions were evident for Denver (59%),

Phoenix (44%), Seattle (44%), San Francisco (39%), Los Angeles (36%), and San

Diego (26%). Mentions of methamphetamine/speed increased during this time period

in Dallas (17%). Methamphetamine/speed mentions in Miami also increased, but the

absolute numbers are quite small (only 16 mentions in 1998). Mentions were stable

from 1997 to 1998 for Atlanta (162 mentions) and Minneapolis (112 mentions).

 Within the 21 metropolitan areas, statistically significant decreases in

methamphetamine/speed mentions between 1997 to 1998 occurred outside central

cities (43%) and inside the central cities represented in DAWN (28%), leaving 1998

levels lower than those of 1996 (Table 28).

PCP

 ED mentions for PCP/PCP combinations remained relatively stable between 1997 and

1998 (Table 2), and the 1998 estimate (4,033) is only 16 percent above the estimate

for 1991 (3,470).

LSD

 There were no statistically significant changes in LSD mentions from 1997 to 1998.

LSD mentions have increased 30 percent from 3,846 in 1991 to 4,982 in 1998 (Table

2).

T
22 Year-End 1998 ED DAWN Data

Figure 9

Number of methamphetamine/speed and amphetamine 

mentions by location

0

2

4

6

8

10

12

14

1990 1991 1992 1993 1994 1995 1996 1997 1998

Thousands

Central City Outside Central City National Panel

Figure 10

Number of methamphetamine/speed and amphetamine 

mentions: 1990 through 1998

0

2

4

6

8

10

12

14

16

18

20

1990 1991 1992 1993 1994 1995 1996 1997 1998

Methamphetamine/speed Amphetamine

Thousands
Year-End 1998 ED DAWN Data 23

Generic name Brand name

acetaminophen Tylenol

alprazolam Xanax

amitriptyline Elavil

carbamazepine Tegretol

carisoprodol Soma

clonazepam Klonopin

cyclobenzaprine Flexeril

diazepam Valium

diphenhydramine Benadryl

doxepin Sinequan

d-propoxyphene Darvocet N, Darvon

fluoxetine Prozac

haloperidol Haldol

imipramine Tofranil

lithium carbonate Eskalith

lorazepam Ativan

naproxen Naprosyn

oxycodone Percocet 5,

Percodan, Tylox

thioridazine Mellaril

trazodone Desyrel

triazolam Halcion

ANNUAL TRENDS IN

PRESCRIPTION AND

OVER-THE-COUNTER

DRUG-RELATED EPISODES

AWN also receives reports of ED episodes involving

the nonmedical use of legal drugs. Accidental

overdoses of over-the-counter (OTC) or prescription

drugs taken as directed are not reportable unless

they were used in combination with an illicit drug.

Generally, most drug-related episodes involving OTC

drugs report suicide attempt or gesture as the motive for

use. In addition, alcohol is reportable only when used in

combination with another drug.

 Mentions of alcohol-in-combination occurred in

34 percent (185,002) of ED drug episodes in

1998. Mentions of alcohol-in-combination were

stable from 1997 to 1998 (Table 2).

 In 1998, the following non-narcotic analgesics were mentioned: acetaminophen (6% of

episodes, 32,257), ibuprofen (3%, 17,146), aspirin (3%, 15,457), and naproxen (1%,

5,549) (Table 2). Mentions of these non-narcotic analgesics were stable between 1997

and 1998, although mentions of acetaminophen decreased from 1996 to 1998.

 Among the narcotic analgesics, hydrocodone was mentioned in 2 percent (12,568) of

ED episodes, and oxycodone, d-propoxyphene, and acetaminophen with codeine were

each mentioned in 1 percent of episodes in 1998 (Table 2). Mentions of

acetaminophen with codeine decreased 23 percent from 1997 to 1998. Mentions of

oxycodone were unchanged from 1997 to 1998, following an increase of 63 percent

from 1996 to 1998. The other narcotic analgesics were unchanged.

 Among the antidepressants, fluoxetine and trazodone were each mentioned in 2

percent of ED episodes and showed no changes between 1997 and 1998 (Table 2).

Mentions of imipramine (0.1% of episodes) and amitriptyline (1% of episodes)

decreased 48 and 21 percent, respectively, from 1997 to 1998.

 Mentions of the benzodiazepines, alprazolam (3% of episodes), diazepam (2%), and

lorazepam (2%), remained stable from 1997 to 1998 (Table 2). Mentions of

clonazepam (3% of episodes) were stable from 1997 to 1998, but increased 30 percent

from 1996 to 1998. Triazolam was mentioned in 0.1 percent of ED episodes in 1998

and was unchanged from 1997 to 1998. Mentions of triazolam have decreased 84

percent since 1991.

 Between 1997 and 1998, a 31 percent decrease was noted for diphenhydramine

mentions, and a 38 percent increase was noted for carisoprodol mentions, which

returned to 1996 levels. (Table 2).

D
24 Year-End 1998 ED DAWN Data
Year-End 1998 ED DAWN Data 25

ANNUAL TRENDS IN SELECTED

METROPOLITAN AREAS

his section presents findings for the 21 selected metropolitan areas oversampled in DAWN.

Readers should note that small changes in the estimates for Baltimore, Buffalo, Denver,

San Diego, and San Francisco may produce statistically significant differences because all

eligible hospitals are included in the sample for those cities. Tables 3 through 16 contain the

metropolitan area estimates and estimates for the National Panel, which represents hospitals

outside those areas.

 Among the 21 metropolitan areas oversampled in DAWN, only Dallas had a significant

increase (16%) in drug-related ED episodes from 1997 to 1998 (Table 4). Episodes in

the other 20 metropolitan areas were unchanged.

COCAINE

 From 1997 to 1998, cocaine mentions increased in 5 of the 21 metropolitan areas in

DAWN: Dallas (45% from 1,778 to 2,586), Los Angeles (23%, from 4,707 to 5,783),

Philadelphia (16%, from 11,202 to 13,049), Washington, DC (15%, from 3,223 to

3,718), and Phoenix (11%, from 1,334 to 1,486) (Table 8). Of these, the increases in

Los Angeles and Washington, DC represented returns to 1996 levels.

 From 1997 to 1998, no decreases in cocaine mentions were observed in any of the 21

metropolitan areas covered in DAWN (Table 8). However, decreases between 1996

and 1998 were noted for Buffalo (44%), San Francisco (20%), Baltimore (19%), and

New York (9%).

HEROIN/MORPHINE

 Five of the 21 metropolitan areas had increases in heroin/morphine mentions between

1997 and 1998. They were: Miami (29%), Washington, DC (25%), New Orleans

(24%), Newark, (16%), and Buffalo (16%) (Table 10).

 Between 1997 and 1998, heroin/morphine mentions decreased only in San Francisco

(13%) (Table 10). Decreases from 1996 to 1998 occurred in San Francisco (24%), Los

Angeles (20%), and New York (17%).

OTHER ILLICIT DRUGS

 Marijuana/hashish mentions, which increased 19 percent nationally, also increased in

Dallas (65%), Philadelphia (17%), and San Diego (16%) (Table 12). Among the 21

metropolitan areas in DAWN, only New Orleans showed a decrease (11%) in

marijuana/hashish mentions from 1997 to 1998.

 From 1997 to 1998, mentions of methamphetamine/speed increased 17 percent only in

Dallas (Table 13). Miami also had a significant increase, but the numbers of mentions

were quite low (from 10 in 1997 to 16 in 1998). Six of the metropolitan areas

oversampled in DAWN had significant decreases in methamphetamine/speed

mentions. They were: Denver (59%), Phoenix and Seattle (44%), San Francisco

(39%), Los Angeles (36%), and San Diego (26%).

T
26 Year-End 1998 ED DAWN Data
Year-End 1998 ED DAWN Data 27

ESTIMATED RATES OF EMERGENCY

DEPARTMENT EPISODES AND MENTIONS

his chapter presents population-based rates for total drug-related ED episodes and

mentions for selected drugs based on data presented in Tables 29 through 56. Data on

drug mention rates supplement data on total numbers of drug episodes. By considering

the number of drug mentions and episodes relative to the size of the general population, the

rate data standardizes the drug mention and episode data and allows drug mention frequencies

to be compared among selected drugs, metropolitan areas, gender and age groups.

As with all DAWN estimates, readers should remember that the same patient may be

involved in multiple drug-related episodes within a given time period. Therefore, the estimates

presented in this report pertain to total ED episodes, not to the number of different patients

involved in these episodes. In this context, rates should be regarded not as prevalence rates

but as indicators of the number of ED drug abuse episodes or mentions per 100,000 population.

Population information is taken from the Census (see Appendix C).

In 1998, ED visits involving drug mentions occurred at the rate of 225 ED episodes per

100,000 total population in the coterminous U.S. (Table 30). Figures 12 through 14 show the

trends from 1994 to 1998 for the DAWN metropolitan areas with the highest 1998 rates of total

ED drug episodes, cocaine, and heroin/morphine, respectively.

In 1998, the 5 cities included in DAWN with the lowest rates of ED episodes per 100,000

population were Minneapolis (184), Los Angeles (202), St. Louis (240), Denver (259), and

Buffalo (283). The 1998 rate for the National Panel was 170 per 100,000 population (Table 32).

During 1998, the highest rates of ED drug episodes and mentions per 100,000 population

occurred for:

 Alcohol-in-combination (77), cocaine (72), heroin/morphine (32), and marijuana/

hashish (32) (Table 30).

 All drug episodes in Baltimore (592), San Francisco (569), Philadelphia (526), Newark

(497), and Chicago (445) (Table 32 and Figure 12).

 Cocaine in Baltimore (296), Philadelphia (275), New York (233), Chicago (232), and

Atlanta (218) (Table 36).

 Heroin/morphine in Baltimore (290), Newark (282), Chicago (159), San Francisco

(150), and Seattle (127) (Table 38).

 Marijuana/hashish in Philadelphia (112), Detroit (102), New Orleans (100), Atlanta (96),

and Chicago (85) (Table 40).

 Methamphetamine/speed in the western U.S.: San Francisco (39), San Diego (30),

Phoenix (22), and Seattle (14), followed by Los Angeles (9), Dallas (8), and Denver (8)

(Table 42).

T
28 Year-End 1998 ED DAWN Data

 Males for total drug abuse episodes (242, Table 46) and mentions of cocaine (97,

Table 50), heroin/morphine (45, Table 52), marijuana/hashish (44, Table 54), and

methamphetamine/speed (6, Table 56).

 Adults age 26 to 34 for total ED episodes (406, Table 46) and mentions of cocaine

(173, Table 50) and heroin/morphine (63, Table 52).

 Young adults age 18 to 25 for marijuana/hashish (83, Table 54) and

methamphetamine/speed (13, Table 56).
Year-End 1998 ED DAWN Data 29

DISCUSSION OF RESULTS

his report presents final estimates from the DAWN ED component for 1998. The previous

sections of this report discuss trends for particular drugs, metropolitan areas, and

population-based rates of drug-related ED visits. The purpose of this section is to highlight

issues that cut across the topics discussed previously and to discuss the possible implications

of those findings.

OVERVIEW

DAWN estimates presented for the first time in this report suggest that total drug-related ED

episodes were relatively stable from 1997 through 1998, continuing a pattern of stability that

began in 1994 (Figure 1). ED mentions of cocaine and heroin/morphine were unchanged from

1997 to 1998 as well. The same period saw a 19 percent increase in ED mentions of

marijuana/hashish.

These findings differ somewhat from those reported in preliminary estimates for the first half

of 1998 (OAS, 1999b). In particular, mid-year comparisons of the first half of 1997 and the first

half of 1998 showed a significant increase in cocaine mentions, a change that disappeared in

the final full-year comparisons. As noted in the 1998 mid-year DAWN report, seasonal

distortions and incomplete reporting can result in preliminary estimates that are not sustained

when the completed year’s data are available.

VARIATIONS IN METHAMPHETAMINE/SPEED MENTIONS

Even based on complete data for the full year, ED mentions of methamphetamine/speed

have varied dramatically since 1993, with steep elevations in mentions in 1994, 1995, and 1997

and equally dramatic plunges in 1996 and 1998 (Figure 10). Between 1997 and 1998,

methamphetamine/speed mentions dropped 33 percent, returning to 1996 levels. This followed

a 56 percent increase from 1996 to 1997, to return to 1995 levels. Prior attempts to explain

these variations in DAWN methamphetamine/speed trends have concentrated on the powerful

economic forces of supply and demand, as well as changes in the purity of the drugs available.

Geography also plays a major part in the methamphetamine/speed story from DAWN.

Methamphetamine/speed use is distributed unevenly across the Nation, according to data from

the Treatment Episode Data Set (TEDS) (OAS, 1999d). TEDS is an unusually large and

powerful data set that tallies admissions to publicly funded substance abuse treatment

programs in all but a few of the 50 states. Because of its extensive geographic scope, TEDS

has been documenting the uneven distribution of methamphetamine/speed across the Nation,

the higher concentration in the west, and its spread eastward. Given this, it is informative to

explore the variability in ED visits involving methamphetamine/speed across the more limited

DAWN geographic base. Analysis of 1998 DAWN data revealed some interesting patterns.

 To a large extent, the fluctuating pattern of methamphetamine/speed mentions is

driven by the estimates for the National Panel – that is, hospitals located outside the 21

metropolitan areas oversampled in DAWN. This is illustrated in Figure 9. Although

more than two-thirds (68%) of the estimated ED mentions of methamphetamine/speed

in 1998 were attributed to the National Panel, these estimates are volatile and relatively

imprecise. Statistical tests that compare methamphetamine/speed mentions for the

T
30 Year-End 1998 ED DAWN Data

National Panel alone for the four most recent 2-year periods – 1997 to 1998, 1996 to

1997, 1996 to 1995, and 1994 to 1995 – revealed no statistically significantly

differences, despite observed changes ranging from 11 to 76 percent. Three factors

contribute to the volatility and lack of precision of these estimates. First, the National

Panel consists of fewer than 100 hospitals whose job is to represent nearly 4,000

hospitals in DAWN estimates for the United States (OAS, 1999a). Such sparse

representation in the sample means that many National Panel hospitals have large

weights. Second, National Panel hospitals contribute relatively little actual (raw) data

to these DAWN estimates. Among the National Panel hospitals, only 35 reported any

methamphetamine/speed mentions in 1998, and of these, only 15 reported more than

2 mentions. Therefore, changes in only a few heavily weighted hospitals led to the

large National Panel spikes observed in 1994, 1995, and 1997. Third, the design of

the National Panel sample does not provide the geographic coverage necessary for

more precise measurement of methamphetamine/speed-related ED visits.

 Within the 21 metropolitan areas oversampled in DAWN, hospitals outside the central

cities contributed to the fluctuating trend in methamphetamine/speed-related ED visits.

Approximately 14 percent of methamphetamine/speed ED mentions were attributed to

facilities outside the central cities. Statistical tests comparing the four 2-year periods

revealed no statistically significant differences from 1994 to 1995 or 1995 to 1996, with

significant differences in excess of 40 percent from 1996 to 1997 and 1997 to 1998.

 Only the central city portions of the DAWN metropolitan areas posted significant

changes in each of the four 2-year periods. Furthermore, in each of these periods, the

magnitude of the change was relatively modest: a 5 percent decrease from 1994 to

1995, an 11 percent decrease from 1995 to 1996 (compared with 31% overall), an 11

percent increase from 1996 to 1997 (compared with 56% overall), and a 28 percent

decrease from 1997 to 1998 (compared with 33% overall).

 Looking across the 21 DAWN metropolitan areas, the vast majority (over 80%) of

estimated ED mentions of methamphetamine/speed come from only 6 of those areas,

all in the western United States: Los Angeles (786 mentions), San Diego (721), San

Francisco (616), Phoenix (446), Seattle (266), and Dallas (186). And when we focus

our attention on the trends for this subset of DAWN (Figure 11), in some cases we

observe trend lines that are shaped quite differently than those discussed earlier and

displayed in Figure 10. From 1997 to 1998, mentions of methamphetamine/speed

declined significantly in Denver (59%), Phoenix (44%), Seattle (44%), San Francisco

(39%), Los Angeles (36%), and San Diego (26%). Methamphetamine/speed mentions

increased only in Dallas (17%).

Generally speaking, methamphetamine/speed-related ED visits are relatively infrequent but

have a systematic geographic profile. Therefore, looking within the individual DAWN area

estimates for methamphetamine/speed reveals a very different picture than is visible at the

aggregate level.

METROPOLITAN AREAS IN DAWN

Findings from DAWN show that the variation in total drug-related ED episodes was

relatively minimal between 1997 and 1998 across the 21 metropolitan areas. Total episodes for

the Nation were stable, and the only change in metropolitan areas participating in DAWN was a
Year-End 1998 ED DAWN Data 31

16 percent increase in Dallas. However, large increases in mentions of particular drugs underlie

this stability. Again, some of these findings differ from those reported as preliminary findings in

the mid-year 1998 DAWN ED report.

With the exception of alcohol, cocaine remains the single drug with the most ED mentions.

While cocaine mentions for the Nation remained stable from 1997 to 1998, cocaine mentions

increased in Dallas (45%), Los Angeles (23%), Philadelphia (16%), Washington, DC (15%), and

Phoenix (11%). Cocaine mentions did not decrease in any of the 21 metropolitan areas

represented in DAWN. Heroin/morphine mentions, which were also stable for the Nation,

increased in Miami (29%), Washington, DC (25%), New Orleans (24%), Buffalo (16%), and

Newark (16%) and decreased only in San Francisco (13%).

In addition, we can survey findings for individual metropolitan areas across multiple drugs

for the period covered by this report. Considering the 4 major illicit drugs of abuse – cocaine,

heroin/morphine, marijuana/hashish, and methamphetamine/speed – no metropolitan area had

significant increases involving all 4 drugs, but Dallas had large increases in 3: marijuana/

hashish (65%), cocaine (45%), and methamphetamine/speed (17%). Three of the 21

metropolitan areas had increases in 2 of the major illicit drugs: cocaine and heroin/morphine

mentions increased in Washington, DC; cocaine and marijuana/hashish mentions increased in

Philadelphia; and heroin/morphine and methamphetamine/speed mentions increased in Miami.

Several metropolitan areas had increases in one of the major illicit drugs: cocaine in Los

Angeles and Phoenix, heroin/morphine in Buffalo, New Orleans, and Newark, and marijuana/

hashish in San Diego.

Metropolitan areas represented in DAWN posted few decreases in specific drugs from 1997

to 1998, except for those involving methamphetamine/speed as discussed above. DAWN

estimates for San Francisco showed significant declines in heroin/morphine and

methamphetamine/speed mentions, and marijuana/hashish mentions decreased significantly in

New Orleans.

With the 21 metropolitan areas in DAWN ranging in population from 1 to 8 million, another

picture can emerge when the rates of drug-related ED visits relative to the size of the population

are considered. A few examples follow. Baltimore, San Francisco, and Philadelphia had the

highest rates of total drug-related ED visits (each in excess of 500 episodes per 100,000

population). Baltimore, which exhibited no significant changes in overall drug mentions from

1997 to 1998, had the highest rates of ED episodes involving cocaine and heroin/morphine in

1998. Philadelphia ranked second in the rate of cocaine episodes, and Newark had the second

highest rate of ED episodes involving heroin/morphine. San Francisco, with declining

methamphetamine/speed and heroin/morphine mentions, had the highest rate of ED visits

involving methamphetamine/speed and ranked fourth in heroin/morphine. San Diego and

Phoenix followed San Francisco in the rate of methamphetamine/speed episodes. Rates of ED

episodes involving marijuana/hashish in 1998 were highest in Philadelphia, Detroit, and New

Orleans.

TRENDS AMONG TEENAGE AND OLDER PATIENTS

Prevention of drug abuse among youth is one of the strategic goals of The National Drug

Control Strategy (ONDCP, 1998). While DAWN cannot directly measure the prevalence of drug

abuse or the effectiveness of prevention programs, ED data from DAWN do provide a snapshot
32 Year-End 1998 ED DAWN Data

of some particular consequences – drug-related ED visits – associated with drug abuse by this

age group.

ED patients age 12 to 17, who accounted for 11 percent of total drug-related ED episodes

in 1998, were involved in 17 percent of marijuana/hashish ED mentions estimated from DAWN.

In the preliminary DAWN mid-year estimates, we reported an increase in marijuana/hashish

mentions for patients in this age group, based on a comparison of the first half of 1998 with the

first half of 1997. Now, comparing complete data for 1998 with 1997, we find no significant

change in mentions of marijuana/hashish or in mentions of cocaine, heroin/morphine, or

methamphetamine/speed for this age group. However, this leveling off follows a 32 percent

increase in marijuana/hashish mentions and a 63 percent increase in heroin/morphine mentions

from 1996 to 1998.

Figure 12 illustrates the sizable increases in ED mentions of illicit drugs between 1991 and

1998 for patients age 12 to 17. Although youth age 12 to 17 are found in lower than average

numbers for methamphetamine/speed (9% of mentions), cocaine (3%), and heroin/morphine

(1%), the long-term trends for these drugs have been upward. Between 1991 and 1998,

mentions of marijuana/hashish rose 517 percent, heroin/morphine rose 399 percent,

methamphetamine/speed rose 145 percent, and cocaine rose 102 percent. We will continue to

monitor trends for this age group in subsequent DAWN reports.

The largest age group tracked by DAWN is adults age 35 and over, who constituted 44

percent of drug-related ED episodes in 1998. From 1997 to 1998, DAWN estimates show

substantial increases for this age group in the total number of drug-related ED episodes (9%) as

well as in ED mentions of marijuana/hashish (22%), cocaine (12%), and heroin/morphine (10%).

In 1995, the 35 and over age group surpassed the 26 to 34 age group in ED mentions of

cocaine for the first time, and the difference in cocaine mentions between the 2 age groups has

widened in subsequent years (Figure 3). Similarly, in 1997, marijuana/hashish ED mentions

among individuals age 35 and over exceeded that of patients age 26 to 34 for the first time

(Figure 7). Figure 13 illustrates the long-term trends for these major drugs of abuse for adults

age 35 and older.

CONCLUSION

It is important to remember that DAWN data show only one dimension of the total

consequences of drug use. DAWN measures the impact of drug use that manifests in visits to

hospital EDs. It does not measure the prevalence of drug use in the population, the untreated

health consequences of drug use, or the impact of drug use on health care settings other than

hospital EDs. For example, the National Household Survey on Drug Abuse (NHSDA) (OAS,

1999c) found that marijuana/hashish use among youth age 12 to 17 was unchanged from 1997

to 1998. Similarly, DAWN estimates for patients age 12 to 17 revealed that drug-related ED

visits involving marijuana/hashish were stable from 1997 to 1998. However, these surveys

measure 2 different aspects of the drug problem in the United States. The NHSDA measures

prevalence of drug use based on a national survey of households; DAWN does not.

Many factors can influence the estimates of ED visits, including trends in ED usage in

general. Comparing 1997 and 1998, the period covered by this report, total ED visits were

relatively stable. Drug users may have visited EDs for a variety of reasons, some of which may

have been life threatening. Others may have sought care at the ED for detoxification, because

they needed medical certification before entering treatment. Some drug-related episodes may
Year-End 1998 ED DAWN Data 33

reflect the same patients making repeated ED visits. The DAWN data may also reflect changes

in hospital services or operations. For example, a hospital that opens a new detoxification unit

may experience an increase in drug-related ED visits; a change in computer systems may result

in systematic changes in drug-episode identification.

Changes in the number of drug-related emergencies may also be due to changes in the use

of drug combinations; patterns of drug use, such as route of administration; amount of drug

used per administration; drug purity; or drug price. For example, a decrease in the purity of

cocaine or heroin/morphine could result in fewer users experiencing unexpected reactions and

overdoses.

Estimates of drug-related ED episodes could increase or decrease over time for reasons

unrelated to the size of the drug using population, such as factors that affect reporting patterns.

For example, some possible factors are:

 Greater awareness of these problems by hospital staff who therefore report drug use

more carefully on medical charts,

 Changing patterns of use of EDs by drug users,

 Different ED usage patterns by population subgroups, and

 Other data collection or sample composition changes (see Appendix B).

Appendix B includes a detailed account of known procedural anomalies. Analysis of

procedural factors that might contribute to spurious results suggests that procedural factors are

unlikely to account for the differences reported here.

REFERENCES

Office of National Drug Control Policy. (1998). The National Drug Control Strategy, 1998: A

Ten Year Plan. Washington, DC: U.S. Government Printing Office.

Substance Abuse and Mental Health Services Administration, Office of Applied Studies.

(1999a). Drug Abuse Warning Network Annual Emergency Department Data 1997. Series

D-9. (DHHS Publication No. [SMA] 99-3331). (BKD-318). Rockville, MD.

Substance Abuse and Mental Health Services Administration, Office of Applied Studies.

(1999b). Mid-Year 1998 Preliminary Emergency Department Data from the Drug Abuse

Warning Network. Series D-10. (DHHS Publication No. [SMA] 99-3316). (BKD-326).

Rockville, MD.

Substance Abuse and Mental Health Services Administration, Office of Applied Studies.

(1999c). National Household Survey on Drug Abuse Population Estimates 1998. Series

H-9. (DHHS Publication No. [SMA] 99-3327). (BKD-331). Rockville, MD.

Substance Abuse and Mental Health Services Administration, Office of Applied Studies.

(1999d). Treatment Episode Data Set (TEDS), 1992-1997: National Admissions to

Substance Abuse Treatment Services. Series S-7. (DHHS Publication No. [SMA]

99-3324). (BKD-317). Rockville, MD.
34 Year-End 1998 ED DAWN Data

Figure 11

Number of methamphetamine/speed mentions by

selected metropolitan area: 1990 through 1998

0

100

200

300

400

500

600

700

800

900

1000

1100

1200

1300

1400

1500

1990 1991 1992 1993 1994 1995 1996 1997 1998

Dallas Denver Los Angeles Phoenix

San Diego San Francisco Seattle

Figure 12

Number of illicit drug-related episodes age 12 to 17:

 1990 through 1998

0

2

4

6

8

10

12

14

16

18

20

1990 1991 1992 1993 1994 1995 1996 1997 1998

Cocaine Heroin/morphine Marijuana/hashish Methamphetamine/speed

Thousan

d

s
Year-End 1998 ED DAWN Data 35

Figure 13

Number of illicit drug-related episodes age 35 and older:

 1990 through 1998

0

10

20

30

40

50

60

70

80

90

1990 1991 1992 1993 1994 1995 1996 1997 1998

Cocaine Heroin/morphine Marijuana/hashish Methamphetamine/speed

Thousan

d

s
36 Year-End 1998 ED DAWN Data
Year-End 1998 ED DAWN Data 37

APPENDIX A:

DETAILED DESCRIPTION

OF DAWN

I. SAMPLE DESIGN

he Drug Abuse Warning Network (DAWN) is a voluntary, national data collection system

that gathers information on substance abuse that manifests in visits to hospital emergency

departments (EDs) in the coterminous United States. Currently, DAWN provides

semiannual and annual estimates of the number of drug-related visits to hospital EDs from

a nationally representative sample of hospitals located throughout the coterminous United

States. The DAWN system is managed by the Office of Applied Studies (OAS), a component of

the Substance Abuse and Mental Health Services Administration (SAMHSA) of the U.S.

Department of Health and Human Services.

Several changes have been made to the sample design since DAWN began in 1972 under

the Drug Enforcement Administration (DEA). In the early 1970s, the DAWN sample consisted

of a random sample of hospital EDs. Over time, however, a number of facilities were lost from

the original sample because of closures, mergers, attrition, or voluntary termination. New

hospitals were recruited to participate, but no sample maintenance plan was devised for

selecting new hospitals to sustain the randomness of the sample. As a result, attrition and

nonrandom replacement led to a sample that was no longer representative of all hospital EDs in

the coterminous United States.

When the National Institute on Drug Abuse (NIDA) assumed responsibility for DAWN in

1980, one of the agency's goals was to implement a new sample that could be used to produce

estimates for the Nation as a whole and for the separate DAWN metropolitan areas. Once a

design was determined and the units were selected, the sample required the recruitment of 300

new hospitals. The cost of the project delayed its initiation until early 1986.

Hospitals eligible for DAWN are non-Federal, short-stay general surgical and medical

hospitals in the coterminous U.S. that have a 24-hour ED. The American Hospital Association's

(AHA) 1984 and 1985 Annual Surveys of Hospitals were used to obtain a sampling frame. (For

a definition of sampling frame and other technical terms used in this report, see the Glossary of

Terms in Appendix D.)

Hospitals in the sampling frame were stratified according to several characteristics. First,

the sampling frame was divided into the 21 DAWN metropolitan areas and the remainder of the

country (called the National Panel). Hospitals having 80,000 or more annual ED visits were

assigned to a single stratum for selection with certainty. Then, the remaining hospitals in the 21

metropolitan areas were classified by location – inside or outside the central city – and by

whether the hospital had an organized outpatient department and/or a chemical/alcohol

inpatient unit – whether they had zero, one, or both types of units. Similarly, hospitals in the

National Panel were classified by the presence/absence of such units.

The 21 metropolitan area boundaries correspond to the Office of Management and Budget

(OMB) 1983 definitions of Metropolitan Statistical Areas (MSAs) and Primary Metropolitan

Statistical Areas (PMSAs) with a few exceptions. In the case of the Boston metropolitan area,

T
38 Year-End 1998 ED DAWN Data

the OMB definition was replaced by the definition for the New England County Metropolitan

Area (NECMA). In several metropolitan areas, use of the PMSAs excluded some counties

covered by DAWN prior to 1988, such as Nassau and Suffolk Counties in New York, certain

counties in the Chicago area, and Niagara County in the Buffalo area. In other areas, such as

Atlanta, counties not previously covered in DAWN were included. In addition to geographic

coverage, the central cities in the new statistical areas differ from those in the old SMAs used

previously in DAWN. For example, Hialeah joined Miami as a central city in the new

Miami-Hialeah area, and Long Beach joined the Los Angeles-Long Beach area. In some

instances in this report, only the first city name is cited, but it always refers to the complete

metropolitan area.

Sample sizes for the metropolitan areas and the National Panel were determined for each

stratum so as to achieve specified levels of precision in the estimates. In this context, precision

refers to the amount of sampling fluctuation inherent in the estimate; the less the fluctuation, the

greater the precision. Target precision levels were expressed as relative standard errors

(RSEs), defined as the ratio of the standard error (SE) of an estimate to the value of the

estimate, expressed as a percentage. Lower RSE values are associated with higher levels of

precision and, other things being equal, increases in sample size serve to reduce the RSE and

thus increase the level of precision of the estimates. Target RSEs were 6 percent for the

national estimates; 6 percent for the New York, Chicago, and Los Angeles metropolitan areas;

and 8 percent for all other metropolitan areas. In 5 of the metropolitan areas (Baltimore,

Buffalo, Denver, San Diego, and San Francisco), such a large proportion of facilities in each

area would have been required to reduce the RSE to 8 percent that the decision was made

simply to select all eligible hospitals.

Once the sample size for each metropolitan area and the National Panel was determined,

the number of sample units was allocated to the various strata based on the theory of optimal

allocation. With this approach, strata with greater variability in drug-related episodes (from

hospital to hospital) receive a proportionally larger number of sample units. Optimal allocation

serves to reduce the RSE of the estimates for a given overall sample size or to enable a

specified RSE to be achieved with a smaller sample.

A total of 685 hospitals was selected for the new sample. Many of the facilities selected,

particularly the larger ones, were already participating in DAWN. As noted earlier, 300 new

hospitals had to be recruited. Recruitment started in April 1986 and proceeded in phases. By

1988, recruitment of the selected facilities was sufficiently complete to produce estimates based

on the new sample.

Some facilities already participating in DAWN were not selected for the new sample. These

facilities were retained in the system for sufficient time to obtain overlapping data for calibrating

the estimates and developing estimation procedures for prior years. The period of overlap

differed by metropolitan area but generally included the last quarter of 1988 and the first half of

1989. Most terminations of nonselected facilities were made in the second half of 1989 or in

1990.

The total number of eligible sample facilities has not remained at the original 685 because

some hospitals have closed or become ineligible since the sample was selected. To preserve

the integrity of the sample and ensure that the DAWN estimates will continue to be

representative, sample maintenance is performed annually. Maintaining the sample involves

updating the sampling frame with the most recent available information on the population of

eligible hospitals. One purpose for updating the sampling frame is to identify newly eligible
Year-End 1998 ED DAWN Data 39

hospitals, or hospitals that are eligible and previously did not have a chance of selection, so that

they can be sampled. A second purpose, which focuses on the estimation process, is to

determine the population of eligible hospitals that the estimates must apply to, as well as the

total number of ED visits among this population, which is used in the calculation of the analytical

weights.

II. WEIGHTS AND PRECISION OF THE ESTIMATES

By 1988, hospital recruitment progressed to a point where national estimates and estimates

for each of the 21 metropolitan areas could be made with reasonable precision. National

estimates are obtained by adding the estimates from the 21 metropolitan areas and the estimate

from the National Panel for each estimation category.

The development of estimates from the sample data involves the application of analytical

weights calculated on the basis of data from the sampling frame and from DAWN reporting

records. Weights are calculated for each quarter of data using a 4-component model that

considers:

 The base sampling weight calculated as the reciprocal of the sampling probability;

 An adjustment for atypical reporting, applicable to certain hospitals that merge, split, or

respond in an unusual way;

 An adjustment for nonresponse based either on complete nonparticipation or failure to

provide data on all the reporting days in a given time period; and

 A correction (benchmark) factor, applied within metropolitan areas, that adjusts the

total number of ED visits among participating sample hospitals to the total for the

population of hospitals as determined from the sampling frame.

The estimation procedure was modified in 1989 to include the adjustments for 2 types of

nonresponse and the ratio or benchmark adjustment based on ancillary data from AHA.

Each estimate from the DAWN ED sample data is subject to sampling variability. This is

the variation of the estimate that would be observed if different samples were drawn from the

same population using the same procedures. The sampling variability of an estimate is

measured by its SE and RSE, which is the standard error divided by the estimate. The

precision of an estimate is inversely related to the degree of sampling variability as measured by

the RSE; the greater the RSE value, the lower the precision.

III. PRELIMINARY VERSUS FINAL ESTIMATES

Final estimates are produced annually when all hospitals participating in DAWN have

submitted their data for that year and when ancillary data used in estimation have become

available. In recent years, the final report has included separate final estimates for the first half

and the second half of the year, although quarterly estimates have been produced in earlier

years. In addition to the final estimates, preliminary estimates are also produced semiannually

based on responding hospitals. Data are weighted to produce national and metropolitan area
40 Year-End 1998 ED DAWN Data

estimates of ED drug-related mentions. The following factors clarify differences between

preliminary and final estimates:

 Final estimates include data from a small number of late-reporting hospitals. Data are

continuously updated for a fixed time period. As such, final estimates usually have

higher response rates.

 Additional hospitals are added to the sample and incorporated into the final estimates

for a given year (not the preliminary estimates for that same year). Most of these

hospitals are "newly eligible" because they became DAWN eligible sometime after the

original sample was selected. The final DAWN estimates are produced after we

receive the most current AHA Annual Survey of Hospitals file. This file is used initially

to establish a sampling frame for DAWN. The most current AHA file is used once a

year to maintain representativeness of the sample. Between the releases of the

preliminary and final estimates, the use of the newer AHA survey can result in hospitals

being added to the sample and incorporated into the final estimates.

 Data from the most current AHA file also are used to produce the final weights.

IV. REVIEW OF ESTIMATION SYSTEM

In 1997 and 1998, a thorough review of the DAWN estimation system was undertaken by

Westat. As a result of this review, the computer programs that compute the weighted estimates

were rewritten to make them more accurate and efficient. While the methodology for computing

weights did not change, errors were discovered in the prior programs that affected the estimates

for 1995 and 1996. Final estimates for these 2 years were presented in the 1997 Mid-Year

Preliminary Report for the first time. The 1995 estimate of total drug-related episodes

decreased by less than 1 percent (from 517,800 to 513,600) while the 1996 estimate increased

by 5.5 percent (from 487,600 to 514,300). These changes had varying effects on the

metropolitan area estimates.

The following changes had the greatest effect on the estimates:

 A change was made in the method for assigning eligibility status to a hospital. The

current system tracks partial year eligibility, which improves the sensitivity of the

DAWN nonresponse adjustment. Formerly, there was no recognition that a hospital

could change its eligibility status during the year.

 A concerted effort was made to ascertain the current eligibility status of all

nonparticipating DAWN sampled hospitals. Changes in status from eligible

nonrespondent to ineligible (or vice versa) also affected the nonresponse adjustment.
Year-End 1998 ED DAWN Data 41

APPENDIX B:

LIMITATIONS OF THE DAWN DATA

I. SOURCES OF ERROR

hen producing estimates from any sample survey, 2 types of errors are possible—

sampling and nonsampling errors. The sampling error of an estimate is the error

caused by the selection of a sample instead of a census of hospitals. Sampling error is

reduced by selecting a large sample or by using efficient sample design and estimation

strategies such as stratification, optimal allocation, and ratio estimation. Nonsampling errors

include nonresponse, difficulties in the interpretation of the collection form, coding errors,

computer processing errors, errors in the sampling frame, and reporting errors.

Many procedures, such as data auditing and periodic retraining of data collectors, are used

in DAWN data collection to minimize nonsampling errors. Moreover, nonrespondent hospitals

are identified for additional recruitment. Late reporters are assigned for priority data collection

and respondents with changes in reporting are designated for followup. Since data are

abstracted from medical records completed by hospital staff who treated the patients, the

accuracy of these reports depends on their careful recording of these conditions.

It is also important to recognize that DAWN does not provide a complete picture of

problems associated with drug use, but rather focuses on the impact that these problems have

on hospital EDs in the United States. If a patient is admitted to another part of the hospital for

treatment, or treated in a physician's office or at a drug treatment center, the episode would not

be included in DAWN.

II. CHANGES IN SAMPLE COMPOSITION AND REPORTING OF EPISODES

Periodic minor modifications are made to the sample to keep it current. Adjustments are

made in the weights to account for sample revisions and for any lapses in reporting by the

sampled hospitals. It is unlikely that modifications to the sample will affect estimates of the total

drug, cocaine, and heroin/morphine mentions over time. Analyses of the previous changes in

the sample composition have found them to have little impact on trends across several years.

It is important to consider the potential impact on DAWN trends from changes in the sample

composition or reporting anomalies in key sample hospitals, particularly for metropolitan area

data. Historically, DAWN analysts and field staff have attempted to identify and document such

situations in the period before data release, and events that may have had a significant impact

on the estimates were published in this section.

However, choosing the particular situations to highlight often involves more art than

science, given that the actual impact on the estimates rarely has been known at the time of

publication. This practice led us to question whether the situations that were being highlighted

actually had the anticipated impact on DAWN estimates.

We analyzed some specific situations highlighted in recent DAWN reports to determine if

those situations had the anticipated effect on DAWN estimates. These analyses have shown

that generally, the types of situations published previously as limitations did not have the

anticipated effects. Changes in small hospitals do not have a large impact on the estimates,

W
42 Year-End 1998 ED DAWN Data

and the DAWN estimation system already corrects for many nonsampling errors. Extensive

quality control measures have been implemented to investigate and address irregularities in the

data prior to publication.

As a result of this analysis, we have concluded that listing inconsequential, nonsampling

errors discredits the DAWN system unnecessarily and possibly contributes to misinterpretation

of DAWN data. Therefore, we have decided to discontinue reporting data limitations unless the

impact on the estimates is clear.
Year-End 1998 ED DAWN Data 43

APPENDIX C:

EXPLANATION OF TABLES

he tables included at the end of this report present estimates of total drug episodes, total

drug mentions, and mentions of 35 specific drugs plus alcohol-in-combination. Also

included are detailed tabulations for cocaine, heroin/morphine, marijuana/hashish, and

methamphetamine/speed mentions. Drug mentions are shown by metropolitan areas, age,

gender, race/ethnicity, central city versus outside central city, motive for taking the substance,

and reason for ED visit. Data shown in these tables are based on the representative sample of

hospitals that was implemented in 1988 and updated periodically since then.

Odd numbered tables report semiannual data from the first half of 1993 through the second

half of 1998. Even numbered tables report annual data from 1991 through 1998. This is the

first publication that presents final annual estimates for 1998.

Tables 29 to 56 report semiannual and annual rate data adjusted for population. The rate

tables present estimates of ED drug episodes and mentions per 100,000 population in

metropolitan areas and in the Nation broken out by age and gender.

The U.S. Bureau of the Census defines Metropolitan Area (MA) as the city core and its

immediately adjacent geographic areas that are highly integrated economically and socially with

the city core. Population-based rates are obtained by taking the estimates of total episodes and

mentions for each demographic category, and dividing by the number of persons in the

population for that demographic category. These standardized data provide the means for

comparing drug episodes and mentions by city over time. Semiannual numbers are based on

the first half of the year and are not comparable to annual numbers, which are based on 12-

month data. Semiannual and annual numbers for 1988 or earlier can be accessed via the

Internet (see page ii) or by ordering earlier reports (see the publications list at the end of this

report).

Population data are derived from the following U.S. Bureau of the Census files:

 Civilian Noninstitutional Population of the U.S. by Age, Race, and Sex (CNP Tables),

which provides monthly population estimates by age, gender, race and Hispanic origin

for the total U.S.;

 1990 Census Counts by Age, Sex and Race (ASR File), which provides population

estimates by state and county, broken out by combinations of age, gender, race, and

Hispanic origin; and

 County-Level Population Estimates (CPOP File), which provides estimates of annual

total population by county as of July 1 of each year.

Population data are obtained by:

 Adjusting the CPOP annual county population counts to the 1990 ASR demographic

counts to produce annual county demographic counts;

T
44 Year-End 1998 ED DAWN Data

 Adjusting the annual county demographic counts to the CNP to produce monthly

county demographic counts; and

 Summing the monthly county demographic counts across all counties in the MA and

across all months in the quarter (half-year or year), to produce semiannual or annual

demographic counts for each DAWN area.
Year-End 1998 ED DAWN Data 45

APPENDIX D:

GLOSSARY OF TERMS

Cause of death: See Drug abuse death.

Coterminous United States: The contiguous 48 continental States and Washington, DC.

Excludes Alaska and Hawaii.

Disposition of ED patient: Suggestions or recommendations made or actions taken by the

hospital as they relate to the patient's presenting problem:

 Treated and released or referred - The patient is given appropriate ED treatment and is

released or, after appropriate ED treatment, the hospital refers the patient to another

agency or to a private physician for additional services.

 Admitted to hospital - The patient is admitted as an inpatient to hospital.

 Left against medical advice - The patient, prior to or after treatment, left without a

physician's approval.

 Died - The patient died while in ED or while an inpatient.

Drug abuse: The nonmedical use of a substance for any of the following reasons: psychic effect,

dependence, or suicide attempt/gesture (see Drug use motive). For the purpose of this

report, nonmedical use means:

 The use of prescription drugs in a manner inconsistent with accepted medical practice;

 The use of over-the-counter drugs contrary to approved labeling; or

 The use of any substance (heroin/morphine, marijuana/hashish, peyote, glue, aerosols,

etc.) for psychic effect, dependence, or suicide.

Drug abuse death: A drug-induced death is any death involving a drug "overdose" in which a

toxic drug level is found or suspected. A drug-related death is any death where the drug

usage is a contributory factor but not the sole cause, (i.e., accidents, disease state,

withdrawal symptoms, etc.); in these cases, causation of death by the drug is not implied.

 "Drug-induced" deaths:

- Direct single-drug cause (overdose); and

- Direct multiple-drug cause (cause not attributable specifically to any one drug but to

drug overdose).

 "Drug-related" deaths:

- Combination with physiological condition;
46 Year-End 1998 ED DAWN Data

- Combination with external physical event; or

- Combination with medical disorder, probably drug caused. (See definitions for each

term.)

- Exclusions: DAWN medical examiner (ME) cases in which AIDS (acquired

immunodeficiency syndrome) was reported and cases in which "drug unknown" was

the only substance reported are excluded from the tables of ME data in Annual ME

Data reports. As in previous years, the ME data in Annual ME Data reports exclude

homicide cases reported to DAWN.

Drug abuse episode or case: A reported ME death or ED admission that involved drug abuse.

Episodes involving children under 6 years of age are not reported to the DAWN system. The

number of ED patients in DAWN is not synonymous with the number of patients involved.

One patient may make repeated visits to an ED or to several EDs, thus producing a number

of episodes. As no patient identifiers are collected, it is impossible to determine the number

of patients involved in the reported ED episodes.

Drug abuser: An ED patient or an ME decedent who had taken a substance(s) without proper

medical supervision for reason(s) of psychic effect, dependence, or suicide attempt/

gesture. See also Drug abuse.

Drug category: A generic grouping of substances reported to DAWN. The DAWN drug groupings

are periodically reviewed in order to reflect the most recent changes in pharmaceutical

classifications and drug legislation. Occasional changes in drug classification should be

taken into consideration when comparing drug data from this report with other DAWN reports.

These classifications may involve street names and brand names, which are sometimes used

to identify a substance and its generic drug group. Such names are carried in DAWN due to

the inability of some drug users to reliably identify a substance other than by its street name.

Therefore, references to substances such as "speed" appear in the tables. Additional

clarification is provided for the following drug categories:

 Alcohol-in-combination - DAWN does not gather data on alcohol used alone, only alcohol

used concomitantly with another abused substance. Therefore, all alcohol mentions are

combination mentions.

 Heroin/morphine - Although heroin may be the ingested drug, it is metabolized to

morphine. Therefore, heroin and morphine are treated as a single drug. In addition, in

DAWN reports the heroin/morphine category includes mentions of opiates not specified as

to type.

 Marijuana/hashish - As both marijuana and hashish are derived from the cannabis plant

and have tetrahydrocannabinol (THC) as their psychoactive ingredient, they are treated as

a single drug in this report.

 Diazepam - Mentions of desmethyldiazepam, a metabolic product of diazepam, are

combined with those of diazepam in this report.

 Methamphetamine/speed - Data for methamphetamine and speed were shown separately

in prior reports. To facilitate analyses, data on these 2 DAWN categories are now shown

together under the aggregate category of "methamphetamine/speed."
Year-End 1998 ED DAWN Data 47

 Fluoxetine and imipramine - In DAWN reports for 1988, mentions of Prozac, an

antidepressant first marketed in December 1987, were misassigned to the imipramine

category. Prozac has since been removed from the imipramine group, combined with

generic fluoxetine, and tabulated under the category of "fluoxetine" for DAWN ED and ME

reports.

 Drug unknown – ED mentions of "drug unknown" may be recorded either when the user

did not know what had been taken or perhaps did not wish to reveal the use of an illicit

substance, or when data were not available in the hospital records. ME cases in which

"drug unknown" is the only substance reported are excluded from the tabulations in this

report. ME mentions of "drug unknown" may result from cases in which the ME knows

that a decedent was a drug abuser (e.g., using drugs intravenously) but has not tested for

specific drugs. ME cases in which "drug unknown" is the only substance reported are

excluded from the tabulations in this report.

Drug concomitance: This term refers to whether a drug abuse episode involved a single drug

mention or multiple mentions.

Drug mention: This refers to a substance that was mentioned in a drug abuse episode. In

addition to alcohol-in-combination, the number of substances that can be reported is up to 4

for each drug abuse ED episode and up to 6 for each ME death. Therefore, the total number

of mentions exceeds the number of total episodes. For ME cases, it should be noted that a

drug mention may or may not be the confirmed "cause" of the death in multiple-drug abuse

cases. Even when only one substance is reported for a case, an allowance should still be

made for reportable drugs not mentioned or for other contributory factors.

Drug use motive: DAWN classifies ED drug abuse episodes according to one or more of the

following reasons for taking a substance(s):

 Psychic effects - A conscious action to use drugs to improve or enhance any physical,

emotional, or social situation or condition. Two categories of psychic effect are:

- Use of drugs for experimentation or to enhance a social situation (e.g., curious, peer

pressure, to get high, fun, "for kicks," to party); and

- Use of drugs to improve or enhance any mental, emotional, or physical state (e.g.,

depression, anxiety, relieve headache, reduce pain, stay awake, relax, help study, get

to sleep).

 Dependence - A psychic and/or physical state characterized by behavior that always

includes a compulsion to take the drug on a continuous or periodic basis in order to

experience its effects or to avoid the discomfort of its absence (e.g., had to take, had to

have, needed a fix).

 Suicide attempt or gesture - Successful or unsuccessful suicide attempt or gesture verified

by a witness, a note left by patient, physician's medical record note, or other evidence.

 Other reason - Self-medication for physical ailment, to prevent pregnancy or induce

abortion, accident, used unknowingly, etc.
48 Year-End 1998 ED DAWN Data

External physical event: A category of drug abuse deaths caused by a physical event that

occurred while the decedent was under the influence of drugs. Examples may include car

accidents, falls, burns, or gunshot wounds.

Facility location: Data from the 21 metropolitan areas in the DAWN ED sample are tabulated

separately for central cities and areas outside central cities.

Form in which drug was acquired/found: The form in which the substance was received by the

user/abuser is coded, not the form in which the substance was consumed.

Hospital emergency department (ED): Only hospitals that met eligibility criteria for DAWN were

recruited to participate. To be eligible, hospitals must be non-Federal, short-stay facilities

with EDs that are open 24 hours a day, and located in the coterminous U.S. Specialty

hospitals, hospital units of institutions, long-term care facilities, and pediatric hospitals are

excluded.

Jurisdiction: The reporting area covered by a single ME's or coroner's office which is almost

always a single county.

Manner of death: Drug abuse deaths reported to DAWN (ME episodes) are coded as either

"accidental/unexpected," "suicide," or "homicide." Data on drug-related homicide deaths are

not included in Annual ME Data reports. The manner-of-death codes are defined as follows:

 Accidental/unexpected – An unintentional death resulting from a drug abuse episode. The

cause of death may be drug induced or drug related. The essential feature of this manner

of death is that the user/abuser did not intend to die.

 Suicide – The deliberate taking of one's own life. The deceased may have used drugs to

bring about his or her own immediate destruction, or the death may be drug related,

involving external physical events (e.g., jumping, hanging, shooting, cutting the wrist) with

the intention of ending one's life.

 Natural – A death not due to external causes but due to a medical disorder or a

physiological disease process. In DAWN this category includes cases in which the

decedent's drug abuse caused the medical disorder or physiological condition, such as

AIDS. This also includes cases where a condition was worsened by the decedent's drug

use (e.g., a heart condition or diabetes). Note that AIDS cases are excluded from the

tables in Annual ME Data reports. Deaths from natural causes are not shown separately

in ME reports but are included in the "unknown/unexpected" manner of death category.

Medical disorder: A category of drug abuse deaths caused by using a drug in combination with a

medical disorder or disease that probably resulted from drug abuse. Examples include

hepatitis, bacterial endocarditis, and tetanus.

Medical examiner (ME): All MEs and coroners in the DAWN ME metropolitan areas or counties

are eligible for participation in DAWN.

Metropolitan area: An area composed of a relatively large core city or cities and the adjacent

geographic areas. Conceptually, these areas are integrated economic and social units with a

large population nucleus. Facilities recruited for the DAWN ED sample were selected from
Year-End 1998 ED DAWN Data 49

the Metropolitan Statistical Areas (MSAs) and Primary Metropolitan Statistical Areas

(PMSAs) as defined in 1983 by the Office of Management and Budget.

National Panel: This term is used to denote 2 concepts relative to DAWN ED data: (1) The

universe of eligible hospitals outside the 21 DAWN metropolitan areas but within the

coterminous U.S. or (2) The sample of hospitals in DAWN that were selected from this

universe. The National Panel sample is weighted to produce estimates for the National Panel

universe. See also Metropolitan area.

p-value: The probability value is the actual probability associated with an obtained statistical

result; this is then compared with the significance level to determine whether that value is

statistically significant. For the p-value to be significant, it must be less than or equal to the

significance level. The traditional significance levels are p less than .001, .01, .05, and .10.

The p-value less than .05 is used in DAWN reports.

Physiological condition: A category of drug abuse deaths caused by the abuse of a drug in

combination with some preexisting and potentially deadly condition not related to drug abuse,

such as diabetes or chronic heart conditions.

Population: See Universe.

Precision: The extent to which an estimate agrees with its mean value in repeated sampling. The

precision of an estimate is measured inversely by its standard error (SE) or relative standard

error (RSE). In ED reports, estimates with an RSE of 50 percent or higher are regarded as

too imprecise and are not printed. ED table cells where such estimates would have appeared

contain the symbol ". . ." (3 dots). See also Relative standard error.

Race/ethnicity: The race/ethnicity categories on the DAWN data collection form are:

 White, not of Hispanic origin - A patient having origins in any of the original peoples of

Europe, North Africa, or the Middle East.

 Black, not of Hispanic origin - A patient having origins in any of the black racial groups of

Africa.

 Hispanic patient of Mexican, Puerto Rican, Cuban, or Central or South American, or other

Spanish culture or origin, regardless of race.

 American Indian/Alaskan Native - A patient having origins in any of the peoples of North

America and who maintains cultural identification through tribal affiliation or community

recognition.

 Asian/Pacific Islander - A patient having origins in any of the original peoples of the Far

East, Southeast Asia, the Indian subcontinent, or the Pacific Islands.

 Other - A patient whose race cannot be classified into any of the categories above. This

residual category was reinstated on the DAWN form in July 1991 after having been

removed in an earlier revision.

Random sample: A sample in which each member of the sampling frame has a known, nonzero

probability of selection.
50 Year-End 1998 ED DAWN Data

Rank: A rank indicates the relative frequency of mentions for a particular drug category within the

total DAWN system. For example, a drug category ranked second indicates that it accounted

for the second highest number of mentions among all drug categories. When 2 or more

drugs received equal numbers of mentions, they are assigned the same rank. It should be

noted that a difference in rank should be considered only as indicative of a difference in

frequency among drugs reported to DAWN, no matter how small, and not as necessarily

denoting a meaningful or significant difference. For example, a difference of one between

ranks of drug categories could mean a difference of one drug mention or a difference of

many.

Reason for ED contact: Drug users reported to an ED and DAWN contact for the following

reasons:

 Unexpected reaction - The drug's effect was different than anticipated, thus, causing

concern (e.g., bad trip, panic, hallucinations, etc.).

 Overdose - Either intentional or accidental (e.g., effects of suicide attempt, coma, etc.).

 Withdrawal - Symptoms which occur when a patient stops taking a substance upon which

she/he is physiologically dependent and suffers physical symptoms, including abdominal

pain, cold sweat, hyperactivity, and tremors that require treatment.

 Chronic effects - Secondary conditions resulting from habitual usage or dependence,

including malnutrition, tetanus, blood poisoning, etc.

 Seeking detoxification - Patients with identified problems with chronic substance abuse

who seek admission to a detoxification program and receive treatment from emergency

department staff. This category was added to the data collection form in 1987.

 Accident/injury - Injuries resulting from accidents that were caused by or related to drug

abuse. This category was added to the data collection form in 1987.

 Other - Reasons which cannot be classified into one of the aforementioned categories.

Reason for taking substance: See drug use motive.

Relative standard error (RSE): A measure of the sampling variability or precision of an estimate

defined as the estimate's SE expressed as a percentage of the estimate's value. (See also

Precision and Standard error.)

Route of drug administration: The method by which the substance was taken into the

user/abuser's body is coded according to the following categories:

 Oral – Substance is ingested through the mouth.

 Injection – Substance enters the body through a vein (intravenously), into the muscle

(intramuscularly), or under the skin (subcutaneously).
Year-End 1998 ED DAWN Data 51

 Inhaled - Gases or fumes of a substance are taken into the body by inhaling through the

nose or mouth into the lungs (e.g., inhaling the fumes of glue, aerosols, paints, gasoline,

etc.).

 Smoked (includes freebase) - Substance (e.g., marijuana/hashish, “crack” cocaine) is

consumed by smoking a cigarette, pipe, or similar device.

 Sniffed/snorted - Substance (e.g., cocaine, heroin/morphine), which is acquired in a

powder or crystalline form, is forcefully inhaled through the nose.

 Other - Used when the route of administration of the substance cannot logically be

included as any of the above.

Sampling frame: A list of units from which the ED sample is drawn. All members of the sampling

frame have a probability of being selected. A sampling frame is constructed such that there

is no duplication and each unit is identifiable. Ideally, the sampling frame and the universe

are the same. The sampling frame for the DAWN hospital ED sample is the American

Hospital Association (AHA) annual survey.

Sampling unit: A member of a sample selected from a sampling frame. For the DAWN sample,

the units are hospitals, and data are collected for all drug-related ED episodes at the

responding hospitals selected for the sample.

Sampling weights: Numeric coefficients used to derive population estimates from a sample.

Single-drug episode, case, or death: A drug abuse episode, case, or death that involves only

one drug.

Source of substance: The immediate source of the substance that the patient abused is coded

as follows:

 Legal prescription - This is coded only when the abuser was legally prescribed the drug of

abuse. If one patient obtains a drug by legal prescription and sells it to another who

abuses it, the source to the abuser is marked "street buy." If the patient for whom the

prescription was issued gives the drug to another patient who abuses it, the source to the

abuse is "other unauthorized procurement."

 Street buy - The drug abuser purchased a drug and/or prescription from a source other

than legitimate channels.

 Other unauthorized procurement - The drug was acquired in a manner not consistent with

accepted medical care but was not bought on the street. This category includes drugs

purchased using forged prescriptions, stolen, or received as a gift.

 Other - Used when the source of the substance cannot logically be included as any of the

above. This category includes all over-the-counter medications.

 Unknown - Reported when information on source was unavailable.
52 Year-End 1998 ED DAWN Data

Standard error (SE): A measure of the sampling variability or precision of an estimate. The SE of

an estimate is expressed in the same units as the estimate itself. For example, an estimate

of 10,000 cocaine mentions with an SE of 500 indicates that the SE is 500 mentions.

Strata (plural), stratum (singular): Subgroups of a population within which separate ED samples

are drawn. Stratification is used to increase the precision of estimates for a given sample

size, or, conversely, to reduce the sample size required to achieve the desired level of

precision. In the DAWN ED sample, the sample is stratified into 21 metropolitan area cells

plus an additional cell for the National Panel. Then, within these cells strata are defined

according to the annual number of ED visits, whether the hospital is located inside or outside

the central city of the metropolitan area, and by the presence or absence of an organized

outpatient department, alcohol/chemical dependence inpatient unit, or both. The strata are

as follows:

Stratum

Annual ED

visits

Location within

metropolitan area

Outpatient department or

alcohol/chemical dependence

inpatient unit

In the 21 DAWN metropolitan areas

0 >80,000 Not applicable Not applicable

1 <80,000 Central city Both

2 <80,000 Central city One only

3 <80,000 Central city Neither

4 <80,000 Outside Central city Both

5 <80,000 Outside Central city One only

6 <80,000 Outside Central city Neither

Stratum

Annual ED

visits

Location within

metropolitan area

Outpatient department or

alcohol/chemical dependence

inpatient unit

In the National Panel

0 >80,000 Not applicable Not applicable

7 <80,000 Not applicable Both

8 <80,000 Not applicable One only

9 <80,000 Not applicable Neither

Note: Stratum “0” is defined for each of the 21 metropolitan area and the National Panel cells.

See Drug Abuse Warning Network Sample Design and Estimation Procedures: Technical

Report, November 1997.

Statistically significant: A difference between 2 estimates is said to be statistically significant if

the value of the statistic used to test the difference is larger or smaller than would be expected

by chance alone. For DAWN estimates, the difference is statistically significant if the p-value

is less than 0.05 (see also p-value).

Therapeutic class: A general grouping of generic drugs such as tranquilizers, narcotic

analgesics, barbiturate sedatives, etc. These groupings are based primarily on a pre-existing

classification used in the National Drug and Therapeutic Index (IMS America, Ltd.). The
Year-End 1998 ED DAWN Data 53

DAWN system has accumulated a vocabulary of more than 7,300 substance names that have

been mentioned in incidents of abuse. This vocabulary is updated monthly by the inclusion of

new abuse substances and, through receipt of identifying information, the reclassification of

drugs. Occasionally, this reclassification may shift a drug to a different therapeutic class

and/or drug grouping.

Universe: The entire set of units for which generalizations are drawn. The universe for the DAWN

ED sample is all short-stay, non-Federal hospitals in the coterminous U.S. with EDs open 24

hours a day. (See also Coterminous United States).
54 Year-End 1998 ED DAWN Data
Year-End 1998 ED DAWN Data 55

Detailed Tables
56 Year-End 1998 ED DAWN Data
 Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec

 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

DRUG EPISODES............... 230,234 230,676 252,625 265,896 270,855 242,777 251,672 262,675 265,194 261,864 271,903 270,641 DRUG MENTIONS............... 394,905 401,857 438,398 461,919 471,933 429,273 442,932 464,630 473,220 470,716 492,116 490,741 

Alcohol-in-combination......... 71,227 72,347 77,606 83,138 86,587 80,338 80,400 85,785 85,230 86,751 91,067 93,936 

Cocaine................................ 60,931 62,492 68,443 74,435 73,183 62,618 71,435 80,998 78,722 82,365 85,760 86,253 Heroin/morphine.................. 30,763 32,469 30,036 33,977 35,500 35,339 35,198 38,648 35,352 36,658 38,553 39,092 Acetaminophen.................... 18,981 15,052 21,450 17,225 18,850 17,713 20,214 18,051 18,428 17,020 17,384 14,873 Aspirin.................................. 10,124 8,834 9,968 9,390 8,601 8,128 8,569 7,285 7,555 7,068 7,487 7,969 Ibuprofen.............................. 9,071 8,464 9,778 9,253 10,590 10,660 8,593 8,386 8,474 8,595 8,769 8,376 

Alprazolam........................... 8,106 8,726 8,054 9,129 9,059 8,023 8,795 7,860 8,686 8,782 9,049 8,783 Marijuana/hashish................ 13,577 15,296 19,078 21,105 24,277 20,994 24,892 28,897 32,402 32,343 37,883 38,987 

Diazepam............................. 6,625 5,785 5,877 7,691 7,404 6,843 6,520 7,081 6,830 6,537 5,846 6,912 

Amitriptyline......................... 4,690 5,174 6,059 5,238 4,848 4,050 5,286 3,587 4,385 4,059 3,671 3,038 Acetamin./codeine............... 3,769 3,886 3,151 3,698 3,427 3,402 2,885 2,948 3,570 3,019 2,341 2,703 OTC sleep aids.................... 2,655 2,725 3,241 3,649 3,340 3,454 4,269 3,358 3,417 2,667 3,062 2,688 Lorazepam........................... 4,756 5,436 5,718 6,530 6,072 5,184 5,411 4,623 5,505 5,313 5,636 4,836 d-Propoxyphene................... 4,209 3,830 3,971 3,507 3,654 3,361 3,527 3,252 3,411 4,203 3,934 2,951 Fluoxetine............................ 3,449 4,088 4,354 4,769 4,719 4,781 5,155 4,441 5,385 5,111 5,364 4,448 Diphenhydramine................. 3,795 3,647 4,444 5,092 4,919 3,766 4,459 4,947 4,765 4,039 3,365 2,745 Methamphetamine/speed..... 4,224 5,702 7,824 9,841 9,678 6,257 4,197 6,805 8,218 8,936 6,534 4,957 Oxycodone........................... 1,692 1,703 2,094 1,990 1,829 1,564 1,495 1,696 2,165 2,692 2,293 2,918 PCP/PCP combinations....... 3,327 3,288 2,962 3,057 3,233 3,004 1,976 1,948 2,210 1,985 2,143 1,890 Lithium carbonate................ 2,768 2,559 2,521 3,443 3,834 2,873 2,667 2,011 2,781 2,083 1,840 1,642 Clonazepam......................... 4,893 5,282 5,954 6,204 6,381 6,421 6,834 6,541 7,364 7,233 8,863 8,587 Hydantoin............................. 1,491 2,037 1,807 1,469 1,997 1,579 1,544 1,391 1,420 1,014 1,408 1,568 Hydrocodone........................ 2,508 3,607 4,150 4,328 4,532 4,445 5,741 4,732 5,170 5,535 5,830 6,739 LSD...................................... 1,521 1,901 1,981 3,169 2,651 3,029 2,474 2,095 3,677 1,542 1,767 3,215 Triazolam............................. 798 466 570 427 407 369 458 267 179 142 350 188 Phenobarbital....................... 1,723 1,298 1,421 1,050 1,346 1,542 1,266 1,069 1,000 830 1,220 1,325 Doxepin................................ 1,811 1,540 1,903 2,365 1,541 1,185 1,102 1,299 1,422 669 914 623 Cyclobenzaprine.................. 1,544 1,103 1,432 1,699 1,320 1,603 1,608 1,991 1,551 2,075 1,538 1,429 Haloperidol........................... 1,856 1,445 1,322 1,751 1,536 1,183 1,256 2,055 1,146 1,160 952 1,179 Amphetamine....................... 2,271 3,267 4,266 5,398 5,633 3,747 3,508 5,801 4,461 5,774 5,321 6,430 Trazodone............................ 2,973 2,710 3,275 4,018 4,814 4,641 4,789 4,421 4,188 4,545 5,158 4,517 Carisoprodol......................... 2,598 3,972 3,484 3,088 4,392 3,379 3,770 3,509 2,960 3,174 4,412 4,042 Naproxen............................. 1,907 1,218 2,126 2,176 2,361 2,892 2,309 2,237 2,710 2,620 2,842 2,706 Imipramine........................... 1,731 1,564 1,457 1,307 1,572 910 735 1,102 826 557 506 211 Carbamazepine.................... 2,266 2,556 1,952 1,929 1,932 1,700 1,878 1,861 1,625 1,845 1,343 1,877 Thioridazine......................... 1,650 1,367 1,405 1,785 1,562 1,005 1,242 1,001 822 905 733 494 TOTAL ED VISITS**............ 43,500 44,151 44,439 45,190 44,027 44,521 45,314 45,876 44,342 45,378 44,309 45,374 

Year-End 1998 ED DAWN Data

Table 1 - Estimated number of emergency department drug episodes, drug mentions, mentions of selected total visits for total coterminous U.S. by half year: First half 1993 - second half 1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

2 This column compares the first half of 1998 to the second half of 1998.3 This column compares the second half of 1997 to the second half of 1998.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For the purposes of this report

0.05 are considered to be statistically significant.

**

 DAWN estimates of emergency department (ED) visits (in 1,000s) should be close to but will not necessarily equal totals from previous year's American Hospital Ass

57
p -value p -value

 Total Total Total Total Total Total Total Total 1991 1992 1993 1994 1995 1996 1997 1998

DRUG EPISODES............... 393,968 433,493 460,910 518,521 513,633 514,347 527,058 542,544 0.217 0.067 

DRUG MENTIONS............... 674,861 751,731 796,762 900,317 901,206 907,561 943,937 982,856 0.135 0.018 +

Alcohol-in-combination......... 121,835 141,772 143,574 160,744 166,925 166,185 171,982 185,002 0.079 0.051 Cocaine................................ 101,189 119,843 123,423 142,878 135,801 152,433 161,087 172,014 0.107 0.040 +Heroin/morphine.................. 35,898 48,003 63,232 64,013 70,838 73,846 72,010 77,645 0.060 0.443 Acetaminophen.................... 30,445 31,355 34,033 38,674 36,563 38,265 35,448 32,257 0.051 0.000 -Aspirin.................................. 21,669 18,834 18,958 19,358 16,729 15,854 14,623 15,457 0.495 0.737 

Ibuprofen.............................. 15,411 16,400 17,534 19,031 21,250 16,979 17,070 17,146 0.952 0.894 Alprazolam........................... 16,235 16,498 16,832 17,183 17,082 16,655 17,468 17,833 0.741 0.453 Marijuana/hashish................ 16,251 23,997 28,873 40,183 45,271 53,789 64,744 76,870 0.008 + 0.000 +Diazepam............................. 14,637 13,947 12,409 13,568 14,248 13,601 13,367 12,758 0.583 0.541 Amitriptyline......................... 8,660 10,132 9,863 11,297 8,898 8,874 8,445 6,710 0.033 - 0.018 -Acetamin./codeine............... 7,134 7,094 7,655 6,849 6,829 5,832 6,589 5,045 0.007 - 0.145 OTC sleep aids.................... 6,339 7,034 5,380 6,890 6,794 7,628 6,084 5,750 0.554 0.001 -Lorazepam........................... 6,910 8,925 10,191 12,248 11,256 10,035 10,818 10,472 0.734 0.648 d-Propoxyphene................... 7,803 6,551 8,039 7,478 7,015 6,780 7,614 6,885 0.379 0.910 

Fluoxetine............................ 6,856 8,327 7,537 9,123 9,499 9,596 10,495 9,812 0.434 0.797 Diphenhydramine................. 6,739 7,861 7,442 9,537 8,685 9,406 8,804 6,110 0.001 - 0.001 -Methamphetamine/speed..... 4,887 6,563 9,926 17,665 15,936 11,002 17,154 11,491 0.009 - 0.634 Oxycodone........................... 3,941 3,750 3,395 4,084 3,393 3,190 4,857 5,211 0.623 0.001 +PCP/PCP combinations....... 3,470 5,282 6,614 6,019 6,237 3,924 4,195 4,033 0.694 0.779 Lithium carbonate................ 4,506 4,653 5,327 5,964 6,707 4,678 4,864 3,481 0.061 0.058 Clonazepam......................... 6,467 8,220 10,175 12,158 12,802 13,375 14,597 17,450 0.053 0.006 +Hydantoin............................. 3,146 3,879 3,528 3,276 3,576 2,935 2,434 2,976 0.342 0.942 Hydrocodone........................ 5,012 6,105 6,115 8,478 8,977 10,473 10,705 12,568 0.102 0.186 LSD...................................... 3,846 3,499 3,422 5,150 5,681 4,569 5,219 4,982 0.770 0.631 Triazolam............................. 3,363 1,666 1,264 997 776 726 322 537 0.206 0.349 Phenobarbital....................... 3,016 3,220 3,021 2,471 2,888 2,335 1,830 2,545 0.142 0.693 Doxepin................................ 3,734 3,605 3,351 4,268 2,726 2,402 2,091 1,537 0.117 0.031 -Cyclobenzaprine.................. 3,092 2,731 2,647 3,130 2,924 3,599 3,626 2,967 0.183 0.209 Haloperidol........................... 3,176 2,896 3,301 3,072 2,718 3,311 2,306 2,131 0.697 0.026 -Amphetamine....................... 2,296 3,713 5,538 9,664 9,380 9,308 10,235 11,751 0.385 0.203 Trazodone............................ 4,255 4,640 5,682 7,293 9,455 9,210 8,733 9,674 0.354 0.571 Carisoprodol......................... 4,228 5,922 6,570 6,571 7,771 7,279 6,133 8,454 0.010 + 0.199 Naproxen............................. 3,423 2,690 3,125 4,302 5,253 4,546 5,330 5,549 0.729 0.113 Imipramine........................... 3,391 4,371 3,295 2,764 2,482 1,837 1,383 717 0.035 - 0.009 -Carbamazepine.................... 3,384 3,319 4,823 3,881 3,633 3,740 3,471 3,219 0.619 0.416 Thioridazine......................... 2,679 2,881 3,017 3,190 2,567 2,243 1,727 1,227 0.132 0.016 -TOTAL ED VISITS**............ 84,189 85,944 87,651 89,629 88,548 91,189 89,720 89,683 0.761 0.000 -

Year-End 1998 ED DAWN Data

1996,

19981,3

Table 2 - Estimated number of emergency department drug episodes, drug mentions, mentions of selected drugs, and total visits, for total coterminous U.S. by year: 1991-1998

1997,

19981,2 

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

**

 DAWN estimates of emergency department (ED) visits (in 1,000s) should be close to but will not necessarily equal totals from previous 

year's American Hospital Association (AHA) Annual Survey.

2 This column compares 1997 to 1998.3 This column compares 1996 to 1998.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in 

the coterminous U.S.

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For 

the purposes of this report, p -values less than 0.05 are considered to be statistically significant.

58
DRUG EPISODES

 Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.......................... 230,234 230,676 252,625 265,896 270,855 242,777 251,672 262,675 265,194 261,864 271,903 270,641 0.87

Atlanta.................................. 3,703 4,024 4,899 5,929 5,689 5,374 4,561 4,839 4,025 3,979 5,544 5,178 0.12

Baltimore.............................. 6,496 6,978 7,527 8,335 8,307 7,659 7,763 8,231 6,618 6,137 6,440 7,296 0.00Boston.................................. 6,283 6,361 6,563 8,662 8,690 7,383 7,109 6,429 6,357 5,872 6,739 6,917 0.71Buffalo.................................. 1,033 1,489 1,499 1,427 1,355 1,358 1,830 1,757 1,571 1,241 1,276 1,407 0.03Chicago................................ 8,216 9,762 9,963 11,548 11,728 10,157 10,974 12,550 12,846 14,045 12,873 13,336 0.06Dallas................................... 2,480 2,258 2,463 2,698 2,652 2,577 2,512 2,466 2,911 3,284 3,632 3,566 0.65Denver................................. 1,685 2,106 2,502 2,532 2,460 2,149 1,779 1,641 2,101 2,237 2,031 2,060 0.69Detroit.................................. 9,193 9,976 9,251 7,910 10,587 8,043 10,596 10,225 9,363 8,241 8,489 8,994 0.38Los Angeles - Long Beach... 10,343 10,268 9,524 9,732 10,027 9,233 10,100 10,178 8,809 8,378 8,127 8,976 0.17

Miami - Hialeah.................... 2,679 2,909 2,888 2,961 3,266 3,156 3,078 3,214 3,239 3,046 3,170 3,255 0.58Minneapolis - St. Paul.......... 2,163 2,395 2,342 2,269 2,229 2,098 2,377 2,459 2,563 2,410 2,248 2,101 0.35New Orleans........................ 2,088 2,004 2,328 2,411 2,619 3,249 2,900 2,944 2,602 2,607 2,766 2,325 0.00New York............................. 21,910 23,205 21,652 21,475 21,027 19,764 21,001 19,470 18,953 18,163 18,047 18,096 0.96Newark................................. 4,924 4,292 4,565 4,829 5,435 5,435 5,274 4,635 4,155 4,738 4,619 4,326 0.03

Philadelphia......................... 10,326 9,474 8,352 9,360 10,361 10,142 10,610 11,025 11,457 11,772 12,674 12,254 0.57Phoenix................................ 3,152 2,778 3,175 3,704 4,184 3,729 3,820 3,614 3,747 3,581 3,754 3,306 0.00St. Louis............................... 2,046 1,974 2,919 3,121 3,080 2,582 3,021 3,168 2,835 2,828 2,861 2,858 0.98San Diego............................ 2,773 2,538 2,582 2,469 2,346 2,315 2,915 2,896 3,081 3,673 3,590 3,391 0.00

San Francisco...................... 6,563 5,200 4,883 6,882 5,071 5,093 4,764 4,772 4,633 4,791 4,596 4,473 0.14Seattle.................................. 3,604 3,662 4,952 5,097 4,494 4,024 4,370 4,106 5,102 5,491 4,625 3,707 0.44

Washington, DC................... 6,142 6,197 6,571 7,581 6,359 5,471 5,939 5,781 5,651 5,543 5,973 5,623 0.00National Panel...................... 112,431 110,825 131,225 134,964 138,888 121,786 124,379 136,275 142,574 139,806 147,829 147,195 0.93

Year-End 1998 ED DAWN Data

H1,H2

98,981

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

2 This column compares the first half of 1998 to the second half of 1998.3 This column compares the second half of 1997 to the second half of 1998.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For the purposes of this report

than 0.05 are considered to be statistically significant.

Table 3 - Estimated number of emergency department drug episodes, by metropolitan area by half year: First half 1993 - second half 1998

p -valu

59
DRUG EPISODES

 Total Total Total Total Total Total Total Total 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.......................... 393,968 433,493 460,910 518,521 513,633 514,347 527,058 542,544 0.217 0.067Atlanta.................................. 6,833 8,767 7,728 10,828 11,063 9,400 8,004 10,722 0.094 0.446 

Baltimore.............................. 10,802 12,946 13,474 15,862 15,966 15,994 12,755 13,736 0.253 0.084 

Boston.................................. 9,532 12,744 12,644 15,225 16,073 13,539 12,229 13,657 0.468 0.953 

Buffalo.................................. 1,660 1,962 2,522 2,926 2,714 3,587 2,812 2,683 0.420 0.001 -Chicago................................ 13,875 17,580 17,978 21,511 21,885 23,524 26,891 26,209 0.653 0.039 +

Dallas................................... 4,356 4,062 4,739 5,160 5,230 4,978 6,195 7,198 0.000 + 0.000 +

Denver................................. 3,442 3,664 3,791 5,034 4,609 3,419 4,338 4,091 0.211 0.001 +Detroit.................................. 14,327 15,777 19,169 17,162 18,630 20,822 17,604 17,483 0.939 0.343 Los Angeles - Long Beach... 17,400 19,697 20,611 19,256 19,260 20,278 17,187 17,103 0.937 0.020 -

Miami - Hialeah.................... 4,688 4,707 5,588 5,849 6,421 6,292 6,285 6,426 0.731 0.699 Minneapolis - St. Paul.......... 3,696 3,923 4,558 4,611 4,327 4,836 4,974 4,348 0.153 0.148 New Orleans........................ 5,767 5,353 4,092 4,739 5,868 5,844 5,209 5,091 0.272 0.000 -New York............................. 36,948 44,759 45,116 43,127 40,792 40,471 37,116 36,142 0.511 0.010 -Newark................................. 8,338 8,748 9,216 9,395 10,870 9,909 8,893 8,944 0.893 0.618 

Philadelphia......................... 16,845 20,573 19,801 17,711 20,502 21,634 23,229 24,928 0.085 0.033 +Phoenix................................ 5,918 6,103 5,930 6,879 7,913 7,434 7,327 7,060 0.134 0.051 St. Louis............................... 4,594 4,405 4,020 6,039 5,662 6,188 5,664 5,719 0.936 0.625 San Diego............................ 5,103 6,088 5,310 5,051 4,661 5,811 6,754 6,982 0.401 0.009 +

San Francisco...................... 11,700 10,592 11,763 11,766 10,165 9,536 9,424 9,070 0.191 0.254 Seattle.................................. 4,744 6,200 7,266 10,049 8,517 8,476 10,593 8,332 0.151 0.891 

Washington, DC................... 10,558 10,687 12,339 14,152 11,830 11,720 11,194 11,596 0.735 0.917 

National Panel...................... 192,840 204,155 223,256 266,189 260,674 260,654 282,380 295,023 0.287 0.020 +

p -value

19981,2 

p -value

1997, 1996,

19981,3

Year-End 1998 ED DAWN Data

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

3 This column compares 1996 to 1998.2 This column compares 1997 to 1998.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments 

in the coterminous U.S.

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For 

the purposes of this report, p -values less than 0.05 are considered to be statistically significant.

Table 4 - Estimated number of emergency department drug episodes, by metropolitan area by year: 1991-1998

60
DRUG MENTIONS

 Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.......................... 394,905 401,857 438,398 461,919 471,933 429,273 442,932 464,630 473,220 470,716 492,116 490,741 0.93

Atlanta.................................. 7,125 7,640 9,416 11,946 11,497 10,822 9,120 9,988 8,129 8,063 10,625 9,593 0.03

Baltimore.............................. 11,128 12,056 12,800 14,096 14,151 12,970 12,964 14,121 11,470 10,593 10,866 12,684 0.00

Boston.................................. 11,502 11,600 12,004 16,228 16,232 13,865 13,146 11,785 11,757 10,663 12,243 12,650 0.66Buffalo.................................. 1,825 2,551 2,503 2,566 2,405 2,467 3,435 3,250 2,953 2,333 2,341 2,594 0.05

Chicago................................ 14,241 17,111 17,310 19,963 20,576 17,861 19,683 22,755 24,192 26,337 23,784 24,591 0.12

Dallas................................... 4,495 4,129 4,457 4,902 4,849 4,806 4,753 4,425 5,400 6,052 6,818 6,601 0.29

Denver................................. 2,891 3,476 4,253 4,163 4,469 3,757 3,063 2,853 3,675 3,863 3,544 3,635 0.55Detroit.................................. 17,079 18,636 16,683 14,065 19,445 14,732 20,025 19,012 17,212 15,291 16,031 16,573 0.65Los Angeles - Long Beach... 17,862 17,701 16,417 16,804 17,321 16,102 17,182 18,054 15,454 14,250 13,734 16,085 0.07

Miami - Hialeah.................... 4,194 4,510 4,645 4,738 5,155 4,932 4,849 5,078 5,288 4,970 5,271 5,485 0.52Minneapolis - St. Paul.......... 4,191 4,564 4,616 4,414 4,300 4,042 4,570 4,594 4,887 4,497 4,276 3,874 0.20New Orleans........................ 4,212 4,013 4,576 4,883 5,044 6,090 5,490 5,550 4,775 4,949 5,155 4,507 0.00New York............................. 31,985 33,390 31,952 32,248 31,401 31,060 33,704 31,919 30,505 29,760 28,922 29,447 0.74Newark................................. 8,449 7,479 8,053 8,476 9,526 9,770 9,942 8,075 7,034 8,004 7,876 7,308 0.03

Philadelphia......................... 18,629 16,366 14,867 16,850 18,722 18,252 19,108 19,693 21,016 21,844 23,102 22,524 0.73Phoenix................................ 5,225 4,785 5,325 6,238 7,043 6,169 6,536 5,999 6,354 6,309 6,390 5,902 0.00St. Louis............................... 3,524 3,283 5,409 5,612 5,693 4,681 5,414 5,626 4,977 5,343 5,317 5,395 0.85San Diego............................ 4,742 4,291 4,482 4,219 4,188 3,994 5,061 5,144 5,493 6,381 6,331 5,859 0.00

San Francisco...................... 9,692 7,847 7,505 10,071 7,812 7,729 7,107 7,118 6,612 6,884 6,392 6,138 0.06Seattle.................................. 6,094 6,032 8,442 8,731 7,520 6,588 7,105 6,638 8,723 9,506 7,795 6,133 0.42

Washington, DC................... 10,716 10,976 11,742 13,480 10,860 9,035 9,929 9,886 9,501 9,474 9,828 9,240 0.00

National Panel...................... 195,104 199,419 230,940 237,227 243,724 219,548 220,748 243,067 257,815 255,354 275,474 273,923 0.92

Year-End 1998 ED DAWN Data

H1,H

98,98

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

2 This column compares the first half of 1998 to the second half of 1998.3 This column compares the second half of 1997 to the second half of 1998.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For the purposes of this repor

than 0.05 are considered to be statistically significant.

Table 5 - Estimated number of emergency department drug mentions, by metropolitan area by half year: F1993 - second half 1998

p -val

61
DRUG MENTIONS

 Total Total Total Total Total Total Total Total 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.......................... 674,861 751,731 796,762 900,317 901,206 907,561 943,937 982,856 0.135 0.018 +Atlanta.................................. 13,230 17,696 14,766 21,362 22,319 19,108 16,191 20,218 0.259 0.772 

Baltimore.............................. 18,011 22,806 23,185 26,897 27,121 27,085 22,063 23,550 0.331 0.148 Boston.................................. 17,239 22,679 23,102 28,231 30,097 24,932 22,420 24,893 0.497 0.992 Buffalo.................................. 2,688 3,246 4,376 5,069 4,873 6,685 5,286 4,935 0.336 0.010 -

Chicago................................ 23,411 30,532 31,352 37,273 38,437 42,439 50,529 48,375 0.495 0.036 +

Dallas................................... 7,761 7,213 8,624 9,360 9,655 9,178 11,452 13,419 0.000 + 0.000 +

Denver................................. 5,981 6,338 6,367 8,417 8,226 5,916 7,538 7,179 0.313 0.001 +Detroit.................................. 24,377 28,378 35,715 30,748 34,177 39,037 32,503 32,604 0.974 0.351 Los Angeles - Long Beach... 30,223 33,723 35,564 33,221 33,423 35,236 29,703 29,820 0.945 0.093 

Miami - Hialeah.................... 7,694 7,813 8,704 9,383 10,087 9,926 10,258 10,756 0.478 0.118 Minneapolis - St. Paul.......... 6,968 7,737 8,756 9,030 8,342 9,164 9,383 8,150 0.116 0.144 New Orleans........................ 9,865 9,873 8,225 9,459 11,134 11,040 9,724 9,662 0.816 0.002 -New York............................. 52,336 65,648 65,375 64,199 62,461 65,623 60,265 58,368 0.485 0.012 -Newark................................. 15,046 14,843 15,928 16,529 19,296 18,017 15,038 15,185 0.820 0.502 

Philadelphia......................... 26,830 35,817 34,994 31,717 36,974 38,801 42,860 45,626 0.251 0.039 +Phoenix................................ 9,907 10,074 10,010 11,563 13,211 12,534 12,663 12,292 0.275 0.487 

St. Louis............................... 8,088 7,610 6,807 11,021 10,374 11,040 10,320 10,712 0.793 0.871 San Diego............................ 8,896 10,291 9,033 8,701 8,182 10,205 11,874 12,190 0.514 0.010 +

San Francisco...................... 17,210 15,436 17,538 17,576 15,541 14,224 13,495 12,530 0.009 - 0.004 -Seattle.................................. 7,993 10,353 12,126 17,173 14,108 13,743 18,228 13,927 0.120 0.912 

Washington, DC................... 18,234 18,329 21,692 25,222 19,896 19,815 18,975 19,068 0.966 0.725 

National Panel...................... 342,872 365,297 394,524 468,167 463,272 463,815 513,169 549,397 0.145 0.005 +

1996,

19981,2 19981,3

p -value p -value

Year-End 1998 ED DAWN Data

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

2 This column compares 1997 to 1998.3 This column compares 1996 to 1998.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments 

in the coterminous U.S.

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For 

the purposes of this report, p -values less than 0.05 are considered to be statistically significant.

Table 6 - Estimated number of emergency department drug mentions, by metropolitan area by year: 1991-1998

1997,

62
COCAINE

 Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.......................... 60,931 62,492 68,443 74,435 73,183 62,618 71,435 80,998 78,722 82,365 85,760 86,253 0.87Atlanta.................................. 2,069 2,314 2,665 3,500 3,384 3,130 2,685 2,749 2,227 2,016 3,127 2,853 0.07

Baltimore.............................. 3,731 3,912 4,297 4,585 4,700 3,903 4,021 4,495 3,212 3,041 3,167 3,704 0.00Boston.................................. 2,025 1,887 1,958 2,757 2,945 2,322 2,166 1,942 1,661 1,672 2,051 2,475 0.02Buffalo.................................. 409 565 564 643 614 721 1,092 1,111 884 642 610 615 0.93

Chicago................................ 3,764 4,876 4,839 5,958 6,003 4,699 5,734 6,954 7,100 7,273 6,883 6,757 0.48

Dallas................................... 678 667 692 733 752 704 690 702 819 959 1,262 1,324 0.30

Denver................................. 365 603 700 599 656 493 406 405 492 581 502 653 0.00Detroit.................................. 4,195 4,796 4,585 3,379 5,420 3,347 5,255 5,180 4,489 3,604 4,172 4,445 0.32Los Angeles - Long Beach... 2,686 2,676 2,548 2,522 2,663 2,322 2,748 2,962 2,295 2,413 2,629 3,154 0.04

Miami - Hialeah.................... 1,280 1,382 1,313 1,428 1,552 1,526 1,488 1,615 1,638 1,616 1,768 1,785 0.91Minneapolis - St. Paul.......... 202 256 252 327 237 229 301 375 359 377 394 378 0.56New Orleans........................ 821 866 967 917 863 1,154 1,078 1,302 1,177 1,186 1,305 1,091 0.00New York............................. 10,499 10,586 10,084 10,130 9,915 9,808 11,070 10,522 10,233 9,969 9,989 9,560 0.46Newark................................. 1,981 1,844 1,996 2,231 2,314 2,345 2,369 2,067 1,627 1,944 1,908 1,835 0.31

Philadelphia......................... 5,168 4,775 4,064 4,382 4,875 4,627 4,915 5,470 5,404 5,798 6,624 6,425 0.69Phoenix................................ 487 350 499 568 667 498 651 731 675 659 749 737 0.78

St. Louis............................... 616 604 1,154 1,175 1,108 734 877 975 707 787 1,017 1,056 0.76San Diego............................ 445 424 384 285 322 322 405 501 394 452 462 509 0.01

San Francisco...................... 1,645 1,390 1,288 1,835 1,296 1,264 1,155 1,160 992 987 912 930 0.33Seattle.................................. 836 924 1,380 1,517 1,211 946 1,128 1,015 1,267 1,583 1,261 1,139 0.78

Washington, DC................... 2,133 2,142 2,162 2,688 2,025 1,517 1,954 1,927 1,604 1,619 1,892 1,826 0.35

National Panel...................... 14,897 14,653 20,051 22,279 19,663 16,005 19,248 26,837 29,465 33,189 33,077 33,001 0.98

Year-End 1998 ED DAWN Data

H1,H2

98,981

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

2 This column compares the first half of 1998 to the second half of 1998.3 This column compares the second half of 1997 to the second half of 1998.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For the purposes of this report

than 0.05 are considered to be statistically significant.

Table 7 - Estimated number of emergency department cocaine mentions, by metropolitan area by half yearhalf 1993 - second half 1998

p -valu

63
COCAINE

 Total Total Total Total Total Total Total Total 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.......................... 101,189 119,843 123,423 142,878 135,801 152,433 161,087 172,014 0.107 0.040 +Atlanta.................................. 3,266 5,118 4,384 6,165 6,515 5,434 4,244 5,980 0.052 0.583 

Baltimore.............................. 6,687 8,078 7,643 8,882 8,603 8,515 6,253 6,871 0.227 0.041 -Boston.................................. 2,992 4,266 3,912 4,715 5,267 4,109 3,333 4,526 0.174 0.663 Buffalo.................................. 469 644 974 1,207 1,334 2,203 1,526 1,225 0.060 0.001 -

Chicago................................ 5,575 8,214 8,640 10,797 10,702 12,688 14,373 13,640 0.445 0.208 

Dallas................................... 1,302 1,221 1,345 1,426 1,457 1,393 1,778 2,586 0.000 + 0.000 +Denver................................. 699 838 968 1,299 1,149 811 1,072 1,154 0.222 0.000 +Detroit.................................. 5,919 6,939 8,991 7,964 8,767 10,435 8,093 8,617 0.615 0.483 Los Angeles - Long Beach... 4,901 5,337 5,362 5,070 4,985 5,710 4,707 5,783 0.008 + 0.906 

Miami - Hialeah.................... 1,838 1,940 2,662 2,742 3,078 3,104 3,254 3,553 0.165 0.011 +Minneapolis - St. Paul.......... 396 449 457 578 465 675 736 773 0.526 0.255 New Orleans........................ 3,486 2,847 1,686 1,884 2,018 2,380 2,363 2,396 0.731 0.881 New York............................. 16,099 20,414 21,085 20,214 19,724 21,592 20,202 19,549 0.495 0.040 -Newark................................. 4,016 4,017 3,825 4,228 4,658 4,436 3,571 3,743 0.417 0.500 

Philadelphia......................... 8,769 10,986 9,943 8,446 9,502 10,384 11,202 13,049 0.002 + 0.015 +Phoenix................................ 803 908 838 1,067 1,165 1,382 1,334 1,486 0.001 + 0.182 

St. Louis............................... 1,419 1,445 1,220 2,329 1,841 1,852 1,494 2,073 0.226 0.669 

San Diego............................ 846 1,149 869 668 644 906 846 971 0.126 0.551 

San Francisco...................... 3,052 2,760 3,035 3,123 2,560 2,315 1,979 1,843 0.113 0.000 -Seattle.................................. 1,124 1,446 1,760 2,896 2,157 2,143 2,850 2,399 0.355 0.420 

Washington, DC................... 4,572 4,236 4,275 4,849 3,542 3,881 3,223 3,718 0.006 + 0.409 National Panel...................... 22,958 26,591 29,550 42,330 35,668 46,085 62,654 66,078 0.591 0.026 +

p -value

19981,2 

p -value

1997, 1996,

19981,3

Year-End 1998 ED DAWN Data

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

2 This column compares 1997 to 1998.3 This column compares 1996 to 1998.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments 

in the coterminous U.S.

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For 

the purposes of this report, p -values less than 0.05 are considered to be statistically significant.

Table 8 - Estimated number of emergency department cocaine mentions, by metropolitan area by year: 1991-1998

64
HEROIN/MORPHINE

 Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.......................... 30,763 32,469 30,036 33,977 35,500 35,339 35,198 38,648 35,352 36,658 38,553 39,092 0.77Atlanta.................................. 106 144 197 260 219 205 216 198 179 220 229 254 0.49

Baltimore.............................. 2,515 3,204 3,394 4,116 4,221 4,001 3,944 4,166 3,035 2,838 3,019 3,706 0.00

Boston.................................. 1,185 1,134 945 1,582 1,594 1,377 1,337 1,415 1,278 1,239 1,366 1,390 0.86Buffalo.................................. 92 188 140 215 155 230 222 227 208 263 228 317 0.00

Chicago................................ 1,480 2,101 2,283 2,505 2,243 2,482 2,628 3,654 3,959 4,674 4,529 4,853 0.08

Dallas................................... 145 151 108 128 148 129 163 184 256 261 262 250 0.77

Denver................................. 97 179 219 276 228 241 201 143 193 283 256 253 0.53Detroit.................................. 1,118 1,262 1,130 975 1,343 1,058 1,614 1,600 1,584 1,462 1,437 1,464 0.83Los Angeles - Long Beach... 1,852 1,872 1,464 1,485 1,422 1,665 1,734 1,570 1,350 1,182 1,223 1,408 0.24

Miami - Hialeah.................... 114 138 129 135 180 156 160 231 280 319 365 408 0.36Minneapolis - St. Paul.......... 61 76 41 37 48 58 49 78 83 88 93 84 0.50New Orleans........................ 57 83 83 114 107 167 135 173 219 212 269 265 0.78New York............................. 5,131 6,220 5,561 5,624 5,288 5,440 5,677 5,490 4,898 4,593 4,626 4,618 0.97Newark................................. 2,422 2,104 2,137 2,361 2,696 2,989 2,978 2,414 1,861 2,506 2,577 2,502 0.32

Philadelphia......................... 1,362 1,116 1,029 1,411 1,877 2,002 1,955 1,985 1,738 2,079 1,672 1,914 0.20Phoenix................................ 251 236 246 236 232 258 290 345 414 418 474 419 0.43

St. Louis............................... 133 82 216 192 206 188 243 259 253 219 304 341 0.34San Diego............................ 408 434 368 327 305 386 560 421 419 508 493 517 0.07

San Francisco...................... 2,019 1,675 1,514 2,040 1,500 1,640 1,582 1,575 1,425 1,327 1,340 1,046 0.00Seattle.................................. 873 854 995 1,098 948 1,086 1,247 1,195 1,403 1,519 1,291 1,148 0.71

Washington, DC................... 803 611 505 755 668 640 692 843 827 864 1,057 1,055 0.94National Panel...................... 8,540 8,607 7,332 8,105 9,872 8,941 7,569 10,483 9,490 9,584 11,443 10,880 0.75

Year-End 1998 ED DAWN Data

H1,H2

98,981

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

2 This column compares the first half of 1998 to the second half of 1998.3 This column compares the second half of 1997 to the second half of 1998.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For the purposes of this report

than 0.05 are considered to be statistically significant.

Table 9 - Estimated number of emergency department heroin/morphine mentions, by metropolitan area by First half 1993 - second half 1998

p -valu

65
HEROIN/MORPHINE

 Total Total Total Total Total Total Total Total 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.......................... 35,898 48,003 63,232 64,013 70,838 73,846 72,010 77,645 0.060 0.443 Atlanta.................................. 157 232 250 456 424 414 400 483 0.099 0.114 

Baltimore.............................. 3,892 5,106 5,719 7,510 8,222 8,111 5,873 6,725 0.090 0.068 

Boston.................................. 1,165 2,061 2,319 2,527 2,971 2,751 2,517 2,756 0.459 0.991 Buffalo.................................. 155 172 279 355 385 448 471 545 0.001 + 0.000 +

Chicago................................ 2,262 2,958 3,581 4,787 4,725 6,282 8,633 9,383 0.502 0.013 +

Dallas................................... 234 276 297 237 276 347 516 512 0.949 0.000 +

Denver................................. 109 123 276 495 470 344 476 509 0.203 0.000 +Detroit.................................. 1,828 1,843 2,380 2,106 2,401 3,214 3,046 2,901 0.735 0.691 Los Angeles - Long Beach... 1,674 2,944 3,724 2,949 3,088 3,305 2,532 2,631 0.648 0.027 -

Miami - Hialeah.................... 145 181 251 264 336 391 599 772 0.000 + 0.000 +Minneapolis - St. Paul.......... 76 94 138 78 106 127 170 177 0.789 0.053 New Orleans........................ 223 152 140 197 274 308 431 534 0.000 + 0.000 +New York............................. 6,019 8,382 11,351 11,185 10,728 11,167 9,491 9,244 0.616 0.003 -Newark................................. 2,328 2,868 4,526 4,498 5,686 5,392 4,367 5,080 0.021 + 0.860 

Philadelphia......................... 2,424 2,364 2,478 2,440 3,879 3,941 3,817 3,586 0.581 0.573 Phoenix................................ 348 324 487 483 490 635 832 893 0.198 0.017 +

St. Louis............................... 177 204 215 408 394 502 472 644 0.147 0.393 San Diego............................ 773 1,022 842 695 691 982 927 1,011 0.388 0.869 

San Francisco...................... 3,140 3,131 3,694 3,555 3,139 3,157 2,751 2,386 0.000 - 0.000 -Seattle.................................. 789 1,100 1,727 2,092 2,034 2,442 2,922 2,439 0.306 0.994 

Washington, DC................... 1,480 1,512 1,414 1,261 1,307 1,535 1,691 2,112 0.000 + 0.000 +

National Panel...................... 6,502 10,956 17,146 15,437 18,813 18,052 19,074 22,323 0.203 0.335 

Year-End 1998 ED DAWN Data

Table 10 - Estimated number of emergency department heroin/morphine mentions, by metropolitan area by year: 1991-1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

2 This column compares 1997 to 1998.3 This column compares 1996 to 1998.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments 

in the coterminous U.S.

1997, 1996,

19981,2 19981,3

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For 

the purposes of this report, p -values less than 0.05 are considered to be statistically significant.

p -value p -value

66
MARIJUANA/HASHISH

Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec

 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.......................... 13,577 15,296 19,078 21,105 24,277 20,994 24,892 28,897 32,402 32,343 37,883 38,987 0.73Atlanta.................................. 404 445 637 890 832 839 692 855 770 808 1,410 1,223 0.10

Baltimore.............................. 312 313 364 405 393 552 507 686 689 713 708 788 0.26Boston.................................. 548 637 812 1,059 1,277 1,122 1,091 1,036 921 847 1,484 1,423 0.77Buffalo.................................. 50 88 108 122 100 195 271 241 275 197 206 246 0.00

Chicago................................ 596 769 984 1,236 1,524 1,396 1,652 1,881 2,060 2,364 2,607 2,395 0.00

Dallas................................... 194 173 242 235 247 308 294 262 435 481 761 752 0.84Denver................................. 86 116 211 195 313 183 147 141 215 290 293 287 0.86Detroit.................................. 1,183 1,532 1,511 1,338 2,089 1,785 2,234 1,981 1,853 1,892 2,049 2,286 0.16Los Angeles - Long Beach... 914 831 890 768 899 807 1,031 1,101 1,061 1,023 1,345 2,079 0.07

Miami - Hialeah.................... 212 260 318 393 478 491 503 513 565 465 564 555 0.87Minneapolis - St. Paul.......... 174 216 252 230 232 237 286 259 309 296 241 250 0.73New Orleans........................ 270 341 460 425 426 599 558 688 636 709 714 482 0.00New York............................. 1,011 1,081 1,181 1,408 1,516 1,460 1,723 1,848 1,942 1,901 1,988 1,696 0.02Newark................................. 219 218 268 360 413 331 346 281 249 251 266 266 1.00

Philadelphia......................... 1,076 879 930 1,154 1,554 1,508 1,689 1,747 2,164 2,392 2,835 2,475 0.16Phoenix................................ 123 103 159 294 279 196 334 276 357 384 385 340 0.27St. Louis............................... 82 73 ... 458 521 340 418 507 521 588 693 645 0.31

San Diego............................ 274 205 273 240 229 251 285 341 456 514 609 518 0.00

San Francisco...................... 227 224 231 248 259 247 232 193 195 195 206 188 0.12Seattle.................................. 203 203 394 476 534 459 479 417 773 890 569 366 0.29

Washington, DC................... 1,007 1,095 1,193 1,519 1,092 943 1,090 1,077 1,169 1,225 1,121 1,241 0.02

National Panel...................... 4,412 5,493 7,216 7,652 9,069 6,745 9,030 12,566 14,785 13,920 16,829 18,486 0.60

Year-End 1998 ED DAWN Data

Table 11 - Estimated number of emergency department marijuana/hashish mentions, by metropolitan area year: First half 1993 - second half 1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

2 This column compares the first half of 1998 to the second half of 1998.3 This column compares the second half of 1997 to the second half of 1998.

... Estimate does not meet standard of precision or is less than 10.NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For the purposes of this report

than 0.05 are considered to be statistically significant.

98,981

p -valu

H1,H2

67
MARIJUANA/HASHISH

Total Total Total Total Total Total Total Total

 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.......................... 16,251 23,997 28,873 40,183 45,271 53,789 64,744 76,870 0.008 + 0.000 +Atlanta.................................. 610 957 849 1,527 1,671 1,547 1,578 2,633 0.159 0.164 

Baltimore.............................. 355 672 625 770 945 1,194 1,402 1,495 0.574 0.032 +Boston.................................. 616 1,006 1,185 1,870 2,400 2,127 1,768 2,907 0.103 0.272 Buffalo.................................. 54 64 138 230 295 512 472 453 0.765 0.341 

Chicago................................ 808 1,488 1,366 2,219 2,919 3,533 4,424 5,002 0.101 0.001 +

Dallas................................... 253 341 367 477 555 556 916 1,513 0.000 + 0.000 +Denver................................. 173 232 202 406 497 288 505 579 0.088 0.000 +Detroit.................................. 807 1,487 2,716 2,849 3,875 4,215 3,746 4,335 0.182 0.890 Los Angeles - Long Beach... 1,055 1,331 1,745 1,658 1,706 2,132 2,084 3,423 0.083 0.142 

Miami - Hialeah.................... 443 364 472 711 969 1,015 1,030 1,118 0.224 0.085 Minneapolis - St. Paul.......... 134 276 391 482 469 544 604 491 0.203 0.630 New Orleans........................ 480 491 610 885 1,025 1,247 1,345 1,196 0.039 - 0.370 New York............................. 1,195 2,004 2,092 2,589 2,976 3,571 3,842 3,684 0.474 0.665 Newark................................. ... 396 436 628 743 627 500 532 0.051 0.408 

Philadelphia......................... 692 1,648 1,955 2,085 3,061 3,436 4,556 5,310 0.034 + 0.000 +Phoenix................................ 129 171 226 453 474 610 741 726 0.866 0.253 

St. Louis............................... 204 216 155 901 861 925 1,109 1,338 0.485 0.359 San Diego............................ 290 416 479 513 480 626 970 1,127 0.009 + 0.000 +

San Francisco...................... 305 278 451 479 507 425 390 394 0.943 0.651 Seattle.................................. 291 342 406 870 993 897 1,663 936 0.062 0.766 

Washington, DC................... 959 1,259 2,102 2,712 2,035 2,167 2,394 2,362 0.944 0.639 National Panel...................... 5,967 8,557 9,905 14,868 15,814 21,596 28,705 35,316 0.124 0.002 +

Year-End 1998 ED DAWN Data

Table 12 - Estimated number of emergency department marijuana/hashish mentions, by metropolitan area by year: 1991-1998

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For 

the purposes of this report, p -values less than 0.05 are considered to be statistically significant.

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

2 This column compares 1997 to 1998.3 This column compares 1996 to 1998.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.... Estimate does not meet standard of precision or is less than 10.

p -value

1997,

19981,2 

p -value

1996,

19981,3

68
METHAMPHETAMINE/SPEED

Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec

 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.......................... 4,224 5,702 7,824 9,841 9,678 6,257 4,197 6,805 8,218 8,936 6,534 4,957 0.09Atlanta.................................. ... 45 49 51 58 89 39 96 85 129 94 67 0.19

Baltimore.............................. ... ... ... ... ... ... ... ... ... ... ... ... ..Boston.................................. ... ... ... ... ... ... ... ... ... ... ... ... ..Buffalo.................................. ... ... ... ... ... ... ... ... ... ... ... ... ..Chicago................................ 12 ... ... 11 28 ... 17 11 10 19 16 18 0.72

Dallas................................... 50 ... 62 92 124 78 53 62 77 82 118 67 0.00Denver................................. 29 26 57 88 100 77 45 59 149 143 66 53 0.00Detroit.................................. 11 13 11 ... ... ... ... ... ... ... ... ... .Los Angeles - Long Beach... 605 622 677 722 813 464 575 694 596 633 418 368 0.34

Miami - Hialeah.................... ... ... ... ... ... ... ... ... ... ... ... ... .Minneapolis - St. Paul.......... 15 27 37 27 57 36 49 59 110 ... 68 43 0.15New Orleans........................ ... ... ... 10 ... 11 10 12 ... 17 13 12 0.19New York............................. 11 ... 11 ... 14 ... ... 15 13 ... 17 19 0.79Newark................................. ... ... ... ... ... ... ... ... ... ... ... ... ..

Philadelphia......................... 60 50 58 34 25 65 19 47 58 43 17 31 0.06Phoenix................................ 229 252 379 434 454 324 397 328 461 339 294 152 0.03

St. Louis............................... 10 18 28 25 58 18 ... 23 23 43 30 ... ..

San Diego............................ 422 508 486 427 413 272 288 378 418 558 421 300 0.00

San Francisco...................... 538 454 475 782 622 484 403 531 484 528 385 232 0.00Seattle.................................. 83 94 126 172 181 79 72 123 212 267 160 106 0.01

Washington, DC................... ... ... ... 32 ... 10 ... ... ... ... 10 ... ..

National Panel...................... 2,112 3,516 5,342 6,904 6,689 4,217 2,177 4,322 5,478 5,976 4,390 3,420 0.29

Year-End 1998 ED DAWN Data

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

p -valu

H1,H2

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).... Estimate does not meet standard of precision or is less than 10.

2 This column compares the first half of 1998 to the second half of 1998.3 This column compares the second half of 1997 to the second half of 1998.1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For the purposes of this report

than 0.05 are considered to be statistically significant.

Table 13 - Estimated number of emergency department methamphetamine/speed mentions, by metropolitahalf year: First half 1993 - second half 1998

98,981

69
METHAMPHETAMINE/SPEED

Total Total Total Total Total Total Total Total

 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.......................... 4,887 6,563 9,926 17,665 15,936 11,002 17,154 11,491 0.009 - 0.634 Atlanta.................................. 38 21 55 101 147 135 214 162 0.158 0.464 

Baltimore.............................. ... ... ... ... ... ... ... ... ... ... 

Boston.................................. 13 12 15 ... ... ... 13 ... ... ... 

Buffalo.................................. ... ... ... ... ... ... ... ... ... ... 

Chicago................................ 18 12 20 20 34 28 29 33 0.273 0.476 

Dallas................................... 99 68 79 154 203 115 159 186 0.009 + 0.000 +Denver................................. 38 31 55 145 176 105 292 120 0.000 - 0.280 Detroit.................................. 29 10 24 17 15 ... ... ... ... ... Los Angeles - Long Beach... 506 828 1,226 1,400 1,276 1,268 1,229 786 0.000 - 0.002 -

Miami - Hialeah.................... ... ... ... ... ... ... 10 16 0.000 + ... Minneapolis - St. Paul.......... 22 42 42 64 93 108 217 112 0.064 0.838 New Orleans........................ 40 18 10 12 18 22 26 25 0.699 0.726 New York............................. 12 20 16 21 23 21 32 36 0.629 0.064 Newark................................. ... 11 ... ... ... ... ... ... ... ... 

Philadelphia......................... 92 142 110 92 91 66 101 48 0.087 0.145 Phoenix................................ 164 279 481 813 777 725 800 446 0.000 - 0.000 -

St. Louis............................... 27 15 29 52 76 39 67 66 0.962 0.334 

San Diego............................ 515 931 929 913 686 666 976 721 0.003 - 0.597 

San Francisco...................... 839 688 992 1,258 1,106 934 1,012 616 0.000 - 0.000 -Seattle.................................. 90 99 177 299 260 195 479 266 0.000 - 0.007 +

Washington, DC................... 22 ... 20 33 24 11 ... 16 ... 0.193 National Panel...................... 2,302 3,315 5,628 12,245 10,906 6,499 11,454 7,810 0.089 0.191 

Year-End 1998 ED DAWN Data

... Estimate does not meet standard of precision or is less than 10.SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

2 This column compares 1997 to 1998.3 This column compares 1996 to 1998.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments 

in the coterminous U.S.

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For 

the purposes of this report, p -values less than 0.05 are considered to be statistically significant.

p -value

1996,

19981,3

Table 14 - Estimated number of emergency department methamphetamine/speed mentions, by metropolitan area by year: 1991-1998

p -value

1997,

19981,2 

70
TOTAL ED VISITS**

Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec

 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.......................... 43,500 44,151 44,439 45,190 44,027 44,521 45,314 45,876 44,342 45,378 44,309 45,374 0.00Atlanta.................................. 546 550 541 588 545 585 564 561 507 534 511 521 0.00

Baltimore.............................. 408 419 408 418 414 423 429 436 434 440 463 468 0.00Boston.................................. 862 884 818 861 797 804 834 880 784 784 770 786 0.00Buffalo.................................. 165 169 158 166 150 151 145 149 132 136 127 144 0.00Chicago................................ 1,020 1,040 1,063 1,082 1,093 1,123 1,095 1,109 1,071 1,126 1,049 1,092 0.00

Dallas................................... 389 407 409 417 416 427 417 419 449 438 462 452 0.00

Denver................................. 244 242 223 225 228 237 230 216 216 223 212 214 0.00Detroit.................................. 770 798 722 713 752 761 746 791 729 720 724 737 0.00Los Angeles - Long Beach... 1,215 1,204 1,158 1,218 1,115 1,123 1,177 1,158 1,068 1,165 1,024 1,118 0.00

Miami - Hialeah.................... 286 285 307 300 309 313 318 314 329 339 354 346 0.00Minneapolis - St. Paul.......... 307 323 273 288 336 347 346 345 335 347 330 331 0.00New Orleans........................ 272 263 280 285 287 288 297 306 285 291 289 274 0.00New York............................. 1,611 1,599 1,641 1,715 1,599 1,597 1,829 1,795 1,735 1,698 1,672 1,799 0.00Newark................................. 342 328 331 347 347 355 332 349 321 328 340 357 0.00

Philadelphia......................... 869 884 804 815 828 829 821 836 807 831 826 865 0.00Phoenix................................ 340 305 322 323 348 352 384 347 348 342 372 345 0.00St. Louis............................... 439 455 460 457 440 429 445 436 409 433 422 397 0.00San Diego............................ 317 301 264 256 243 260 291 284 291 295 298 313 0.00

San Francisco...................... 309 281 287 291 238 243 252 243 239 241 256 257 0.00Seattle.................................. 363 334 353 349 279 291 309 290 283 299 279 271 0.00

Washington, DC................... 569 587 587 608 582 594 535 555 536 541 552 560 0.00National Panel...................... 31,858 32,496 33,030 33,468 32,681 32,989 33,518 34,059 33,036 33,829 32,977 33,725 0.00

Year-End 1998 ED DAWN Data

Table 15 - Estimated number of total emergency department visits, by metropolitan area by half year: First - second half 1998

98,981

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

2 This column compares the first half of 1998 to the second half of 1998.3 This column compares the second half of 1997 to the second half of 1998.**

 DAWN estimates of emergency department (ED) visits (in 1,000s) should be close to but will not necessarily equal totals from previous year's American Hospital Ass

Annual Survey.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

p -valu

H1,H2

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For the purposes of this report

than 0.05 are considered to be statistically significant.

71
TOTAL ED VISITS**

Total Total Total Total Total Total Total Total

 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.......................... 84,189 85,944 87,651 89,629 88,548 91,189 89,720 89,683 0.761 0.000 -Atlanta.................................. 1,059 1,046 1,096 1,129 1,129 1,125 1,041 1,032 0.726 0.002 -

Baltimore.............................. 803 790 827 825 838 865 873 931 0.000 + 0.000 +

Boston.................................. 1,683 1,749 1,746 1,679 1,601 1,714 1,568 1,556 0.793 0.000 -

Buffalo.................................. 336 346 333 324 300 294 268 272 0.000 + 0.000 -

Chicago................................ 2,098 2,197 2,060 2,145 2,216 2,204 2,197 2,141 0.000 - 0.000 -

Dallas................................... 722 757 796 826 843 835 886 914 0.000 + 0.000 +

Denver................................. 427 469 486 448 464 446 439 426 0.000 - 0.000 -Detroit.................................. 1,522 1,507 1,568 1,435 1,513 1,537 1,449 1,461 0.000 + 0.000 -Los Angeles - Long Beach... 2,303 2,296 2,419 2,376 2,237 2,335 2,233 2,142 0.000 - 0.000 -

Miami - Hialeah.................... 574 565 571 607 622 632 668 700 0.000 + 0.000 +Minneapolis - St. Paul.......... 656 623 630 561 683 691 683 661 0.000 - 0.000 -New Orleans........................ 506 521 535 566 575 603 576 563 0.000 - 0.000 -New York............................. 3,221 3,233 3,210 3,356 3,196 3,624 3,432 3,472 0.000 + 0.000 -Newark................................. 637 617 670 679 702 681 649 697 0.000 + 0.000 +

Philadelphia......................... 1,720 1,827 1,752 1,619 1,657 1,657 1,638 1,691 0.000 + 0.001 +Phoenix................................ 601 631 645 645 701 732 690 717 0.000 + 0.000 -St. Louis............................... 863 789 894 917 869 880 841 819 0.000 - 0.000 -San Diego............................ 612 614 618 520 504 575 586 611 0.000 + 0.000 +

San Francisco...................... 558 543 589 578 481 495 479 513 0.000 + 0.000 +Seattle.................................. 637 652 697 702 570 599 582 550 0.000 - 0.000 -

Washington, DC................... 1,101 1,048 1,156 1,195 1,176 1,090 1,077 1,112 0.000 + 0.000 +

National Panel...................... 61,553 63,124 64,354 66,498 65,670 67,577 66,864 66,702 0.224 0.000 -

Year-End 1998 ED DAWN Data

Table 16 - Estimated number of total emergency department visits, by metropolitan area by year: 1991-1998

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. 

For the purposes of this report, p -values less than 0.05 are considered to be statistically significant.

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

2 This column compares 1997 to 1998.3 This column compares 1996 to 1998.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

**

 DAWN estimates of emergency department (ED) visits (in 1,000s) should be close to but will not necessarily equal totals from previous 

year's American Hospital Association (AHA) Annual Survey.

p -value

1997,

19981,2 

p -value

1996,

19981,3

72
DRUG EPISODES

Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec

 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.***............................. 230,234 230,676 252,625 265,896 270,855 242,777 251,672 262,675 265,194 261,864 271,903 270,641 

AGE

6-34......................................... 146,567 141,765 158,735 166,198 165,408 144,530 150,391 152,993 155,293 151,416 154,273 147,687 12-17....................................... 27,092 22,947 31,498 28,974 32,604 28,118 33,383 30,566 33,126 28,312 32,496 26,591 18-25....................................... 49,936 48,340 54,393 57,868 54,238 49,471 47,928 50,697 52,641 52,006 50,798 52,640 26-34....................................... 68,730 69,904 72,398 78,797 77,881 66,123 68,461 71,174 68,917 69,981 70,484 67,999 35+.......................................... 82,902 88,355 91,698 98,447 104,781 97,536 100,825 109,280 108,947 109,683 116,837 122,335 

GENDER

Male......................................... 112,469 119,252 125,998 137,336 135,680 120,457 122,807 134,851 136,327 133,638 141,162 140,193 

Female..................................... 115,477 109,048 124,538 125,795 132,477 119,685 125,878 125,194 126,468 125,761 127,820 128,410 

RACE/ETHNICITY

White....................................... 121,955 123,288 135,083 144,229 145,154 132,484 134,980 139,078 143,733 140,509 145,650 149,796 Black........................................ 62,747 64,181 68,527 72,645 74,541 64,848 65,063 70,269 68,043 66,853 69,304 67,177 

Hispanic................................... 24,731 23,503 24,552 25,886 25,830 21,531 26,446 28,586 26,454 26,253 30,084 27,078 Other race................................ 3,303 2,541 3,099 2,951 3,089 2,447 3,201 2,819 3,107 2,990 2,809 2,574 

Race unknown......................... 17,497 17,163 21,365 20,185 22,241 21,468 21,982 21,923 23,856 25,259 24,055 24,017 

FACILITY LOCATION

Central city............................... 79,196 83,014 82,369 87,900 89,537 81,834 85,920 86,007 81,984 81,597 82,642 83,018 

Outside central city.................. 38,182 36,360 39,031 43,032 42,430 39,157 41,373 40,393 40,635 40,461 41,432 40,428 National Panel......................... 112,431 110,825 131,225 134,964 138,888 121,786 124,379 136,275 142,574 139,806 147,829 147,195 

DRUG USE MOTIVE

Recreational use...................... 17,781 18,640 19,963 23,985 23,593 22,614 23,536 30,336 29,082 26,993 27,515 29,520 

Dependence............................ 71,361 72,792 79,301 86,240 88,295 75,696 80,971 86,499 87,460 91,101 92,671 96,422 Suicide..................................... 92,042 88,170 99,775 99,997 104,401 96,718 95,668 95,742 99,635 91,847 98,216 91,681 Other/unknown motive............. 49,050 51,075 53,586 55,674 54,566 47,749 51,497 50,098 49,017 51,924 53,500 53,018 

REASONS FOR ED CONTACT

Unexpected reaction................ 26,870 27,699 31,189 35,406 31,284 26,098 28,940 32,963 35,504 33,183 34,218 36,962 Overdose................................. 123,562 120,203 132,232 137,341 141,373 130,349 127,055 125,860 128,330 116,594 127,490 117,674 Chronic effects......................... 24,989 25,192 26,904 29,106 33,188 26,978 26,987 26,480 24,116 25,157 25,717 24,393 

Seeking detox.......................... 24,734 22,664 25,058 27,155 26,545 23,938 28,388 31,535 32,226 35,662 35,618 37,425 

Withdrawal............................... 4,720 6,405 7,233 6,791 8,161 6,965 7,223 7,790 6,984 8,193 8,320 9,659 Other/unknown reason............. 25,359 28,514 30,008 30,097 30,305 28,449 33,079 38,047 38,034 43,076 40,540 44,528 

Year-End 1998 ED DAWN Data

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

Table 17 - Estimated number of emergency department drug episodes, by age, gender, race/ethnicity, hosplocation, drug use motive, and reason for emergency department contact: First half 1993 - second half 199

*** Total includes patients whose gender or age was unknown.

2 This column compares the first half of 1998 to the second half of 1998.3 This column compares the second half of 1997 to the second half of 1998.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

9

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For the purposes of this report

0.05 are considered to be statistically significant.

p 

73
DRUG EPISODES

Total Total Total Total Total Total Total Total

 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.***............................. 393,968 433,493 460,910 518,521 513,633 514,347 527,058 542,544 0.217 0.067 

AGE

6-34......................................... 261,873 277,887 288,332 324,933 309,937 303,384 306,709 301,960 0.493 0.886 12-17....................................... 47,494 46,822 50,039 60,472 60,722 63,949 61,437 59,086 0.394 0.035 -18-25....................................... 92,410 96,307 98,276 112,262 103,708 98,625 104,647 103,438 0.721 0.220 26-34....................................... 121,354 133,506 138,634 151,195 144,003 139,634 138,897 138,483 0.910 0.824 35+.......................................... 130,852 154,570 171,257 190,145 202,316 210,105 218,630 239,172 0.002 + 0.001 +

GENDER

Male......................................... 189,455 219,607 231,721 263,334 256,137 257,658 269,965 281,355 0.145 0.014 +

Female..................................... 200,972 210,051 224,526 250,333 252,162 251,072 252,229 256,230 0.507 0.459 

RACE/ETHNICITY

White....................................... 221,541 235,643 245,243 279,312 277,637 274,057 284,242 295,447 0.264 0.085 Black........................................ 106,914 122,880 126,929 141,171 139,389 135,332 134,896 136,481 0.724 0.841 

Hispanic................................... 33,082 42,174 48,233 50,438 47,360 55,032 52,707 57,162 0.518 0.756 

Other race................................ 4,298 4,892 5,844 6,050 5,536 6,020 6,097 5,382 0.148 0.136 

Race unknown......................... 28,133 27,905 34,660 41,550 43,709 43,905 49,115 48,072 0.813 0.306 

FACILITY LOCATION

Central city............................... 136,436 158,892 162,210 170,269 171,372 171,926 163,581 165,660 0.578 0.274 

Outside central city.................. 64,692 70,445 74,542 82,063 81,587 81,766 81,096 81,860 0.808 0.982 National Panel......................... 192,840 204,155 223,256 266,189 260,674 260,654 282,380 295,023 0.287 0.020 +

DRUG USE MOTIVE

Recreational use...................... 30,362 35,008 36,421 43,948 46,207 53,873 56,075 57,035 0.751 0.523 

Dependence............................ 114,009 135,280 144,152 165,541 163,991 167,470 178,561 189,094 0.185 0.054 Suicide..................................... 172,710 172,403 180,212 199,773 201,120 191,410 191,481 189,897 0.815 0.855 

Other/unknown motive............. 76,887 90,801 100,125 109,259 102,315 101,595 100,941 106,518 0.278 0.473 

REASONS FOR ED CONTACT

Unexpected reaction................ 41,246 52,588 54,569 66,595 57,382 61,902 68,687 71,180 0.393 0.004 +Overdose................................. 224,189 232,674 243,765 269,573 271,722 252,915 244,924 245,164 0.967 0.264 Chronic effects ........................ 43,964 46,865 50,180 56,010 60,166 53,467 49,273 50,110 0.721 0.338 

Seeking detox.......................... 36,704 44,815 47,398 52,213 50,483 59,923 67,888 73,043 0.425 0.136 

Withdrawal............................... 7,166 9,851 11,125 14,025 15,127 15,013 15,176 17,979 0.024 + 0.028 +Other/unknown reason............. 40,699 46,700 53,872 60,105 58,754 71,127 81,110 85,068 0.548 0.050 

Year-End 1998 ED DAWN Data

p -value

1996,

19981,3

Table 18 - Estimated number of emergency department drug episodes, by age, gender, race/ethnicity, hospital location, drug use motive, and reason for emergency department contact: 1991-1998

p -value

1997,

19981,2 

*** Total includes patients whose gender or age was unknown.

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For the 

purposes of this report, p -values less than 0.05 are considered to be statistically significant.

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

2 This column compares 1997 to 1998.3 This column compares 1996 to 1998.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments inthe coterminous U.S.

74
DRUG MENTIONS

Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec

 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.***............................. 394,905 401,857 438,398 461,919 471,933 429,273 442,932 464,630 473,220 470,716 492,116 490,741 

AGE

6-34......................................... 248,051 244,305 272,779 282,465 282,169 250,727 257,923 267,326 271,389 268,280 273,532 262,805 12-17....................................... 40,713 36,421 49,404 44,250 50,506 42,536 50,145 46,514 52,456 46,170 51,860 43,435 18-25....................................... 83,684 83,591 93,038 98,233 92,590 86,061 81,437 89,945 92,600 93,133 91,489 93,065 26-34....................................... 122,542 123,681 129,779 139,345 138,235 121,140 125,525 130,138 125,315 127,637 129,651 125,758 35+.......................................... 145,360 156,665 162,871 177,748 188,693 177,294 184,247 196,454 200,310 201,077 217,120 226,812 

GENDER

Male......................................... 194,715 205,480 223,271 239,186 239,965 214,214 219,983 242,521 244,437 242,043 258,370 256,971 

Female..................................... 196,407 192,145 211,479 217,633 227,283 210,470 217,656 217,617 224,909 224,458 228,763 230,246 

RACE/ETHNICITY

White....................................... 216,776 223,412 240,915 260,311 260,361 243,975 243,698 253,185 265,068 260,410 273,988 282,330 Black........................................ 106,201 108,759 117,266 123,184 129,976 110,427 112,470 121,325 118,566 117,978 122,088 116,961 

Hispanic................................... 39,100 37,237 39,737 40,848 40,497 34,493 44,629 48,745 44,889 46,466 51,553 47,185 

Other race................................ 5,318 4,379 5,133 4,725 4,944 4,026 5,545 5,438 4,890 4,959 5,020 4,369 

Race unknown......................... 27,510 28,069 35,347 32,851 36,155 36,352 36,590 35,936 39,807 40,904 39,467 39,895 

FACILITY LOCATION

Central city............................... 130,936 137,459 137,657 147,683 152,191 139,906 147,940 149,567 142,699 142,178 142,150 143,175 

Outside central city.................. 68,390 64,443 69,801 77,010 76,018 69,819 74,244 71,995 72,706 73,185 74,491 73,643 National Panel......................... 195,104 199,419 230,940 237,227 243,724 219,548 220,748 243,067 257,815 255,354 275,474 273,923 

DRUG USE MOTIVE

Recreational use...................... 28,960 31,421 32,825 37,642 37,929 36,851 38,289 51,074 48,885 45,229 46,332 51,292 

Dependence............................ 117,686 118,289 131,925 143,424 148,717 128,299 139,928 150,209 152,316 159,865 163,309 168,860 

Suicide..................................... 168,217 167,209 185,927 187,231 192,770 181,021 177,710 177,789 188,644 176,055 191,196 179,993 

Other/unknown motive............. 80,042 84,937 87,722 93,623 92,516 83,102 87,004 85,558 83,376 89,567 91,278 90,595 

REASONS FOR ED CONTACT

Unexpected reaction................ 43,461 45,489 50,906 56,893 51,730 43,200 46,957 53,676 59,223 54,407 56,928 61,190 Overdose................................. 219,468 220,876 236,971 250,532 253,855 238,810 230,787 230,813 236,689 219,593 243,800 225,387 Chronic effects......................... 36,842 37,299 41,578 44,695 53,156 43,214 43,780 42,453 39,269 40,399 41,914 39,927 

Seeking detox.......................... 44,430 38,887 44,844 47,307 49,485 43,842 52,883 58,745 59,974 69,443 67,439 70,749 

Withdrawal............................... 7,177 9,974 10,751 10,156 11,595 9,929 10,920 11,764 10,647 11,897 12,242 15,418 Other/unknown reason............. 43,527 49,330 53,348 52,337 52,112 50,279 57,605 67,177 67,418 74,977 69,793 78,069 

Year-End 1998 ED DAWN Data

H

9

Table 19 - Estimated number of emergency department drug mentions, by age, gender, race/ethnicity, hospdrug use motive, and reason for emergency department contact: First half 1993 - second half 1998

p 

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).*** Total includes patients whose gender or age was unknown.

2 This column compares the first half of 1998 to the second half of 1998.3 This column compares the second half of 1997 to the second half of 1998.1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For the purposes of this report

0.05 are considered to be statistically significant.

75

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.
DRUG MENTIONS

Total Total Total Total Total Total Total Total

 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.***............................. 674,861 751,731 796,762 900,317 901,206 907,561 943,937 982,856 0.135 0.018 +

AGE

6-34......................................... 440,437 476,533 492,356 555,245 532,896 525,249 539,669 536,337 0.812 0.498 12-17....................................... 72,545 72,970 77,134 93,654 93,041 96,659 98,626 95,295 0.508 0.753 18-25....................................... 153,202 166,680 167,275 191,271 178,651 171,382 185,733 184,555 0.856 0.088 26-34....................................... 213,864 235,322 246,224 269,124 259,375 255,663 252,952 255,409 0.763 0.998 35+.......................................... 232,532 273,609 302,025 340,618 365,987 380,701 401,388 443,932 0.003 + 0.000 +

GENDER

Male......................................... 325,953 382,788 400,195 462,457 454,180 462,505 486,480 515,342 0.073 0.008 +

Female..................................... 342,839 361,572 388,552 429,112 437,753 435,273 449,367 459,009 0.439 0.099 

RACE/ETHNICITY

White....................................... 396,904 426,793 440,188 501,226 504,336 496,883 525,478 556,318 0.157 0.021 +Black........................................ 173,347 205,800 214,960 240,450 240,403 233,795 236,544 239,049 0.754 0.669 

Hispanic................................... 51,928 67,384 76,337 80,585 74,990 93,374 91,355 98,738 0.582 0.699 

Other race................................ 6,861 8,027 9,697 9,859 8,970 10,982 9,849 9,389 0.619 0.121 

Race unknown......................... 45,820 43,726 55,580 68,198 72,507 72,526 80,711 79,362 0.866 0.362 

FACILITY LOCATION

Central city............................... 217,701 261,137 268,395 285,340 292,097 297,507 284,877 285,326 0.949 0.271 

Outside central city.................. 114,288 125,297 132,833 146,811 145,836 146,240 145,891 148,134 0.710 0.811 National Panel......................... 342,872 365,297 394,524 468,167 463,272 463,815 513,169 549,397 0.145 0.005 +

DRUG USE MOTIVE

Recreational use...................... 47,320 55,700 60,381 70,467 74,780 89,363 94,115 97,625 0.512 0.329 

Dependence............................ 184,101 221,472 235,976 275,348 277,016 290,137 312,180 332,169 0.212 0.043 +Suicide..................................... 315,936 321,991 335,426 373,158 373,791 355,499 364,698 371,189 0.643 0.370 

Other/unknown motive............. 127,504 152,568 164,979 181,344 175,618 172,562 172,944 181,873 0.305 0.448 

REASONS FOR ED CONTACT

Unexpected reaction................ 62,606 82,938 88,951 107,799 94,930 100,633 113,630 118,118 0.391 0.002 +Overdose................................. 403,791 424,935 440,343 487,503 492,665 461,600 456,282 469,187 0.302 0.611Chronic effects ........................ 66,551 71,489 74,141 86,273 96,371 86,233 79,668 81,841 0.589 0.500

Seeking detox.......................... 63,071 77,834 83,318 92,151 93,326 111,628 129,417 138,188 0.481 0.101 

Withdrawal............................... 11,121 14,856 17,151 20,907 21,524 22,684 22,544 27,660 0.031 + 0.048 +Other/unknown reason............. 67,720 79,679 92,858 105,685 102,390 124,782 142,394 147,863 0.649 0.073 

Year-End 1998 ED DAWN Data

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

2 This column compares 1997 to 1998.3 This column compares 1996 to 1998.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

p -value

1996,

19981,3

Table 20 - Estimated number of emergency department drug mentions, by age, gender, race/ethnicity, hospital location, drug use motive, and reason for emergency department contact: 1991-1998

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For the 

purposes of this report, p -values less than 0.05 are considered to be statistically significant.

p -value

1997,

19981,2 

*** Total includes patients whose gender or age was unknown.

76
COCAINE

Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec

 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.***............................. 60,931 62,492 68,443 74,435 73,183 62,618 71,435 80,998 78,722 82,365 85,760 86,253 

AGE

6-34......................................... 38,406 37,988 41,984 45,976 43,258 34,868 39,692 43,699 42,175 43,830 44,169 43,713 12-17....................................... 578 992 1,100 954 1,191 860 1,236 1,345 2,084 1,547 2,235 2,074 18-25....................................... 11,109 11,050 11,821 13,571 11,699 9,417 10,207 11,858 12,340 12,880 11,886 12,622 26-34....................................... 26,714 25,944 29,061 31,439 30,362 24,591 28,243 30,489 27,743 29,400 29,995 29,015 35+.......................................... 22,259 24,354 26,076 28,162 29,829 27,518 31,561 37,162 36,302 38,301 41,394 42,335 

GENDER

Male......................................... 40,944 41,743 45,562 50,563 48,391 41,308 46,286 54,606 52,059 54,122 55,784 56,603 

Female..................................... 19,597 20,339 22,498 23,165 23,976 20,703 24,537 25,650 26,089 27,268 29,107 29,074 

RACE/ETHNICITY

White....................................... 15,799 16,919 19,127 21,716 20,810 19,208 20,726 23,994 24,049 26,823 25,735 27,219 

Black........................................ 34,332 34,374 36,247 40,737 40,503 32,914 36,990 40,997 40,770 41,491 42,745 41,813 

Hispanic................................... 6,211 6,502 7,028 6,345 6,005 5,498 7,959 9,781 8,498 8,262 11,388 9,821 

Other race................................ 226 336 534 356 290 251 464 336 377 447 407 412 

Race unknown......................... 4,363 4,361 5,505 5,282 5,575 4,747 5,296 5,891 5,028 5,343 5,485 6,988 

FACILITY LOCATION

Central city............................... 36,270 38,408 38,184 40,642 42,416 37,261 41,400 43,143 39,359 39,143 41,346 41,113 

Outside central city.................. 9,624 9,290 10,207 11,515 11,105 9,352 10,787 11,018 9,897 10,034 11,337 12,140 National Panel......................... 14,897 14,653 20,051 22,279 19,663 16,005 19,248 26,837 29,465 33,189 33,077 33,001 

DRUG USE MOTIVE

Recreational use...................... 6,663 7,403 7,628 8,485 8,025 8,310 8,248 13,158 11,299 11,512 11,293 11,876 

Dependence............................ 39,450 38,442 43,971 47,295 46,942 39,808 46,228 48,879 48,304 50,850 52,740 52,647 Suicide..................................... 4,710 4,687 5,558 6,161 6,337 5,735 5,978 7,067 6,936 7,513 7,869 7,786 Other/unknown motive............. 10,108 11,960 11,287 12,494 11,880 8,764 10,981 11,895 12,183 12,490 13,858 13,944 

REASONS FOR ED CONTACT

Unexpected reaction................ 14,054 13,799 16,002 17,760 14,404 11,532 14,316 16,108 16,725 16,138 17,732 17,511 Overdose................................. 8,840 10,151 10,105 12,086 11,111 10,141 10,320 12,464 12,089 12,159 13,403 12,546 Chronic effects......................... 11,379 11,565 13,467 13,562 17,665 13,478 14,333 13,895 12,678 12,192 12,930 12,703 

Seeking detox.......................... 17,041 14,759 16,892 18,795 17,877 15,688 19,729 22,432 22,351 25,491 24,469 24,711 

Withdrawal............................... 1,271 1,800 1,683 1,672 1,632 1,843 1,914 1,760 1,578 1,843 1,920 2,011 Other/unknown reason............. 8,345 10,419 10,293 10,560 10,495 9,936 10,823 14,340 13,300 14,542 15,305 16,770 

3 This column compares the second half of 1997 to the second half of 1998.

H

9

Year-End 1998 ED DAWN Data

Table 21 - Estimated number of emergency department cocaine mentions, by age, gender, race/ethnicity, hlocation, drug use motive, and reason for emergency department contact: First half 1993 - second half 1998

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

p 

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For the purposes of this report

0.05 are considered to be statistically significant.

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).*** Total includes patients whose gender or age was unknown.

2 This column compares the first half of 1998 to the second half of 1998.

77
COCAINE

Total Total Total Total Total Total Total Total

 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.***............................. 101,189 119,843 123,423 142,878 135,801 152,433 161,087 172,014 0.107 0.040 +

AGE

6-34......................................... 70,113 78,188 76,394 87,960 78,126 83,391 86,005 87,882 0.644 0.348 12-17....................................... 2,138 1,533 1,570 2,054 2,051 2,581 3,630 4,309 0.322 0.061 18-25....................................... 21,766 23,883 22,159 25,392 21,116 22,065 25,220 24,508 0.678 0.108 26-34....................................... 46,137 52,760 52,658 60,500 54,953 58,732 57,143 59,010 0.472 0.917 35+.......................................... 30,582 41,288 46,614 54,238 57,348 68,723 74,602 83,729 0.005 + 0.004 +

GENDER

Male......................................... 66,602 80,595 82,687 96,125 89,698 100,891 106,181 112,386 0.200 0.074 

Female..................................... 33,778 38,194 39,936 45,663 44,679 50,187 53,357 58,181 0.063 0.017 +

RACE/ETHNICITY

White....................................... 29,198 31,927 32,718 40,843 40,018 44,720 50,871 52,955 0.588 0.014 +Black........................................ 56,106 69,123 68,706 76,984 73,417 77,986 82,260 84,558 0.533 0.285 

Hispanic................................... 9,012 11,824 12,713 13,373 11,502 17,740 16,760 21,209 0.274 0.448 

Other race................................ 513 502 561 890 541 800 824 819 0.959 0.903 

Race unknown......................... 6,360 6,467 8,724 10,788 10,323 11,187 10,371 12,472 0.162 0.447 

FACILITY LOCATION

Central city............................... 60,269 74,589 74,678 78,825 79,677 84,543 78,502 82,459 0.065 0.611 

Outside central city.................. 17,962 18,663 18,915 21,722 20,457 21,805 19,931 23,477 0.012 + 0.372 National Panel......................... 22,958 26,591 29,550 42,330 35,668 46,085 62,654 66,078 0.591 0.026 +

DRUG USE MOTIVE

Recreational use...................... 14,740 14,997 14,066 16,113 16,335 21,406 22,811 23,169 0.829 0.626 

Dependence............................ 65,348 77,455 77,892 91,265 86,749 95,107 99,154 105,388 0.247 0.251 Suicide..................................... 6,619 7,402 9,397 11,718 12,072 13,045 14,449 15,655 0.313 0.160 

Other/unknown motive............. 14,481 19,988 22,068 23,782 20,644 22,876 24,673 27,802 0.184 0.141 

REASONS FOR ED CONTACT

Unexpected reaction................ 23,025 28,755 27,852 33,762 25,936 30,424 32,863 35,244 0.153 0.027 +Overdose................................. 14,662 16,242 18,991 22,191 21,251 22,784 24,249 25,949 0.223 0.031 +Chronic effects ........................ 20,868 23,407 22,944 27,029 31,143 28,227 24,870 25,634 0.624 0.291 

Seeking detox.......................... 25,492 30,826 31,801 35,687 33,565 42,161 47,842 49,181 0.760 0.296 

Withdrawal............................... 1,960 2,268 3,071 3,355 3,475 3,673 3,421 3,931 0.261 0.631 Other/unknown reason............. 15,182 18,344 18,764 20,854 20,432 25,163 27,842 32,075 0.190 0.046 +

the coterminous U.S.

1997,

19981,2 

1996,

19981,3

Year-End 1998 ED DAWN Data

*** Total includes patients whose gender or age was unknown.SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

2 This column compares 1997 to 1998.3 This column compares 1996 to 1998.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in 

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For the 

purposes of this report, p -values less than 0.05 are considered to be statistically significant.

p -value

Table 22 - Estimated number of emergency department cocaine mentions, by age, gender, race/ethnicity, hospital location, drug use motive, and reason for emergency department contact: 1991-1998

p -value

78
HEROIN/MORPHINE

Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec

 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.***............................. 30,763 32,469 30,036 33,977 35,500 35,339 35,198 38,648 35,352 36,658 38,553 39,092 

AGE

6-34......................................... 14,580 14,926 13,928 16,569 16,050 15,774 15,262 16,683 15,900 16,099 17,060 16,758 

12-17....................................... 137 143 ... 265 144 260 229 330 531 848 444 465 18-25....................................... 3,807 4,212 3,794 4,576 4,039 4,511 4,288 4,980 5,029 4,965 5,448 5,998 26-34....................................... 10,633 10,569 9,890 11,728 11,868 11,002 10,741 11,374 10,339 10,286 11,166 10,294 35+.......................................... 16,128 17,485 16,058 17,301 19,408 19,512 19,884 21,908 19,401 20,513 21,439 22,274 

GENDER

Male......................................... 21,633 23,040 20,358 23,642 24,636 24,530 23,662 26,150 24,340 23,760 26,102 26,363 

Female..................................... 8,942 9,217 9,407 10,108 10,297 10,482 11,187 12,233 10,793 12,495 12,012 12,574 

RACE/ETHNICITY

White....................................... 11,349 11,679 10,773 12,610 13,890 13,181 11,693 13,691 12,955 13,927 14,289 15,302 Black........................................ 11,265 12,082 12,615 13,374 13,520 13,733 13,753 14,634 13,667 12,906 14,070 13,776 

Hispanic................................... 5,478 5,849 4,396 5,056 4,596 5,242 5,715 6,052 4,188 5,046 5,740 5,779 

Other race................................ ... 206 120 162 221 145 286 191 432 232 428 215 

Race unknown......................... 2,177 2,654 2,132 2,774 3,272 3,038 3,752 4,079 4,109 4,547 4,026 4,021 

FACILITY LOCATION

Central city............................... 16,825 19,003 18,092 20,552 20,219 20,708 21,773 23,016 21,317 21,941 21,849 22,720 

Outside central city.................. 5,364 4,807 4,612 5,320 5,409 5,689 5,856 5,149 4,545 5,133 5,260 5,492 National Panel......................... 8,540 8,607 7,332 8,105 9,872 8,941 7,569 10,483 9,490 9,584 11,443 10,880 

DRUG USE MOTIVE

Recreational use...................... 2,995 2,342 1,649 2,505 2,159 3,118 2,826 3,498 2,381 2,471 2,179 2,183 

Dependence............................ 23,144 24,767 23,966 26,540 28,539 27,012 27,945 29,349 28,160 28,844 30,662 31,565 Suicide..................................... 942 1,173 1,069 1,213 1,159 1,412 1,136 1,718 1,549 1,922 1,846 1,676 

Other/unknown motive............. 3,681 4,187 3,353 3,719 3,643 3,796 3,290 4,083 3,262 3,420 3,866 3,668 

REASONS FOR ED CONTACT

Unexpected reaction................ 3,364 3,485 2,652 3,655 3,083 3,141 3,087 3,514 3,364 3,361 3,950 4,053 Overdose................................. 7,872 8,685 6,281 7,470 7,116 8,808 7,085 8,097 7,506 7,967 7,839 7,867 Chronic effects......................... 7,179 7,102 7,830 8,701 9,172 8,532 9,053 8,704 7,725 8,119 7,884 7,879 

Seeking detox.......................... 7,579 6,817 7,374 7,457 8,465 7,870 9,127 9,998 9,737 10,087 10,630 11,404 

Withdrawal............................... 2,339 3,220 3,353 3,580 4,352 3,955 3,840 3,990 3,546 3,610 4,495 4,328 Other/unknown reason............. 2,431 3,160 2,546 3,113 3,312 3,033 3,007 4,345 3,474 3,513 3,755 3,561 

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).*** Total includes patients whose gender or age was unknown.

2 This column compares the first half of 1998 to the second half of 1998.3 This column compares the second half of 1997 to the second half of 1998.1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For the purposes of this report

0.05 are considered to be statistically significant.

Year-End 1998 ED DAWN Data

H

9

p 

... Estimate does not meet standard of precision or is less than 10.

Table 23 - Estimated number of emergency department heroin/morphine mentions, by age, gender, race/ethhospital location, drug use motive, and reason for emergency department contact: First half 1993 - second 

79
HEROIN/MORPHINE

Total Total Total Total Total Total Total Total

 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.***............................. 35,898 48,003 63,232 64,013 70,838 73,846 72,010 77,645 0.060 0.443 

AGE

6-34......................................... 18,445 22,502 29,506 30,497 31,824 31,946 31,999 33,818 0.233 0.516 12-17....................................... 182 232 280 507 404 559 1,379 909 0.317 0.049 +18-25....................................... 4,704 5,860 8,019 8,370 8,550 9,268 9,994 11,446 0.139 0.149 26-34....................................... 13,559 16,409 21,203 21,618 22,869 22,115 20,625 21,460 0.342 0.721 35+.......................................... 17,310 25,376 33,613 33,359 38,919 41,792 39,914 43,714 0.032 + 0.448 

GENDER

Male......................................... 23,638 34,781 44,672 44,000 49,166 49,812 48,099 52,464 0.073 0.414 

Female..................................... 11,951 12,832 18,159 19,515 20,779 23,420 23,289 24,586 0.231 0.527 

RACE/ETHNICITY

White....................................... 13,367 17,926 23,027 23,383 27,071 25,384 26,883 29,591 0.081 0.253 Black........................................ 15,175 18,600 23,347 25,989 27,253 28,387 26,573 27,846 0.321 0.849 

Hispanic................................... 5,118 8,519 11,327 9,452 9,838 11,767 9,234 11,519 0.128 0.875 

Other race................................ 178 294 699 282 367 477 664 643 0.843 0.077 

Race unknown......................... 2,060 2,665 4,831 4,906 6,310 7,831 8,656 8,047 0.520 0.793 

FACILITY LOCATION

Central city............................... 22,721 29,374 35,828 38,644 40,926 44,789 43,258 44,569 0.413 0.980 

Outside central city.................. 6,675 7,673 10,170 9,932 11,098 11,005 9,678 10,753 0.010 + 0.886 National Panel......................... 6,502 10,956 17,146 15,437 18,813 18,052 19,074 22,323 0.203 0.335 

DRUG USE MOTIVE

Recreational use...................... 2,803 3,786 5,337 4,154 5,277 6,324 4,852 4,361 0.231 0.007 -

Dependence............................ 28,222 36,271 47,911 50,505 55,551 57,294 57,004 62,227 0.050 0.302 Suicide..................................... 1,160 1,563 2,115 2,282 2,571 2,854 3,471 3,522 0.901 0.112 Other/unknown motive............. 3,713 6,384 7,869 7,071 7,439 7,373 6,683 7,535 0.068 0.763 

REASONS FOR ED CONTACT

Unexpected reaction................ 3,781 5,219 6,848 6,306 6,224 6,600 6,725 8,003 0.006 + 0.012 +Overdose................................. 7,110 12,226 16,557 13,752 15,924 15,182 15,473 15,706 0.801 0.548 Chronic effects ........................ 10,759 13,310 14,280 16,532 17,704 17,756 15,845 15,763 0.904 0.090 

Seeking detox.......................... 7,982 9,204 14,396 14,831 16,334 19,126 19,824 22,034 0.350 0.503 

Withdrawal............................... 3,133 3,535 5,559 6,933 8,308 7,829 7,156 8,823 0.001 + 0.066 Other/unknown reason............. 3,133 4,509 5,591 5,659 6,345 7,352 6,987 7,316 0.700 0.969 

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

2 This column compares 1997 to 1998.3 This column compares 1996 to 1998.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

Year-End 1998 ED DAWN Data

Table 24 - Estimated number of emergency department heroin/morphine mentions, by age, gender, race/ethnicity, hospital location, drug use motive, and reason for emergency department contact: 1991-1998

p -value

1997,

19981,2 

*** Total includes patients whose gender or age was unknown.

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For the 

purposes of this report, p -values less than 0.05 are considered to be statistically significant.

p -value

1996,

19981,3

80
MARIJUANA/HASHISH

Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec

 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.***............................. 13,577 15,296 19,078 21,105 24,277 20,994 24,892 28,897 32,402 32,343 37,883 38,987 

AGE

6-34......................................... 10,856 12,225 14,954 16,906 18,752 16,528 19,088 22,229 23,551 23,955 27,770 28,066 12-17....................................... 1,834 2,413 3,272 3,267 4,049 3,925 4,371 5,611 5,841 5,215 7,348 5,786 18-25....................................... 4,379 5,166 6,416 7,443 7,759 7,044 7,094 8,635 9,925 9,463 10,780 12,127 26-34....................................... 4,640 4,639 5,263 6,190 6,932 5,545 7,535 7,899 7,724 9,263 9,628 10,142 35+.......................................... 2,582 3,042 4,092 4,185 5,504 4,374 5,779 6,617 8,692 8,351 10,068 10,729 

GENDER

Male......................................... 9,664 10,576 13,077 14,976 16,796 14,484 16,457 20,194 21,795 21,384 24,975 25,820 

Female..................................... 3,710 4,658 5,771 5,991 7,082 6,135 8,317 8,383 10,326 10,702 12,361 12,928 

RACE/ETHNICITY

White....................................... 6,189 7,294 8,868 10,014 10,963 9,919 11,460 13,044 15,973 15,927 18,073 20,363 Black........................................ 4,824 5,281 6,855 8,197 9,253 7,657 8,748 10,204 10,331 10,789 12,380 12,071 

Hispanic................................... 1,231 1,459 1,628 1,481 2,085 1,656 2,917 3,382 3,417 3,263 4,202 3,464 Other race................................ 72 130 171 131 166 235 142 242 304 220 242 255 

Race unknown......................... 1,263 1,131 1,556 1,282 1,810 1,527 1,624 2,024 2,376 2,143 2,985 2,834 

FACILITY LOCATION

Central city............................... 5,674 6,333 7,302 8,283 9,760 9,482 10,354 10,573 11,058 11,833 12,692 12,418 

Outside central city.................. 3,485 3,463 4,561 5,169 5,448 4,768 5,508 5,758 6,559 6,589 8,361 8,083 National Panel......................... 4,412 5,493 7,216 7,652 9,069 6,745 9,030 12,566 14,785 13,920 16,829 18,486 

DRUG USE MOTIVE

Recreational use...................... 3,465 3,874 5,392 5,123 6,595 5,714 6,416 8,839 9,191 8,008 9,698 9,929 

Dependence............................ 5,409 5,371 6,931 8,083 9,799 8,345 9,573 11,454 11,727 12,212 13,084 13,689 Suicide..................................... 1,093 1,274 1,795 2,139 2,163 2,261 3,031 2,496 3,582 3,400 4,361 4,684 Other/unknown motive............. 3,611 4,776 4,960 5,760 5,719 4,674 5,872 6,107 7,902 8,722 10,740 10,685 

REASONS FOR ED CONTACT

Unexpected reaction................ 4,062 4,783 6,059 5,425 6,573 5,444 6,659 7,487 8,780 7,331 9,135 8,873 Overdose................................. 2,152 2,557 3,215 3,844 3,917 3,826 4,838 5,014 5,831 5,132 7,005 7,213 Chronic effects......................... 1,324 1,230 1,826 2,359 3,554 2,893 3,194 2,794 2,803 2,795 3,461 3,217 

Seeking detox.......................... 2,815 2,567 2,669 3,516 3,911 3,255 3,560 4,201 5,085 5,837 5,447 6,347 

Withdrawal............................... 187 173 258 354 151 276 220 462 285 479 405 865 Other/unknown reason............. 3,037 3,986 5,051 5,607 6,171 5,302 6,422 8,939 9,617 10,768 12,429 12,470 

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).*** Total includes patients whose gender or age was unknown.

2 This column compares the first half of 1998 to the second half of 1998.3 This column compares the second half of 1997 to the second half of 1998.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

p 

H

Year-End 1998 ED DAWN Data

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For the purposes of this report

0.05 are considered to be statistically significant.

Table 25 - Estimated number of emergency department marijuana/hashish mentions, by age, gender, race/ehospital location, drug use motive, and reason for emergency department contact: First half 1993 - second 

9

81
MARIJUANA/HASHISH

Total Total Total Total Total Total Total Total

 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.***............................. 16,251 23,997 28,873 40,183 45,271 53,789 64,744 76,870 0.008 + 0.000 +

AGE

6-34......................................... 13,291 19,267 23,081 31,860 35,280 41,317 47,506 55,836 0.011 + 0.000 +12-17....................................... 2,130 3,104 4,247 6,539 7,974 9,982 11,056 13,135 0.055 0.001 +18-25....................................... 5,687 8,294 9,545 13,860 14,803 15,729 19,388 22,907 0.037 + 0.000 +26-34....................................... 5,469 7,857 9,278 11,452 12,477 15,434 16,986 19,770 0.039 + 0.001 +35+.......................................... 2,882 4,689 5,624 8,277 9,879 12,396 17,043 20,796 0.016 + 0.000 +

GENDER

Male......................................... 11,321 17,137 20,241 28,053 31,280 36,651 43,179 50,796 0.012 + 0.000 +

Female..................................... 4,725 6,463 8,368 11,762 13,216 16,700 21,028 25,289 0.022 + 0.000 +

RACE/ETHNICITY

White....................................... 8,030 10,484 13,483 18,882 20,882 24,505 31,900 38,436 0.085 0.000 +Black........................................ 5,621 8,934 10,104 15,053 16,910 18,952 21,121 24,452 0.014 + 0.000 +

Hispanic................................... 1,392 2,724 2,690 3,109 3,741 6,300 6,680 7,666 0.403 0.149 Other race................................ 93 107 202 302 401 384 524 497 0.769 0.312 

Race unknown......................... 1,114 1,749 2,394 2,837 3,337 3,648 4,520 5,819 0.107 0.002 +

FACILITY LOCATION

Central city............................... 6,600 9,930 12,008 15,585 19,242 20,927 22,891 25,110 0.048 + 0.004 +

Outside central city.................. 3,684 5,511 6,948 9,730 10,216 11,266 13,148 16,444 0.009 + 0.000 +National Panel......................... 5,967 8,557 9,905 14,868 15,814 21,596 28,705 35,316 0.124 0.002 +

DRUG USE MOTIVE

Recreational use...................... 4,478 6,041 7,339 10,515 12,310 15,255 17,199 19,628 0.065 0.021 +

Dependence............................ 7,064 9,043 10,780 15,014 18,144 21,027 23,939 26,772 0.186 0.006 +Suicide..................................... 1,262 2,147 2,367 3,934 4,425 5,527 6,982 9,045 0.110 0.013 +Other/unknown motive............. 3,447 6,767 8,387 10,719 10,393 11,979 16,624 21,425 0.026 + 0.001 +

REASONS FOR ED CONTACT

Unexpected reaction................ 4,470 7,345 8,846 11,484 12,017 14,146 16,111 18,008 0.193 0.006 +Overdose................................. 2,519 4,321 4,708 7,059 7,743 9,852 10,964 14,218 0.005 + 0.000 +Chronic effects ........................ 2,066 2,357 2,553 4,185 6,447 5,988 5,598 6,679 0.061 0.400 

Seeking detox.......................... 3,295 4,543 5,382 6,185 7,166 7,761 10,923 11,794 0.601 0.007 +

Withdrawal............................... 376 251 360 612 427 682 764 1,271 0.277 0.200 Other/unknown reason............. 3,525 5,181 7,023 10,658 11,473 15,360 20,385 24,899 0.037 + 0.001 +

Year-End 1998 ED DAWN Data

Table 26 - Estimated number of emergency department marijuana/hashish mentions, by age, gender, race/ethnicity, hospital location, drug use motive, and reason for emergency department contact: 1991-1998

p -value

1997,

19981,2 

*** Total includes patients whose gender or age was unknown.

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For the 

purposes of this report, p -values less than 0.05 are considered to be statistically significant.

p -value

1996,

19981,3

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

2 This column compares 1997 to 1998.3 This column compares 1996 to 1998.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

82
METHAMPHETAMINE/SPEED

Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul 

 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 19

TOTAL U.S.***............................... 4,224 5,702 7,824 9,841 9,678 6,257 4,197 6,805 8,218 8,936 6,534 

AGE

6-34............................................ 3,288 4,444 6,072 7,263 7,116 4,592 3,278 4,550 5,797 6,654 4,593 

12-17.......................................... 293 371 896 1,072 1,085 353 318 710 ... 949 795 

18-25.......................................... 1,688 1,736 2,344 3,151 2,785 2,003 1,704 2,024 2,149 2,569 1,847 

26-34.......................................... 1,306 2,336 2,830 3,040 3,246 2,236 1,256 1,748 2,787 3,137 1,951 35+............................................. 934 1,248 1,747 2,571 2,559 1,662 916 2,248 2,421 2,275 1,938 

GENDER

Male........................................... 2,902 3,845 5,045 6,349 6,147 4,177 2,501 4,628 5,266 6,127 4,016 Female....................................... 1,303 1,770 2,751 3,459 3,496 1,989 1,618 2,101 2,870 2,785 2,387 

RACE/ETHNICITY

White......................................... 3,096 3,975 5,646 6,728 6,141 4,119 2,521 4,258 5,638 6,164 4,983 Black.......................................... 150 197 350 632 477 450 209 591 563 303 162 Hispanic..................................... 519 824 1,114 1,491 ... 990 559 1,115 ... 1,379 602 Other race.................................. 35 42 47 67 ... 173 ... 136 ... 153 46 

Race unknown........................... 425 663 667 ... 949 525 723 705 743 937 741 

FACILITY LOCATION

Central city................................. 1,276 1,233 1,314 1,757 1,727 1,183 1,212 1,371 1,394 1,464 1,182 Outside central city.................... 837 952 1,168 1,180 1,263 857 808 1,111 1,346 1,495 961 National Panel............................ 2,112 3,516 5,342 6,904 6,689 4,217 2,177 4,322 5,478 5,976 4,390 

DRUG USE MOTIVE

Recreational use........................ 1,203 1,489 1,659 2,584 2,135 1,336 1,447 1,656 1,899 2,174 1,559 Dependence............................... 1,632 1,866 3,099 4,023 4,576 2,671 1,719 3,129 4,227 4,785 3,507 

Suicide....................................... 478 387 ... 435 535 563 279 520 693 705 524 Other/unknown motive............... 912 ... ... ... 2,433 1,688 751 ... 1,399 1,272 944 

REASONS FOR ED CONTACT

Unexpected reaction.................. 1,549 2,140 2,897 3,462 3,019 2,149 1,708 2,495 3,580 3,091 1,964 Overdose................................... 1,162 1,683 1,884 2,571 2,570 1,485 738 1,437 1,958 1,667 1,316 Chronic effects........................... 586 725 881 1,671 1,639 1,239 772 1,136 1,063 1,291 1,036 Seeking detox............................ 498 340 876 499 810 288 319 575 489 671 884 

Withdrawal................................. 41 ... ... 247 ... ... ... 189 67 ... ... Other/unknown reason............... 389 ... 901 1,391 972 844 572 973 1,062 1,905 968 

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).... Estimate does not meet standard of precision or is less than 10.*** Total includes patients whose gender or age was unknown.NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

Year-End 1998 ED DAWN Data

3 This column compares the second half of 1997 to the second half of 1998.1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For the purposes of this report

considered to be statistically significant.

2 This column compares the first half of 1998 to the second half of 1998.

Table 27 - Estimated number of emergency department methamphetamine/speed mentions, by age, genderhospital location, drug use motive, and reason for emergency department contact: First half 1993 - second 

83
METHAMPHETAMINE/SPEED

Total Total Total Total Total Total Total Total

 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.***............................. 4,887 6,563 9,926 17,665 15,936 11,002 17,154 11,491 0.009 - 0.634 

AGE

6-34......................................... 3,716 5,177 7,731 13,335 11,709 7,828 12,451 8,252 0.031 - 0.577 12-17....................................... 442 669 663 1,968 1,438 1,028 1,810 1,081 0.211 0.825 18-25....................................... 1,302 1,719 3,425 5,494 4,788 3,728 4,718 3,482 0.151 0.624 26-34....................................... 1,972 2,790 3,642 5,870 5,482 3,004 5,924 3,689 0.014 - 0.270 35+.......................................... 1,168 1,378 2,182 4,318 4,221 3,165 4,696 3,233 0.005 - 0.881 

GENDER

Male......................................... 3,057 4,459 6,747 11,394 10,324 7,129 11,393 6,809 0.008 - 0.600 

Female..................................... 1,810 2,022 3,073 6,210 5,485 3,719 5,654 4,536 0.079 0.193 

RACE/ETHNICITY

White....................................... 3,485 4,607 7,070 12,374 10,260 6,779 11,802 8,454 0.034 - 0.039 +Black........................................ 370 263 347 982 927 800 866 490 0.009 - 0.001 -

Hispanic................................... 622 925 1,343 2,606 2,865 1,674 2,553 ... ... ... Other race................................ 41 54 77 114 409 321 253 82 0.044 - 0.100 

Race unknown......................... 369 714 1,088 1,590 1,474 1,428 1,680 985 0.019 - 0.103 

FACILITY LOCATION

Central city............................... 1,720 1,846 2,509 3,072 2,910 2,584 2,858 2,057 0.000 - 0.002 -

Outside central city.................. 865 1,402 1,789 2,348 2,120 1,919 2,842 1,623 0.000 - 0.049 -National Panel......................... 2,302 3,315 5,628 12,245 10,906 6,499 11,454 7,810 0.089 0.191 

DRUG USE MOTIVE

Recreational use...................... 1,428 2,103 2,691 4,243 3,471 3,104 4,073 2,822 0.043 - 0.650 

Dependence............................ 2,131 2,216 3,498 7,123 7,247 4,848 9,012 6,326 0.174 0.046 +Suicide..................................... 400 ... 865 922 1,098 799 1,398 805 0.030 - 0.982 

Other/unknown motive............. 929 1,661 2,872 ... 4,120 2,251 2,671 1,538 0.128 0.245 

REASONS FOR ED CONTACT

Unexpected reaction................ 1,481 2,345 3,689 6,359 5,168 4,202 6,671 4,110 0.039 - 0.883 Overdose................................. 1,017 1,916 2,844 4,454 4,055 2,175 3,625 2,052 0.001 - 0.777 Chronic effects ........................ 1,087 949 1,310 2,551 2,879 1,908 2,354 1,585 0.000 - 0.465 

Seeking detox.......................... 371 537 839 1,375 1,098 894 1,161 1,287 0.697 0.046 +

Withdrawal............................... ... ... 130 ... ... 277 378 ... ... ... Other/unknown reason............. 702 501 1,114 2,292 1,816 1,546 2,966 1,915 0.145 0.309 

19981,3

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

2 This column compares 1997 to 1998.3 This column compares 1996 to 1998.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in 

the coterminous U.S.

Year-End 1998 ED DAWN Data

p -value

1 In this column, "+" and "-" denote statistically significant increases and decreases, respectively, between estimates for periods noted. For the 

purposes of this report, p -values less than 0.05 are considered to be statistically significant.

Table 28 - Estimated number of emergency department methamphetamine/speed mentions, by age, gender, race/ethnicity, hospital location, drug use motive, and reason for emergency department contact: 1991-1998

... Estimate does not meet standard of precision or is less than 10.*** Total includes patients whose gender or age was unknown.

p -value

1997, 1996,

19981,2 

84
 Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec

 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

DRUG EPISODES....................... 100.8 100.4 110.0 115.1 116.7 104.1 107.3 111.3 111.8 109.8 113.3 112.1

DRUG MENTIONS...................... 172.9 175.0 191.0 200.0 203.4 184.0 188.9 196.8 199.5 197.3 205.0 203.2Alcohol-in-combination................ 31.2 31.5 33.8 36.0 37.3 34.4 34.3 36.3 35.9 36.4 37.9 38.9Cocaine....................................... 26.7 27.2 29.8 32.2 31.5 26.8 30.5 34.3 33.2 34.5 35.7 35.7Heroin/morphine.......................... 13.5 14.1 13.1 14.7 15.3 15.1 15.0 16.4 14.9 15.4 16.1 16.2Acetaminophen............................ 8.3 6.6 9.3 7.5 8.1 7.6 8.6 7.6 7.8 7.1 7.2 6.2

Aspirin......................................... 4.4 3.8 4.3 4.1 3.7 3.5 3.7 3.1 3.2 3.0 3.1 3.3Ibuprofen..................................... 4.0 3.7 4.3 4.0 4.6 4.6 3.7 3.6 3.6 3.6 3.7 3.5Alprazolam................................... 3.5 3.8 3.5 4.0 3.9 3.4 3.8 3.3 3.7 3.7 3.8 3.6Marijuana/hashish....................... 5.9 6.7 8.3 9.1 10.5 9.0 10.6 12.2 13.7 13.6 15.8 16.1Diazepam.................................... 2.9 2.5 2.6 3.3 3.2 2.9 2.8 3.0 2.9 2.7 2.4 2.9Amitriptyline................................. 2.1 2.3 2.6 2.3 2.1 1.7 2.3 1.5 1.8 1.7 1.5 1.3Acetamin./codeine....................... 1.7 1.7 1.4 1.6 1.5 1.5 1.2 1.2 1.5 1.3 1.0 1.1OTC sleep aids............................ 1.2 1.2 1.4 1.6 1.4 1.5 1.8 1.4 1.4 1.1 1.3 1.1Lorazepam................................... 2.1 2.4 2.5 2.8 2.6 2.2 2.3 2.0 2.3 2.2 2.3 2.0d-Propoxyphene.......................... 1.8 1.7 1.7 1.5 1.6 1.4 1.5 1.4 1.4 1.8 1.6 1.2Fluoxetine.................................... 1.5 1.8 1.9 2.1 2.0 2.0 2.2 1.9 2.3 2.1 2.2 1.8Diphenhydramine......................... 1.7 1.6 1.9 2.2 2.1 1.6 1.9 2.1 2.0 1.7 1.4 1.1Methamphetamine/speed............ 1.8 2.5 3.4 4.3 4.2 2.7 1.8 2.9 3.5 3.7 2.7 2.1Oxycodone.................................. 0.7 0.7 0.9 0.9 0.8 0.7 0.6 0.7 0.9 1.1 1.0 1.2PCP/PCP combinations............... 1.5 1.4 1.3 1.3 1.4 1.3 0.8 0.8 0.9 0.8 0.9 0.8Lithium carbonate........................ 1.2 1.1 1.1 1.5 1.7 1.2 1.1 0.9 1.2 0.9 0.8 0.7Clonazepam................................ 2.1 2.3 2.6 2.7 2.8 2.8 2.9 2.8 3.1 3.0 3.7 3.6Hydantoin.................................... 0.7 0.9 0.8 0.6 0.9 0.7 0.7 0.6 0.6 0.4 0.6 0.6Hydrocodone............................... 1.1 1.6 1.8 1.9 2.0 1.9 2.4 2.0 2.2 2.3 2.4 2.8LSD............................................. 0.7 0.8 0.9 1.4 1.1 1.3 1.1 0.9 1.5 0.6 0.7 1.3Triazolam..................................... 0.3 0.2 0.2 0.2 0.2 0.2 0.2 0.1 0.1 0.1 0.1 0.1Phenobarbital.............................. 0.8 0.6 0.6 0.5 0.6 0.7 0.5 0.5 0.4 0.3 0.5 0.5Doxepin....................................... 0.8 0.7 0.8 1.0 0.7 0.5 0.5 0.6 0.6 0.3 0.4 0.3Cyclobenzaprine.......................... 0.7 0.5 0.6 0.7 0.6 0.7 0.7 0.8 0.7 0.9 0.6 0.6Haloperidol.................................. 0.8 0.6 0.6 0.8 0.7 0.5 0.5 0.9 0.5 0.5 0.4 0.5Amphetamine.............................. 1.0 1.4 1.9 2.3 2.4 1.6 1.5 2.5 1.9 2.4 2.2 2.7Trazodone................................... 1.3 1.2 1.4 1.7 2.1 2.0 2.0 1.9 1.8 1.9 2.1 1.9Carisoprodol................................ 1.1 1.7 1.5 1.3 1.9 1.4 1.6 1.5 1.2 1.3 1.8 1.7Naproxen..................................... 0.8 0.5 0.9 0.9 1.0 1.2 1.0 0.9 1.1 1.1 1.2 1.1Imipramine................................... 0.8 0.7 0.6 0.6 0.7 0.4 0.3 0.5 0.3 0.2 0.2 0.1Carbamazepine........................... 1.0 1.1 0.9 0.8 0.8 0.7 0.8 0.8 0.7 0.8 0.6 0.8Thioridazine................................. 0.7 0.6 0.6 0.8 0.7 0.4 0.5 0.4 0.3 0.4 0.3 0.2TOTAL ED VISITS**.................... 19,048.5 19,225.9 19,357.6 19,565.7 18,974.6 19,085.0 19,323.4 19,432.4 18,691.4 19,020.3 18,459.7 18,792.2

Year-End 1998 ED DAWN Data

Table 29 - Estimated rate of emergency department drug episodes, drug mentions, mentions of selected drugs, and total visits per 100,000 population for total coterminous U.S. by half year: First half 1993 - second half 1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

**

 DAWN estimates of emergency department (ED) visits (in 1,000s) should be close to but will not necessarily equal totals from previous year's American Hospital 

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

85Association (AHA) Annual Survey.
 Total Total Total Total Total Total Total Total

 1991 1992 1993 1994 1995 1996 1997 1998

DRUG EPISODES....................... 175.8 191.4 201.3 225.2 220.8 218.6 221.5 225.4

DRUG MENTIONS...................... 301.2 331.9 347.9 391.0 387.4 385.7 396.8 408.3Alcohol-in-combination................ 54.4 62.6 62.7 69.8 71.7 70.6 72.3 76.8Cocaine....................................... 45.2 52.9 53.9 62.0 58.4 64.8 67.7 71.5Heroin/morphine.......................... 16.0 21.2 27.6 27.8 30.4 31.4 30.3 32.3Acetaminophen............................ 13.6 13.8 14.9 16.8 15.7 16.3 14.9 13.4

Aspirin......................................... 9.7 8.3 8.3 8.4 7.2 6.7 6.1 6.4Ibuprofen..................................... 6.9 7.2 7.7 8.3 9.1 7.2 7.2 7.1Alprazolam................................... 7.2 7.3 7.4 7.5 7.3 7.1 7.3 7.4

Marijuana/hashish....................... 7.3 10.6 12.6 17.5 19.5 22.9 27.2 31.9Diazepam.................................... 6.5 6.2 5.4 5.9 6.1 5.8 5.6 5.3Amitriptyline................................. 3.9 4.5 4.3 4.9 3.8 3.8 3.5 2.8Acetamin./codeine....................... 3.2 3.1 3.3 3.0 2.9 2.5 2.8 2.1OTC sleep aids............................ 2.8 3.1 2.3 3.0 2.9 3.2 2.6 2.4Lorazepam................................... 3.1 3.9 4.5 5.3 4.8 4.3 4.5 4.3d-Propoxyphene.......................... 3.5 2.9 3.5 3.2 3.0 2.9 3.2 2.9Fluoxetine.................................... 3.1 3.7 3.3 4.0 4.1 4.1 4.4 4.1Diphenhydramine......................... 3.0 3.5 3.2 4.1 3.7 4.0 3.7 2.5Methamphetamine/speed............ 2.2 2.9 4.3 7.7 6.8 4.7 7.2 4.8Oxycodone.................................. 1.8 1.7 1.5 1.8 1.5 1.4 2.0 2.2PCP/PCP combinations............... 1.5 2.3 2.9 2.6 2.7 1.7 1.8 1.7Lithium carbonate........................ 2.0 2.1 2.3 2.6 2.9 2.0 2.0 1.4Clonazepam................................ 2.9 3.6 4.4 5.3 5.5 5.7 6.1 7.2Hydantoin.................................... 1.4 1.7 1.5 1.4 1.5 1.2 1.0 1.2Hydrocodone............................... 2.2 2.7 2.7 3.7 3.9 4.5 4.5 5.2LSD............................................. 1.7 1.5 1.5 2.2 2.4 1.9 2.2 2.1Triazolam..................................... 1.5 0.7 0.6 0.4 0.3 0.3 0.1 0.2Phenobarbital.............................. 1.3 1.4 1.3 1.1 1.2 1.0 0.8 1.1Doxepin....................................... 1.7 1.6 1.5 1.9 1.2 1.0 0.9 0.6Cyclobenzaprine.......................... 1.4 1.2 1.2 1.4 1.3 1.5 1.5 1.2Haloperidol.................................. 1.4 1.3 1.4 1.3 1.2 1.4 1.0 0.9Amphetamine.............................. 1.0 1.6 2.4 4.2 4.0 4.0 4.3 4.9Trazodone................................... 1.9 2.0 2.5 3.2 4.1 3.9 3.7 4.0Carisoprodol................................ 1.9 2.6 2.9 2.9 3.3 3.1 2.6 3.5Naproxen..................................... 1.5 1.2 1.4 1.9 2.3 1.9 2.2 2.3Imipramine................................... 1.5 1.9 1.4 1.2 1.1 0.8 0.6 0.3Carbamazepine........................... 1.5 1.5 2.1 1.7 1.6 1.6 1.5 1.3Thioridazine................................. 1.2 1.3 1.3 1.4 1.1 1.0 0.7 0.5TOTAL ED VISITS**.................... 37,573.7 37,944.8 38,274.9 38,923.9 38,059.9 38,756.1 37,712.6 37,252.9

Year-End 1998 ED DAWN Data

Table 30 - Estimated rate of emergency department drug episodes, drug mentions, mentions of selected drugs, and total visits per 100,000 population for total coterminous U.S. by year: 1991-1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

**

 DAWN estimates of emergency department (ED) visits (in 1,000s) should be close to but will not necessarily equal totals 

from previous year's American Hospital Association (AHA) Annual Survey.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

86
DRUG EPISODES

 Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.......................... 101 100 110 115 117 104 107 111 112 110 113 112Atlanta.................................. 142 153 187 224 214 201 170 179 148 146 202 188

Baltimore.............................. 295 315 340 374 372 341 344 362 290 267 279 314Boston.................................. 179 180 186 244 244 206 197 177 175 160 183 187Buffalo.................................. 115 165 166 157 148 148 198 189 168 132 135 148Chicago................................ 147 174 177 204 206 178 191 217 221 241 219 226Dallas................................... 107 97 105 115 112 109 105 103 121 136 149 146Denver................................. 113 140 166 167 162 140 116 106 135 143 129 130Detroit.................................. 227 245 227 193 257 194 255 244 223 195 199 210Los Angeles - Long Beach... 128 127 118 119 123 112 122 122 106 100 96 106

Miami - Hialeah.................... 149 161 160 163 179 172 167 173 173 162 168 171Minneapolis - St. Paul.......... 96 106 103 100 97 91 103 106 110 103 95 89New Orleans........................ 183 175 203 209 226 279 248 250 220 219 231 193New York............................. 276 290 271 267 260 244 257 237 230 219 216 215Newark................................. 289 251 267 280 314 312 301 263 235 266 258 240

Philadelphia......................... 230 210 185 206 227 221 230 237 245 251 268 258Phoenix................................ 162 142 163 189 212 188 192 180 186 177 184 162St. Louis............................... 91 87 129 137 134 112 130 136 121 120 121 120

San Diego............................ 122 111 113 107 102 100 125 124 131 155 151 142

San Francisco...................... 433 341 321 450 330 329 307 305 295 303 289 280Seattle.................................. 197 199 269 276 242 215 233 217 269 288 241 192

Washington, DC................... 169 169 180 206 172 147 159 154 150 146 156 146National Panel...................... 68 67 79 81 83 72 74 80 83 81 85 84

Year-End 1998 ED DAWN Data

Table 31 - Estimated rate of emergency department drug episodes per 100,000 population, by metropolitan area by half year: First half 1993 - second half 1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

87
DRUG EPISODES

 Total Total Total Total Total Total Total Total 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.......................... 176 191 201 225 221 219 222 225Atlanta.................................. 267 338 295 411 416 349 294 390

Baltimore.............................. 500 593 610 715 712 705 556 592Boston.................................. 276 365 359 430 449 375 335 370Buffalo.................................. 188 220 279 323 296 387 300 283Chicago................................ 253 317 320 381 384 409 462 445Dallas................................... 191 176 203 220 221 208 257 295Denver................................. 234 247 252 333 302 222 278 259Detroit.................................. 361 393 472 420 452 499 417 409Los Angeles - Long Beach... 219 246 255 237 235 245 205 202

Miami - Hialeah.................... 266 264 310 323 351 340 336 339Minneapolis - St. Paul.......... 167 175 201 203 189 208 212 184New Orleans........................ 515 473 358 412 505 497 438 424New York............................. 474 568 566 538 504 494 448 432Newark................................. 500 519 540 547 626 564 500 497

Philadelphia......................... 382 461 439 391 448 467 496 526Phoenix................................ 310 317 304 351 400 372 363 346St. Louis............................... 208 197 178 265 246 266 241 240San Diego............................ 227 269 232 220 201 249 286 293

San Francisco...................... 788 705 775 771 659 612 598 569Seattle.................................. 264 342 396 545 457 450 556 433

Washington, DC................... 296 296 338 386 319 313 295 303National Panel...................... 119 125 135 160 155 154 164 170

Table 32 - Estimated rate of emergency department drug episodes per 100,000 population, by metropolitan area by year: 1991-1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

Year-End 1998 ED DAWN Data 88
DRUG MENTIONS

 Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.......................... 173 175 191 200 203 184 189 197 200 197 205 203Atlanta.................................. 273 291 359 452 433 406 340 370 300 296 388 348

Baltimore.............................. 506 545 579 633 633 577 574 621 502 461 470 545Boston.................................. 327 328 340 457 455 387 365 325 323 291 332 342Buffalo.................................. 203 282 277 282 263 269 372 350 316 248 248 273Chicago................................ 255 304 308 353 362 313 343 394 417 451 405 417Dallas................................... 193 177 191 209 205 203 199 185 224 250 280 270Denver................................. 193 231 283 275 294 246 199 184 236 247 225 230Detroit.................................. 422 458 410 343 473 356 481 454 409 361 376 387Los Angeles - Long Beach... 221 218 203 206 212 196 208 217 185 170 163 190

Miami - Hialeah.................... 234 250 257 261 282 269 263 273 283 265 279 288Minneapolis - St. Paul.......... 186 201 204 194 188 176 198 197 209 191 181 163New Orleans........................ 369 350 399 423 435 523 469 471 403 415 430 374New York............................. 402 418 400 401 389 383 413 389 370 359 346 351Newark................................. 497 437 471 492 550 561 568 458 397 449 439 405

Philadelphia......................... 414 362 329 371 410 398 414 424 450 465 489 474Phoenix................................ 269 245 273 318 357 311 328 299 316 312 314 288St. Louis............................... 156 145 239 246 248 203 234 241 212 227 224 226San Diego............................ 208 187 196 183 181 172 217 219 233 270 266 245

San Francisco...................... 640 515 493 658 508 500 457 455 421 436 402 384Seattle.................................. 333 328 459 472 405 353 378 351 459 498 406 318

Washington, DC................... 295 300 321 366 294 243 266 263 251 249 257 241National Panel...................... 118 120 139 142 146 130 130 143 151 148 159 157

Year-End 1998 ED DAWN Data

Table 33 - Estimated rate of emergency department drug mentions per 100,000 population, by metropolitan area by half year: First half 1993 - second half 1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

89
DRUG MENTIONS

 Total Total Total Total Total Total Total Total 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.......................... 301 332 348 391 387 386 397 408Atlanta.................................. 516 683 564 811 839 710 596 736

Baltimore.............................. 834 1,044 1,050 1,212 1,210 1,194 963 1,016Boston.................................. 499 650 655 797 842 690 614 674Buffalo.................................. 304 364 485 559 532 721 564 520Chicago................................ 426 550 559 661 675 737 868 822Dallas................................... 339 312 370 399 408 384 474 550Denver................................. 407 427 424 558 539 383 483 455Detroit.................................. 614 707 880 753 828 935 770 763Los Angeles - Long Beach... 381 421 440 409 407 425 355 353Miami - Hialeah.................... 437 439 483 518 551 536 548 567Minneapolis - St. Paul.......... 314 346 387 397 363 395 400 344New Orleans........................ 882 873 719 822 958 939 818 804New York............................. 671 832 820 801 771 802 728 697Newark................................. 902 880 933 963 1,112 1,026 846 844Philadelphia......................... 608 803 776 700 807 838 916 963Phoenix................................ 519 523 514 591 668 627 627 602St. Louis............................... 365 340 301 484 451 475 439 450San Diego............................ 396 454 395 379 353 436 503 511San Francisco...................... 1,159 1,028 1,155 1,152 1,008 912 856 786Seattle.................................. 445 571 661 931 757 729 957 724Washington, DC................... 511 508 594 687 537 529 501 498National Panel...................... 212 224 239 282 276 273 299 316

Table 34 - Estimated rate of emergency department drug mentions per 100,000 population, by metropolitan area by year: 1991-1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

Year-End 1998 ED DAWN Data 90
COCAINE

 Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.......................... 27 27 30 32 32 27 31 34 33 35 36 36Atlanta.................................. 79 88 102 133 128 117 100 102 82 74 114 104

Baltimore.............................. 170 177 194 206 210 174 178 198 141 132 137 159

Boston.................................. 58 53 55 78 83 65 60 54 46 46 56 67

Buffalo.................................. 45 62 62 71 67 79 118 120 95 68 65 65Chicago................................ 67 87 86 105 106 82 100 120 122 125 117 114Dallas................................... 29 29 30 31 32 30 29 29 34 40 52 54Denver................................. 24 40 47 40 43 32 26 26 32 37 32 41Detroit.................................. 104 118 113 83 132 81 126 124 107 85 98 104Los Angeles - Long Beach... 33 33 31 31 33 28 33 36 28 29 31 37

Miami - Hialeah.................... 71 77 73 79 85 83 81 87 88 86 94 94Minneapolis - St. Paul.......... 9 11 11 14 10 10 13 16 15 16 17 16New Orleans........................ 72 76 84 80 74 99 92 110 99 100 109 91New York............................. 132 132 126 126 123 121 136 128 124 120 120 114Newark................................. 116 108 117 130 134 135 135 117 92 109 106 102

Philadelphia......................... 115 106 90 96 107 101 107 118 116 124 140 135Phoenix................................ 25 18 26 29 34 25 33 37 34 33 37 36

St. Louis............................... 27 27 51 52 48 32 38 42 30 33 43 44San Diego............................ 20 19 17 12 14 14 17 21 17 19 19 21

San Francisco...................... 109 91 85 120 84 82 74 74 63 63 57 58Seattle.................................. 46 50 75 82 65 51 60 54 67 83 66 59

Washington, DC................... 59 59 59 73 55 41 52 51 42 43 50 48National Panel...................... 9 9 12 13 12 10 11 16 17 19 19 19

Year-End 1998 ED DAWN Data

Table 35 - Estimated rate of emergency department cocaine mentions per 100,000 population, by metropolitan area by half year: First half 1993 - second half 1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

91
COCAINE

 Total Total Total Total Total Total Total Total 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.......................... 45 53 54 62 58 65 68 72Atlanta.................................. 127 198 167 234 245 202 156 218

Baltimore.............................. 310 370 346 400 384 376 273 296Boston.................................. 87 122 111 133 147 114 91 123

Buffalo.................................. 53 72 108 133 146 238 163 129Chicago................................ 102 148 154 192 188 220 247 232

Dallas................................... 57 53 58 61 62 58 74 106

Denver................................. 48 56 65 86 75 53 69 73Detroit.................................. 149 173 222 195 212 250 192 202Los Angeles - Long Beach... 62 67 66 62 61 69 56 68Miami - Hialeah.................... 104 109 148 151 168 168 174 187Minneapolis - St. Paul.......... 18 20 20 25 20 29 31 33New Orleans........................ 312 252 147 164 174 203 199 199New York............................. 206 259 265 252 244 264 244 233Newark................................. 241 238 224 246 268 253 201 208

Philadelphia......................... 199 246 221 186 208 224 239 275Phoenix................................ 42 47 43 55 59 69 66 73

St. Louis............................... 64 65 54 102 80 80 64 87San Diego............................ 38 51 38 29 28 39 36 41San Francisco...................... 206 184 200 205 166 149 126 116Seattle.................................. 63 80 96 157 116 114 150 125Washington, DC................... 128 117 117 132 96 104 85 97

National Panel...................... 14 16 18 26 21 27 37 38

Table 36 - Estimated rate of emergency department cocaine mentions per 100,000 population, by metropolitan area by year: 1991-1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

Year-End 1998 ED DAWN Data 92
HEROIN/MORPHINE

 Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.......................... 14 14 13 15 15 15 15 16 15 15 16 16Atlanta.................................. 4 6 8 10 8 8 8 7 7 8 8 9

Baltimore.............................. 114 145 153 185 189 178 175 183 133 124 131 159

Boston.................................. 34 32 27 45 45 38 37 39 35 34 37 38

Buffalo.................................. 10 21 16 24 17 25 24 24 22 28 24 33Chicago................................ 26 37 41 44 40 44 46 63 68 80 77 82Dallas................................... 6 7 5 5 6 5 7 8 11 11 11 10

Denver................................. 7 12 15 18 15 16 13 9 12 18 16 16Detroit.................................. 28 31 28 24 33 26 39 38 38 35 34 34Los Angeles - Long Beach... 23 23 18 18 17 20 21 19 16 14 15 17

Miami - Hialeah.................... 6 8 7 7 10 9 9 12 15 17 19 21Minneapolis - St. Paul.......... 332223234444New Orleans........................ 5 7 7 10 9 14 12 15 19 18 22 22New York............................. 65 78 70 70 66 67 70 67 59 55 55 55Newark................................. 142 123 125 137 156 172 170 137 105 141 144 139

Philadelphia......................... 30 25 23 31 41 44 42 43 37 44 35 40Phoenix................................ 13 12 13 12 12 13 15 17 21 21 23 21

St. Louis............................... 6 4 10 8 9 8 11 11 11 9 13 14

San Diego............................ 18 19 16 14 13 17 24 18 18 22 21 22

San Francisco...................... 133 110 100 133 98 106 102 101 91 84 84 65Seattle.................................. 48 46 54 59 51 58 66 63 74 80 67 60

Washington, DC................... 22 17 14 21 18 17 19 22 22 23 28 28National Panel...................... 554565566676

Year-End 1998 ED DAWN Data

Table 37 - Estimated rate of emergency department heroin/morphine mentions per 100,000 population, by metropolitan area by half year: First half 1993 - second half 1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

93
HEROIN/MORPHINE

 Total Total Total Total Total Total Total Total 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.......................... 16 21 28 28 30 31 30 32Atlanta.................................. 6 9 10 17 16 15 15 18

Baltimore.............................. 180 234 259 338 367 358 256 290

Boston.................................. 34 59 66 71 83 76 69 75

Buffalo.................................. 18 19 31 39 42 48 50 57Chicago................................ 41 53 64 85 83 109 148 159Dallas................................... 10 12 13 10 12 15 21 21Denver................................. 7 8 18 33 31 22 31 32Detroit.................................. 46 46 59 52 58 77 72 68Los Angeles - Long Beach... 21 37 46 36 38 40 30 31Miami - Hialeah.................... 8 10 14 15 18 21 32 41Minneapolis - St. Paul.......... 34635678New Orleans........................ 20 13 12 17 24 26 36 44New York............................. 77 106 142 140 133 136 115 110Newark................................. 140 170 265 262 328 307 246 282

Philadelphia......................... 55 53 55 54 85 85 82 76Phoenix................................ 18 17 25 25 25 32 41 44

St. Louis............................... 8 9 10 18 17 22 20 27

San Diego............................ 34 45 37 30 30 42 39 42San Francisco...................... 211 208 243 233 204 203 175 150Seattle.................................. 44 61 94 113 109 130 154 127

Washington, DC................... 41 42 39 34 35 41 45 55National Panel...................... 4 7 10 9 11 11 11 13

Table 38 - Estimated rate of emergency department heroin/morphine mentions per 100,000 population, by metropolitan area by year: 1991-1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

Year-End 1998 ED DAWN Data 94
MARIJUANA/HASHISH

 Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.......................... 6 7 8 9 11 9 11 12 14 14 16 16Atlanta.................................. 16 17 24 34 31 31 26 32 28 30 51 44

Baltimore.............................. 14 14 17 18 18 25 22 30 30 31 31 34Boston.................................. 16 18 23 30 36 31 30 29 25 23 40 38Buffalo.................................. 6 10 12 13 11 21 29 26 29 21 22 26

Chicago................................ 11 14 18 22 27 24 29 33 36 41 44 41

Dallas................................... 8 7 10 10 11 13 12 11 18 20 31 31

Denver................................. 6 8 14 13 21 12 10 9 14 19 19 18Detroit.................................. 29 38 37 33 51 43 54 47 44 45 48 53Los Angeles - Long Beach... 11 10 11 9 11 10 13 13 13 12 16 25

Miami - Hialeah.................... 12 14 18 22 26 27 27 28 30 25 30 29Minneapolis - St. Paul.......... 8 10 11 10 10 10 12 11 13 13 10 11New Orleans........................ 24 30 40 37 37 51 48 58 54 60 60 40New York............................. 13 14 15 18 19 18 21 23 24 23 24 20Newark................................. 13 13 16 21 24 19 20 16 14 14 15 15

Philadelphia......................... 24 19 21 25 34 33 37 38 46 51 60 52Phoenix................................ 6 5 8 15 14 10 17 14 18 19 19 17

St. Louis............................... 4 3 ... 20 23 15 18 22 22 25 29 27San Diego............................ 12 9 12 10 10 11 12 15 19 22 26 22

San Francisco...................... 15 15 15 16 17 16 15 12 12 12 13 12Seattle.................................. 11 11 21 26 29 25 26 22 41 47 30 19

Washington, DC................... 28 30 33 41 30 25 29 29 31 32 29 32National Panel...................... 3 3 4 5 5 4 5 7 9 8 10 11

Year-End 1998 ED DAWN Data

Table 39 - Estimated rate of emergency department marijuana/hashish mentions per 100,000 population, by metropolitan area by half year: First half 1993 - second half 1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).... Estimate does not meet standard of precision or is less than 10.NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

95
MARIJUANA/HASHISH

Total Total Total Total Total Total Total Total

 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.......................... 7 11 13 18 20 23 27 32Atlanta.................................. 24 37 32 58 63 58 58 96

Baltimore.............................. 16 31 28 35 42 53 61 65Boston.................................. 18 29 34 53 67 59 48 79Buffalo.................................. 6 7 15 25 32 55 50 48

Chicago................................ 15 27 24 39 51 61 76 85

Dallas................................... 11 15 16 20 24 23 38 62Denver................................. 12 16 14 27 33 19 32 37Detroit.................................. 20 37 67 70 94 101 89 102Los Angeles - Long Beach... 13 17 22 20 21 26 25 41Miami - Hialeah.................... 25 20 26 39 53 55 55 59Minneapolis - St. Paul.......... 6 12 17 21 20 23 26 21New Orleans........................ 43 43 53 77 88 106 113 100New York............................. 15 25 26 32 37 44 46 44Newark................................. ... 24 26 37 43 36 28 30

Philadelphia......................... 16 37 43 46 67 74 97 112Phoenix................................ 7 9 12 23 24 31 37 36St. Louis............................... 9 10 7 40 37 40 47 56San Diego............................ 13 18 21 22 21 27 41 47San Francisco...................... 21 19 30 31 33 27 25 25Seattle.................................. 16 19 22 47 53 48 87 49

Washington, DC................... 27 35 58 74 55 58 63 62National Panel...................... 4 5 6 9 9 13 17 20

Year-End 1998 ED DAWN Data

Table 40 - Estimated rate of emergency department marijuana/hashish mentions per 100,000 population, by metropolitan area by year: 1991-1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.... Estimate does not meet standard of precision or is less than 10.

96
METHAMPHETAMINE/SPEED

 Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.......................... 233443234432Atlanta.................................. ... 22223243532

Baltimore.............................. ... ... ... ... ... ... ... ... ... ... ... ...Boston.................................. ... ... ... ... ... ... ... ... ... ... ... ...Buffalo.................................. ... ... ... ... ... ... ... ... ... ... ... ...Chicago................................ 0 ... ... 0 1 ... 000000

Dallas................................... 2 ... 3453233353

Denver................................. 2 2 4 6 7 5 3 4 10 9 4 3Detroit.................................. 0 0 0 ... ... ... ... ... ... ... ... ...Los Angeles - Long Beach... 8 8 8 9 10 6 7 8 7 8 5 4

Miami - Hialeah.................... ... ... ... ... ... ... ... ... ... ... ... ...Minneapolis - St. Paul.......... 1 1 2 1 3 2 2 3 5 ... 3 2

New Orleans........................ ... ... ... 1 ... 1 1 1 ... 1 1 1New York............................. 0 ... 0 ... 0 ... ... 0 0 ... 0 0Newark................................. ... ... ... ... ... ... ... ... ... ... ... ...

Philadelphia......................... 111111011101Phoenix................................ 12 13 19 22 23 16 20 16 23 17 14 7

St. Louis............................... 0 1 1 1 3 1 ... 1 1 2 1 ...

San Diego............................ 19 22 21 19 18 12 12 16 18 24 18 13

San Francisco...................... 36 30 31 51 40 31 26 34 31 33 24 15Seattle.................................. 5 5 7 9 10 4 4 7 11 14 8 6

Washington, DC................... ... ... ... 1 ... 0 ... ... ... ... 0 ...National Panel...................... 123443133432

Year-End 1998 ED DAWN Data

Table 41 - Estimated rate of emergency department methamphetamine/speed mentions per 100,000 population, by metropolitan area by half year: First half 1993 - second half 1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).... Estimate does not meet standard of precision or is less than 10.NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

97
METHAMPHETAMINE/SPEED

Total Total Total Total Total Total Total Total

 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.......................... 23487575

Atlanta.................................. 21246586

Baltimore.............................. ... ... ... ... ... ... ... ...

Boston.................................. 0 0 0 ... ... ... 0 ...

Buffalo.................................. ... ... ... ... ... ... ... ...

Chicago................................ 00001111

Dallas................................... 43379578Denver................................. 3 2 4 10 12 7 19 8Detroit.................................. 1 0 1 0 0 ... ... ...Los Angeles - Long Beach... 6 10 15 17 16 15 15 9Miami - Hialeah.................... ... ... ... ... ... ... 1 1Minneapolis - St. Paul.......... 12234595New Orleans........................ 42112222New York............................. 00000000Newark................................. ... 1 ... ... ... ... ... ...

Philadelphia......................... 23222121Phoenix................................ 9 15 25 42 39 36 40 22

St. Louis............................... 11123233San Diego............................ 23 41 41 40 30 29 41 30San Francisco...................... 57 46 65 82 72 60 64 39Seattle.................................. 5 6 10 16 14 10 25 14Washington, DC................... 1 ... 1 1 1 0 ... 0

National Panel...................... 12377475

Year-End 1998 ED DAWN Data

Table 42 - Estimated rate of emergency department methamphetamine/speed mentions per 100,000 population, by metropolitan area by year: 1991-1998

... Estimate does not meet standard of precision or is less than 10.SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

98
TOTAL ED VISITS**

 Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.......................... 19,049 19,226 19,358 19,566 18,975 19,085 19,323 19,432 18,691 19,020 18,460 18,792Atlanta.................................. 20,911 20,941 20,599 22,258 20,523 21,915 21,028 20,769 18,710 19,595 18,638 18,914

Baltimore.............................. 18,512 18,936 18,427 18,756 18,530 18,835 18,999 19,153 18,966 19,134 20,035 20,128Boston.................................. 24,504 25,016 23,166 24,226 22,348 22,423 23,143 24,265 21,517 21,412 20,905 21,224Buffalo.................................. 18,282 18,622 17,473 18,284 16,356 16,421 15,715 16,002 14,096 14,498 13,460 15,166Chicago................................ 18,230 18,477 18,907 19,127 19,247 19,664 19,081 19,189 18,447 19,298 17,863 18,499Dallas................................... 16,731 17,390 17,493 17,757 17,608 18,014 17,478 17,455 18,636 18,080 18,994 18,483Denver................................. 16,270 16,087 14,822 14,881 14,951 15,476 14,967 13,962 13,875 14,241 13,479 13,518Detroit.................................. 19,026 19,589 17,750 17,404 18,264 18,402 17,928 18,884 17,320 17,006 16,997 17,209Los Angeles - Long Beach... 15,048 14,843 14,282 14,939 13,619 13,654 14,243 13,931 12,791 13,888 12,138 13,174

Miami - Hialeah.................... 15,920 15,796 16,982 16,541 16,955 17,034 17,221 16,909 17,590 18,056 18,745 18,181Minneapolis - St. Paul.......... 13,624 14,229 12,029 12,642 14,671 15,058 14,939 14,827 14,347 14,783 13,963 13,955New Orleans........................ 23,820 22,940 24,445 24,719 24,773 24,708 25,349 25,960 24,074 24,405 24,108 22,719New York............................. 20,260 20,004 20,537 21,332 19,800 19,668 22,413 21,854 21,014 20,450 20,025 21,416Newark................................. 20,123 19,144 19,358 20,173 20,059 20,387 18,969 19,776 18,136 18,394 18,942 19,794

Philadelphia......................... 19,323 19,545 17,785 17,930 18,133 18,060 17,791 17,994 17,280 17,697 17,481 18,201Phoenix................................ 17,491 15,614 16,492 16,448 17,664 17,765 19,294 17,314 17,270 16,889 18,253 16,852St. Louis............................... 19,471 20,028 20,269 20,020 19,187 18,614 19,184 18,668 17,433 18,342 17,774 16,653San Diego............................ 13,879 13,125 11,516 11,115 10,534 11,210 12,488 12,110 12,362 12,445 12,516 13,089

San Francisco...................... 20,372 18,422 18,855 18,991 15,482 15,730 16,199 15,531 15,182 15,220 16,108 16,094Seattle.................................. 19,836 18,138 19,197 18,855 14,984 15,578 16,465 15,329 14,919 15,656 14,527 14,062

Washington, DC................... 15,636 16,036 16,046 16,508 15,743 15,980 14,326 14,741 14,179 14,237 14,459 14,566National Panel...................... 19,333 19,609 19,936 20,077 19,514 19,591 19,800 19,984 19,287 19,637 19,025 19,340

Year-End 1998 ED DAWN Data

Table 43 - Estimated rate of total emergency department visits per 100,000 population, by metropolitan area by half year: First half 1993 - second half 1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

**

 DAWN estimates of emergency department (ED) visits (in 1,000s) should be close to but will not necessarily equal totals from previous year's American 

Hospital Association (AHA) Annual Survey.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

99
TOTAL ED VISITS**

Total Total Total Total Total Total Total Total

 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.......................... 37,574 37,945 38,275 38,924 38,060 38,756 37,713 37,253Atlanta.................................. 41,319 40,371 41,852 42,862 42,441 41,796 38,307 37,552

Baltimore.............................. 37,172 36,178 37,448 37,184 37,365 38,153 38,101 40,163Boston.................................. 48,702 50,120 49,521 47,395 44,772 47,412 42,929 42,130Buffalo.................................. 37,982 38,800 36,905 35,759 32,776 31,718 28,595 28,630Chicago................................ 38,181 39,567 36,707 38,034 38,911 38,270 37,747 36,363Dallas................................... 31,570 32,761 34,123 35,251 35,623 34,933 36,715 37,476Denver................................. 29,052 31,604 32,356 29,703 30,429 28,926 28,117 26,998Detroit.................................. 38,328 37,550 38,616 35,153 36,666 36,815 34,325 34,207Los Angeles - Long Beach... 29,015 28,649 29,890 29,223 27,273 28,173 26,682 25,315Miami - Hialeah.................... 32,574 31,704 31,715 33,521 33,990 34,129 35,648 36,924Minneapolis - St. Paul.......... 29,580 27,799 27,854 24,673 29,731 29,766 29,131 27,917New Orleans........................ 45,225 46,057 46,757 49,165 49,481 51,311 48,480 46,823New York............................. 41,282 40,988 40,263 41,871 39,468 44,265 41,462 41,445Newark................................. 38,178 36,586 39,264 39,533 40,447 38,747 36,530 38,739Philadelphia......................... 38,991 40,960 38,868 35,715 36,193 35,786 34,979 35,685Phoenix................................ 31,496 32,707 33,100 32,940 35,430 36,602 34,158 35,101St. Louis............................... 38,980 35,247 39,501 40,288 37,800 37,850 35,778 34,424San Diego............................ 27,247 27,112 27,002 22,629 21,745 24,597 24,807 25,607San Francisco...................... 37,542 36,134 38,788 37,846 31,213 31,728 30,402 32,202Seattle.................................. 35,475 35,950 37,969 38,051 30,563 31,790 30,577 28,588Washington, DC................... 30,818 29,042 31,673 32,555 31,723 29,068 28,416 29,025National Panel...................... 38,079 38,627 38,943 40,014 39,105 39,784 38,926 38,366

Year-End 1998 ED DAWN Data

Table 44 - Estimated rate of total emergency department visits per 100,000 population, by metropolitan area by year: 1991-1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).

**

 DAWN estimates of emergency department (ED) visits (in 1,000s) should be close to but will not necessarily equal 

totals from previous year's American Hospital Association (AHA) Annual Survey.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

100
DRUG EPISODES

Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec

 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.***.................. 101 100 110 115 117 104 107 111 112 110 113 112

AGE

6-34.............................. 135 131 147 154 153 134 139 142 144 140 143 13612-17............................ 130 109 147 133 148 127 150 136 147 125 142 11618-25............................ 180 175 194 208 196 179 174 184 192 189 184 18926-34............................ 183 188 198 218 217 186 194 202 198 202 206 20035+............................... 69 73 76 80 85 78 80 85 84 84 89 92

GENDER

Male.............................. 102 107 114 123 121 107 109 118 119 116 122 120Female.......................... 98 92 105 105 110 99 104 103 103 102 103 103

Year-End 1998 ED DAWN Data

Table 45 - Estimated rate of emergency department drug episodes per 100,000 population by age, gender: First half 1993 - second half 1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).*** Total includes patients whose gender or age was unknown.NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U

101
DRUG EPISODES

Total Total Total Total Total Total Total Total

 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.***..................... 176 191 201 225 221 219 222 225

AGE

6-34.................................. 241 256 266 300 287 281 284 279

12-17................................ 236 228 238 280 275 286 272 25818-25................................ 327 345 356 402 375 358 381 37226-34................................ 317 353 371 416 403 396 400 40635+................................... 113 131 142 156 162 165 168 181

GENDER

Male................................. 175 201 209 237 228 227 235 242Female............................. 173 179 190 210 210 207 205 206

Year-End 1998 ED DAWN Data

Table 46 - Estimated rate of emergency department drug episodes per 100,000 population by age, gender: 1991-1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.*** Total includes patients whose gender or age was unknown.

102
DRUG MENTIONS

Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec

 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.***.................. 173 175 191 200 203 184 189 197 200 197 205 203AGE

6-34............................... 229 225 252 261 261 232 239 247 251 248 253 24312-17............................. 195 172 230 203 230 192 225 207 233 203 227 19018-25............................. 302 303 332 353 334 311 296 327 337 339 331 33326-34............................. 327 332 356 385 385 341 356 370 359 369 379 37135+................................ 121 129 134 145 152 142 146 154 155 154 165 170

GENDER

Male............................... 176 185 201 215 214 190 194 212 213 210 223 220

Female.......................... 167 162 178 182 189 174 180 179 184 182 184 185

Year-End 1998 ED DAWN Data

Table 47 - Estimated rate of emergency department drug mentions per 100,000 population by age, gender: First half 1993 - second half 1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).*** Total includes patients whose gender or age was unknown.NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

103
DRUG MENTIONS

Total Total Total Total Total Total Total Total

 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.***..................... 301 332 348 391 387 386 397 408

AGE

6-34.................................. 405 439 454 513 493 486 500 495

12-17................................ 361 356 367 433 422 432 436 41618-25................................ 541 598 606 685 645 623 676 66426-34................................ 559 622 659 740 727 726 728 74935+................................... 202 232 250 279 294 299 309 335

GENDER

Male................................. 302 350 361 416 405 407 423 443Female............................. 296 309 329 360 364 358 366 369

Year-End 1998 ED DAWN Data

Table 48 - Estimated rate of emergency department drug mentions per 100,000 population by age, gender: 1991-1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.*** Total includes patients whose gender or age was unknown.

104
COCAINE

Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec

 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.***..................... 27 27 30 32 32 27 31 34 33 35 36 36

AGE

6-34.................................. 35 35 39 43 40 32 37 40 39 41 41 40

12-17................................ 3 5 5 4 5 4 6 6 9 7 10 9

18-25................................ 40 40 42 49 42 34 37 43 45 47 43 45

26-34................................ 71 70 80 87 85 69 80 87 80 85 88 8635+................................... 19 20 22 23 24 22 25 29 28 29 31 32

GENDER

Male................................. 37 38 41 45 43 37 41 48 45 47 48 49Female............................. 17 17 19 19 20 17 20 21 21 22 24 23

Year-End 1998 ED DAWN Data

Table 49 - Estimated rate of emergency department cocaine mentions, per 100,000 population by age, gender: First half 1993 - second half 1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).*** Total includes patients whose gender or age was unknown.

NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

105
COCAINE

Total Total Total Total Total Total Total Total

 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.***..................... 45 53 54 62 58 65 68 72

AGE

6-34.................................. 65 72 71 81 72 77 80 81

12-17................................ 11 8 8 10 9 12 16 1918-25................................ 77 86 80 91 76 80 92 8826-34................................ 121 139 141 166 154 167 165 173

35+................................... 27 35 39 44 46 54 57 63

GENDER

Male................................. 62 74 75 87 80 89 92 97Female............................. 29 33 34 38 37 41 44 47

Year-End 1998 ED DAWN Data

Table 50 - Estimated rate of emergency department cocaine mentions per 100,000 population by age, gender: 1991-1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.*** Total includes patients whose gender or age was unknown.

106
HEROIN/MORPHINE

Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec

 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.***.................. 14 14 13 15 15 15 15 16 15 15 16 16AGE

6-34............................... 13 14 13 15 15 15 14 15 15 15 16 1612-17............................. 1 1 ... 111122422

18-25............................. 14 15 14 16 15 16 16 18 18 18 20 2226-34............................. 28 28 27 32 33 31 30 32 30 30 33 3035+................................ 13 14 13 14 16 16 16 17 15 16 16 17

GENDER

Male............................... 20 21 18 21 22 22 21 23 21 21 23 23

Female.......................... 8 8 8 9 9 9 9 10 9 10 10 10

Year-End 1998 ED DAWN Data

Table 51 - Estimated rate of emergency department heroin/morphine mentions per 100,000 population by age, gender: First half 1993 - second half 1998

... Estimate does not meet standard of precision or is less than 10.SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).*** Total includes patients whose gender or age was unknown.NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

107
HEROIN/MORPHINE

Total Total Total Total Total Total Total Total

 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.***..................... 16 21 28 28 30 31 30 32

AGE

6-34.................................. 17 21 27 28 30 30 30 31

12-17................................ 11122364

18-25................................ 17 21 29 30 31 34 36 41

26-34................................ 35 43 57 60 64 63 59 6335+................................... 15 22 28 27 31 33 31 33

GENDER

Male................................. 22 32 40 40 44 44 42 45Female............................. 10 11 15 16 17 19 19 20

Year-End 1998 ED DAWN Data

Table 52 - Estimated rate of emergency department heroin/morphine mentions per 100,000 population by age, gender: 1991-1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.*** Total includes patients whose gender or age was unknown.

108
MARIJUANA/HASHISH

Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec

 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.***................ 6 7 8 9 11 9 11 12 14 14 16 16

AGE

6-34............................. 10 11 14 16 17 15 18 21 22 22 26 26

12-17........................... 9 11 15 15 18 18 20 25 26 23 32 25

18-25........................... 16 19 23 27 28 26 26 31 36 34 39 43

26-34........................... 12 12 14 17 19 16 21 23 22 27 28 3035+.............................. 233344557688

GENDER

Male............................ 9 10 12 13 15 13 15 18 19 19 22 22Female........................ 3 4 5 5 6 5 7 7 8 9 10 10

Year-End 1998 ED DAWN Data

Table 53 - Estimated rate of emergency department marijuana/hashish mentions per 100,000 population by age, gender: First half 1993 - second half 1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).*** Total includes patients whose gender or age was unknown.NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

109
MARIJUANA/HASHISH

Total Total Total Total Total Total Total Total

 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.***..................... 7 11 13 18 20 23 27 32

AGE

6-34.................................. 12 18 21 29 33 38 44 52

12-17................................ 11 15 20 30 36 45 49 5718-25................................ 20 30 35 50 54 57 71 8326-34................................ 14 21 25 32 35 44 49 5835+................................... 3 4 5 7 8 10 13 16

GENDER

Male................................. 11 16 18 25 28 32 38 44Female............................. 4 6 7 10 11 14 17 20

Year-End 1998 ED DAWN Data

Table 54 - Estimated rate of emergency department marijuana/hashish mentions per 100,000 population by age, gender: 1991-1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.*** Total includes patients whose gender or age was unknown.

110
METHAMPHETAMINE/SPEED

Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec Jan - Jun Jul - Dec

 1993 1993 1994 1994 1995 1995 1996 1996 1997 1997 1998 1998

TOTAL U.S.***................ 233443234432

AGE

6-34............................. 346774345643

12-17........................... 1 2 4 5 5 2 1 3 ... 4 4 ...

18-25........................... 6 6 8 11 10 7 6 7 8 9 7 6

26-34........................... 46889645896535+.............................. 111221122221

GENDER

Male............................ 345664245542Female........................ 122332122222

Year-End 1998 ED DAWN Data

Table 55 - Estimated rate of emergency department methamphetamine/speed mentions per 100,000 population by age, gender: First half 1993 - second half 1998

... Estimate does not meet standard of precision or is less than 10.SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).*** Total includes patients whose gender or age was unknown.NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.

111
METHAMPHETAMINE/SPEED

Total Total Total Total Total Total Total Total

 1991 1992 1993 1994 1995 1996 1997 1998

TOTAL U.S.***..................... 23487575

AGE

6-34.................................. 3 5 7 12 11 7 12 8

12-17................................ 2339758518-25................................ 5 6 12 20 17 14 17 1326-34................................ 5 7 10 16 15 9 17 1135+................................... 11243342

GENDER

Male................................. 3 4 6 10 9 6 10 6Female............................. 22355354

Year-End 1998 ED DAWN Data

Table 56 - Estimated rate of emergency department methamphetamine/ speed mentions per 100,000 population by age, gender: 1991-1998

SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 1998 (07/1999 update).NOTE: These estimates are based on a representative sample of non-Federal, short-stay hospitals with 24-hour emergency departments in the coterminous U.S.*** Total includes patients whose gender or age was unknown.

112