drug abuse warning network

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					This is a voluntary national data collection, which collects information on the results of drug abuse in
visits to hospital emergency departments (ED) contiguous United States. Hospitals in the DAWN system
tracks not include federal, short-stay, general hospitals, 24 hours EDepresentative coterminous United
States as a sample of hospitals in 21 major metropolitan areas wholelus. The system also collects data
on drug-related deaths from a nonrandom sample of medical examiners. These data are in separate
annual reports titled DAWN medical examiner reported.

Data from the DAWN system collected is one of the most widely used indicators of national drug
abuserequently used by researchers and policy makers to determine the nature and scope of the
medical consequences of drug use at national and in the participating cities. Although data are widely
used to monitor trends and patterns of drug abuse, should be used with caution DAWN. DAWN data
represent only information on individuals entering an emergency room because of his drug use.
Therefore, the data will be the most serious cases of drug abuse. Consequences of drug use that are less
serious, are not represented in the data. In addition, data analysis requires knowledge of the nature of
case reporting DAWN. For example, the data contains emergency room system is not only of overdose,
but on individuals, detoxification in an emergency room or those who have chronic effects of drugs
useituations not necessarily need emergency treatment. Therefore, DAWN cases reflect phenomena
other than medical consequences (eg, changes in medical treatment, the availability of non-hospital).


DAWN was created in 1972 by the U.S. Department of Justice, Drug Enforcement Administration (DEA)
as a surveillance system for new drugs. Since 1980, the DAWN system by the National Institute on Drug
Abuse (NIDA) and, more recently, the Office of Applied Studies, Drug and MEN-TAL Health Services
Administration (SAMHSA), which currently manages it. Managed

The Emergency-Room System.

In the beginning, was the system of DAWN emergency room of a sample of hospitals in 21 cities and a
representative number of hospitals in the nation as a whole. In subsequent years, however, led to
changes in the hospital participate in a sample that was not representative of all hospitals in harmony
EDS U.S.. Included so that the collected data from the DAWN system before 1988 as the only drug cases
for hospitals in the sample, the actual estimates of the number of drug-related deaths and hospital
emergency departments in urban centers or in the country are not available for these years (1972-
1987). The primary utility of the data prior to 1988, therefore to examine trends in drug-related deaths
and emergencies in the participating hospitals, over time, instead of deriving estimates of the actual
number of cases in the United States.
DAWN data were collected from a representative sample of eligible hospitals in the coterminous United
States. It includes an oversampling 20-1 metropolitan and of a national sample of hospitals from
locations outside these areas. This sample design corrected the limits of the pre-1988 sample. It also
allows conclusions about the actual number of episodes of drug abuse in the continental United States
and for each DAWN metropolitan areas.


In each participating institution is a journalist to make a rule, a member of a hospital emergency room or
medical records of personnel engaged in data collection. The reporter checked records for each case,
may be included in the DAWN system records and demographic information and information about the
circumstances of the episode, including the date and time of the ED visit and Due to the person came to
the emergency. Mentioned for each drug, including the DAWN report, has acquired the form in which
the drug, its source and route of administration. One reason for taking substances is recorded. A report
for each case is then submitted to SAMHSA for data entry.

The following criteria for determining whether a statement is used DAWN cases. For each record, the
patient must be between six and 97 years and must meet all the following criteria:

    1. The patient was treated in hospital emergency rooms.
    2. The patient presented problem (s) was caused by or in connection with drug use, regardless of
       whether drug taking minutes or hours occurred before the visit.
    3. The case involved the nonmedical use of legal drugs or using illegal drugs.
    4. The patient base for the consumption of the substance (s) contain The patient's reason for
       taking the substance(s) included one of the following: (1) DEPENDENCE, (2) SUICIDE attempt or
       gesture, or (3) psychic effects.

DAWN cases do not include accidental ingestion or inhalation of the substance, and do not include the
side effects of prescription drugs or OTC. Up to four substances can be reported for each drug abuse
death or emergency room cases. Alcohol is reportable only when used in combination with a reportable
Trends in emergency situations and drug-related deaths

Drug-related episodes in 1999. In 1999, there were an estimated 554,932 ED drug episodes in the United
States coincide. Episodes in males and females in approximately equal numbers took place.

Dependence (37% of episodes) and suicide (32%) were the most frequently cited reasons for drug use.
The reason why the review as part of contact in the emergency room, the data show that an overdose
(OD) of the most frequent reason cited for the majority of episodes (42%), while the rest episodes were
due to another cause.

In 1999, the largest number of episodes (196,277 or 35% of all episodes) due to alcohol in combination
with other drugs. The other drugs were mentioned most often cocaine (168,763 or 30%), heroin /
morphine (84,409 or 15%), amphetamines (11,954 or 2%), and methamphetamine / speed (10 447 or
2%). In 1999, mentioned marijuana / hashish exceeded heroin / morphine mentions the change of
classification of illegal drugs was mentioned as constant since 1990.

Long-term trends, 1990-1999. The number of episodes of drug-related deaths increased 49 percent from
1990 to 1999 from 371 208-554 932. Although men, women are consistently mentioned in the illegal
drug outweigh its long-term patterns of growth are similar. Doubled from 1990 to 1999, mentions of
cocaine and heroin / morphine than for men and women. ED mentions of marijuana / hashish in 1999
were five and six times the 1990 level for men and women, respectively. Terms of the four main illicit
drugs increased from 1990 to 1999 is as follows: marijuana / hashish (15,706 to 87,150, or 455%),
methamphetamine / speed (5236 to 10,447 or 100%), heroin / morphine (33,884 -84 409, or 149%) and
cocaine (80,355 to 168,763 or 110%). Emergencies for people over 35 has increased significantly over
the period (124%), while the number of episodes for 25 years and younger increased by less than 20

Among youth aged 12-17 years, the references to marijuana / hashish increased 489 percent (2170-12
784) between 1990 and 1999. This increase is significant when one considers that the total number of
drug-related episodes in patients in this age group rose only 7 percent (from 49 109-52 783) between
1990 and 1999. In addition, long-term trends of methamphetamine / amphetamine, cocaine, and heroin
/ morphine in adolescents 12 to 17 show the increasing use of individuals in this age group.

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