October 7, 2010 |
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During 2008, there were nearly 4.4 million drug-related ED visits; of these, 1.8 percent (79,400 visits) resulted in discharge into police custody. One quarter (25.1 percent) of these visits were made by patients aged 18 to 24, one quarter (24.9 percent) were made by patients aged 25 to 34, and one fifth (20.7 percent) were made by patients aged 35 to 44 (Figure 1). About 1 in 10 visits (9.8 percent) were made by patients aged 12 to 17. Nearly three quarters (70.7 percent) of the visits resulting in discharge into police custody were made by male patients (data not shown).
Age Group | Percentage of Visits |
---|---|
Aged 12 to 17 | 9.8% |
Aged 18 to 24 | 25.1% |
Aged 25 to 34 | 24.9% |
Aged 35 to 44 | 20.7% |
Aged 45 to 54 | 14.3% |
Aged 55 or Older | 5.2% |
Source: 2008 SAMHSA Drug Abuse Warning Network (DAWN). |
Illicit drugs were involved in about three fifths (61.6 percent) of the ED visits made by patients who were discharged into police custody (Table 1). The three illicit drugs most commonly involved were cocaine (24.1 percent), heroin (18.1 percent), and marijuana (17.4 percent).
Alcohol was involved in about one third (34.7 percent) of the visits. However, the number of alcohol-related ED visits resulting in discharge into police custody was probably higher. The alcohol category includes visits involving alcohol taken in combination with other drugs for all patients and visits involving only alcohol for patients younger than 21. DAWN does not track alcohol only visits for patients aged 21 or older.
Pharmaceuticals were involved in nearly half (45.3 percent) of the ED visits made by patients discharged into police custody. Pain relievers were involved in 21.1 percent of these visits, with narcotic pain relievers accounting for 16.8 percent. Drugs that treat anxiety or insomnia were involved in 16.7 percent of visits, with benzodiazepines accounting for 15.3 percent.
Drug Category | Estimated Number of ED Visits |
Percentage of Visits* |
---|---|---|
Total ED Visits | 79,400 | 100.0% |
Alcohol** | 27,587 | 34.7% |
Illicit Drugs | 48,881 | 61.6% |
Cocaine | 19,115 | 24.1% |
Heroin | 14,379 | 18.1% |
Marijuana | 13,810 | 17.4% |
Stimulants | 5,673 | 7.1% |
Pharmaceuticals | 35,995 | 45.3% |
Pain Relievers | 16,752 | 21.1% |
Narcotic Pain Relievers | 13,337 | 16.8% |
Drugs for Anxiety or Insomnia | 13,264 | 16.7% |
Benzodiazepines (e.g., Alprazolam) | 12,110 | 15.3% |
* Because multiple drugs may be involved in each visit, estimates of visits by drug may add to more than the total, and percentages may add to more than 100 percent. ** The alcohol category includes visits involving alcohol in combination with other drugs for all patients as well as visits involving only alcohol for patients younger than 21. DAWN does not track alcohol only visits for patients aged 21 or older. Source: 2008 SAMHSA Drug Abuse Warning Network (DAWN). |
The drugs involved in the ED visits made by patients who were discharged into police custody varied by age (Figure 2). Visits made by patients aged 21 or older were more likely than those made by patients younger than 21 to involve cocaine (29.0 vs. 7.9 percent) or pharmaceuticals (49.4 vs. 32.1 percent) and were less likely to involve marijuana (12.3 vs. 33.9 percent). Among visits made by patients younger than 21, 61.4 percent involved alcohol.
Selected Drugs | Younger than 21 |
21 or Older |
---|---|---|
Illicit Drugs | 55.9% | 63.3% |
Cocaine | 7.9% | 29.0% |
Marijuana | 33.9% | 12.3% |
Pharmaceuticals | 32.1% | 49.4% |
Source: 2008 SAMHSA Drug Abuse Warning Network (DAWN). |
The drugs involved in ED visits made by patients who were discharged into police custody did not vary by gender (Figure 3). Specifically, 51.3 percent of visits made by females involved pharmaceuticals, and 56.8 percent involved illicit drugs. Among visits made by males, 42.8 percent of those visits involved pharmaceuticals, and 63.5 percent involved illicit drugs.
Selected Drugs | Male | Female |
---|---|---|
Illicit Drugs | 63.5% | 56.8% |
Cocaine | 24.5% | 23.0% |
Marijuana | 18.4% | 14.9% |
Pharmaceuticals | 42.8% | 51.3% |
Source: 2008 SAMHSA Drug Abuse Warning Network (DAWN). |
The ED presents a unique opportunity to conduct a screening, brief intervention, and/or treatment referrals for individuals with substance use disorders. This report shows that over three in five drug-related ED visits made by patients who were discharged into police custody involved illicit drugs and nearly half involved pharmaceuticals. In addition to informing police of clinical findings, specific drugs, and possible indications of side effects, ED treatment staff may wish to document information that can help ensure that the patients receive appropriate and timely follow-up care either during or beyond their criminal justice system involvement.
Accurate and complete information about the drugs that individuals use prior to being discharged into police custody may also help treatment providers to monitor emerging drugs, forecast future treatment needs among the criminal justice population, and plan and develop programs tailored to specific demographic groups within this population.
The Drug Abuse Warning Network (DAWN) is a public health surveillance system that monitors drug-related morbidity and mortality. DAWN uses a probability sample of hospitals to produce estimates of drug-related emergency department (ED) visits for the United States and selected metropolitan areas annually. DAWN also produces annual profiles of drug-related deaths reviewed by medical examiners or coroners in selected metropolitan areas and States. Any ED visit related to recent drug use is included in DAWN. All types of drugs—licit and illicit—are covered. Alcohol is included for adults when it occurs with another drug. Alcohol always is reported for minors even if no other drug is present. DAWN's method of classifying drugs was derived from the Multum Lexicon, Copyright 2008, Multum Information Services, Inc. The Multum Licensing Agreement can be found in DAWN annual publications and at http://www.multum.com/license.htm. DAWN is one of three major surveys conducted by the Substance Abuse and Mental Health Services Administration's Office of Applied Studies (SAMHSA/OAS). For more information on other OAS surveys, go to http://samhsa.gov/data/. SAMHSA has contracts with Westat (Rockville, MD) and RTI International (Research Triangle Park, NC) to operate the DAWN system and produce publications. For publications and additional information about DAWN, go to http://DAWNinfo.samhsa.gov/. |
The DAWN Report is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report or other reports from the Office of Applied Studies are available online: http://samhsa.gov/data/. Citation of the source is appreciated. For questions about this report, please e-mail: shortreports@samhsa.hhs.gov.
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This page was last updated on July 13, 2010. |