June 18, 2010 |
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The estimated number of ED visits involving nonmedical use of narcotic pain relievers rose from 144,644 in 2004 to 305,885 in 2008, an increase of 111 percent (Figure 1). Visits more than doubled for both male and female patients (increasing 110 and 113 percent, respectively), and among both patients younger than 21 and those aged 21 or older (increasing 113 and 112 percent, respectively) (Figure 2).
Year | Number of ED Visits |
---|---|
2004 | 144,644 |
2005 | 168,376 |
2006 | 201,280 |
2007 | 237,143 |
2008 | 305,885 |
Source: 2008 (08/2009 update) SAMHSA Drug Abuse Warning Network (DAWN). |
Gender/Age Group | 2004 | 2008 |
---|---|---|
Gender | ||
Male (110%) | 71,700 | 150,790 |
Female (113%) | 72,935 | 155,053 |
Age Group | ||
Younger than 21 (113%) | 13,735 | 29,196 |
Aged 21 or Older (112%) | 130,781 | 276,659 |
*Percentages shown in parentheses represent the percent changes between 2004 and 2008. Source: 2008 (08/2009 update) SAMHSA Drug Abuse Warning Network (DAWN). |
Between 2004 and 2008, ED visits involving nonmedical use of six types of narcotic pain relievers increased; specifically, these include oxycodone products, hydrocodone products, methadone, morphine products, fentanyl products, and hydromorphone products (Figure 3).3,4 ED visits involving oxycodone products, hydrocodone products, and methadone—the three most frequently reported narcotic pain relievers in each year—increased 152, 123, and 73 percent, respectively. While ED visits involving hydromorphone products showed the largest increase (259 percent), far fewer visits involved these products.
Narcotic Pain Relievers | 2004 | 2008 |
---|---|---|
Oxycodone Products (152%) | 41,701 | 105,214 |
Hydrocodone Products (123%) | 39,844 | 89,051 |
Methadone (73%) | 36,806 | 63,629 |
Morphine Products (106%) | 13,966 | 28,818 |
Fentanyl Products (105%) | 9,823 | 20,179 |
Hydromorphone Products (259%) | 3,385 | 12,142 |
*Percentages shown in parentheses represent the percent changes between 2004 and 2008. Source: 2008 (08/2009 update) SAMHSA Drug Abuse Warning Network (DAWN). |
The number of ED visits in the United States involving nonmedical use of these six types of narcotic pain relievers increased for both male and female patients (Table 1). Increases in visits for each of these drugs were also seen for persons aged 21 or older. Among patients aged 21 or older, increases were seen for oxycodone (154 percent), hydrocodone (119 percent), fentanyl products (111 percent), morphine products (96 percent), and methadone (70 percent). Involvement of hydromorphone had the highest increase (259 percent) among patients aged 21 or older, but far fewer visits involved these products.
Narcotic Pain Reliever | Male Patients | Female Patients | ||||
---|---|---|---|---|---|---|
2004 | 2008 | Percent Change |
2004 | 2008 | Percent Change |
|
Oxycodone Products | 23,134 | 57,335 | 148% | 18,567 | 47,873 | 158% |
Hydrocodone Products | 16,378 | 38,854 | 137% | 23,464 | 50,193 | 114% |
Methadone | 22,424 | 35,620 | 59% | 14,376 | 27,976 | 95% |
Morphine Products | 6,218 | 13,913 | 124% | 7,748 | 14,904 | 92% |
Fentanyl Products | 4,198 | 9,688 | 131% | 5,624 | 10,491 | 87% |
Hydromorphone Products | 1,218 | 4,907 | 303% | 2,166 | 7,235 | 234% |
Source: 2008 (08/2009 update) SAMHSA Drug Abuse Warning Network (DAWN). |
Among patients younger than 21, the overall increase in ED visits involving the nonmedical use of narcotic pain relievers was driven by increases in visits involving hydrocodone and oxycodone products. Similar to the patterns in ED visits made by patients aged 21 or older, visits by patients younger than 21 that involved hydrocodone products increased 157 percent and those that involved oxycodone products increased 147 percent. Data for visits involving fentanyl products, hydromorphone products, morphine products, and methadone for the younger than 21 age group were either suppressed because of low precision or had percent changes that were not statistically significant (data for drug involvement by age group are not shown).
Over the 5-year period from 2004 to 2008, there were marked increases in the number of medical emergencies that involved the nonmedical use of narcotic pain relievers and resulted in ED visits. Additionally, visits involving certain types of narcotic pain relievers—such as hydromorphone products—increased more than others. Continued monitoring of these trends is vital for ensuring that potential emerging drug problems are identified and addressed as quickly as possible.
The findings reported here highlight the need to strengthen prevention and education programs designed to reduce the misuse of prescription drugs. Increased efforts are needed to educate the public about the risks of misusing narcotic pain relievers and how to recognize possible symptoms of abuse. Prevention and education campaigns should continue to focus on the dangers of sharing prescription medications, the importance of preventing others from having access to personal prescription medications, and methods for properly disposing of remaining dosage units once the need for medication has passed. Additionally, ongoing efforts are needed to keep doctors and other health care professionals informed about emerging drug problems and to help them understand the importance of exercising care in prescribing pain relievers and monitoring their patients or clients for signs of misuse.
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 is always 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 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://www.oas.samhsa.gov/. 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://oas.samhsa.gov/. 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 May 24, 2010. |
SAMHSA, an agency in the Department of Health and Human Services, is the Federal Government's lead agency for improving the quality and availability of substance abuse prevention, addiction treatment, and mental health services in the United States.
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