SAMHSA is re-establishing the Drug Abuse Warning Network (DAWN), a nationwide public health surveillance system that will improve emergency department (ED) monitoring of substance use crises, including those related to opioids.
DAWN will retain the valuable aspects of legacy DAWN, such as direct chart review to identify DAWN cases, an inclusive case definition in order to identify all ED visits related to substance use (not just abuse), and collecting detailed information about the drugs involved in ED visits, using the most specific terminologies available in the ED records (for example, brand names or slang terms). Important improvements to new DAWN include improved timeliness of data, data available at more frequent intervals, and data for a wider range of geographic types, including urban, suburban, and rural areas. Having data available more quickly means that DAWN can serve as a true “early warning” system and inform public health response efforts in local areas.
The data will come from non-Federal, general hospitals with EDs that are open 24 hours a day/7 days a week. Recruitment of hospitals began in 2019 and will continue until the target of 50 participating hospitals is met. Participation by hospitals is optional.
In comparison to legacy DAWN (DAWN data collection through 2011), which produced estimates of drug-related ED visits for the Nation and a selection of metropolitan areas, DAWN will function as a smaller-scale sentinel surveillance system, or an ‘early warning’ system. DAWN will focus on detecting “outbreaks,” i.e., sudden increases in ED visits for specific drugs, identifying new and novel psychoactive substances, monitoring the magnitude of the health effects from substance use (as reflected in ED visits), and documenting the geographic, temporal, and demographic distribution of the problems to inform planning and policy at the local, state, and national levels.
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