MARCH 2004

Highlights From DAWN: Baltimore, 2002

This special report presents findings based on data Top 5 drugs in drug abuse-related
submitted by 20 hospitals in the Baltimore ED visits in Baltimore, 2002
metropolitan area for 2002.
10,000
■ Of the 1.1 million visits to Baltimore area
emergency departments (EDs) in 2002, about
one percent (12,904) were related to drug abuse.
■ During 2002, the most common drugs involved 7,500

in these ED visits were cocaine, heroin, narcotic

Number of visits
analgesics (pain relievers), alcohol in combination 5,969
with other drugs, and marijuana.
5,000 4,715
■ Heroin-related ED visits in Baltimore increased
4 percent between 2001 and 2002, but have 3,848

decreased 45 percent since 1995. 3,189

■ Among the 21 DAWN areas, Baltimore ranked in 2,500

2,044
the top 3 in terms of ED visits involving heroin,
cocaine, and pain relievers.

0
Cocaine Heroin Narcotic Alcohol-in- Marijuana
analgesics combination
(pain relievers)

DAWN: The Warning Network

Local information is essential to
Seattle
support local action, and drugs, drug
use, and drug-related morbidity can Detroit
Minneapolis
differ dramatically across communities. Buffalo
DAWN focuses on metropolitan areas Boston
Chicago
to reveal emerging drug problems Denver Baltimore New York
San Francisco St. Louis Washington
before they become widespread. Newark
DAWN detects new drugs, new drug Philadelphia

combinations, new health consequences Los Angeles

Phoenix Atlanta
of drug use, and changing patterns involving Dallas
old drugs. Facilities participating in DAWN San
Diego
can use this information to train staff and
New
improve patient care. Communities can use this information to Orleans
plan, target resources, and act more effectively. Miami

Today, hospitals in Baltimore and 20 other metropolitan areas serve their

communities by participating in DAWN. Expansion to other areas is underway.
DAWN serves a diverse audience. In addition to participating facilities, users include researchers and policy analysts; pharmaceutical firms;
State and local substance abuse agencies; community coalitions; and Federal agencies, including the White House Office of National Drug
Control Policy, the Food and Drug Administration, and the National Institute on Drug Abuse. For more information, go to
http://DAWNinfo.samhsa.gov/.
 400
300 Baltimore
2 H I G H L I G H T S F R O M DA W N : BA LT I M O R E 2 0 0 2

per 100,000
population
Cocaine 300 Baltimore
200

100,000
Trends inCocaine
Top 4 Drugs, 1995-2002

population
Rate perRate
200 U.S.
100

Cocaine 100 U.S.

0
1995 1996 1997 1998 1999 2000 2001 2002
400
■ Cocaine-related ED visits in Baltimore increased 0
20 percent (to 257 visits per 100,000 population) 200 1995 1996 1997 1998 1999 2000 2001 2002

between 2001 and 2002, but decreased 33 300 Baltimore

per 100,000
percent since 1995. 200

population
150
Cocaine

100,000
200
■ More than 80 percent of cocaine-related ED

population
150 Baltimore

Rate
visits in Baltimore also involved other drugs.
Marijuana 100

100,000
per
100 U.S.

population
Less than 5 percent of cocaine-related ED visits

Rate perRate
■
100
U.S.
Baltimore
were attributedMarijuana
to "crack" in Baltimore. 50
0
1995 1996 1997 1998 1999 2000 2001 U.S.
2002
50
0
1995 1996 1997 1998 1999 2000 2001 2002
Heroin 200
0
1995 1996 1997 1998 1999 2000 2001 2002
■ Heroin-related ED visits in Baltimore increased 400
150

per 100,000
4 percent (to 203 visits per 100,000 population)
population
400
between 2001 and 2002, but decreased 45
Marijuana
100,000 300
100 Baltimore
percent since 1995 heroin
(from 366 visits per 100,000).
population
Baltimore
perRate

300
200
U.S.
100,000

■ More than half (55 percent) of the heroin- 50

population

Baltimore
related ED visits inheroin
Rate perRate

Baltimore also involved

200
other drugs. 100
0
1995 1996 1997 1998 1999 2000 2001 U.S.
2002
100
0
1995 1996 1997 1998 1999 2000 2001 U.S.
2002
400
0
1995 1996 1997 1998 1999 2000 2001 2002
Pain Relievers 200
300 Baltimore
per 100,000
population

■ From 1995 toNarcotic

2002,heroin
pain relievers
implicated 200
150
Baltimore
analgesics...
Baltimore
100,000

200
in drug abuse-related ED visits increased more
population
Rate

than 400 percent in analgesics...

Narcotic Baltimore (from 30 to 165 400
150
100
100,000
per

100
mentions per 100,000 population). The increase
population
Rate perRate

U.S.
nationally was 139 percent (from 19 to 46 300
100 U.S.
50 Baltimore
Rate per 100,000

mentions per 100,000). 0

population

1995 1996 1997 1998 1999 2000 2001 2002

U.S.
Cocaine
■ Oxycodone and methadone were the most 200
50
0
1995 1996 1997 1998 1999 2000 2001 2002
frequently named pain relievers in drug-related 200
U.S.
Baltimore
ED visits in Baltimore in 2002. 100
0
1995 1996 1997 1998 1999 2000 2001 2002
Narcotic analgesics... 150
Rate per 100,000

0
population

1995 1996 1997 1998 1999 2000 2001 2002

Marijuana
100

■ From 1995 to 2002, marijuana-related ED visits 200

U.S.
in Baltimore rose over 100 percent (from 42 to 50

88 visits per 100,000 population). The national 150

Rate per 100,000

rate (47 visits per 100,000 in 2002) increased 0

population

1995 1996 1997 1998 1999 2000 2001 2002

Baltimore
almost 140 percent over the same 8-year period.
Marijuana 100

■ Marijuana was reported in about 16 percent of U.S.

all drug abuse-related ED visits in Baltimore 50

and was usually reported in combination with

other drugs. 0
1995 1996 1997 1998 1999 2000 2001 2002

400

300
00
 H I G H L I G H T S F R O M DA W N : BA LT I M O R E 2 0 0 2 3

Comparisons
??? Across 21 Metropolitan Areas
The following figures show Baltimore in relation to the Nation and 20 other metropolitan areas represented in DAWN
for selected drugs in 2002. Comparisons across areas are possible because the number of visits for each drug
is represented in terms of a rate per 100,000 population. Not all differences in rates are statistically significant.

Cocaine visits H
Cocaine visits
Cocaine visits Heroin
Rate visits
perHeroin
100,000 visits
population, 2002 Ra
Rate perRate
100,000 population,
per 100,000 2002 2002
population, Rate perRate
100,000 population,
per 100,000 2002 2002
population,
Total U.S. 78
Total U.S.Total U.S. 78 78 Total U.S.Total U.S. 36
Chicago 36 275
220
Chicago Chicago 275 275 Chicago Chicago
Philadelphia 274220 220
214
Philadelphia
Philadelphia 274 274 Newark Newark
Baltimore 257 214 214
203
BaltimoreBaltimore 257 257 Baltimore
MiamiBaltimore 240 203 203 S
171
Miami Miami 240 240 San Francisco
San Francisco
Atlanta 171
239 171
Atlanta Atlanta 239 239 Seattle Seattle
Newark 128
186 128
Newark Newark 186 186 New YorkNew York
Detroit 123
182 123
Detroit Detroit 182 182 Boston Boston
Buffalo 111171 111
Buffalo Buffalo 171 171 Philadelphia
Philadelphia
New York 109166 109
New YorkNew York 166 166 Buffalo
Seattle Buffalo 93 93
164
Seattle Seattle 164 164 Detroit Detroit
Boston 93 93
156
Boston Boston 156 156 St.Miami
Louis Miami 85 85
153 N
St. LouisSt. Louis 153 153 New
San Orleans
New Orleans
Francisco 53 53 150
San Francisco
San Francisco 150 150 NewSt. LouisSt. Louis
Orleans 51 51 145
New Orleans
New Orleans 145 145 Denver Denver
Los Angeles 43 43
108 Was
Los Angeles
Los Angeles 108 108 Washington, DC
Washington,
Denver DC 38 8238
Denver Denver 82 82 DC Angeles 29 7129
Los Angeles
Washington, Los
Washington, DC
Washington, DC 71 71 San Diego
PhoenixSan Diego 28 59 28
Phoenix Phoenix 59 59 Phoenix Phoenix
Minneapolis 23 55 23
Minneapolis
Minneapolis 55 55 Atlanta 20 46 20
Dallas Atlanta
Dallas Dallas 46 46 Minneapolis 1632
Minneapolis
San Diego 16
San Diego32
San Diego 32 10
Dallas 0 Dallas 10 300
225
0 0 300 300 0 0 225 225

Pain Reliever visits Marijuana visits B

Marijuana
Marijuana visits
Rate per 100,000 visits2002
population, Benzodiazepines
Rate 100,000 population, 2002 visits
perBenzodiazepines visits PainPain
Re
Ra
Rate perRate
100,000 population,
per 100,000 2002 2002
population, Rate perRate
100,000 population,
per 100,000 2002 2002
population, Rate perRate
100,0
p

Total U.S. 46 Total U.S. 47

41 41 Total U.S.T
Total U.S.Total U.S.
Baltimore 47 47 165 Total U.S.Total U.S.
Philadelphia 150
102
102 102 BaltimoreB
Philadelphia
Philadelphia
Buffalo 106 150 150 Boston
Detroit Boston 146
95
95124 95 Buffalo
Detroit Detroit
New Orleans 98 146 146 Philadelphia
Philadelphia
St. Louis N
82 82 New Orleans
New
St. LouisSt.Detroit
Louis 97 124 124 New Orleans
New Orleans
Boston 119
78 78 Detroit
Boston Boston
Boston 97 119 119 St.Miami
LouisSt. Louis 111
111 69 96 69 Boston
Miami Miami
Seattle 95 111 Detroit Detroit
Atlanta
60 Seattle
Atlanta Atlanta
Philadelphia 81 96 96 BaltimoreBaltimore 88 60
68 88 5778 57 Philadelphia
Phil
BaltimoreBaltimore
St. Louis 88 Newark Newark
Chicago
5372 53 St. Louis
Chicago Chicago
Newark 6478 78 New Phoenix
Orleans Phoenix
50 50 Newark
New Orleans
New Orleans
Phoenix 62
72 72 Seattle Seattle 65
49 49 Phoenix
Seattle Chicago
Seattle 65
61 65 Miami
Los Angeles Miami 64
47 47 Chicago
Los Angeles
LosNew
Angeles
York 64
55 64 Chicago
Buffalo Chicago 56
45 45 New YorkN
Buffalo Buffalo
San Francisco 5652 56 San Diego
Washington, San Diego
DC 55 Sa
42 42 San Francisco
San F
Washington, DC
Washington, DC
San Diego 46
55 55 San Francisco
San Francisco
Newark 54
35 35 San Diego
Sa
Newark Newark
Minneapolis 40
54 54 Buffalo
New York Buffalo 47
34 34 Minneapolis
Min
New YorkNew York
Denver 47
34 47 Atlanta Atlanta
Minneapolis 47
30 46 30 Denver
Minneapolis
Minneapolis
Atlanta 30
47 47 San Dallas
Diego Dallas
28 46 28 Atlanta
San Diego
San
Los Diego
Angeles 28
46 46 Los Phoenix
Angeles
Los Angeles
2639 26 Los Angeles
Los
Phoenix Phoenix
Dallas 46
28 46 Minneapolis
San Minneapolis
Francisco
39 2638 26 Dallas
San Francisco
San Francisco
Washington, DC 26 39 Denver Denver
38 22 22 Washington, DC
Washin
Denver Denver
Miami 22 38 New YorkNew York
Dallas 27 Was
Miami
Dallas Dallas 0 27 27 225 Washington, DC 0
Washington, DC 21 21 160
130
0 0 160 160 0 0 130 130
4 H I G H L I G H T S F R O M DA W N : BA LT I M O R E 2 0 0 2

About
??? DAWN
The Drug Abuse Warning Network (DAWN) is a national surveillance system that monitors drug-related
morbidity and mortality. Section 505 of the Public Health Service Act assigns this responsibility to the Substance
Abuse and Mental Health Services Administration (SAMHSA), an agency of the U.S. Department of Health and
Human Services. The Act requires SAMHSA to report annually on drug-related visits to hospital emergency
departments and on drug-related deaths reviewed by medical examiners and coroners. SAMHSA has a contract
with Westat, a private research firm based in Rockville, MD, to operate the DAWN system.

DAWN collects data from a scientific sample of hospital emergency departments and a set of medical examiners
and coroners from across the U.S., with concentrations in selected metropolitan areas. Each participating facility
has a DAWN Reporter who is specially trained to identify DAWN cases by retrospectively reviewing emergency
department medical records or death investigation case files. No patient, family member, or physician is ever
interviewed. No direct identifiers for individual patients or decedents are collected.

Beginning in 2003, DAWN cases include any emergency department visit or death that was related to drug use.
Reportable cases include drug abuse, misuse, overmedication, accidental and malicious poisonings, and adverse
drug reactions. For each case, the DAWN Reporter submits a case report detailing the specific drugs involved,
and characteristics of the patient or decedent and event (visit or death). Patient and decedent characteristics
include demographics (age, gender, race/ethnicity) and ZIP code. Other data items include date/time, chief
complaint, diagnoses, and disposition for each emergency department visit; and date, cause, manner, and place
of death for each decedent.

U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES