1. Findings from theDrug Abuse Warning Network Immediate and Sustained Release Opioid Analgesics Judy K. Ball, Ph.D., M.P.A. Office of Applied Studies, Substance Abuse and Mental Health Services Administration 9 September 2003

2. Emergency Departments • Stratified probability sample • Short-term, general, non-Federal hospitals operating 24-hour emergency departments • Representative estimates for coterminous U.S. • 437 hospitals (80%) participated in 2002

3. DAWN Cases • Age 6-97 treated in ED • ED visit related to drug abuse • Abuse defined by patient’s motive for drug use • Dependence • Psychic effects • Suicide attempt/gesture

4. Drug Detail in DAWN • Illicit, prescription, OTC drugs • Specificity depends on medical record • Brand (trade) names – MSContin • Chemical names – morphine sulfate • Generic names – morphine • Classes – opiates • Street names • Multiple drugs per visit – drug “mentions”

5. Mentions of Selected Drugs inED Visits Related to Drug Abuse Source: Drug Abuse Warning Network

6. ED Mentions of Opiates/Opioids, 2002 Hydrocodone Unnamed Oxycodone All others Morphine 2,775 Fentanyl 1,506 Source: Drug Abuse Warning Network

7. Narcotic Analgesics, by Type

8. Unnamed Opiates, ED Mentions Source: Drug Abuse Warning Network

9. Hydrocodone, ED Mentions Source: Drug Abuse Warning Network

10. Hydromorphone, ED Mentions Source: Drug Abuse Warning Network

11. Fentanyl, ED Mentions Source: Drug Abuse Warning Network

12. Morphine, ED Mentions Source: Drug Abuse Warning Network

13. Oxycodone, ED Mentions Source: Drug Abuse Warning Network

14. Oxycodone, ED Mentions Source: Drug Abuse Warning Network

15. Oxycodone, ED Mentions Source: Drug Abuse Warning Network

16. Oxycodone, ED Mentions Source: Drug Abuse Warning Network

17. SR SR IR IR IR 1997 1998 1999 SR IR IR SR SR IR 2000 2001 2002 Oxycodone ED Mentions, 1997-2002

18. Drugs in Combination, 2002 Source: Drug Abuse Warning Network

19. Limitations of DAWN • Reportable cases of drug abuse, based on patient’s intent • Variable reporting of nonspecific terms • Cannot distinguish diversion vs. abuse with legitimate prescriptions • No information on health