11 Key Findings from SAMHSA’s Drug-Related Emergency Department’s Report

The Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) and the Center for Behavioral Health Statistics and Quality (CBHSQ) created the Drug Abuse Warning Network (DAWN) in 2016 when authorized by the 21st Century Cures Act. DAWN is a nationwide public surveillance system that collects data from Emergency Department (ED) visits resulting from substance use and overdoses. DAWN has worked since 2018 to improve ED monitoring of substance use-related visits, including those related to opioids. Data is collected from electronic health records (EHR) of participating hospitals. The intention of the data collected is to help SAMHSA, public health professionals, clinicians, and policy makers understand the landscape opioid and substance use in the United States.

DAWN’s key objectives include:

Monitoring demographic and geographic trends related to ED-related substance use.
Identifying emerging trends related to psychoactive substances and/or combination substances.
Providing national estimates of substance-related ED visits to key stakeholder’s and the public.

A new report was just released titled, “Preliminary Findings from Drug-Related Emergency Department Visits”. This report identified 141,529 drug-related emergency department (ED) visits from 52 participating hospitals. The data was analyzed to (1) generate nationally representative weighted estimates for the top five drugs in drug-related ED visits, (2) assess monthly trends and drugs involved in polysubstance ED visits in a subset of sentinel hospitals, and (3) identify drugs new to DAWN’s Drug Reference Vocabulary (DRV) in 2021.

Key Finding #1

The top 5 of all drug-related ED visits in 2021 were:

Alcohol 39.33%

Opioids 14.07%

Methamphetamine 11.02%

Marijuana 10.78%

Cocaine 4.71%

Key Finding #2

The top 6 drugs involved in polysubstance ED visits (i.e., visits related to more than one drug) were: alcohol, methamphetamine, marijuana, cocaine, heroin, and fentanyl.

Note: The majority of alcohol-related ED visits were due to alcohol alone, with a significant percentage of methamphetamine-, marijuana-, cocaine-, heroin-, and fentanyl-related ED visits involved at least one other drug.

Key Finding #3

When looking at statistics related to age, people aged 18 – 25 had the second highest percentage of ED visits related to marijuana (26.80%) and fentanyl (16.90%).

26.8

ED visits related to marijuana, ages 18 - 25

16.90

ED visits related to fentanyl, ages 18 - 25

Key Finding #4

Gender differences were as follows, males had a higher percentage of ED visits for all top five drugs as compared to females. However, the differences were much smaller (54.04% males vs. 45.94% females) for ED visits related to other opioid pain medications and their combinations.

Key Finding #5

When looking at differences in race, Black or African American patients had the highest percentage of ED visits related to cocaine (44.19%), and the second highest percentage of ED visits related to marijuana (23.87%) and heroin (20.35%).

44.19

ED visits related to cocaine, Black or African American patients

23.87

ED visits related to marijuana, Black or African American patients

20.35

ED visits related to heroin, Black or African American patients

Key Finding #6

Geographic regions varied greatly with more than 1/3 of ED visits related to fentanyl were from the West region alone (39.65%). The West and South census regions combined accounted for more than two-thirds of ED visits related to methamphetamine (71.02%). The West and South regions combined accounted for the majority of visits related to other opioid pain medications and their combinations (59.51%).

Key Finding #7

Alcohol related ED visits in 2021 were more likely to be Not Hispanic or Latino, White, male, among those aged 26 to 64, and from the West census region. When comparing underage (under 21) vs. adult (21 and over) age groups, the majority of the patients were over 21 years of age (95.58%).

Key Finding #8

Opioids (Fentanyl, heroin, and other opioid-related) visits were more likely to be Not Hispanic or Latino, White, male, and among those aged 26 to 44. Males accounted for the majority of opioid (54.04% and 45.94% respectively). Black or African American patients accounted for 20.35 percent of all heroin-related ED visits, but a smaller portion for fentanyl (8.39%) and other opioid-related ED visits (10.59%). Other opioid-related ED visits peaked in quarter 2, heroin-related ED visits peaked in quarter 3, and fentanyl-related ED visits peaked in quarter 4

Key Finding #9

Methamphetamine-related ED visits were more likely to be Not Hispanic or Latino, White, male, among those aged 26 to 44, and from the South census region. White patients accounted for the majority (62.45%) of all methamphetamine-related ED visits, followed by Black or African American patients (9.95%). The South and West census regions accounted for over 70 %of methamphetamine-related ED visits. Methamphetamine-related ED visits peaked in quarter 2 before declining in quarters 3 and 4.

62.45

ED visits related to methamphetamine, White patients

9.95

ED visits related to methamphetamine, Black or African American patients

Key Finding #10

Marijuana-related ED visits were more likely to be Not Hispanic or Latino, White, male, and among those aged 26 to 44. Patients aged 18-25 accounted for the second highest percentage of these ED visits. While marijuana- related ED visits were highest in the South census region, each census region accounted for at least 20 percent of these visits. Marijuana-related ED visits peaked in quarter 2 before declining in quarters 3 and 4.

Key Finding #11

Cocaine-related ED visits were more likely to be Not Hispanic or Latino, Black or African American, male, and among those aged 26 to 44. Patients ages 45-64 accounted for the second highest percentage of these visits. Cocaine-related ED visits peaked in quarter 2 before declining in quarters 3 and 4.

Upcoming Related Training:

Opioid Misuse and Vulnerable Populations Training for Mandated Reporters – Hospital Staff, Nurses, Physicians: LIVE WEBINAR

August 24, 2022

This Training is designed to educate mandated reporters on opioid misuse and abuse and how to report to Nevada Adult Protective Services if you suspect abuse of vulnerable adults.

Learning Objectives:

Be able to define opioid misuse
Understand the biology and neurobiology of opioid use, misuse and abuse
Describe how aging changes substance metabolism
List at least 2 signs and symptoms of opioid misuse among vulnerable adults
Be able to describe at least two difficulties that families experience as they cope with opioid use among older adults and vulnerable family members

Presented by: Teresa Sacks, M.P.H.& Angela Broadus, PhD, CPS/ICPS
Continuing Education Units: 2 CEUs

Your Turn: What trends are you seeing in your practice?

References:

Substance Abuse and Mental Health Services Administration. (2022). Preliminary Findings from Drug-Related Emergency Department Visits, 2021; Drug Abuse Warning Network (HHS Publication No. PEP22-07-03-001). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/.