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1992.05.12 :  DAWN Data

Contact:  James Miller (301) 443-8956   Home (301) 854-3937
Mona Brown  (301) 443-6245
Home (301) 330-4686
May 12, 1992

        New data released today from the National Institute on Drug
Abuse's Drug Abuse Warning Network (DAWN)--which monitors drug-
related emergency room episodes in the nation's hospitals--show a
continuing upward trend in those episodes, especially those
involving heroin and cocaine. 
        Drug-related emergencies increased 4 percent from 100,381
episodes reported in the second quarter of 1991 to 104,479 reported
in the third quarter of 
1991.  This increase held true for most of
the drugs reported to DAWN, and for most of the metropolitan areas
included in DAWN's emergency room sample, but overall, the increase
was not statistically significant at the 95 percent confidence
level.
        Heroin-related emergencies increased about 10 percent, from
9,432 in the second quarter of 1991 to 10,364 in the third quarter
of 1991, but this increase was also not statistically significant
for the total United States.  However, five metropolitan areas had
statistically significant increases for this period:  Boston,
Miami-Hialeah, New Orleans, Newark and Phoenix.
        Cocaine emergencies had a statistically significant
increase of about 13 percent, from 25,370 mentions in the second
quarter of 1991 to 28,700 in the third quarter of 
1991.

                          - More -- 2 -

      These indicators for the third quarter of 1991 continued an
unwelcome trend for both cocaine and heroin showing statistically
significant increases in drug-related emergencies from the fourth
quarter of 1990 through the present reporting period.  However,
marijuana mentions had a statistically significant decrease by 31
percent from second quarter to third quarter 1991, a reversal of
what had been an upward trend since the fourth quarter of 1990.
      HHS Secretary Louis W. Sullivan, M.D., said, "While these
data are not a direct measure of increased drug use, but rather of
emergency medical consequences of drug use, we must regard 
these increases with utmost seriousness.   
      "Therefore, I am urging the Congress to approve in full the
president's FY 1993 treatment budget which proposes a $248 million
increase over last year for treatment services.  This would
increase the total budget for treatment services to over $2 billion
and, assuming that nonfederal treatment services do not reduce
their effort, would provide additional capacity to treat over
100,000 more people annually.  If we do not get this additional
capacity, we will continue to see increases in the use of emergency
rooms--as reflected by the DAWN statistics--because drug users will
have no other place to go.  
      "Furthermore, I have today authorized the Public Health
Service to undertake some important measures to help jurisdictions
impacted by these increases--actions that cannot replace what we
need from Congress, but will help these cities cope with the
emergency room increase." 
                          - More -- 3 -

      To confront potential problems in the immediate future,
Secretary Sullivan said $19 million in Drug Forfeiture funds has
been made available for two programs:  a drug treatment capacity
expansion program, and a program of residential prevention and
treatment for substance abusing women and their children. 
      Assistant Secretary for Health James Mason, M.D., who heads
the Public Health Service, said that a number of treatment and
prevention efforts would be especially directed toward heroin use. 
      Dr. Mason said, "We are particularly disturbed by reports
from several sources about an increase in availability of high-
purity, cheap heroin.  This may lead more casual drug users, who
would not 
ordinarily use heroin, to become involved with the drug by smoking
or snorting it.  This habit may progress to injecting drug use,
significantly increasing the risk of HIV infection."
      Elaine M. Johnson, Ph.D., acting administrator of the
Alcohol, Drug Abuse, and Mental Health Administration, announced
several immediate PHS actions to help meet the drug abuse treatment
needs in the five metropolitan areas where the DAWN data indicate
the most significant problems.   
   -- First, a total of $5 million in ADAMHA funds will be made
available immediately to expand treatment and prevention activities
in New York City, Newark, Baltimore, Detroit and Seattle.  In
addition, because of the recent disruptions of drug abuse services
in Los Angeles, that city will also be included.  These funds will
provide an immediate infusion of additional treatment dollars to
each of the six urban areas, and will help grassroots prevention
activity in these cities to head off any potential growth in heroin
or other drug use among younger age groups.  


                          - More -- 4 -


   -- Second, ADAMHA will convene meetings of relevant State
Substance Abuse Directors, and local officials from the six areas
to hold first-hand discussions of what needs to be done, and what
additional state and local resources might be devoted to solving 
this problem--including monies from the federal Alcohol, Drug
Abuse, and Mental Health block grants.

       A further step will be issuance by ADAMHA's Office for
Treatment Improvement of a new series of "Treatment Improvement
Protocols" to bring the best and latest professional advice on
treatment issues to local treatment programs around the country,
including a special issue on methadone treatment for heroin
addiction. 

      ADAMHA also will expand its use of information
dissemination mechanisms already in place such as the Regional
Alcohol and Drug Abuse Resource (RADAR) network to continue to
spread the word about the serious medical consequences of using
heroin, cocaine and other dangerous drugs.   

      Dr. Johnson also announced longer-term steps the agency
would take to assist five other areas where the DAWN data indicate
that statistically significant increases in heroin episodes
occurred in at least one of the last two quarters reported by DAWN
(2nd or 3rd quarter of 1991).  Special teams of experts will be
formed to provide technical assistance on how to prevent increased
drug use in the cities of: Boston, Miami, New Orleans, Phoenix and
Washington, D.C.  These consultations also will provide valuable
information for developing and fine-tuning drug abuse treatment
needs in FY '93 and beyond.      
 
      NIDA Acting Director Richard A. Millstein also said that
"NIDA maintains several major surveillance systems to identify and
monitor changes in cocaine and heroin use."  NIDA's Community
Epidemiology Work Group, a network of drug abuse professionals,
monitors drug trends in local communities.  A field studies team
maintains ongoing contact with ethnographic researchers in major
U.S. cities, law enforcement personnel, medical examiners and
treatment providers, to update NIDA's drug intelligence.  It is
also conducting an eight-component heroin project involving field
work and analysis of data from a variety of sources.  Millstein
said that "While we continue to collect information to get a better
understanding of increases in drug-related emergencies, we want to
alert communities to these potential problems so they can respond
with appropriate health treatment services."



                          - More -- 5 -


      "Through these and other actions during the rest of FY '92
and throughout FY '93, we are confident that we will see a
resumption of the long-term downward trend in drug-related health
crises," Secretary Sullivan said.  "This administration is
dedicated 100 percent to that goal, and I am confident we will
realize it through the steps we have set in motion."         

      ADAMHA is one of the eight Public Health Service agencies
in HHS.


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