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Q. What is SAMHSA?
A. The
Substance Abuse and Mental Health Services Administration
(SAMHSA), an agency of the U.S. Department of Health
and Human Services, was created in 1992 to focus attention,
programs, and funding on improving the lives of people
with or at risk for mental and substance abuse disorders.
SAMHSA is required, under Section 505 of the Public Health
Service Act (42 U.S.C. 290aa-4), to collect data on drug-related
emergency department visits and deaths.
Q. How do you obtain data for DAWN? Are people interviewed?
A. To obtain data for DAWN, emergency department
medical records and death investigation case files are reviewed.
Patients, their families, and their physicians are never
interviewed.
Q. What drugs are included in DAWN data?
A. Thousands of drugs of all types are included in
DAWN. These include:
- Illegal drugs of abuse;
- Prescription and over-the-counter medications;
- Dietary supplements;
- Non-pharmaceutical inhalants;
- Alcohol in combination with other drugs (adults and children);
and
- Alcohol alone (age < 21).
Q. What kinds of ED cases are reported to DAWN?
A. All types of ED visits related to recent drug
use are reported to DAWN. Additional information on the types
of ED cases collected by DAWN can be found in the Collecting
the Data section of this website.
Q. What kinds of drug-related deaths are reported to
DAWN?
A. All types of drug-related deaths are reported
to DAWN. Additional Information about the types of drug-related
deaths collected by DAWN can be found in the Collecting
the Data section of this website.
Q. Now that DAWN collects data on all kinds of drug-related
ED visits and deaths, why hasn’t the name been changed?
A. In spite of DAWN’s broader scope, the focus is
still on substance abuse. The inclusion of all types of drug-related
ED visits and deaths is the result of an evaluation of DAWN’s
data collection methods, which revealed that drug abuse cases
were being missed because medical records did not always
explicitly state that the ED visit or death was because of
drug abuse. Therefore, DAWN now casts a wider net, so to
speak, by collecting data on all drug-related ED visits and
deaths, and by collecting more details about each case. This
allows us to make a more accurate determination of drug abuse
cases, as well as other drug-related emergencies that impact
the public health.
Q. Does DAWN only collect data on drug overdoses?
A. No. Although overdoses are included in the cases
reported to DAWN, many other types of drug-related events
are also reported. For example, some drug-related ED visits
or deaths may be the result of accidents or injuries. Others
may be the result of adverse reactions, drug interactions,
or accidental ingestion.
Q. How can my city/hospital/ME join DAWN?
A. Full details are provided in the Building the
Network section of this web site.
Q. What hospitals are eligible for DAWN?
A. Short-term, general, non-Federal hospitals that
operate 24-hour emergency departments are eligible to participate
in DAWN. A full description of the DAWN sample and eligibility
criteria is provided in the Why
Hospitals Join DAWN section of this web site.
Q. How many drug-related deaths were there in the U.S.
last year?
A. DAWN cannot produce a measure of the total number
of drug-related deaths in the U.S. The DAWN mortality data
are collected from selected medical examiner and coroner
jurisdictions nationwide. These facilities are not drawn
from a scientific sample, so it is not possible to project
to the U.S as a whole. The National Vital Statistics System,
maintained by the National Center for Health Statistics,
is the source for national data on mortality.
Q. I’m interested in my local hospital. How can I find
out how many drug-related ED visits it had?
A. DAWN cannot release data for individual hospitals.
This is because DAWN collects data about a sensitive topic
(drug abuse) from confidential patient medical records. Under
Section 501(n) of the Public Health Service Act (42 U.S.C.
290aa) DAWN data can only be used for the purpose for which
it was collected and identifiable information cannot be released
without consent. For this reason, all data are aggregated
for reporting at the metropolitan area or national level.
Q. Could DAWN data be used to identify people who come
to emergency rooms die because of drug use?
A. No. Federal laws prohibit release of information
that would identify an individual in DAWN data. DAWN does
not collect any direct identifiers for individual patients
or decedents. That is, we do not collect names, medical record
numbers, addresses, dates of birth, or social security numbers.
To further protect individuals from the chance of being identified
based on other data items, we do not provide raw data files
for public use; do not publish data for a specific hospital;
publish only aggregated metropolitan area or national data;
and suppress table cells (i.e., delete the data) when there
are so few cases that an individual might be identified from
available information. Detailed information can be found
under the Privacy and Confidentiality section
of this website.
Q. What is the difference between a city and a metropolitan
area?
A. A metropolitan area is an area comprising a relatively
large core city or cities and the adjacent geographic areas.
Conceptually, these areas are integrated social and economic
units with a large population nucleus. A metropolitan area
can comprise one county or many, and can cross state boundaries.
Q. How do you define a metropolitan area?
A. We rely on the boundaries of metropolitan areas
as defined by the Office of Management and Budget (OMB),
based on data from the decennial Census.
A. The current New DAWN ED sample is based on the
definitions of the Metropolitan Statistical Areas issued
by the Office of Management and Budget (OMB) in 2003, which
are based on the 2000 decennial Census. A metropolitan area
can comprise one county or many, and can cross state boundaries.
A listing of the metropolitan areas reported on by covered
by DAWN, and their components, can be found in Table 1.2.
Q. What metropolitan areas does DAWN include?
A. These are shown in the map at http://DAWNinfo.samhsa.gov/.
Q. Can DAWN produce estimates for rural or suburban areas?
A. No, the DAWN sample of hospitals can produce estimates
for the Nation and for selected metropolitan areas. It cannot
produce estimates for rural areas.
Q. How many medical examiner/coroner jurisdictions participate
in DAWN and where are they?
A. This number varies from year to year. To find
this information for the most recent year, see DAWN
Mortality.
Q. What is the difference between a medical examiner
and a coroner?
A. Most medical examiners are licensed physicians
or forensic pathologists, and are generally appointed (rather
than elected). They may have jurisdiction over a county,
district, or entire state. Unlike medical examiners, coroners
need not be physicians; usually the only prerequisite for
serving as a coroner is that the individual be more than
18 years of age and a resident of the county or district
to be served. Coroners are typically elected rather than
appointed. They may have jurisdiction over counties or districts
within states.
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