Heroin, Cocaine, and Alcohol + Drugs Top Lists of Drug-Related Deaths
Heroin, cocaine, and alcohol-in-combination with other drugs were
the three most common substances implicated in drug-related deaths
by medical examiners participating in SAMHSA's Drug Abuse Warning
Network (DAWN) in 2000. Narcotic analgesics—including methadone,
codeine, hydrocodone, and oxycodone—also frequently ranked
in the top 10 drugs mentioned by medical examiners in the survey.
In 2000, 137 medical-examiner jurisdictions from 43 metropolitan
areas reported on drug-related deaths to DAWN.
Among the jurisdictions participating, the highest numbers of
drug-related deaths were reported from Los
Angeles (1,192), Philadelphia (942),
New York (924), Chicago
(869), and Detroit (704). Twenty or fewer
drug abuse deaths were reported from Boulder, Casper, Fargo, Indianapolis,
Manchester-Nashua, Middlesex-Somerset, and Sioux Falls. However,
not all jurisdictions within these metropolitan areas necessarily
participate in DAWN.
The report, Mortality Data from the Drug Abuse Warning Network,
2000, found drug abuse deaths among adolescents and young adults
were relatively rare—fewer than 20 percent of deaths reported
to DAWN were under age 25. In about half of the participating areas,
those under age 25 represented less than 10 percent of all the drug-related
deaths. In contrast, more than one-third of all drug abuse deaths
in nearly half of the cities were people age 45 and older. In every
metropolitan area, more than half of the drug-related deaths were
men. In 30 metropolitan areas, more than half of the drug abuse
deaths reported to DAWN were drug-induced (overdoses) and usually
involved multiple drugs.
"Too many people realize too late that substance abuse can
lead to incredible losses. Lost family and friends. Lost jobs and
opportunity. And, as this report shows, lost lives," said
Health and Human Services Secretary Tommy G. Thompson. "We
are committed to supporting treatment programs that combat the personal
despair and community disintegration brought by drug addiction."
"One life lost to drugs is one too many. Effective prevention
and treatment programs are key to helping reduce the needless loss
of life that results from abuse of drugs," said SAMHSA Administrator
Charles G. Curie, M.A., A.C.S.W. "We are working with states
and local drug treatment providers to build treatment capacity and
to implement the most effective treatment services available."
The release of Mortality Data from the Drug Abuse Warning
Network, 2000, marks the debut of a redesigned DAWN report
on drug-abuse-related mortality. It replaces the previous DAWN Annual
Medical Examiner Data reports. Changes in the format and content
of this report are designed to provide more information about the
metropolitan areas represented in DAWN and about their component
The report now includes three sections: metropolitan area profiles,
abbreviated profiles for areas with few cases, and area "spotlights."
This design provides more detailed information about the larger
metropolitan areas, but also includes basic information about jurisdictions
with fewer deaths, without compromising the confidentiality of decedents.
Jurisdictions of special interest (such as urban counties) now have
their own "spotlight" sections.
Among other key findings in the report:
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Major Drugs of Abuse
- In half of the participating metropolitan areas, heroin,
cocaine, and alcohol-in-combination accounted for 40 percent or
more of all drug mentions. They accounted for the vast majority
of drug mentions in reported cases from Newark (66 percent), Portland
(67 percent), and Chicago (74 percent).
- No consistent trends appeared in heroin mentions across
the metropolitan areas. From 1999 to 2000, the number of heroin/morphine
mentions decreased in 12 metro areas and increased in 13 other metropolitan
- No consistent trends appeared in cocaine mentions across
the metropolitan areas. Twelve cities reported a decrease in the
frequency of cocaine involvement from 1999 to 2000, while 11 cities
saw an overall increase in deaths involving cocaine during that
- In three cities (Minneapolis, Baltimore, and Norfolk), alcohol
was involved in more than half of all drug-related deaths.
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Other Drugs of Abuse
- Only three metropolitan areas had a drug other than heroin/morphine,
cocaine, or alcohol-in-combination as the most frequently mentioned
substance in their drug abuse-related deaths. Oklahoma City's
most common drug was methamphetamine (56 mentions); Louisville's
most common drug was cannabis (45); and in Providence, the most
frequently mentioned substance was unspecified narcotic analgesics
- Methamphetamine deaths continue to be concentrated in the
Midwest and West. Among participating areas on the East Coast, only
Long Island had more than a few mentions (38).
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- In DAWN, "club drugs" is a category that includes
mentions of the following drugs: Ketamine; methylenedioxymethamphetamine
(MDMA or Ecstasy); gamma hydroxy butyrate (GHB) and its precursor
gamma butyrolactone (GBL); and flunitrazepam (Rohypnol).
- As in prior years, club drugs together accounted for very
few deaths in any of the metropolitan areas participating in DAWN.
Only 10 cities reported more than five mentions of club drugs in
drug-related deaths. The cities with the most mentions were Los
Angeles (27 mentions), Dallas (10), Chicago (9), and Miami (9).
- In nearly all cases, club drugs were reported in combination
with at least one other substance.
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Abuse of Prescription Drugs
- Codeine ranked in the top 10 drugs mentioned in 17 cities,
including Philadelphia (216 mentions), Los Angeles (201), Phoenix
(124), Detroit (103), San Francisco (92), and Chicago (88).
- Hydrocodone ranked among the 10 most common drugs in 15
cities, including Los Angeles (80 mentions), Detroit (48), Dallas
(25), Oklahoma City (22), and San Diego (22).
- Oxycodone ranked among the 10 most common drugs in 15 cities,
including Philadelphia (87 mentions), Las Vegas (27), and Boston
(21). These mentions cannot be attributed to specific brands,
such as OxyContin.
- Of non-narcotic prescription drugs, diazepam (a benzodiazepine)
and diphenhydramine were the most frequently mentioned.
- Methadone ranked in the top 10 drugs in 19 cities, including
New York (146 mentions), Phoenix (47), and Chicago (46).
DAWN reports annually on deaths related to drug abuse, using data
provided by participating death investigation jurisdictions in metropolitan
areas in the United States. In 2000, 137 jurisdictions in 43 metropolitan
The DAWN mortality data capture deaths where an illegal drug or
a legal drug used for nonmedical purposes contributed to a death,
either directly (overdose) or indirectly. Deaths involving prescription
drugs are reportable to DAWN only when the death involved intentional
abuse. Accidental ingestions with no intent of abuse or adverse
reactions to drugs taken as prescribed are not reportable.
The drug-abuse deaths described in this report do not represent
the Nation as a whole, nor do they necessarily represent the total
number of deaths related to drug abuse in any given metropolitan
area. Rather, DAWN cases reflect the number of drug abuse deaths
reviewed, identified, and reported by participating medical examiners
and coroners in selected metropolitan areas. DAWN also collects
information on drug-related, emergency department visits from a
national sample of hospitals. These data are contained in a separate
report, Emergency Department Trends from the Drug Abuse Warning
To obtain a copy of Mortality Data from the Drug Abuse Warning
Network, 2000, and other DAWN reports, contact SAMHSA's National
Clearinghouse for Drug and Alcohol Information at P.O. Box 2345,
Rockville, MD 20847. Telephone: 1 (800) 729-6686 (English and
Spanish) or 1 (800) 487-4889 (TDD). The report can also be
found on SAMHSA's Web site, dawninfo.samhsa.gov/.
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