SAMHSA is re-establishing the Drug Abuse Warning Network (DAWN), a nationwide public health surveillance system that will improve emergency department (ED) monitoring of substance use crises, including those related to opioids. Hospital participation will continue to be voluntary. Data collection will begin in mid-2019 with a group of 25 hospitals, and will grow to 50 hospitals in DAWN’s second year.
In comparison to legacy DAWN (DAWN data collection through 2011), which produced estimates of drug-related ED visits for the Nation and a selection of metropolitan areas, DAWN will function as a smaller-scale sentinel surveillance system, or an ‘early warning’ system. DAWN will focus on detecting “outbreaks,” i.e., sudden increases in ED visits for specific drugs, identifying new and novel psychoactive substances, monitoring the magnitude of the health effects from substance use (as reflected in ED visits), and documenting the geographic, temporal, and demographic distribution of the problem in order to yield data to inform planning and policy at the local, state, and national levels.
DAWN will retain the valuable aspects of legacy DAWN, such as direct chart review to identify DAWN cases, an inclusive case definition in order to identify all ED visits related to substance use (not just abuse), and collecting detailed information about the drugs involved in ED visits, using the most specific terminology available in the ED record (for example, brand names or slang terms). Important improvements to new DAWN include improved timeliness of data, data available at more frequent intervals, and data for a wider range of geographic area types, including urban, suburban, and rural areas. Having data available more quickly means that DAWN can serve as a true “early warning” system and inform public health response efforts in local areas.