Drug Abuse Warning Network (DAWN)
The Drug Abuse Warning Network (DAWN) is a nationwide public health surveillance system that captures data on emergency department visits related to recent substance use and misuse directly from the electronic health records of participating hospitals. SAMHSA administered DAWN from 1992 through 2011 (legacy DAWN) and reestablished the current version of DAWN in 2018.
The Drug Abuse Warning Network (DAWN) is a nationwide public health surveillance system that captures data on emergency department (ED) visits related to recent substance use and misuse directly from the electronic health records of participating hospitals. The key objectives of DAWN are to:
- Monitor demographic and geographic distribution, and identify trends in substance-related ED visits;
- Provide timely data and serve as an early warning system that identifies emerging and novel psychoactive substances and/or combinations of substances; and
- Provide national estimates of substance
Where Do the Data Come From?
DAWN data are collected from a selection of non-federal, short-stay, general surgical, and medical hospitals with at least one ED open 24 hours a day, 7 days a week and more than 100 visits per month. The recruitment of 53 hospitals was completed in 2021.
Frequently Asked Questions
1. What is DAWN?
- The Drug Abuse Warning Network (DAWN) is a nationwide public health surveillance system administered by the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Center for Behavioral Health Statistics and Quality (CBHSQ). DAWN captures data on emergency department (ED) visits related to recent substance use and misuse directly from the electronic health records of participating hospitals. SAMHSA administered DAWN from 1992 through 2011 (legacy DAWN), and re-established the current DAWN in 2018.
2. Who is responsible for DAWN?
- Authorized by the 21st Century Cures Act in December 2016, DAWN is a data collection program of CBHSQ. SAMHSA is required and authorized, under section 42 U.S.C. §290aa-4(d)(1)(A), to collect the number of individuals admitted to the emergency rooms of hospitals as a result of the abuse of alcohol or other drugs. SAMHSA is authorized to receive protected health information from hospital ED’s for the purpose of public health surveillance under the HIPAA Privacy Rule (45 C.F.R. 164.512(b)(1)). Such disclosures are permitted and do not require the authorization of the patient.
3. Can I compare data from legacy DAWN (1992-2011) to data from the DAWN launched in 2018?
- Data should not be compared between legacy DAWN and the current DAWN version. The sample designs are different with the current iteration’s design established to provide surveillance.
4. How does DAWN define a drug-related emergency department (ED) visit?
- In DAWN, a drug-related ED visit is a visit in which the patient was treated in the ED for a condition that was induced by or related to recent drug and/or alcohol use.
5. How does DAWN define a drug?
- DAWN defines a drug as any substance and/or combination that falls under the following categories: alcohol, illicit drugs, prescription medications, over-the-counter medications (OTCs), dietary supplements, non-pharmaceutical inhalants, and substances that are vaped. DAWN classifies drugs using DAWN’s Drug Reference Vocabulary (DRV).
6. What is the DAWN Drug Reference Vocabulary (DRV)?
- The DAWN DRV is a comprehensive drug vocabulary and classification system for all the substances collected by DAWN. The DAWN DRV is derived from the Multum Lexicon©, 2020 Cerner Multum, Inc. The classification was modified to meet DAWN's unique requirements.
7. How are DAWN data abstracted?
- DAWN medical record abstractors review ED records to identify drug-related visits. They access hospital’s electronic health record systems to review records and abstract data when an ED visit meets the DAWN case definition.
8. How does DAWN ensure patient confidentiality?
- DAWN data elements do not include direct identifiers. All DAWN project staff are trained on protections and procedures to ensure the privacy and confidentiality of all health information. Additionally, suppression rules are applied to minimize disclosure risk.
9. What is a sentinel hospital? Why does DAWN include sentinel hospitals?
- In DAWN, a sentinel hospital is defined as a large urban hospital selected from a high-priority sentinel area. A high priority sentinel area is defined as counties with high mortality and morbidity associated with opioid, cocaine, and psychostimulant overdose.
- Sentinel hospitals are expected to yield cases of concern, allowing for the collection and analysis of data quickly so a plan of action for addressing key and emerging problems can be developed. Therefore, DAWN includes 10 sentinel hospitals selected by SAMHSA across the nation.
10. How is the quality of DAWN data assessed?
- DAWN uses a multi-step process to ensure data quality. Automated checks are embedded in the web-based abstraction system at initial entry to minimize errors, and machine learning algorithms are applied to each drug-related visit once submitted. Cases flagged by the machine learning model are subject to human review for accuracy. Quality audits are performed on each abstractor’s data bi-annually to focus training needs and assess quality.
Short Reports and Spotlights
Drug Abuse Warning Network (DAWN) Non-Fatal Overdoses Short Report presents: (1) national estimates and characteristics of non-fatal overdose ED...