|
Overall, the estimated number of PCP-related ED visits increased more than 400 percent between 2005 and 2011 (from 14,825 to 75,538 visits); more recently, the number of these visits doubled between 2009 and 2011 (from 36,719 to 75,538; Figure 1). In comparison, ED visits involving other hallucinogens—specifically MDMA (Ecstasy) and LSD—increased to a lesser extent between 2005 and 2011. MDMA-related ED visits increased 100 percent (from 11,287 to 22,498 visits), and LSD-related ED visits increased 141 percent (from 2,001 to 4,819 visits).
![]() |
Drug | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 |
---|---|---|---|---|---|---|---|
PCP* | 14,825 | 21,960 | 28,173 | 37,266 | 36,719 | 53,542 | 75,538 |
MDMA (Ecstasy)** | 11,287 | 16,784 | 12,751 | 17,888 | 22,847 | 21,836 | 22,498 |
LSD*** | 2,001 | 4,002 | 3,561 | 3,287 | 4,028 | 3,817 | 4,819 |
* The number of visits involving PCP in 2005, 2006, 2007, 2008, 2009, and 2010 is significantly different from 2011 at the .05 level. ** The number of visits involving MDMA (Ecstasy) in 2005 and 2007 is significantly different from 2011 at the .05 level. *** The number of visits involving LSD in 2005 is significantly different from 2011 at the .05 level. Source: 2005 to 2011 SAMHSA Drug Abuse Warning Network (DAWN). |
Increases in PCP-related ED visits were seen among people of both genders. The sharpest increase occurred between 2009 and 2011, with ED visits by males nearly doubling and visits by females more than doubling. Between 2005 and 2011, PCP-related ED visits by males increased nearly fivefold (from 10,721 to 51,906 visits), and visits by females increased nearly sixfold (from 4,007 to 23,598 visits; Figure 2).
![]() |
Gender | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 |
---|---|---|---|---|---|---|---|
Total* | 14,825 | 21,960 | 28,173 | 37,266 | 36,719 | 53,542 | 75,538 |
Male* | 10,721 | 15,298 | 20,667 | 24,020 | 26,686 | 38,111 | 51,906 |
Female* | 4,007 | 6,661 | 7,507 | 13,246 | 10,032 | 15,431 | 23,598 |
* The difference between 2005 and 2011 is statistically significant at the .05 level. Source: 2005 to 2011 SAMHSA Drug Abuse Warning Network (DAWN). |
Increases were also observed for young adults. The largest increase by age group was seen among patients aged 25 to 34; in this age group, the number of PCP-related visits increased 518 percent (from 5,556 visits to 34,329) (Table 1). Also, visits by adults aged 18 to 24 increased 289 percent (from 3,643 visits to 14,175). There were no statistically significant increases for the other age groups.
Age Group | Number of ED Visits, 2005 |
Number of ED Visits, 2011 |
Percent Change, 2005 to 2011 |
---|---|---|---|
Total ED Visits | 14,825 | 75,538 | 410% |
Aged 12 to 17 | 691 | 1,965 | 184% |
Aged 18 to 24** | 3,643 | 14,175 | 289% |
Aged 25 to 34** | 5,556 | 34,329 | 518% |
Aged 35 to 44 | 3,651 | 14,606 | 300% |
Aged 45 or Older | *** | *** | *** |
* ED visits for which age is unknown have been excluded. ** The difference between 2005 and 2011 is statistically significant at the .05 level. *** Low precision; no estimate reported. Source: 2005 to 2011 SAMHSA Drug Abuse Warning Network (DAWN). |
Increases in PCP-related visits involving young adults were also observed for male patients aged 18 to 24 and 25 to 34. For females, the increase only occurred among patients aged 25 to 34, although it was substantial (from 1,189 visits in 2005 to 12,570 in 2011) (Figure 3). Because of low statistical precision, trends for males and females in other age groups could not be evaluated.
![]() |
Year | Males Aged 18 to 24** |
Females Aged 18 to 24 |
Males Aged 25 to 34** |
Females Aged 25 to 34** |
---|---|---|---|---|
2005 | 2,244 | 1,398 | 4,270 | 1,189 |
2011 | 10,254 | 3,921 | 21,759 | 12,570 |
* ED visits for which age and gender are unknown have been excluded. ** The difference between 2005 and 2011 is statistically significant at the .05 level. Source: 2005 to 2011 SAMHSA Drug Abuse Warning Network (DAWN). |
In 2011, about two thirds (69 percent) of the 75,538 ED visits involving PCP were made by males. Visits made by patients aged 25 to 34 accounted for nearly half (45 percent) of PCP-related ED visits; visits made by those aged 18 to 24 and those aged 35 to 44 each accounted for 19 percent of visits.
Approximately 7 out of 10 (72 percent) PCP-related visits involved other drugs combined with PCP (Figure 4). PCP was combined with one other substance in 37 percent of visits, with two other substances in 18 percent of visits, and with three or more other substances in 18 percent of visits. About one quarter of the PCP-related visits in 2011 involved PCP only (28 percent).
![]() |
Number of Substances | Percentage |
---|---|
PCP Only | 28% |
PCP and 1 Substance | 37% |
PCP and 2 Substances | 18% |
PCP and 3 or More Substances | 18% |
Note: Percentages may not sum to 100 due to rounding. Source: 2011 SAMHSA Drug Abuse Warning Network (DAWN). |
About half of the PCP-related visits in 2011 involved PCP combined with other illicit drugs (48 percent); one third involved marijuana (32 percent), and one fifth involved cocaine (20 percent) (Table 2). About 27 percent involved PCP and pharmaceuticals such as pain relievers (16 percent) and anti-anxiety and insomnia medications (13 percent). These pharmaceuticals, which have a sedative effect on the body, can interact dangerously with PCP.5
Age Group | Number of ED Visits |
Percentage of Visits* |
---|---|---|
Total ED Visits | 75,538 | 100% |
In Combination with Alcohol | ** | ** |
In Combination with Other Illicit Drugs | 36,053 | 48% |
Marijuana | 23,965 | 32% |
Cocaine | 14,964 | 20% |
Heroin | 3,795 | 5% |
In Combination with Pharmaceuticals | 20,486 | 27% |
Pain Relievers | 12,089 | 16% |
Narcotic Pain Relievers*** | 4,038 | 5% |
Anti-anxiety and Insomnia Medications | 9,806 | 13% |
Benzodiazepines | 9,530 | 13% |
* Because multiple drugs may be involved in each visit, estimates of visits by drug may add to more than the total, and percentages may add to more than 100 percent. ** Low precision; no estimate reported *** Narcotic pain relievers include common brand names such as Vicodin®, Percocet®, OxyContin®, and Darvon®. Source: 2011 SAMHSA Drug Abuse Warning Network (DAWN). |
The recent increase in ED visits involving PCP is of particular concern because within the class of illicit drugs that cause hallucinations, PCP is reputed to be the most dangerous and is especially known for causing violent behavior.1 Although PCP may have once been recognized in the general population as a dangerous drug, potential users today may be less likely to know of these risks because of "generational forgetting."6 Findings from the National Forensic Laboratory Information System (NFLIS), which collects data from Federal, State, and local forensic laboratories, support the DAWN finding that PCP abuse is reemerging. In 2011, PCP was ranked 19th on the NFLIS list of the 25 most frequently reported drugs, with an estimated 6,151 total reports.7 Although DAWN is not capable of producing valid regional estimates, metropolitan area estimates suggest that the distribution of ED visits involving PCP and patterns of PCP use are not geographically uniform.2
Based on the DAWN findings, prevention efforts could include warnings about the use of PCP and additional efforts to target adults aged 25 to 34. Increased efficiency might result from geographic targeting of prevention and treatment efforts based on additional studies. Describing common drug combinations with PCP in prevention campaigns may also help to raise awareness that tobacco or marijuana can be laced with PCP; DAWN data show that one third of PCP-related ED visits in 2011 involved marijuana.
By recognizing the signs and symptoms of PCP intoxication, health care providers—especially those on the front lines of emergency care—can help to ensure that patients who come into medical facilities receive immediate and appropriate care. For ED personnel in metropolitan areas with high rates of illicit drug use, heightened awareness of the reemergence of PCP may be especially useful for assessing patients who present with violent or suicidal behavior.
The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities. The Drug Abuse Warning Network (DAWN) is a public health surveillance system that monitors drug-related morbidity and mortality. DAWN uses a probability sample of hospitals to produce estimates of drug-related emergency department (ED) visits for the United States and selected metropolitan areas annually. DAWN also produces annual profiles of drug-related deaths reviewed by medical examiners or coroners in selected metropolitan areas and States. Any ED visit related to recent drug use is included in DAWN. All types of drugs—licit and illicit—are covered. Alcohol involvement is documented for patients of all ages if it occurs with another drug. Alcohol is considered an illicit drug for minors and is documented even if no other drug is involved. The classification of drugs used in DAWN is derived from the Multum Lexicon, copyright 2012 Lexi-Comp, Inc., and/or Cerner Multum, Inc. The Multum Licensing Agreement governing use of the Lexicon can be found at http://www.samhsa.gov/data/DAWN.aspx. DAWN is one of three major surveys conducted by SAMHSA's Center for Behavioral Health Statistics and Quality (CBHSQ). For more information on other CBHSQ surveys, go to http://www.samhsa.gov/data/. SAMHSA has contracts with Westat (Rockville, MD) and RTI International (Research Triangle Park, NC) to operate the DAWN system and produce publications. For publications and additional information about DAWN, go to http://www.samhsa.gov/data/DAWN.aspx. |
DAWN_143