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DRUG ABUSE WARNING NETWORK, 2010:
AREA PROFILES OF DRUG-RELATED MORTALITY



U.S. Department of Health and Human Services
Substance Abuse and Mental Health Services Administration
Center for Behavioral Health Statistics and Quality

ACKNOWLEDGMENTS

This report was prepared by the Center for Behavioral Health Statistics and Quality (CBHSQ), Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS), and by RTI International (a trade name of Research Triangle Institute, Research Triangle Park, NC). Work by RTI was performed under contract number HHSS283200700002I with SAMHSA.

PUBLIC DOMAIN NOTICE

All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authorization of the Office of Communications, SAMHSA, HHS.

RECOMMENDED CITATION

Substance Abuse and Mental Health Services Administration, Drug Abuse Warning Network, 2010: Area Profiles of Drug-Related Mortality. HHS Publication No. (SMA) 12-4699, DAWN Series D-36. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012.

ELECTRONIC ACCESS

This publication may be downloaded from https://store.samhsa.gov. Or please call SAMHSA at

1-877-SAMHSA-7 (1-877-726-4727)
(English and Español)

ORIGINATING OFFICE

Center for Behavioral Health Statistics and Quality
Substance Abuse and Mental Health Services Administration
1 Choke Cherry Road, Rockville, MD 20857

May 2012



CONTENTS

Acknowledgments

DAWN Mortality Data
Drug-related deaths
Drugs
Deaths included in this publication
Standardized death rates
Limitations of the data

Participation in DAWN 2010

Summary of Findings

Description of Profiles
Full profiles
Brief profiles for selected metropolitan areas
County profiles
State profiles

Profiles
Alabama
Birmingham-Hoover, AL

Arizona
Phoenix-Mesa-Glendale, AZ

Arkansas
Fort Smith, AR-OK

California
Los Angeles-Long Beach-Santa Ana, CA
San Diego-Carlsbad-San Marcos, CA
San Francisco-Oakland-Fremont, CA
Contra Costa County
San Francisco-San Mateo-Redwood City, CA
San Francisco County

Colorado
Denver-Aurora-Broomfield, CO
Adams County
Arapahoe County
Denver County

Delaware
Statewide
Dover, DE
Seaford, DE

District of Columbia
Washington-Arlington-Alexandria, DC-VA-MD-WV
District of Columbia

Florida
Miami-Fort Lauderdale-Pompano Beach, FL
Miami-Dade County
Palm Beach County

Georgia
Atlanta-Sandy Springs-Marietta, GA
Fulton County

Hawaii
Honolulu, HI

Illinois
Chicago-Joliet-Naperville, IL-IN-WI
Cook County
Lake County
Will County

Indiana
Indianapolis-Carmel, IN
Marion County

Louisiana
New Orleans-Metairie-Kenner, LA
Jefferson Parish

Maine
Statewide
Augusta-Waterville, ME
Bangor, ME
Lewiston-Auburn, ME
Portland-South Portland-Biddeford, ME
Rockland, ME

Maryland
Statewide
Baltimore-Towson, MD
Baltimore City
Baltimore County
Cambridge, MD
Cumberland, MD-WV
Easton, MD
Hagerstown-Martinsburg, MD-WV
Lexington Park, MD
Ocean Pines, MD
Salisbury, MD

Massachusetts
Statewide
Barnstable Town, MA
Boston-Cambridge-Quincy, MA-NH
Essex County
Middlesex County
Norfolk County
Suffolk County
Pittsfield, MA
Springfield, MA
Hampden County
Worcester, MA

Michigan
Detroit-Warren-Livonia, MI
Macomb County
Oakland County
Wayne County

Minnesota
Brainerd, MN
Mankato-North Mankato, MN
Minneapolis-St. Paul-Bloomington, MN-WI
Hennepin County
Ramsey County

Missouri
Kansas City, MO-KS
Jackson County
St. Louis, MO-IL
St. Louis City
St. Louis County

New Hampshire
Statewide
Berlin, NH-VT
Claremont, NH
Concord, NH
Keene, NH
Laconia, NH
Lebanon, NH-VT
Manchester-Nashua, NH

New Mexico
Statewide
Alamogordo, NM
Albuquerque, NM
Bernalillo County
Carlsbad-Artesia, NM
Clovis, NM
Deming, NM
Española, NM
Farmington, NM
Gallup, NM
Grants, NM
Hobbs, NM
Las Cruces, NM
Las Vegas, NM
Los Alamos, NM
Portales, NM
Roswell, NM
Ruidoso, NM
Santa Fe, NM
Silver City, NM
Taos, NM

New York
Buffalo-Niagara Falls, NY
Erie County
New York-Northern New Jersey-Long Island, NY-NJ-PA
NY Suburban, NY
Nassau County
Suffolk County
Newark-Edison, NJ-PA

North Dakota
Fargo, ND-MN
Grand Forks, ND-MN

Ohio
Cleveland-Elyria-Mentor, OH
Steubenville-Weirton, OH-WV

Oklahoma
Statewide
Ada, OK
Altus, OK
Ardmore, OK
Bartlesville, OK
Duncan, OK
Durant, OK
Elk City, OK
Enid, OK
Guymon, OK
Lawton, OK
McAlester, OK
Miami, OK
Muskogee, OK
Oklahoma City, OK
Oklahoma County
Ponca City, OK
Shawnee, OK
Stillwater, OK
Tahlequah, OK
Tulsa, OK
Tulsa County
Weatherford, OK
Woodward, OK

Oregon
Statewide
Albany-Lebanon, OR
Astoria, OR
Bend, OR
Brookings, OR
Coos Bay, OR
Corvallis, OR
Eugene-Springfield, OR
Grants Pass, OR
Hood River, OR
Klamath Falls, OR
La Grande, OR
Medford, OR
Ontario, OR-ID
Pendleton-Hermiston, OR
Portland-Vancouver-Hillsboro, OR-WA
Multnomah County
Prineville, OR
Roseburg, OR
Salem, OR
The Dalles, OR

Pennsylvania
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD
Delaware County
New Castle County
Philadelphia County

Rhode Island
Statewide
Providence-New Bedford-Fall River, RI-MA
Bristol County
Providence County

South Dakota
Sioux Falls, SD

Tennessee
Kingsport-Bristol-Bristol, TN-VA

Texas
Dallas-Fort Worth-Arlington, TX
Collin County
Houston-Sugar Land-Baytown, TX

Utah
Statewide
Brigham City, UT
Cedar City, UT
Heber, UT
Logan, UT-ID
Ogden-Clearfield, UT
Price, UT
Provo-Orem, UT
Utah County
Salt Lake City, UT
Salt Lake County
St. George, UT
Vernal, UT

Vermont
Statewide
Barre, VT
Bennington, VT
Burlington-South Burlington, VT
Rutland, VT

Virginia
Statewide
Blacksburg-Christiansburg-Radford, VA
Charlottesville, VA
Culpeper, VA
Danville, VA
Harrisonburg, VA
Lynchburg, VA
Martinsville, VA
Richmond, VA
Roanoke, VA
Staunton-Waynesboro, VA
Virginia Beach-Norfolk-Newport News, VA-NC
Winchester, VA-WV

Washington
Seattle-Tacoma-Bellevue, WA
King County
Pierce County
Snohomish County

West Virginia
Statewide
Beckley, WV
Bluefield, WV-VA
Charleston, WV
Clarksburg, WV
Fairmont, WV
Huntington-Ashland, WV-KY-OH
Morgantown, WV
Oak Hill, WV
Parkersburg-Marietta-Vienna, WV-OH
Point Pleasant, WV-OH
Wheeling, WV-OH

Wisconsin
Milwaukee-Waukesha-West Allis, WI

List of Tables
Table 1. Participation of medical examiner/coroner jurisdictions in DAWN, 2010
Table 2. Rates of drug-related deaths and drug-related suicide deaths per 100,000 population, 2010
Table 3. Rates of drug-related deaths and percentage change, 2009 and 2010

List of Figures
Figure 1. Sample metropolitan area profile layout

List of Appendixes
Appendix A: Multum Lexicon End-User License Agreement
Appendix B: Glossary of Terms
Appendix C: DAWN Mortality Data Collection



DAWN MORTALITY DATA

The Drug Abuse Warning Network (DAWN) is a public health surveillance system that monitors drug-related deaths referred to medical examiners and coroners (ME/Cs). In 2010, there were 543 participating ME/Cs who identified and reported to DAWN on all deaths referred to their offices that met the DAWN criteria for being a drug-related death. These ME/Cs represent the larger metropolitan and micropolitan areas in 37 States and, collectively, cover over one third of the nation's population. Findings in this publication reflect data on drug-related deaths that occurred during calendar year 2010 and were reported by participating ME/Cs to DAWN. In selected tables, data from reporting year 2009 are included for comparison. The Center for Behavioral Health Statistics and Quality (CBHSQ) of the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services, is responsible for DAWN.

The mortality component of DAWN does not rely on a statistical sample of ME/Cs. Findings cannot be considered representative of ME/Cs that did not participate, and results cannot be extrapolated to the United States as a whole. DAWN mortality data for 2003 and later are not comparable to mortality data for any years prior to 2003 because of changes introduced in the 2003 reporting year.

Drug-related deaths

Since 2003, a DAWN case is any death reviewed by an ME/C that was related to recent drug use. Findings in this publication pertain to drug-related deaths and drug-related suicide deaths reported by participating death investigation jurisdictions as DAWN cases.1 The data items submitted on drug-related deaths are described in Appendix C.

DAWN cases are identified through a retrospective review of decedent case files in each participating death investigation jurisdiction. A DAWN case is any death that is determined by the ME/C as being related to drug use. The relationship between the death and the drug does not need to be causal; the drug only needs to be implicated in the death. The drug use may have been for legitimate, therapeutic purposes or for the purpose of drug abuse or misuse, but in either case, the drug use must have been recent.

These eligibility criteria for a DAWN case are intentionally broad and inclusive. Since death record documentation varies in clarity and comprehensiveness across jurisdictions, broad criteria reduce the potential for judgment calls that could cause data to vary systematically and unexpectedly across reporters and jurisdictions. Broad criteria also capture a diverse set of drug-related deaths that support a wide variety of analytical purposes and interests.

For decedents under the age of 21, DAWN cases include deaths where the only drug involved was alcohol. For those aged 21 or older, there must be at least one other drug involved besides alcohol for the death to be a DAWN case.

Drugs

Drugs that make a death eligible for DAWN include:

Deaths included in this publication

Findings in this publication focus on two major categories of drug-related deaths, based on the manner of death as determined by the ME/C.

  1. Drug-related deaths (other than drug-related suicide deaths) include the following:

    • Natural or accidental deaths with drug involvement. These two categories capture deaths involving (1) medical use, nonmedical use, overuse, and misuse of prescription and over-the-counter medications; and (2) obvious drug abuse.
    • Homicide by drug. This category was designed to capture malicious poisonings; that is, the decedent was administered a drug(s) by another person for a malicious purpose.
    • Deaths with drug involvement when manner of death denoted by the ME/C was "could not be determined" (CNBD). This manner of death is assigned by the ME/C when a definitive ruling of suicide, homicide, natural, or accidental death is not possible.
  2. Drug-related suicide deaths include suicide deaths with drug involvement. The determination of suicide is made by the ME/C. Because of the broad eligibility criteria for determining DAWN cases, drug-related suicide deaths include more than deaths due to overdoses. A reported drug may not be the cause of the suicide death even if only one drug was involved. Drug(s) must be a contributing factor, though.

Findings reported in this publication are based on investigations that were completed and submitted by June 29, 2011, for deaths that occurred during 2010. Death investigations that were not concluded by the ME/C by the end of the data collection period are excluded.

Standardized death rates

Death rates (i.e., the number of deaths per 100,000 population) are reported to permit comparisons within or across areas or across demographic subgroups. This use of death rates, as opposed to counts, is important because two areas with similar numbers of drug-related deaths may have vastly different populations. Rates, which take population differences into account, standardize these comparisons.

Limitations of the data

There are limitations to be considered when reviewing counts of drug-related deaths, deaths by type of drug, rates of death, and changes in the number of deaths between years:

PARTICIPATION IN DAWN 2010

DAWN relies on the voluntary cooperation of ME/Cs in selected areas of the United States to provide standardized data on drug-related deaths. For 2010, there were 373 counties in 157 metropolitan areas and 450 counties in 13 States that submitted mortality data to DAWN.3,4

Table 1 provides information on the metropolitan areas and States that participated in 2010. It includes the following:

Table 1
Participation of medical examiner/coroner jurisdictions in DAWN, 2010
State Area* Total jurisdictions (counties) Participating jurisdictions (counties) Percent of jurisdictions in area that participated Population in participating jurisdictions Percent of area population covered by participating ME/Cs
* Names in italics are submetropolitan areas within the larger metropolitan statistical area.
NOTE: ME/Cs = medical examiners and coroners.
SOURCE: Center for Behavioral Health Statistics and Quality, SAMHSA, Drug Abuse Warning Network, 2010.
Thirteen states 450 450 100% 39,509,127 100%
One hundred fifty-seven metropolitan and micropolitan statistical areas 518 373 72% 107,090,799 72%
Three submetropolitan areas 21 8 38% 5,466,403 44%
Five hundred forty-three counties 543 543 100% 109,958,074 100%
Alabama Birmingham-Hoover, AL 7 1 14% 665,067 59%
Arizona Phoenix-Mesa-Glendale, AZ 2 1 50% 4,023,096 92%
Arkansas Fort Smith, AR-OK 5 2 40% 91,356 31%
California Los Angeles-Long Beach-Santa Ana, CA 2 1 50% 9,848,432 76%
California San Diego-Carlsbad-San Marcos, CA 1 1 100% 3,054,008 100%
California San Francisco-Oakland-Fremont, CA 5 3 60% 2,575,793 60%
California San Francisco-San Mateo-Redwood City, CA 3 2 67% 1,534,404 86%
Colorado Denver-Aurora-Broomfield, CO 10 8 80% 2,538,039 99%
Delaware Statewide 3 3 100% 885,218 100%
Delaware Dover, DE 1 1 100% 157,763 100%
Delaware Seaford, DE 1 1 100% 192,769 100%
District of Columbia Washington-Arlington-Alexandria, DC-VA-MD-WV 22 22 100% 5,476,789 100%
Florida Miami-Fort Lauderdale-Pompano Beach, FL 3 2 67% 3,780,752 68%
Georgia Atlanta-Sandy Springs-Marietta, GA 28 6 21% 2,070,435 38%
Hawaii Honolulu, HI 1 1 100% 907,738 100%
Illinois Chicago-Joliet-Naperville, IL-IN-WI 14 9 64% 8,767,431 92%
Indiana Indianapolis-Carmel, IN 10 2 20% 1,032,430 59%
Louisiana New Orleans-Metairie-Kenner, LA 7 4 57% 563,002 47%
Maine Statewide 16 16 100% 1,318,450 100%
Maine Augusta-Waterville, ME 1 1 100% 121,107 100%
Maine Bangor, ME 1 1 100% 149,439 100%
Maine Lewiston-Auburn, ME 1 1 100% 106,550 100%
Maine Portland-South Portland-Biddeford, ME 3 3 100% 516,871 100%
Maine Rockland, ME 1 1 100% 40,804 100%
Maryland Statewide 24 24 100% 5,700,058 100%
Maryland Baltimore-Towson, MD 7 7 100% 2,691,154 100%
Maryland Cambridge, MD 1 1 100% 32,047 100%
Maryland Cumberland, MD-WV 2 2 100% 99,751 100%
Maryland Easton, MD 1 1 100% 36,267 100%
Maryland Hagerstown-Martinsburg, MD-WV 3 3 100% 266,179 100%
Maryland Lexington Park, MD 1 1 100% 103,009 100%
Maryland Ocean Pines, MD 1 1 100% 49,131 100%
Maryland Salisbury, MD 2 2 100% 120,185 100%
Massachusetts Statewide 14 14 100% 6,594,083 100%
Massachusetts Barnstable Town, MA 1 1 100% 221,157 100%
Massachusetts Boston-Cambridge-Quincy, MA-NH 7 7 100% 4,588,990 100%
Massachusetts Pittsfield, MA 1 1 100% 129,308 100%
Massachusetts Springfield, MA 3 3 100% 698,972 100%
Massachusetts Worcester, MA 1 1 100% 803,781 100%
Michigan Detroit-Warren-Livonia, MI 6 5 83% 4,313,651 98%
Minnesota Brainerd, MN 2 2 100% 91,259 100%
Minnesota Mankato-North Mankato, MN 2 1 50% 32,230 35%
Minnesota Minneapolis-St. Paul-Bloomington, MN-WI 13 9 69% 2,693,777 82%
Missouri Kansas City, MO-KS 15 4 27% 1,124,938 54%
Missouri St. Louis, MO-IL 16 9 56% 2,400,698 85%
New Hampshire Statewide 10 10 100% 1,324,703 100%
New Hampshire Berlin, NH-VT 2 2 100% 37,890 100%
New Hampshire Claremont, NH 1 1 100% 42,699 100%
New Hampshire Concord, NH 1 1 100% 149,081 100%
New Hampshire Keene, NH 1 1 100% 77,051 100%
New Hampshire Laconia, NH 1 1 100% 61,362 100%
New Hampshire Lebanon, NH-VT 3 3 100% 171,764 100%
New Hampshire Manchester-Nashua, NH 1 1 100% 405,939 100%
New Mexico Statewide 33 33 100% 2,009,963 100%
New Mexico Alamogordo, NM 1 1 100% 63,213 100%
New Mexico Albuquerque, NM 4 4 100% 858,036 100%
New Mexico Carlsbad-Artesia, NM 1 1 100% 52,716 100%
New Mexico Clovis, NM 1 1 100% 44,416 100%
New Mexico Deming, NM 1 1 100% 27,040 100%
New Mexico Española, NM 1 1 100% 40,682 100%
New Mexico Farmington, NM 1 1 100% 124,157 100%
New Mexico Gallup, NM 1 1 100% 70,517 100%
New Mexico Grants, NM 1 1 100% 27,040 100%
New Mexico Hobbs, NM 1 1 100% 60,246 100%
New Mexico Las Cruces, NM 1 1 100% 206,429 100%
New Mexico Las Vegas, NM 1 1 100% 28,329 100%
New Mexico Los Alamos, NM 1 1 100% 18,079 100%
New Mexico Portales, NM 1 1 100% 18,820 100%
New Mexico Roswell, NM 1 1 100% 63,628 100%
New Mexico Ruidoso, NM 1 1 100% 21,018 100%
New Mexico Santa Fe, NM 1 1 100% 147,552 100%
New Mexico Silver City, NM 1 1 100% 29,905 100%
New Mexico Taos, NM 1 1 100% 31,516 100%
New York Buffalo-Niagara Falls, NY 2 2 100% 1,123,926 100%
New York New York-Northern New Jersey-Long Island, NY-NJ-PA 23 6 26% 3,931,999 21%
New York NY Suburban, NY 5 4 80% 3,275,472 77%
New York Newark-Edison, NJ-PA 13 2 15% 656,527 10%
North Dakota Fargo, ND-MN 2 2 100% 200,141 100%
North Dakota Grand Forks, ND-MN 2 1 50% 30,780 32%
Ohio Cleveland-Elyria-Mentor, OH 5 1 20% 1,275,860 61%
Ohio Steubenville-Weirton, OH-WV 3 2 67% 53,249 44%
Oklahoma Statewide 77 77 100% 3,687,417 100%
Oklahoma Ada, OK 1 1 100% 37,424 100%
Oklahoma Altus, OK 1 1 100% 25,372 100%
Oklahoma Ardmore, OK 2 2 100% 57,452 100%
Oklahoma Bartlesville, OK 1 1 100% 50,711 100%
Oklahoma Duncan, OK 1 1 100% 43,493 100%
Oklahoma Durant, OK 1 1 100% 40,789 100%
Oklahoma Elk City, OK 1 1 100% 21,119 100%
Oklahoma Enid, OK 1 1 100% 58,935 100%
Oklahoma Guymon, OK 1 1 100% 21,136 100%
Oklahoma Lawton, OK 1 1 100% 113,256 100%
Oklahoma McAlester, OK 1 1 100% 45,218 100%
Oklahoma Miami, OK 1 1 100% 31,630 100%
Oklahoma Muskogee, OK 1 1 100% 71,417 100%
Oklahoma Oklahoma City, OK 7 7 100% 1,227,395 100%
Oklahoma Ponca City, OK 1 1 100% 46,116 100%
Oklahoma Shawnee, OK 1 1 100% 70,275 100%
Oklahoma Stillwater, OK 1 1 100% 79,731 100%
Oklahoma Tahlequah, OK 1 1 100% 46,034 100%
Oklahoma Tulsa, OK 7 7 100% 929,079 100%
Oklahoma Weatherford, OK 1 1 100% 26,722 100%
Oklahoma Woodward, OK 1 1 100% 19,963 100%
Oregon Statewide 36 36 100% 3,826,015 100%
Oregon Albany-Lebanon, OR 1 1 100% 116,594 100%
Oregon Astoria, OR 1 1 100% 37,248 100%
Oregon Bend, OR 1 1 100% 158,636 100%
Oregon Brookings, OR 1 1 100% 21,155 100%
Oregon Coos Bay, OR 1 1 100% 62,802 100%
Oregon Corvallis, OR 1 1 100% 82,623 100%
Oregon Eugene-Springfield, OR 1 1 100% 351,166 100%
Oregon Grants Pass, OR 1 1 100% 81,035 100%
Oregon Hood River, OR 1 1 100% 21,886 100%
Oregon Klamath Falls, OR 1 1 100% 66,254 100%
Oregon La Grande, OR 1 1 100% 25,042 100%
Oregon Medford, OR 1 1 100% 201,313 100%
Oregon Ontario, OR-ID 2 1 50% 30,751 57%
Oregon Pendleton-Hermiston, OR 2 2 100% 84,893 100%
Oregon Portland-Vancouver-Hillsboro, OR-WA 7 5 71% 1,799,061 80%
Oregon Prineville, OR 1 1 100% 22,566 100%
Oregon Roseburg, OR 1 1 100% 103,227 100%
Oregon Salem, OR 2 2 100% 396,116 100%
Oregon The Dalles, OR 1 1 100% 24,153 100%
Pennsylvania Philadelphia-Camden-Wilmington, PA-NJ-DE-MD 11 5 45% 3,367,030 56%
Rhode Island Statewide 5 5 100% 1,053,300 100%
Rhode Island Providence-New Bedford-Fall River, RI-MA 6 6 100% 1,600,786 100%
South Dakota Sioux Falls, SD 4 1 25% 183,013 77%
Tennessee Kingsport-Bristol-Bristol, TN-VA 5 3 60% 93,303 31%
Texas Dallas-Fort Worth-Arlington, TX 12 2 17% 1,450,306 22%
Texas Houston-Sugar Land-Baytown, TX 10 1 10% 4,071,206 69%
Utah Statewide 29 29 100% 2,784,647 100%
Utah Brigham City, UT 1 1 100% 49,905 100%
Utah Cedar City, UT 1 1 100% 45,287 100%
Utah Heber, UT 1 1 100% 21,602 100%
Utah Logan, UT-ID 2 1 50% 115,281 90%
Utah Ogden-Clearfield, UT 3 3 100% 541,584 100%
Utah Price, UT 1 1 100% 19,994 100%
Utah Provo-Orem, UT 2 2 100% 555,556 100%
Utah Salt Lake City, UT 3 3 100% 1,130,299 100%
Utah St. George, UT 1 1 100% 137,469 100%
Utah Vernal, UT 1 1 100% 31,539 100%
Vermont Statewide 14 14 100% 621,829 100%
Vermont Barre, VT 1 1 100% 58,700 100%
Vermont Bennington, VT 1 1 100% 36,415 100%
Vermont Burlington-South Burlington, VT 3 3 100% 208,086 100%
Vermont Rutland, VT 1 1 100% 63,018 100%
Virginia Statewide 134 134 100% 7,883,401 100%
Virginia Blacksburg-Christiansburg-Radford, VA 4 4 100% 159,608 100%
Virginia Charlottesville, VA 5 5 100% 196,790 100%
Virginia Culpeper, VA 1 1 100% 46,509 100%
Virginia Danville, VA 2 2 100% 105,823 100%
Virginia Harrisonburg, VA 2 2 100% 120,282 100%
Virginia Lynchburg, VA 6 6 100% 247,473 100%
Virginia Martinsville, VA 2 2 100% 69,528 100%
Virginia Richmond, VA 20 20 100% 1,238,343 100%
Virginia Roanoke, VA 6 6 100% 300,441 100%
Virginia Staunton-Waynesboro, VA 3 3 100% 118,158 100%
Virginia Virginia Beach-Norfolk-Newport News, VA-NC 16 15 94% 1,650,429 99%
Virginia Winchester, VA-WV 3 3 100% 124,011 100%
Washington Seattle-Tacoma-Bellevue, WA 3 3 100% 3,408,138 100%
West Virginia Statewide 55 55 100% 1,820,042 100%
West Virginia Beckley, WV 1 1 100% 79,195 100%
West Virginia Bluefield, WV-VA 2 2 100% 106,840 100%
West Virginia Charleston, WV 5 5 100% 304,244 100%
West Virginia Clarksburg, WV 3 3 100% 92,454 100%
West Virginia Fairmont, WV 1 1 100% 56,714 100%
West Virginia Huntington-Ashland, WV-KY-OH 5 2 40% 136,350 48%
West Virginia Morgantown, WV 2 2 100% 120,368 100%
West Virginia Oak Hill, WV 1 1 100% 46,129 100%
West Virginia Parkersburg-Marietta-Vienna, WV-OH 4 3 75% 99,867 62%
West Virginia Point Pleasant, WV-OH 2 1 50% 25,573 45%
West Virginia Wheeling, WV-OH 3 2 67% 76,584 53%
Wisconsin Milwaukee-Waukesha-West Allis, WI 4 1 25% 959,548 62%

An awareness of the extent of DAWN's coverage within a given area is needed to interpret DAWN mortality data appropriately. ME/C participants in DAWN are not part of a scientific sample at either the metropolitan or the national level. Within a metropolitan area, if all ME/Cs participate, the findings are representative of the area. If some ME/Cs do not participate, findings based on participating counties are not statistically representative of nonparticipating jurisdictions. Some generalizations may be warranted, though, if the larger counties in metropolitan areas participate. For example, while only one of the seven counties that make up the Birmingham, AL, metropolitan statistical area (MSA) participated in DAWN in 2010, that county is home to almost 60 percent of the area's total population. In the Sioux Falls, SD, MSA, the one participating county out of a possible four counties accounts for 77 percent of the population.

Among the metropolitan areas listed in Table 1, population coverage exceeded 90 percent in 129 metropolitan areas, with 100 percent coverage in 123 of those areas. The remaining metropolitan areas had population coverage that ranged from a low of 21 percent for the New York-Northern New Jersey-Long Island area to 85 percent for the St. Louis metropolitan area. Population coverage for the 13 participating States is 100 percent.

SUMMARY OF FINDINGS

Table 2 reports the rates of drug-related deaths and drug-related suicide deaths per 100,000 population for metropolitan areas and States that participated in DAWN in 2010. Table 3 compares the rates of drug-related deaths in 2010 with those found for 2009 and reports the percentage change. (Comparisons are not made for drug-related suicide deaths because of their small numbers.) Table 3 is limited to those areas where the same jurisdictions participated in 2009 as in 2010. Tables 2 and 3 include indicators of the population coverage in DAWN for 2010.

Table 2
Rates of drug-related deaths and drug-related suicide deaths per 100,000 population, 2010
State Area* Rate of drug-related deaths per 100,000 population Rate of drug-related suicide deaths per 100,000 population Population in participating jurisdictions Percent of area population covered by participating ME/Cs
* Names in italics are submetropolitan areas within the larger metropolitan statistical area.
Drug-related deaths exclude drug-related suicide deaths.
NOTE: ME/Cs = medical examiners and coroners.
SOURCE: Center for Behavioral Health Statistics and Quality, SAMHSA, Drug Abuse Warning Network, 2010.
Alabama Birmingham-Hoover, AL 14.3 0.8 665,067 59%
Arizona Phoenix-Mesa-Glendale, AZ 18.4 3.0 4,023,096 92%
Arkansas Fort Smith, AR-OK 17.5 4.4 91,356 31%
California Los Angeles-Long Beach-Santa Ana, CA 9.0 1.1 9,848,432 76%
California San Diego-Carlsbad-San Marcos, CA 13.7 2.9 3,054,008 100%
California San Francisco-Oakland-Fremont, CA 12.3 1.6 2,575,793 60%
California Contra Costa County 9.6 1.4 1,041,389 100%
California San Francisco-San Mateo-Redwood City, CA 14.2 1.8 1,534,404 86%
California San Francisco County 21.0 1.2 815,366 100%
Colorado Denver-Aurora-Broomfield, CO 14.0 2.8 2,538,039 99%
Colorado Adams County 14.5 1.8 441,005 100%
Colorado Arapahoe County 13.8 1.9 565,404 100%
Colorado Denver County 24.7 3.6 610,336 100%
Delaware Statewide 16.9 3.4 885,218 100%
Delaware Dover, DE 13.9 2.5 157,763 100%
Delaware Seaford, DE 15.0 3.6 192,769 100%
District of Columbia Washington-Arlington-Alexandria, DC-VA-MD-WV 6.4 1.3 5,476,789 100%
District of Columbia District of Columbia 17.7 1.7 599,718 100%
Florida Miami-Fort Lauderdale-Pompano Beach, FL 9.1 1.7 3,780,752 68%
Florida Miami-Dade County 5.1 0.9 2,500,579 100%
Florida Palm Beach County 16.9 3.4 1,280,173 100%
Georgia Atlanta-Sandy Springs-Marietta, GA 8.7 1.3 2,070,435 38%
Georgia Fulton County 9.7 1.2 1,033,612 100%
Hawaii Honolulu, HI 14.0 4.1 907,738 100%
Illinois Chicago-Joliet-Naperville, IL-IN-WI 9.4 0.9 8,767,431 92%
Illinois Cook County 9.6 0.5 5,287,160 100%
Illinois Lake County 10.1 1.0 712,614 100%
Illinois Will County 9.5 1.0 685,269 100%
Indiana Indianapolis-Carmel, IN 12.9 2.2 1,032,430 59%
Indiana Marion County 12.3 2.5 890,925 100%
Louisiana New Orleans-Metairie-Kenner, LA 16.9 1.4 563,002 47%
Louisiana Jefferson Parish 17.4 1.6 443,347 100%
Maine Statewide 10.6 2.2 1,318,450 100%
Maine Augusta-Waterville, ME 14.0 2.5 121,107 100%
Maine Bangor, ME 11.4 2.0 149,439 100%
Maine Lewiston-Auburn, ME 11.3 4.7 106,550 100%
Maine Portland-South Portland-Biddeford, ME 11.0 1.9 516,871 100%
Maine Rockland, ME 4.9 2.5 40,804 100%
Maryland Statewide 10.1 1.0 5,700,058 100%
Maryland Baltimore-Towson, MD 13.5 1.2 2,691,154 100%
Maryland Baltimore City 27.0 1.7 637,419 100%
Maryland Baltimore County 10.0 1.0 789,915 100%
Maryland Cambridge, MD 21.8 3.1 32,047 100%
Maryland Cumberland, MD-WV 18.0 4.0 99,751 100%
Maryland Easton, MD 8.3 0.0 36,267 100%
Maryland Hagerstown-Martinsburg, MD-WV 11.6 0.8 266,179 100%
Maryland Lexington Park, MD 10.7 1.0 103,009 100%
Maryland Ocean Pines, MD 16.3 0.0 49,131 100%
Maryland Salisbury, MD 8.3 0.8 120,185 100%
Massachusetts Statewide 12.5 1.2 6,594,083 100%
Massachusetts Barnstable Town, MA 10.9 1.8 221,157 100%
Massachusetts Boston-Cambridge-Quincy, MA-NH 11.4 1.3 4,588,990 100%
Massachusetts Essex County 10.8 0.9 742,661 100%
Massachusetts Middlesex County 9.6 1.1 1,505,126 100%
Massachusetts Norfolk County 9.2 1.8 666,384 100%
Massachusetts Suffolk County 18.2 1.6 753,516 100%
Massachusetts Pittsfield, MA 4.6 0.0 129,308 100%
Massachusetts Springfield, MA 13.6 1.4 698,972 100%
Massachusetts Hampden County 15.1 0.8 471,107 100%
Massachusetts Worcester, MA 14.6 0.7 803,781 100%
Michigan Detroit-Warren-Livonia, MI 19.8 1.7 4,313,651 98%
Michigan Macomb County 22.8 2.9 831,511 100%
Michigan Oakland County 13.3 1.7 1,205,625 100%
Michigan Wayne County 22.8 1.0 1,925,809 100%
Minnesota Brainerd, MN 12.1 2.2 91,259 100%
Minnesota Mankato-North Mankato, MN 3.1 3.1 32,230 35%
Minnesota Minneapolis-St. Paul-Bloomington, MN-WI 7.8 1.4 2,693,777 82%
Minnesota Hennepin County 7.4 1.5 1,156,301 100%
Minnesota Ramsey County 13.2 2.2 506,301 100%
Missouri Kansas City, MO-KS 13.2 1.8 1,124,938 54%
Missouri Jackson County 15.7 1.8 705,689 100%
Missouri St. Louis, MO-IL 15.8 1.8 2,400,698 85%
Missouri St. Louis City 31.7 2.8 356,538 100%
Missouri St. Louis County 13.2 1.5 992,526 100%
New Hampshire Statewide 12.5 3.1 1,324,703 100%
New Hampshire Berlin, NH-VT 10.6 0.0 37,890 100%
New Hampshire Claremont, NH 2.3 0.0 42,699 100%
New Hampshire Concord, NH 8.7 0.7 149,081 100%
New Hampshire Keene, NH 10.4 6.5 77,051 100%
New Hampshire Laconia, NH 4.9 6.5 61,362 100%
New Hampshire Lebanon, NH-VT 17.5 7.0 171,764 100%
New Hampshire Manchester-Nashua, NH 12.8 3.0 405,939 100%
New Mexico Statewide 17.1 3.8 2,009,963 100%
New Mexico Alamogordo, NM 15.8 4.7 63,213 100%
New Mexico Albuquerque, NM 20.3 4.1 858,036 100%
New Mexico Bernalillo County 22.9 4.8 642,609 100%
New Mexico Carlsbad-Artesia, NM 28.5 0.0 52,716 100%
New Mexico Clovis, NM 6.8 4.5 44,416 100%
New Mexico Deming, NM 7.4 3.7 27,040 100%
New Mexico Española, NM 29.5 2.5 40,682 100%
New Mexico Farmington, NM 9.7 4.8 124,157 100%
New Mexico Gallup, NM 8.5 2.8 70,517 100%
New Mexico Grants, NM 11.1 0.0 27,040 100%
New Mexico Hobbs, NM 11.6 1.7 60,246 100%
New Mexico Las Cruces, NM 12.6 3.9 206,429 100%
New Mexico Las Vegas, NM 17.6 7.1 28,329 100%
New Mexico Los Alamos, NM 11.1 0.0 18,079 100%
New Mexico Portales, NM 21.3 5.3 18,820 100%
New Mexico Roswell, NM 11.0 0.0 63,628 100%
New Mexico Ruidoso, NM 14.3 4.8 21,018 100%
New Mexico Santa Fe, NM 16.9 2.0 147,552 100%
New Mexico Silver City, NM 6.7 13.4 29,905 100%
New Mexico Taos, NM 22.2 0.0 31,516 100%
New York Buffalo-Niagara Falls, NY 10.2 1.1 1,123,926 100%
New York Erie County 9.5 1.2 909,341 100%
New York New York-Northern New Jersey-Long Island, NY-NJ-PA 9.7 1.4 3,931,999 21%
New York NY Suburban, NY 10.4 1.4 3,275,472 77%
New York Nassau County 8.5 0.7 1,357,481 100%
New York Suffolk County 11.9 1.7 1,518,501 100%
New York Newark-Edison, NJ-PA 6.1 1.5 656,527 10%
North Dakota Fargo, ND-MN 4.5 0.5 200,141 100%
North Dakota Grand Forks, ND-MN 19.5 0.0 30,780 32%
Ohio Cleveland-Elyria-Mentor, OH 20.1 1.5 1,275,860 61%
Ohio Steubenville-Weirton, OH-WV 30.0 0.0 53,249 44%
Oklahoma Statewide 17.3 1.6 3,687,417 100%
Oklahoma Ada, OK 24.0 2.7 37,424 100%
Oklahoma Altus, OK 7.9 0.0 25,372 100%
Oklahoma Ardmore, OK 34.8 1.7 57,452 100%
Oklahoma Bartlesville, OK 9.9 0.0 50,711 100%
Oklahoma Duncan, OK 25.3 4.6 43,493 100%
Oklahoma Durant, OK 17.2 0.0 40,789 100%
Oklahoma Elk City, OK 14.2 0.0 21,119 100%
Oklahoma Enid, OK 10.2 0.0 58,935 100%
Oklahoma Guymon, OK 9.5 0.0 21,136 100%
Oklahoma Lawton, OK 7.1 0.9 113,256 100%
Oklahoma McAlester, OK 19.9 2.2 45,218 100%
Oklahoma Miami, OK 9.5 0.0 31,630 100%
Oklahoma Muskogee, OK 19.6 0.0 71,417 100%
Oklahoma Oklahoma City, OK 17.2 1.8 1,227,395 100%
Oklahoma Oklahoma County 21.9 2.1 716,727 100%
Oklahoma Ponca City, OK 15.2 0.0 46,116 100%
Oklahoma Shawnee, OK 8.5 0.0 70,275 100%
Oklahoma Stillwater, OK 12.5 0.0 79,731 100%
Oklahoma Tahlequah, OK 19.6 0.0 46,034 100%
Oklahoma Tulsa, OK 21.5 2.3 929,079 100%
Oklahoma Tulsa County 23.6 2.8 601,979 100%
Oklahoma Weatherford, OK 3.7 0.0 26,722 100%
Oklahoma Woodward, OK 10.0 0.0 19,963 100%
Oregon Statewide 13.4 3.9 3,826,015 100%
Oregon Albany-Lebanon, OR 10.3 1.7 116,594 100%
Oregon Astoria, OR 32.2 0.0 37,248 100%
Oregon Bend, OR 14.5 4.4 158,636 100%
Oregon Brookings, OR 0.0 0.0 21,155 100%
Oregon Coos Bay, OR 22.3 8.0 62,802 100%
Oregon Corvallis, OR 8.5 0.0 82,623 100%
Oregon Eugene-Springfield, OR 17.9 7.1 351,166 100%
Oregon Grants Pass, OR 0.0 0.0 81,035 100%
Oregon Hood River, OR 9.1 0.0 21,886 100%
Oregon Klamath Falls, OR 12.1 4.5 66,254 100%
Oregon La Grande, OR 8.0 4.0 25,042 100%
Oregon Medford, OR 11.4 5.5 201,313 100%
Oregon Ontario, OR-ID 13.0 6.5 30,751 57%
Oregon Pendleton-Hermiston, OR 7.1 2.4 84,893 100%
Oregon Portland-Vancouver-Hillsboro, OR-WA 14.1 3.7 1,799,061 80%
Oregon Multnomah County 22.1 4.0 726,919 100%
Oregon Prineville, OR 4.4 4.4 22,566 100%
Oregon Roseburg, OR 17.4 2.9 103,227 100%
Oregon Salem, OR 11.4 4.0 396,116 100%
Oregon The Dalles, OR 8.3 0.0 24,153 100%
Pennsylvania Philadelphia-Camden-Wilmington, PA-NJ-DE-MD 19.5 2.0 3,367,030 56%
Pennsylvania Delaware County 21.0 3.8 558,082 100%
Pennsylvania New Castle County 18.5 3.6 534,686 100%
Pennsylvania Philadelphia County 24.5 1.5 1,547,372 100%
Rhode Island Statewide 18.4 2.3 1,053,300 100%
Rhode Island Providence-New Bedford-Fall River, RI-MA 18.7 2.3 1,600,786 100%
Rhode Island Bristol County 19.4 2.4 547,486 100%
Rhode Island Providence County 18.8 2.7 627,732 100%
South Dakota Sioux Falls, SD 0.5 1.6 183,013 77%
Tennessee Kingsport-Bristol-Bristol, TN-VA 11.8 3.2 93,303 31%
Texas Dallas-Fort Worth-Arlington, TX 7.4 1.4 1,450,306 22%
Texas Collin County 7.6 1.9 791,656 100%
Texas Houston-Sugar Land-Baytown, TX 11.1 2.1 4,071,206 69%
Utah Statewide 13.5 2.1 2,784,647 100%
Utah Brigham City, UT 10.0 0.0 49,905 100%
Utah Cedar City, UT 13.2 4.4 45,287 100%
Utah Heber, UT 4.6 0.0 21,602 100%
Utah Logan, UT-ID 3.5 1.7 115,281 90%
Utah Ogden-Clearfield, UT 14.0 1.8 541,584 100%
Utah Price, UT 30.0 5.0 19,994 100%
Utah Provo-Orem, UT 11.3 1.3 555,556 100%
Utah Utah County 11.2 1.3 545,312 100%
Utah Salt Lake City, UT 15.2 2.9 1,130,299 100%
Utah Salt Lake County 15.1 3.1 1,034,992 100%
Utah St. George, UT 16.0 0.7 137,469 100%
Utah Vernal, UT 0.0 3.2 31,539 100%
Vermont Statewide 8.4 3.4 621,829 100%
Vermont Barre, VT 8.5 1.7 58,700 100%
Vermont Bennington, VT 8.2 5.5 36,415 100%
Vermont Burlington-South Burlington, VT 11.1 2.9 208,086 100%
Vermont Rutland, VT 9.5 4.8 63,018 100%
Virginia Statewide 7.8 1.8 7,883,401 100%
Virginia Blacksburg-Christiansburg-Radford, VA 16.3 1.9 159,608 100%
Virginia Charlottesville, VA 6.6 1.0 196,790 100%
Virginia Culpeper, VA 4.3 0.0 46,509 100%
Virginia Danville, VA 9.4 0.9 105,823 100%
Virginia Harrisonburg, VA 5.8 0.8 120,282 100%
Virginia Lynchburg, VA 9.3 1.2 247,473 100%
Virginia Martinsville, VA 17.3 1.4 69,528 100%
Virginia Richmond, VA 5.8 1.7 1,238,343 100%
Virginia Roanoke, VA 11.6 5.3 300,441 100%
Virginia Staunton-Waynesboro, VA 11.0 2.5 118,158 100%
Virginia Virginia Beach-Norfolk-Newport News, VA-NC 7.7 1.8 1,650,429 99%
Virginia Winchester, VA-WV 16.1 3.2 124,011 100%
Washington Seattle-Tacoma-Bellevue, WA 14.3 2.6 3,408,138 100%
Washington King County 13.9 2.5 1,916,576 100%
Washington Pierce County 15.9 3.1 796,896 100%
Washington Snohomish County 13.5 2.3 694,666 100%
West Virginia Statewide 28.3 2.6 1,820,042 100%
West Virginia Beckley, WV 60.6 2.5 79,195 100%
West Virginia Bluefield, WV-VA 45.9 2.8 106,840 100%
West Virginia Charleston, WV 30.6 2.3 304,244 100%
West Virginia Clarksburg, WV 18.4 2.2 92,454 100%
West Virginia Fairmont, WV 7.1 0.0 56,714 100%
West Virginia Huntington-Ashland, WV-KY-OH 42.5 1.5 136,350 48%
West Virginia Morgantown, WV 14.1 2.5 120,368 100%
West Virginia Oak Hill, WV 26.0 0.0 46,129 100%
West Virginia Parkersburg-Marietta-Vienna, WV-OH 7.0 3.0 99,867 62%
West Virginia Point Pleasant, WV-OH 35.2 0.0 25,573 45%
West Virginia Wheeling, WV-OH 23.5 5.2 76,584 53%
Wisconsin Milwaukee-Waukesha-West Allis, WI 16.3 1.4 959,548 62%
Table 3
Rates of drug-related deaths and percentage change, 2009 and 2010
State Area* Rate of drug-related deaths per 100,000 population, 2009 Rate of drug-related deaths per 100,000 population, 2010 Percent change in rate, 2009 to 2010 Population in participating jurisdictions, 2010 Percent of area population covered by participating ME/Cs, 2010
* Names in italics are submetropolitan areas within the larger metropolitan statistical area.
Drug-related deaths exclude drug-related suicide deaths.
NOTE: ME/Cs = medical examiners and coroners. NC = no rate calculated because different jurisdictions participated in 2009 and 2010. NP = no percent change calculated, as there were no deaths in one or both years.
SOURCE: Center for Behavioral Health Statistics and Quality, SAMHSA, Drug Abuse Warning Network, 2010.
Alabama Birmingham-Hoover, AL 21.8 14.3 −34.6 665,067 59%
Arizona Phoenix-Mesa-Glendale, AZ 18.5 18.4 −0.6 4,023,096 92%
Arkansas Fort Smith, AR-OK 17.6 17.5 −0.4 91,356 31%
California Los Angeles-Long Beach-Santa Ana, CA 9.1 9.0 −1.3 9,848,432 76%
California San Diego-Carlsbad-San Marcos, CA 12.4 13.7 10.4 3,054,008 100%
California San Francisco-Oakland-Fremont, CA NC NC NC 2,575,793 60%
California Contra Costa County 7.8 9.6 23.4 1,041,389 100%
California San Francisco-San Mateo-Redwood City, CA NC NC NC 1,534,404 86%
California San Francisco County 19.9 21.0 5.4 815,366 100%
Colorado Denver-Aurora-Broomfield, CO 16.4 14.0 −14.7 2,538,039 99%
Colorado Adams County 14.4 14.5 0.9 441,005 100%
Colorado Arapahoe County 14.8 13.8 −6.5 565,404 100%
Colorado Denver County 31.9 24.7 −22.5 610,336 100%
Delaware Statewide 14.1 16.9 19.9 885,218 100%
Delaware Dover, DE 9.0 13.9 55.2 157,763 100%
Delaware Seaford, DE 20.5 15.0 −26.7 192,769 100%
District of Columbia Washington-Arlington-Alexandria, DC-VA-MD-WV 7.5 6.4 −14.6 5,476,789 100%
District of Columbia District of Columbia 23.5 17.7 −24.8 599,718 100%
Florida Miami-Fort Lauderdale-Pompano Beach, FL 8.4 9.1 7.8 3,780,752 68%
Florida Miami-Dade County 6.5 5.1 −21.7 2,500,579 100%
Florida Palm Beach County 12.2 16.9 38.4 1,280,173 100%
Georgia Atlanta-Sandy Springs-Marietta, GA NC NC NC 2,070,435 38%
Georgia Fulton County 9.3 9.7 4.6 1,033,612 100%
Hawaii Honolulu, HI 12.8 14.0 9.0 907,738 100%
Illinois Chicago-Joliet-Naperville, IL-IN-WI 9.3 9.4 0.5 8,767,431 92%
Illinois Cook County 9.5 9.6 0.5 5,287,160 100%
Illinois Lake County 10.9 10.1 −7.0 712,614 100%
Illinois Will County 11.5 9.5 −17.3 685,269 100%
Indiana Indianapolis-Carmel, IN 14.8 12.9 −13.2 1,032,430 59%
Indiana Marion County 15.4 12.3 −19.7 890,925 100%
Louisiana New Orleans-Metairie-Kenner, LA 16.1 16.9 4.8 563,002 47%
Louisiana Jefferson Parish 17.5 17.4 −1.0 443,347 100%
Maine Statewide 11.6 10.6 −8.3 1,318,450 100%
Maine Augusta-Waterville, ME 4.9 14.0 183.6 121,107 100%
Maine Bangor, ME 14.1 11.4 −19.1 149,439 100%
Maine Lewiston-Auburn, ME 14.9 11.3 −24.6 106,550 100%
Maine Portland-South Portland-Biddeford, ME 13.6 11.0 −18.6 516,871 100%
Maine Rockland, ME 2.4 4.9 100.7 40,804 100%
Maryland Statewide 13.0 10.1 −22.3 5,700,058 100%
Maryland Baltimore-Towson, MD 18.2 13.5 −25.9 2,691,154 100%
Maryland Baltimore City 41.5 27.0 −35.0 637,419 100%
Maryland Baltimore County 12.8 10.0 −21.9 789,915 100%
Maryland Cambridge, MD 6.2 21.8 250.2 32,047 100%
Maryland Cumberland, MD-WV 14.0 18.0 28.7 99,751 100%
Maryland Easton, MD 8.3 8.3 −0.2 36,267 100%
Maryland Hagerstown-Martinsburg, MD-WV 20.8 11.6 −44.0 266,179 100%
Maryland Lexington Park, MD 8.8 10.7 20.9 103,009 100%
Maryland Ocean Pines, MD 18.3 16.3 −10.9 49,131 100%
Maryland Salisbury, MD 15.0 8.3 −44.4 120,185 100%
Massachusetts Statewide 14.3 12.5 −13.0 6,594,083 100%
Massachusetts Barnstable Town, MA 13.5 10.9 −19.8 221,157 100%
Massachusetts Boston-Cambridge-Quincy, MA-NH 13.9 11.4 −18.6 4,588,990 100%
Massachusetts Essex County 14.2 10.8 −24.2 742,661 100%
Massachusetts Middlesex County 11.1 9.6 −13.5 1,505,126 100%
Massachusetts Norfolk County 10.7 9.2 −14.6 666,384 100%
Massachusetts Suffolk County 25.0 18.2 −27.2 753,516 100%
Massachusetts Pittsfield, MA 17.0 4.6 −72.6 129,308 100%
Massachusetts Springfield, MA 15.3 13.6 −11.3 698,972 100%
Massachusetts Hampden County 18.9 15.1 −20.5 471,107 100%
Massachusetts Worcester, MA 11.5 14.6 26.6 803,781 100%
Michigan Detroit-Warren-Livonia, MI 21.5 19.8 −8.2 4,313,651 98%
Michigan Macomb County 22.0 22.8 3.7 831,511 100%
Michigan Oakland County 15.0 13.3 −11.3 1,205,625 100%
Michigan Wayne County 25.7 22.8 −11.2 1,925,809 100%
Minnesota Brainerd, MN 16.5 12.1 −26.7 91,259 100%
Minnesota Mankato-North Mankato, MN NC NC NC 32,230 35%
Minnesota Minneapolis-St. Paul-Bloomington, MN-WI 7.7 7.8 1.1 2,693,777 82%
Minnesota Hennepin County 7.9 7.4 −6.4 1,156,301 100%
Minnesota Ramsey County 12.5 13.2 5.8 506,301 100%
Missouri Kansas City, MO-KS 11.8 13.2 12.7 1,124,938 54%
Missouri Jackson County 13.7 15.7 14.9 705,689 100%
Missouri St. Louis, MO-IL 13.3 15.8 18.8 2,400,698 85%
Missouri St. Louis City 25.2 31.7 25.7 356,538 100%
Missouri St. Louis County 11.3 13.2 17.0 992,526 100%
New Hampshire Statewide 11.7 12.5 6.3 1,324,703 100%
New Hampshire Berlin, NH-VT 0.0 10.6 NP 37,890 100%
New Hampshire Claremont, NH 7.0 2.3 −66.6 42,699 100%
New Hampshire Concord, NH 10.1 8.7 −13.3 149,081 100%
New Hampshire Keene, NH 10.4 10.4 0.3 77,051 100%
New Hampshire Laconia, NH 11.4 4.9 −57.2 61,362 100%
New Hampshire Lebanon, NH-VT 14.5 17.5 20.3 171,764 100%
New Hampshire Manchester-Nashua, NH 13.3 12.8 −4.0 405,939 100%
New Mexico Statewide 22.4 17.1 −23.6 2,009,963 100%
New Mexico Alamogordo, NM 25.2 15.8 −37.3 63,213 100%
New Mexico Albuquerque, NM 28.8 20.3 −29.5 858,036 100%
New Mexico Bernalillo County 31.7 22.9 −27.9 642,609 100%
New Mexico Carlsbad-Artesia, NM 19.3 28.5 47.7 52,716 100%
New Mexico Clovis, NM 11.4 6.8 −40.6 44,416 100%
New Mexico Deming, NM 3.7 7.4 100.6 27,040 100%
New Mexico Española, NM 49.2 29.5 −40.0 40,682 100%
New Mexico Farmington, NM 10.6 9.7 −8.8 124,157 100%
New Mexico Gallup, NM 8.5 8.5 0.0 70,517 100%
New Mexico Grants, NM 11.0 11.1 0.7 27,040 100%
New Mexico Hobbs, NM 10.1 11.6 14.8 60,246 100%
New Mexico Las Cruces, NM 14.3 12.6 −12.2 206,429 100%
New Mexico Las Vegas, NM 21.1 17.6 −16.3 28,329 100%
New Mexico Los Alamos, NM 16.4 11.1 −32.5 18,079 100%
New Mexico Portales, NM 0.0 21.3 NP 18,820 100%
New Mexico Roswell, NM 19.0 11.0 −42.1 63,628 100%
New Mexico Ruidoso, NM 19.1 14.3 −25.2 21,018 100%
New Mexico Santa Fe, NM 16.5 16.9 2.9 147,552 100%
New Mexico Silver City, NM 30.0 6.7 −77.7 29,905 100%
New Mexico Taos, NM 25.3 22.2 −12.4 31,516 100%
New York Buffalo-Niagara Falls, NY 9.2 10.2 10.7 1,123,926 100%
New York Erie County 9.3 9.5 1.3 909,341 100%
New York New York-Northern New Jersey-Long Island, NY-NJ-PA 10.4 9.7 −7.1 3,931,999 21%
New York NY Suburban, NY 11.1 10.4 −6.5 3,275,472 77%
New York Nassau County 9.6 8.5 −11.0 1,357,481 100%
New York Suffolk County 13.0 11.9 −8.8 1,518,501 100%
New York Newark-Edison, NJ-PA 6.9 6.1 −11.6 656,527 10%
North Dakota Fargo, ND-MN 5.6 4.5 −19.6 200,141 100%
North Dakota Grand Forks, ND-MN 6.5 19.5 198.4 30,780 32%
Ohio Cleveland-Elyria-Mentor, OH 18.2 20.1 10.0 1,275,860 61%
Ohio Steubenville-Weirton, OH-WV 26.2 30.0 14.8 53,249 44%
Oklahoma Statewide 15.6 17.3 10.9 3,687,417 100%
Oklahoma Ada, OK 35.1 24.0 −31.5 37,424 100%
Oklahoma Altus, OK 0.0 7.9 NP 25,372 100%
Oklahoma Ardmore, OK 15.8 34.8 120.2 57,452 100%
Oklahoma Bartlesville, OK 13.8 9.9 −28.7 50,711 100%
Oklahoma Duncan, OK 18.4 25.3 37.2 43,493 100%
Oklahoma Durant, OK 17.3 17.2 −0.6 40,789 100%
Oklahoma Elk City, OK 4.6 14.2 206.4 21,119 100%
Oklahoma Enid, OK 10.3 10.2 −1.3 58,935 100%
Oklahoma Guymon, OK 9.7 9.5 −2.1 21,136 100%
Oklahoma Lawton, OK 8.9 7.1 −20.6 113,256 100%
Oklahoma McAlester, OK 24.5 19.9 −18.8 45,218 100%
Oklahoma Miami, OK 15.8 9.5 −39.9 31,630 100%
Oklahoma Muskogee, OK 11.3 19.6 73.6 71,417 100%
Oklahoma Oklahoma City, OK 12.1 17.2 41.6 1,227,395 100%
Oklahoma Oklahoma County 13.6 21.9 61.5 716,727 100%
Oklahoma Ponca City, OK 10.9 15.2 39.5 46,116 100%
Oklahoma Shawnee, OK 21.5 8.5 −60.4 70,275 100%
Oklahoma Stillwater, OK 10.1 12.5 23.8 79,731 100%
Oklahoma Tahlequah, OK 21.8 19.6 −10.5 46,034 100%
Oklahoma Tulsa, OK 19.5 21.5 10.4 929,079 100%
Oklahoma Tulsa County 24.3 23.6 −2.7 601,979 100%
Oklahoma Weatherford, OK 34.1 3.7 −89.0 26,722 100%
Oklahoma Woodward, OK 10.1 10.0 −0.9 19,963 100%
Oregon Statewide 12.9 13.4 4.2 3,826,015 100%
Oregon Albany-Lebanon, OR 11.3 10.3 −8.5 116,594 100%
Oregon Astoria, OR 21.5 32.2 49.6 37,248 100%
Oregon Bend, OR 5.7 14.5 154.4 158,636 100%
Oregon Brookings, OR 0.0 0.0 NP 21,155 100%
Oregon Coos Bay, OR 11.1 22.3 100.7 62,802 100%
Oregon Corvallis, OR 6.1 8.5 39.5 82,623 100%
Oregon Eugene-Springfield, OR 25.8 17.9 −30.4 351,166 100%
Oregon Grants Pass, OR 0.0 0.0 NP 81,035 100%
Oregon Hood River, OR 4.6 9.1 96.9 21,886 100%
Oregon Klamath Falls, OR 4.5 12.1 167.9 66,254 100%
Oregon La Grande, OR 4.0 8.0 100.7 25,042 100%
Oregon Medford, OR 11.5 11.4 −0.4 201,313 100%
Oregon Ontario, OR-ID 13.0 13.0 0.3 30,751 57%
Oregon Pendleton-Hermiston, OR 8.3 7.1 −14.9 84,893 100%
Oregon Portland-Vancouver-Hillsboro, OR-WA 13.1 14.1 7.4 1,799,061 80%
Oregon Multnomah County 20.3 22.1 9.2 726,919 100%
Oregon Prineville, OR 8.7 4.4 −49.3 22,566 100%
Oregon Roseburg, OR 6.8 17.4 158.0 103,227 100%
Oregon Salem, OR 14.6 11.4 −22.0 396,116 100%
Oregon The Dalles, OR 4.2 8.3 97.8 24,153 100%
Pennsylvania Philadelphia-Camden-Wilmington, PA-NJ-DE-MD NC NC NC 3,367,030 56%
Pennsylvania Delaware County 18.3 21.0 14.4 558,082 100%
Pennsylvania New Castle County 13.4 18.5 38.7 534,686 100%
Pennsylvania Philadelphia County 26.7 24.5 −8.3 1,547,372 100%
Rhode Island Statewide 17.3 18.4 6.7 1,053,300 100%
Rhode Island Providence-New Bedford-Fall River, RI-MA 17.4 18.7 7.9 1,600,786 100%
Rhode Island Bristol County 17.6 19.4 10.2 547,486 100%
Rhode Island Providence County 18.5 18.8 1.8 627,732 100%
South Dakota Sioux Falls, SD 0.6 0.5 −1.5 183,013 77%
Tennessee Kingsport-Bristol-Bristol, TN-VA 11.8 11.8 0.0 93,303 31%
Texas Dallas-Fort Worth-Arlington, TX 6.5 7.4 14.0 1,450,306 22%
Texas Collin County 6.5 7.6 16.3 791,656 100%
Texas Houston-Sugar Land-Baytown, TX 11.5 11.1 −3.0 4,071,206 69%
Utah Statewide 15.4 13.5 −12.5 2,784,647 100%
Utah Brigham City, UT 12.2 10.0 −17.9 49,905 100%
Utah Cedar City, UT 9.0 13.2 47.1 45,287 100%
Utah Heber, UT 19.0 4.6 −75.6 21,602 100%
Utah Logan, UT-ID 12.4 3.5 −72.1 115,281 90%
Utah Ogden-Clearfield, UT 15.8 14.0 −11.0 541,584 100%
Utah Price, UT 25.4 30.0 18.2 19,994 100%
Utah Provo-Orem, UT 11.4 11.3 −0.9 555,556 100%
Utah Utah County 11.1 11.2 0.9 545,312 100%
Utah Salt Lake City, UT 18.8 15.2 −19.2 1,130,299 100%
Utah Salt Lake County 19.4 15.1 −22.3 1,034,992 100%
Utah St. George, UT 9.6 16.0 67.4 137,469 100%
Utah Vernal, UT 10.0 0.0 NP 31,539 100%
Vermont Statewide 12.9 8.4 −35.0 621,829 100%
Vermont Barre, VT 11.9 8.5 −28.5 58,700 100%
Vermont Bennington, VT 13.7 8.2 −39.9 36,415 100%
Vermont Burlington-South Burlington, VT 14.5 11.1 −23.6 208,086 100%
Vermont Rutland, VT 19.0 9.5 −49.8 63,018 100%
Virginia Statewide 7.8 7.8 0.3 7,883,401 100%
Virginia Blacksburg-Christiansburg-Radford, VA 22.7 16.3 −28.1 159,608 100%
Virginia Charlottesville, VA 5.6 6.6 17.4 196,790 100%
Virginia Culpeper, VA 6.5 4.3 −33.6 46,509 100%
Virginia Danville, VA 7.5 9.4 25.6 105,823 100%
Virginia Harrisonburg, VA 8.4 5.8 −30.7 120,282 100%
Virginia Lynchburg, VA 6.5 9.3 42.9 247,473 100%
Virginia Martinsville, VA 25.7 17.3 −32.8 69,528 100%
Virginia Richmond, VA 6.8 5.8 −14.9 1,238,343 100%
Virginia Roanoke, VA 20.4 11.6 −42.8 300,441 100%
Virginia Staunton-Waynesboro, VA 16.1 11.0 −31.8 118,158 100%
Virginia Virginia Beach-Norfolk-Newport News, VA-NC 7.0 7.7 9.3 1,650,429 99%
Virginia Winchester, VA-WV 16.3 16.1 −0.9 124,011 100%
Washington Seattle-Tacoma-Bellevue, WA 16.2 14.3 −11.6 3,408,138 100%
Washington King County 15.6 13.9 −10.5 1,916,576 100%
Washington Pierce County 18.6 15.9 −14.5 796,896 100%
Washington Snohomish County 15.1 13.5 −10.7 694,666 100%
West Virginia Statewide 23.3 28.3 21.3 1,820,042 100%
West Virginia Beckley, WV 40.6 60.6 49.3 79,195 100%
West Virginia Bluefield, WV-VA 31.9 45.9 43.9 106,840 100%
West Virginia Charleston, WV 21.1 30.6 45.0 304,244 100%
West Virginia Clarksburg, WV 16.3 18.4 13.1 92,454 100%
West Virginia Fairmont, WV 10.6 7.1 −33.4 56,714 100%
West Virginia Huntington-Ashland, WV-KY-OH 27.2 42.5 56.4 136,350 48%
West Virginia Morgantown, WV 15.1 14.1 −6.4 120,368 100%
West Virginia Oak Hill, WV 25.9 26.0 0.4 46,129 100%
West Virginia Parkersburg-Marietta-Vienna, WV-OH 12.0 7.0 −41.7 99,867 62%
West Virginia Point Pleasant, WV-OH 27.3 35.2 28.9 25,573 45%
West Virginia Wheeling, WV-OH 20.8 23.5 13.1 76,584 53%
Wisconsin Milwaukee-Waukesha-West Allis, WI 17.4 16.3 −6.4 959,548 62%

DESCRIPTION OF PROFILES

DAWN mortality data are displayed for metropolitan and micropolitan areas with 30 or more drug-related deaths and participating ME/Cs covering more than 50 percent of the area population and for all participating States in six figures and tables that span two or more pages.5 These are referred to as "full profiles." Individual counties that are part of a multicounty metropolitan area and reported 60 or more drug-related deaths also receive full profiles that are referred to as "county profiles."6 Metropolitan areas with fewer than 30 drug-related deaths or less than 50 percent population coverage receive a brief profile that includes just one table.

Among the 157 metropolitan areas, full profiles are provided for 45 metropolitan areas. Brief profiles are provided for 112 metropolitan areas that either submitted 30 or fewer drug-related deaths or had less than 50 percent population coverage. County profiles are provided for 47 individual counties. Just over one third of the nation's population is covered by the ME/Cs participating in DAWN.

The profiles are arranged by State, by metropolitan area within the State, and then by county within the metropolitan area. For the New York and San Francisco metropolitan areas, profiles are also provided for subgroupings of counties within the metropolitan area that may be of local interest.

The Contents to this publication lists the profiles in the order in which they appear.

Full profiles

The full profile is composed of six exhibits plus a map and demographic information on the State or metropolitan area and its constituent counties. Figure 1 shows the general layout of the full profile. All profiles observe the following conventions:

Figure 1
Sample metropolitan area profile layout

Figure 1

D

Map

Each profile begins with a map displaying the boundaries of the metropolitan area or State and its component counties. In this publication, the terms "death investigation jurisdiction," "jurisdiction," and "county" are used interchangeably because ME/Cs' offices are typically organized by county. In the few cases where there are multiple ME/Cs in a county, counts of deaths are aggregated and reported at the county level.

Both participating and nonparticipating jurisdictions are shown in the map. Jurisdictions that provided mortality data for 2010 are colored white. Jurisdictions in the area that did not provide data are shaded light blue. Areas outside of the metropolitan area or State are shaded darker blue.

Metropolitan and micropolitan area definitions used in this publication are those established by the Office of Management and Budget (OMB) based on the 2000 decennial U.S. Census and updated annually thereafter.7 By OMB convention, the name of each MSA reflects the largest population centers (i.e., cities) in that MSA. If the relative population sizes of cities in an MSA change (i.e., the second largest becomes the largest), OMB changes the name of the MSA to reflect the new order of cities by size (i.e., the name of the larger city will appear first). This publication uses the name of the MSA that was current at the end of the data collection year 2010. Based on population changes, OMB also adds and deletes entire metropolitan and micropolitan areas or alters the counties included in areas. This publication provides profiles for all metropolitan and micropolitan areas identified by OMB at the end of 2010 for which DAWN received mortality data for at least one constituent county.

Next to the map, the following items appear:

Table A: Metro area overview: Deaths and population by county, 2010

Appearing below the map, Table A lists each of the component jurisdictions for the area. Each jurisdiction is numbered to correspond to the numbers shown on the area map. In metropolitan areas that cross State borders, jurisdictions are ordered first by State and then alphabetically by county name. Nonparticipating jurisdictions are included in the list with a shaded background to distinguish them from participating jurisdictions.

Information in Table A for each jurisdiction includes the following:

The top row of the table totals this information for just the participating jurisdictions.

Rates, because they are population adjusted, can be compared across jurisdictions, metropolitan areas, and States. This standardization does not take into account, however, the differences in applicable laws that specify which deaths are subject to ME/C review or other factors that may confound comparisons.

The subsequent tables and figures (B through F) are based on data aggregated across the participating jurisdictions in each metropolitan area or State.

Figure B: Deaths by manner of death, 2010

Figure B is a pie chart that displays manner of death for drug-related deaths and drug-related suicide deaths. The manner of death reported here is that assigned by the ME/C using the categories provided on the U.S. Standard Certificate of Death. Solid-colored slices are reserved for drug-related deaths other than suicides; the patterned slice shows the suicide deaths. Reading clockwise, the manners of death are identified as follows:

Figure C: Top 5 drugs involved: Drug-related deaths, 2010
Top 5 drugs involved: Drug-related suicide deaths, 2010

Separate bar charts show the five most common types of drugs (e.g., opiates/opioids, benzodiazepines) reported to DAWN for drug-related deaths and drug-related suicide deaths across the participating jurisdictions. The number shown above each bar is the number of deaths reported for a specific drug type. The name of the drug type is printed below each bar. Each bar is partitioned to display separately the portion of deaths involving a single drug type (solid blue area in bottom portion of bar) versus multiple drug types (striped area in top of bar). A bar is not printed if there are fewer than four deaths associated with a drug type, and therefore, fewer than five bars may appear. The top 5 drug types are identified from among 17 different drug types, as listed in Table F (see below).

A single death that involved two drugs of different types (e.g., cocaine and heroin) would be counted in two bars (e.g., cocaine and heroin, respectively). As a result, summing the number of deaths reported in each bar will double-count deaths that involved multiple types of drugs. A death that involved two drugs of the same type (e.g., multiple opiates/opioids, such as methadone and heroin) will be counted once (e.g., in the bar for opiates/opioids).

Grouping drugs by drug type eliminates double counting due to the following causes: redundant drug reports (e.g., "cocaine" and its metabolite "benzoylecgonine" being reported for the same death); redundant reports from nonspecific terms (e.g., "heroin" and "opiates" being reported for the same death); and drug reports that may be indistinguishable (e.g., "heroin" and "morphine").

Figure D: Death rates by sex and age: Drug-related deaths, 2010
Death rates by sex and age: Drug-related suicide deaths, 2010

Figure D displays the sex and categorical age of decedents in drug-related deaths and drug-related suicide deaths, in terms of deaths per 100,000 population. Only participating jurisdictions are included in the calculation of these rates. Taking population size into account enables comparisons to be made across age and sex subgroups.

Table E: Place of death, 2010

Table E reports the place of death for drug-related deaths and drug-related suicide deaths. Deaths in emergency departments and other health care facilities have been combined into the single category "Health care facility."

Table F: Drug-related deaths by drug category, 2009-2010

Table F reports, by drug type or drug, the count of drug-related deaths and drug-related suicide deaths for 2009 and 2010. The first row of Table F summarizes deaths across all drug categories; the subsequent rows provide detail for 17 specific drug types or drugs of particular interest.

Data for both 2009 and 2010 are reported when the same jurisdictions participated in both years. If comparable data are not available for both 2009 and 2010 (e.g., in the Atlanta metropolitan area, Cherokee County participated in 2009 but not in 2010), the 2009 columns are left blank.

Counts of drug-related deaths and drug-related suicide deaths include deaths that involved both single and multiple drugs. Summing these deaths across drug types or drugs could result in double counting deaths associated with multiple drug types. To provide a better understanding of single-drug versus multidrug involvement, counts of single-drug deaths are reported. Single-drug deaths involve the listed drug type or drug and no other, and they are a subset of the total count of deaths.

The 17 drug categories shown in this table are derived from DAWN's standard drug classification scheme and include the following:9

The next six rows in Table F pertain to illicit drugs:

The remaining rows in Table F are devoted to prescription and over-the-counter pharmaceuticals. For this table, heroin is categorized and reported on as an opiate/opioid. Low-frequency drugs have been aggregated into higher-level categories:

Brief profiles for selected metropolitan areas

To warrant a full profile, the participating jurisdictions of a metropolitan area in combination must have reported more than 30 drug-related deaths or drug-related suicide deaths, and the area's population coverage must exceed 50 percent. If either of these two conditions was not met, a brief profile is provided for the area. In contrast to full profiles, brief profiles include only a map and Table A (see above).

County profiles

County profiles are produced for individual jurisdictions in which 60 or more drug-related deaths were reported. The purpose is to distinguish findings for a single location from those of the metropolitan area as a whole. County profiles may appear for jurisdictions even if the metropolitan area itself had less than 50 percent population coverage. In some instances, even if a jurisdiction has 60 or more deaths, a county profile may not be needed. Such is the case when a metropolitan area contains only one county or had only one county participating in DAWN.

County profiles have essentially the same format as the full metropolitan area profile. County profiles include the map; Figures B, C, and D; and Tables E and F, as described above. Because of the small numbers, drug-related suicide deaths have been removed from all exhibits except the jurisdiction summary and Figure B.

State profiles

Thirteen statewide ME/C systems participated in DAWN in 2010. A full profile is provided for each of the following States:

A Glossary of Terms used in this report appears in Appendix B. Additional detail on the DAWN data collection methodology is provided in Appendix C.



End Notes

1 DAWN uses the terms "death investigation jurisdiction," "jurisdiction," and "county" interchangeably because ME/Cs' offices are typically organized by county. In the few cases where there are multiple ME/Cs in a county, counts of deaths are aggregated and reported at the county level.

2 To be reportable, a nonpharmaceutical substance must be intentionally consumed by inhalation, sniffing, or snorting and must have a psychoactive effect when inhaled. Additional information on inhalants as reported by DAWN is provided in Appendix B: Glossary of Terms.

3 There is overlap between the metropolitan areas and States. In total, mortality data were received for 543 jurisdictions: 93 jurisdictions are only in metropolitan areas, 170 jurisdictions are only in States, and 280 jurisdictions are in both.

4 DAWN uses the metropolitan area definitions established by the Office of Management and Budget in 2000 as updated each year through 2010. See Appendix C for additional detail.

5 For brevity, when this publication refers to metropolitan areas, the term includes both metropolitan and micropolitan areas.

6 If a metropolitan area has only one participating county, a separate profile is not provided for the county, as the reported data would be identical to those provided for the metropolitan area.

7 Office of Management and Budget (OMB), Revised Definitions of Metropolitan Statistical Areas, New Definitions of Micropolitan Statistical Areas and Combined Statistical Areas, and Guidance on Uses of the Statistical Definitions of These Areas, Bulletin No. 03-04, June 6, 2003. (Available at http://www.whitehouse.gov/omb/bulletins_index2003-2005.) Updates describing new metropolitan or micropolitan areas and changes to existing areas are provided annually by OMB. (Available at http://www.whitehouse.gov/omb/bulletins_default.)

8 For 2010, population counts were drawn from the 2010 United States Resident Population Census files (available from the U.S. Census Bureau at http://www2.census.gov/census_2010/03-Demographic_Profile/). For 2009, population estimates were developed based on the vintage 2009 United States Resident Population by Age, Sex, Race, and Hispanic Origin files (available at http://www.census.gov/popest/data/historical/2000s/vintage_2009/index.html) calibrated to synchronize the estimates with the 2010 decennial census counts. Additional details on the method to estimate population for 2009 are provided in the 2010 DAWN Methods report (available at https://www.samhsa.gov/data/data-we-collect/dawn-drug-abuse-warning-network).

9 The classification of drugs used in DAWN is derived from the Multum Lexicon, © 2011 Lexi-Comp, Inc. and/or Cerner Multum, Inc. The classification was modified to meet DAWN's unique requirements (2011). The Multum Licensing Agreement governing use of the Lexicon can be found in Appendix A and on the Internet at https://www.samhsa.gov/data/data-we-collect/dawn-drug-abuse-warning-network.

10 Some examples may assist readers in interpreting this classification. A death that involved heroin and methadone would be counted in the "Opiates/opioids" row, in the "Heroin (specified)" row, and in the "Methadone" row. A death that involved morphine would be counted in the "Opiates/opioids" row and in the "All other opiates/opioids" row. A death that involved both morphine and codeine would be counted in the "Opiates/opioids" row and in the "All other opiates/opioids" row.

11 Note that morphine and unspecified opiates are not grouped in the "Heroin (specified)" category. Morphine is not classified as heroin because it is not possible to differentiate morphine, the metabolite of heroin, from morphine itself. Most drugs in the category "Heroin (specified)" were reported to DAWN as heroin or its metabolite monoacetylmorphine. A few were reported as acetylmorphine, diacetylmorphine, acetylcodeine, monoacetylcodeine, heroin dope, or black tar heroin.

12 The term "morphine" or "free morphine" accounted for most drug reports classified as "morphine," and the term "opiates" accounted for most of the unspecified opiates.



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