Stephen J.LurieMD, PhD, Contributing EditorIndividualAuthor
In Reply: We applaud SAMHSA for its efforts
to redesign DAWN. Improvements in timeliness, sampling strategy, and the criteria
used to identify DAWN cases will go a long way toward ensuring that DAWN data
provide a more accurate assessment of the health consequences of drug abuse.
We hope that SAMHSA also will consider changes in data collection and
reporting procedures. One important data collection limitation is the assignment
of only 1 reason (motive) for taking all the drugs that are mentioned as having
been ingested in a single episode. The motive assigned to the entire episode
may not accurately reflect the specific reason that each drug was ingested.
Additionally, the reporting of heroin and morphine as a single category makes
it impossible to distinguish between the abuse of an illicit drug and the
appropriate use of an essential pain medication. Moreover, the DAWN drug categories
should be updated to reflect their pharmacology, eg, moving ibuprofen and
naproxen from "other" drugs to "non-narcotic analgesics" and moving hydrocodone
from "other/unspecific narcotic analgesics" to "narcotic analgesics." It would
also be more appropriate to replace "narcotic" with "opioid."
Fontanarosa PB, Joranson DE, Ryan KM, Gilson AM, Dahl JL. Reporting Drug Abuse in the Emergency Department—Reply. JAMA. 2000;284(5):564. doi:10.1001/jama.284.5.561