Drug-Related Emergency Room Visits Decrease, U.S. Reports

In another sign of progress in the war on substance abuse, the number of drug-related visits to hospital emergency rooms across the country has fallen for the first time in the 1990s, federal health officials announced Tuesday.

After rising steadily through 1994, drug-caused emergency treatment declined 6% from 1995 to 1996, according to the federal government’s Drug Abuse Warning Network, a national reporting system. The data came from responses from 21 metropolitan communities, including Los Angeles and San Francisco.

The statistically significant decrease resulted mostly from a drop in cases that involved legal drugs--prescription drugs as well as over-the-counter drugs such as aspirin and ibuprofen, the government said.

But the trends most lauded Tuesday by health officials were the leveling out of cases related to heroin and cocaine use, a drop in cases involving methamphetamine and an apparent drop in the rate of increase in episodes involving marijuana and hashish use.

These findings are especially significant in light of the dramatic increases that preceded them, officials said.

“The reasons for this apparent turnaround involve everyone in America--parents, teachers, coaches, religious leaders and community coalitions,” Barry McCaffrey, the national drug policy director, said. “The media also plays a large role. . . . Everyone has been a part of effectively spreading the message that drug abuse is devastating to the user and the nation. The slight success we are seeing encourages us to continue our hard work.”

But the fact that marijuana-related episodes continued to increase, even though at a much slower rate, prompted Health and Human Services Secretary Donna Shalala to warn that “marijuana is a powerful drug with potentially serious consequences” and caution that “our work to prevent substance abuse and treat addiction is far from finished.”

McCaffrey said the decreases in drug-related emergency treatment, “though slight,” give credence to other recent surveys that indicate “the upward slope of drug abuse has indeed begun to be arrested. The numbers are an incentive to turn these slight decreases into substantial long-term reductions.”

Recently, HHS released its annual study of teenage drug use showing that use of illicit substances appears to be leveling off after rising throughout the 1990s; marijuana use among older teens, however, continued to climb upward.

The findings released Tuesday showed that the number of cocaine-related episodes, which increased 78% between 1990 and 1994, remained constant between 1994 and 1996. Heroin-related episodes, which rose 113% from 1990 to 1995, showed no change from 1995 to 1996.

Episodes of methamphetamine-related emergency room visits, after increasing 237% from 1990 to 1994, fell by 39% between 1994 and 1996. Between the first and second halves of 1996, however, such incidents increased 71%, from 4,000 to 6,800.

Officials said the drop may be the result of the short supply of so-called speed in many Western cities from mid-1995 through early 1996--the result of stepped-up efforts on the part of drug agents to crack down on meth labs--and cautioned that the number of speed-related cases could continue to climb.

While marijuana and hashish-related cases were statistically unchanged between 1995 and 1996, the rate of increase appears to be slowing, health officials said.

The kinds of drug-related episodes that result in emergency room visits typically involve overdoses, drug interactions with alcohol, accidents resulting from disorientation and impaired reflexes, and suicide attempts, officials said.

Dr. Nelba Chavez, administrator of the Substance Abuse and Mental Health Services Administration, said the survey’s information about changing patterns of drug abuse will influence how resources are spent on treatment and prevention programs so the government can be “responsive to emerging trends.”

For example, new grants from SAMHSA recently were awarded to study the treatment of marijuana-dependent youth.

Between 1994 and 1996, statistically significant decreases were seen in five cities, including Boston, Denver, New York, San Francisco and Washington, according to the report.

New Orleans and Newark, N.J., both experienced statistically significant increases. In Los Angeles and 13 other cities, the numbers remained unchanged, the report said.

Among the report’s key findings:

* In 1996, there were 487,600 drug-related emergency department episodes overall, down significantly from 1994 (518,500) and 1995 (517,800).

* There was no statistically significant change in the total number of cocaine-related cases between 1995 (138,000) and 1996 (144,200);

* Between 1995 and 1996, there were no changes in either cocaine- or heroin-related episodes by age, gender or race/ethnicity. However, between 1994 and 1996, there was a 21% increase in cocaine cases and a 20% increase in heroin cases among those aged 35 and older.