Drug Abuse Warning Network (DAWN), 2011

The Drug Abuse Warning Network (DAWN) is a nationally representative public health surveillance system that has monitored drug related emergency department (ED) visits to hospitals since the early 1970s. First administered by the Drug Enforcement Administration (DEA) and the National Institute on Drug Abuse (NIDA), the responsibility for DAWN now rests with the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Behavioral Health Statistics and Quality (CBHSQ). Over the years, the exact survey methodology has been adjusted to improve the quality, reliability, and generalizability of the information produced by DAWN. The current approach was first fully implemented in the 2004 data collection year.
DAWN relies on a longitudinal probability sample of hospitals located throughout the United States. To be eligible for selection into the DAWN sample, a hospital must be a non-Federal, short-stay, general surgical and medical hospital located in the United States, with at least one 24-hour ED. DAWN cases are identified by the systematic review of ED medical records in participating hospitals. The unit of analysis is any ED visit involving recent drug use. DAWN captures both ED visits that are directly caused by drugs and those in which drugs are a contributing factor but not the direct cause of the ED visit. The reason a patient used a drug is not part of the criteria for considering a visit to be drug-related. Therefore, all types of drug-related events are included: drug misuse or abuse, accidental drug ingestion, drug-related suicide attempts, malicious drug poisonings, and adverse reactions. DAWN does not report medications that are unrelated to the visit.
The DAWN public-use dataset provides information for all types of drugs, including illegal drugs, prescription drugs, over-the-counter medications, dietary supplements, anesthetic gases, substances that have psychoactive effects when inhaled, alcohol when used in combination with other drugs (all ages), and alcohol alone (only for patients aged 20 or younger). Public-use dataset variables describe and categorize up to 22 drugs contributing to the ED visit, including toxicology confirmation and route of administration. Administrative variables specify the type of case, case disposition, categorized episode time of day, and quarter of year. Metropolitan area is included for represented metropolitan areas. Created variables include the number of unique drugs reported and case-level indicators for alcohol, non-alcohol illicit substances, any pharmaceutical, non-medical use of pharmaceuticals, and all misuse and abuse of drugs. Demographic items include age category, sex, and race/ethnicity. Complex sample design and weighting variables are included to calculate various estimates of drug-related ED visits for the Nation as a whole, as well as for specific metropolitan areas, from the ED visits classified as DAWN cases in the selected hospitals.

药物滥用预警网络（Drug Abuse Warning Network, DAWN）是一套具有全国代表性的公共卫生监测系统，自20世纪70年代初起，便持续监测与药物相关的医院急诊科（emergency department, ED）就诊情况。该系统最初由美国缉毒局（Drug Enforcement Administration, DEA）与美国国家药物滥用研究所（National Institute on Drug Abuse, NIDA）负责管理运营，如今其管理职责已移交至物质滥用与精神健康服务管理局（Substance Abuse and Mental Health Services Administration, SAMHSA）下属的行为健康统计与质量中心（Center for Behavioral Health Statistics and Quality, CBHSQ）。多年来，为提升DAWN产出数据的质量、可靠性与可推广性，其具体调查方法历经多次优化调整。现行调查方案于2004年数据采集年度首次全面推行。

DAWN采用覆盖全美医疗机构的纵向概率抽样框架。符合入选条件的医院需满足：为美国境内的非联邦所有、提供短期住院服务的综合内外全科医院，且至少设有一处24小时运行的急诊科。DAWN的病例通过对参与医院的急诊科医疗记录开展系统审查进行识别。其分析单元为所有涉及近期药物使用的急诊科就诊病例。DAWN既涵盖直接由药物引发的急诊科就诊，也纳入药物虽为诱因但并非直接致病原因的就诊场景。患者用药动机并非判定就诊是否与药物相关的依据，因此所有类型的药物相关事件均被纳入统计范畴，包括药物误用或滥用、意外服药、药物相关自杀未遂、恶意药物投毒以及药物不良反应。DAWN不会统计与本次就诊无关的药物使用记录。

DAWN的公共使用数据集涵盖各类药物相关信息，包括非法药物、处方药、非处方药、膳食补充剂、麻醉气体、吸入型精神活性物质、与其他药物联用的酒精（覆盖所有年龄段），以及仅针对20岁及以下患者的单纯酒精使用情况。公共使用数据集的变量可对最多22种导致急诊科就诊的药物进行描述与分类，包括毒理学检测结果与给药途径。管理类变量涵盖病例类型、病例处置转归、按时段划分的就诊时段分类以及就诊季度。对于有代表性的都会区域，数据中会标注其所属都会区。衍生变量包括报告的独特药物数量，以及针对酒精、非酒精非法物质、任何处方药、非医疗目的使用处方药以及所有药物误用与滥用的病例级标识。人口统计学变量包括年龄分组、性别以及种族/族裔。数据集同时包含复杂抽样设计与加权变量，可基于入选医院中被归类为DAWN病例的急诊科就诊数据，计算全美及特定都会区域的各类药物相关急诊科就诊估计值。

搜集汇总

背景与挑战

背景概述

Drug Abuse Warning Network (DAWN), 2011数据集是一个全国性的公共卫生监测系统，记录了2011年美国药物滥用相关的急诊部门访问情况。数据集涵盖多种药物类型和详细的人口统计信息，采用复杂抽样设计以提供全国范围的估算。