Drug and Alcohol Emergency Room Visits Disappeared in 2010

Based on Substance Abuse and Mental Health Services Administration (SAMHSA)’s Drug Abuse Warning Network (DAWN) data, emergency room visits for substance abuse, particularly opioids, had been growing substantially throughout the early 2000s as prescription narcotics like Hydrocodone and Oxycodone were being prescribed in wide numbers.

SAMHSA suspended the DAWN survey in 2011, so there is no data available for the years 2012-2020 and so there was little data about how the emergency room visits for prescription narcotics transformed into the more recent epidemic related to the potent narcotic fentanyl.

But the Centers for Disease Control (CDC)’s National Hospital Ambulatory Medical Care Survey (NAMCS) gives a glimpse into emergency room care at the time, and it shows an odd and stark drop in 2010 related to drug and alcohol abuse as if millions of people suddenly stopped overdosing.

What was around 2 million people visiting the emergency room a year related to drugs and alcohol became 130,000 to 200,000 in a matter of a year. By percentage of all injury-related visits, it went from 4.5 percent to half a percent.

While the DAWN and NAMCS surveys have different methodologies and different categories—NAMCS didn’t separate out alcohol from drug abuse until 2015—they should ostensibly have some similarities. There’s no other apparent major changes in other non-opioid drug or alcohol abuse that might account for such a drop.

Less Usage, More Overdoses

A previous Investigative Economics story highlighted the discrepancy between opioid prescriptions, which are declining, and opioid deaths and overdoses, which haven’t substantially changed.

Additionally, SAMHSA’s National Survey on Drug Use and Health shows a steady decline in opioid use since 2015 for those 12 and older.

With fewer and fewer prescriptions and less opioid use, ostensibly that should lead to fewer overdoses, even with the prevalence of fentanyl, which can have dosage amounts 50 to 100 times more potent than heroin.

The NAMCS data supports the trends in the prescribing and drug use data—declining availability, usage, and overdoses for prescription opioids.

Prescription Rate vs. Overdose Rate

If overdose rates did drop off in the 2011-2015 period before fentanyl became popular, that would contradict statements by groups like the National Center for Drug Abuse Statistics that support alternative approaches to dealing with the opioid epidemic:

“Opioid prescriptions does not appear to have a direct effect on the number of prescription overdoses.”

And the and the American Medical Association (AMA):

“Reductions in opioid prescribing have not led to reductions in drug-related mortality.”