Indicator Description
Emergency department cases resulting from substance use are an indicator of the level of community harm. They are also a teachable moment in which screenings, brief interventions, and referrals can be successful and reduce the occurrence of repeated health care visits. Emergency department use contributes to the high medical costs associated with substance use.

Events that lead to emergency room visits reflect the prevalence of drug and alcohol use in a community, characteristics of the drugs being used, and practices of combining substances that may have lethal doses.

Many states have some version of the Uniform Accident and Sickness Policy Provision Law (UPPL), which gives insurance carriers the legal right to deny claims for the care of any injury sustained by an insured person who was intoxicated or under the influence of drugs at the time of the injury. These laws may serve as strong disincentives for emergency room staff to report alcohol or drug use.

What to Measure

• The annual number of emergency room cases where staff have identified alcohol or drug use as a factor.
• Express as a rate per 100,000 population.
• Report as a percentage of all emergency room cases.
• The presence of a version of the Uniform Accident and Sickness Policy Provision Law (UPPL) in your state.

Where to Find Local Data

This indicator is likely to be available in only those communities that participate in special surveillance programs:

• State Alcohol and Drug Abuse Authority: Check to see if your community participates in a surveillance program.
• Drug Abuse Warning Network (DAWN): DAWN is a public health surveillance system that monitors drug-related visits to hospital emergency departments and drug-related deaths investigated by medical examiners and coroners.

Interpretation Guidelines

Be aware of the following when interpreting emergency room cases as a measure of community substance use:

• The same person may use the emergency room for a substance use-related episode more than one time, even many times, during a year.
• This indicator is sensitive not only to the level of use, but to the types of substances available, the purity of such substances, the pattern of mixing or combining drugs in a harmful way, the mode of administration, and the number of suicide attempts.

Drug Abuse Warning Network.