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Er Visits From Illicit Substances


Every year in the United States, more than 136 million people visit an emergency room for issues ranging from the relatively benign to the potentially fatal. While the reasons for an ER visit vary considerably from person to person, there is one all-too-common factor among many of them: the influence of illicit drugs. In recent history, the number of ER cases where illicit drugs may have been a contributing factor has skyrocketed dramatically.

We analyzed historical data from 2004 to 2011 from the Substance Abuse and Mental Health Services Administration (SAMHSA) to learn more about this alarming trend.

The numbers in the cases above include both illicit and licit drug usage, providing more of a total overview of the role drugs play in ER visits. Illicit (illegal) use can include underage drinking, use of prohibited drugs, and unauthorized use of prescription drugs. Other cases involve the legal use of prescription drugs or alcohol, some of which led to adverse reactions or accidental overdoses. When these ER cases are separated into various age groups, it becomes easier to see the changes over time, and the notable growth visualized here highlights a growing problem with both illicit and prescription drug abuse or misuse.

While there are many different types of drugs that were reported over the multi-year study period, there are eight that stand out as the most significant in terms of number of occurrences. At the start of the survey period in 2004, the total number of reports from these top drugs numbered approximately 2.5 million. By 2011, the number of reports increased to nearly 4 million, spurred by the significantly higher frequency of analgesic and anxiolytic abuse.

The major spike in these drugs could be a result of multiple phenomena. First, there are countless, relatively harmless OTC analgesics such as aspirin and other NSAIDs, which are expected to be present in injury cases. These licit cases account for approximately 44% of all samples.

The remaining majority of ER visits where drugs were found are a result of abuse and misuse of drugs. Opioids, a highly addictive subset of analgesics, saw significant increases in abuse cases. Oxycodone, for example, increased 240% over the survey period. Abuse and misuse cases of codeine, methadone, and morphine all grew by large percentages as well. Benzodiazepines such as Xanax, Klonopin, and Valium were also highly abused and misused and account for a notable amount of ER cases. Long-term prescriptions for these potentially addictive and dangerous drugs are on the rise as well, especially in the older age groups, suggesting this demographic could benefit particularly well from drug abuse counseling and treatment options.

The numbers make obvious the fact that “prescription” doesn’t necessarily mean safe. Use of medication in doses or for lengths of time that exceed what’s written on the prescription can constitute substance abuse. Accordingly, this misuse of prescription medication can usher in all of the adverse consequences one would expect from any type of drug abuse – including the development of substance dependency. If you’re having trouble limiting your use of medication to prescribed parameters for painkillers, benzodiazepines or any other medicine, a prescription addiction treatment program might be the answer – call 1-888-439-3435 Who Answers? for information about your treatment program options.

Consider the numbers at the first and last year of the reports. We see that while all the total occurrences for all drugs are up over time, some varied more across the age groups than others. Cannabinoids, stimulants, and cocaine, for example, have grown rather uniformly across the age groups, while analgesics and anxiolytics have really exploded for those in their early 20s to mid-30s.

For the youngest and oldest age groups, cannabinoids and pharmaceuticals account for the biggest increase in drug reports for ER visits respectively. This perhaps hints at the increased availability of these drugs for the very young and old alike.

When it comes to strictly illicit (prohibited, underage, or without prescription) use of drugs and alcohol, some cities fare worse than others. Of the cities that we analyzed, Boston was the worst-offending city in four out of eight drug categories, with a terribly high rate of heroin abuse—and subsequently, heroin-related ER admissions—at 353% above the national average. Sadly, that trend continues through today with surging rates of heroin abuse and overdose cases throughout Massachusetts.

The other cities in the study have very little to be happy about either. In an overwhelming majority of the results, most of the cities had above average rates for most of the drugs listed. Other standout offenders include San Francisco and Miami, with 375% and 158% the national average for stimulant- and cocaine- related ER visits, respectively. These were by no means the only cities with drug abuse problems, but they are among the worst.


Detailed cataloging of the drugs found being used by ER patients has proven to be an effective way to gain some insight on the growing drug problem in the United States. The increase in occurrences across the board echoes what we see in the news. Over 52 million people in this country have abused prescription drugs, and while Americans account for only 5% of the world’s population, we consume 75% of the global supply of prescription drugs.

There’s plenty of evidence to suggest that heroin abuse is a national crisis as well. While the number of heroin abusers is markedly less than those who abuse painkillers, studies suggest that these numbers are changing. The high costs of pharmaceutical drugs are resulting in more and more people turning to heroin for a cheaper fix, and the total number of ER visits reporting either is on the rise. The nation’s drug problem is very real, and as our analysis shows, it’s worthy of great attention.

An analysis of substance-related visits to the ER helps to shine a light on ever-changing national trends in both the most commonly abused substance types and the age groups that are most impacted. It shouldn’t take much investigation, however, to realize that any drug or alcohol related trip to the ER should serve as a frightening wake-up call to all involved parties. Both prescription and illicit substance abuse pose great threat of injury to all individuals’ health and well-being, and conversely to our nation as a whole. Substance abuse treatment help needn’t always come at the hands of an ER or other emergency services. Get help by visiting, or call 1-888-439-3435 Who Answers? for more information about how drug and alcohol addiction treatment can turn your life around.


We looked at SAMHSA’s DAWN emergency department data reports (found here) to determine how many substances are sending people to the ER across America. Substances were grouped based on SAMHSA drug grouping method, which can be found here. We looked at the top eight substances and compared them to determine the change in ER visits by year and age. We focused on ages 12 and up and excluded any data under that age range. Totals may be greater than the overall number of ER visits as the drug reports data available do not take multidrug visits into account for each age range.



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