medical examiner offices. In 1999, 139 medical examiners and coroners in 41 metropolitan areas reported to DAWN. However, this component is not based on a probability sample. As a result, drug-related deaths from DAWN cannot be extrapolated to the nation as a whole or to individual metropolitan areas in which medical examiner participation is incomplete. Also, medical examiners review only a limited number of the deaths occurring in their jurisdiction, and the types of cases under medical examiner review varies across jurisdictions. There is no linkage between the medical examiner and emergency department components of DAWN.
Existing surveys of drug use collect information on frequencies of use but not on the quantity of drugs that users consume. The absence of information on drug consumption leaves a major gap in the nation’s ability to monitor the dimensions of drug problems. Data on drug consumption are essential for understanding the operation of drug markets; the dynamics of initiation, intensification, and desistance; the response of drug use to changes in prices; and the public health and economic consequences of drug use. The committee recommends that work be started to develop methods for acquiring consumption data.
The committee acknowledges that obtaining accurate consumption data may present problems that cannot be easily solved. Accurate quantity information cannot be elicited directly if drug consumers do not have quantitative knowledge of the weight and purity of the drugs bought on any given purchase occasion. The committee could not find systematic research on the subject, but discussions with the Drug Enforcement Administration staff and ethnographers suggest that drug users commonly describe the purchased material in informal terms (e.g., bags, vials, rocks, lines) that do not translate into precise measures of weight and purity.
Even if drug users cannot provide precise information on the weight and purity of their drug purchases, they may be able report valuable data related to consumption. In particular, they may be able to report their expenditures on drugs and to give informal descriptions of the quantity consumed (see the section below on drug prices).3 Whether or not consumers can or will provide accurate information about these details of drug purchases warrants investigation.
Consumers’ lack of quantitative knowledge of what they have bought is also a source of serious difficulty in acquiring data on drug prices. This is because the price is the cost of a specified quantity of a drug with a