demographic and geographic groups. For example, the MTF sample cannot be used to accurately estimate prevalence rates by race or by state. The NHSDA, which has recently been redesigned to provide adequate representative subsamples for each of the 50 states, cannot reasonably be used to draw conclusions about local drug use. Many important drug control policies, however, occur within local boundaries.

These surveys may also be ineffective at describing the characteristics of illegal drug users, or at least users of more stigmatized drugs. Consider heroin. With only 63 past-year heroin users in the 1998 NHSDA survey, little can be learned about the demographic or socioeconomic characteristics of this group.

The committee recommends that methods be developed to supplement the data collected in the National Household Survey of Drug Abuse and Monitoring the Future in order to obtain adequate coverage of subpopulations with high rates of drug use. One possibility is to broaden the sampling frames of the existing surveys. MTF might be redesigned to cover teenagers rather than just students. The NHSDA might be expanded to cover institutionalized populations. Redesigning MTF and expanding the NHSDA pose challenging tasks, but the committee does not see insurmountable scientific problems given sufficient will and resources. Another possibility is to combine data from the NHSDA and MTF with other sources of information. In the next section, we discuss some of the data sources that could be linked.

What the ADAM and DAWN Can and Cannot Reveal About Drug Use

ADAM and DAWN are samples of particular events in the United States. These surveys can be used to draw inferences about the population of users identified through these events. ADAM is designed to provide estimates of the frequency and characteristics of arrests in which the arrested person has used drugs. DAWN can be used to estimate the number of person-visits to emergency departments for problems related to illegal drugs. Tracking drug use through arrest and emergency department events could serve to detect emerging problems in high-risk populations. ADAM and DAWN could also be used to evaluate the burden placed on the criminal justice system and hospitals by drug-related episodes. It remains the case, however, that ADAM and DAWN provide information on events, rather than people. These data cannot be used to infer drug use in general populations.6


As noted by the Substance Abuse and Mental Health Administration with regard to DAWN, “The survey is designed to capture data on [emergency department] episodes that

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