Maryland Jurisdiction Epidemiological Profiles Chartbook



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Jurisdiction Epidemiological Profiles Chartbook February 13, 2014 The Statewide Epidemiological Outcomes Workgroup Department of Pharmaceutical Health Services Research University of Baltimore School of Pharmacy Saratoga Building, 12 th Floor 220 Arch Street Baltimore, 21201 www.pharmacy.umaryland.edu/programs/seow

CONTRIBUTORS This report was compiled by the following faculty, staff, and students of the Department of Pharmaceutical Health Services Research in the University of School of Pharmacy: Linda Simoni-Wastila, BSPharm, PhD Professor and Director, SEOW 410.706.4352 lsimoniw@rx.umaryland.edu Corinne Woods, BSPharm, MPH Research Pharmacist, Pharmaceutical Research Computing SEOW Project Coordinator Wendy Klein-Schwartz, PharmD Associate Professor, Poison Center Patience Moyo, BA, PhD Student Graduate Research Assistant Yu-Jung Jenny Wei, PhD Post-Doctoral Fellow Ting-Ying Jane Huang, BSPharm, PhD Candidate Graduate Research Assistant Jeanne Yang, MCP Information Systems Engineer, Pharmaceutical Research Computing Katherine Fornili, MPH, RN, CARN Assistant Professor, UMB School of Nursing ACKNOWLEDGMENTS We thank Kathleen Rebbert-Franklin, Sue Jenkins, Larry Dawson, and Virgil Boysaw and the other staff at the Alcohol and Drug Abuse Administration (ADAA) in the Department of Health and Mental Hygiene for their support and guidance on this report.

Table of Contents Data Sources & Considerations for Use... 1 JURISDICTION RANKINGS Alcohol-Related Inpatient Hospitalizations... 5 Alcohol-Related Emergency Department Visits... 6 Opioid-Related Inpatient Hospitalizations... 7 Opioid-Related Emergency Department Visits... 8 Treatment Admissions... 9 Alcohol... 9 Marijuana... 10 Prescription Opioids... 11 Benzodiazepines... 12 Heroin... 13 Crack/Cocaine... 14 Co-Occurring Mental Illness... 15 Co-Occurring Mental Illness by County of Patient Residence... 16 Co-Occurring Mental Illness by County Where the Treatment Facility is Located... 17 Alcohol-Impaired Crashes... 18 All Ages... 18 Aged 16-25 Years... 19 Marijuana Use... 20 Past-Month Use... 20 Perceptions of Risk of Smoking Marijuana... 21 Cocaine, Past-Year Use... 22 Pain Reliever, Past-Year Non-Medical Use... 23 Illicit Drug Use... 24 Past-Month Use of Illicit Drugs Other than Marijuana... 24 Past-Year Needing but Not Receiving Treatment... 25 Alcohol Use... 26

Past-Month Use... 26 Past-Month Binge Drinking... 27 Past-Year Needing but Not Receiving Treatment vs Abuse or Dependence... 28 JURISDICTION FINDINGS (Jurisdiction listed in alphabetical order; Baltimore City the last.) Alcohol-Related Inpatient Hospitalizations and Emergency Department Visits... 30 Opioid-Related Inpatient Hospitalizations and Emergency Department Visits... 54 Substance Use Treatment Admissions... 78 Motor Vehicle Crashes among Residents Aged 16-25 Years... 103

Data Sources & Considerations for Use Data Organization: Rankings of jurisdictions on their standing on select indicators are presented first followed by jurisdictions sorted alphabetically (Baltimore City at the end) under specific data sources. Health Services Cost Review Commission (HSCRC): In, the HSCRC an independent agency is charged with regulating hospital rates for all payers and is responsible for maintaining both the inpatient and outpatient facility data sets. The inpatient dataset contains discharge medical record abstracts and billing data on each of the state's approximately 800,000 yearly inpatient admissions. Hospitals submit data to the HSCRC on a quarterly basis and the agency generates research-ready datasets for public use. Access to the research level version of the inpatient or outpatient data requires the submission of an application to the HSCRC. Data is available through 2012. http://www.hscrc.state.md.us/ Important considerations regarding HSCRC data: 1. The county indicated in the charts refers to the location of the patient s place of residence and may not be the jurisdiction in which the hospital providing service is situated. 2. The data are available at the event level rather than individual level. This means that one individual can contribute multiple observations in the data. Automated Accident Reporting System (MAARS): The MAARS data is comprised of information extracted from motor vehicle accident reports submitted by over 200 law enforcement agencies. The purpose is to provide safety professionals, public officials, the private sector, and the general public information about traffic crashes throughout. It presents data extracted from motor vehicle crash reports submitted by more than 200 law enforcement agencies to the Enhanced Automated Accident Reporting System (MAARS). All crashes resulting in a vehicle being towed away, personal injury, or fatality are reported. Crash data are recorded by the state, county, or local law enforcement officer at the scene of the reportable crash. The Central Records Division of the State Police manages MAARS and provides copies of the reports to the public for a fee. The SHA maintains the electronic crash database, and is the primary contact for distribution of raw crash data. MHSO provides summary statistics based on reports generated from SHA s database. MAARS data through 2011 was used for this report. Important considerations regarding MAARS data: 1

1. Impaired crashes are those with at least one driver reported to be under the influence of either 'alcohol' or both 'alcohol and drugs'. 2. Crashes with unknown/unspecified age or gender were excluded, as well as those involving drugs only. National Survey on Drug Use and Health (NSDUH): The NSDUH provides national- and statelevel data on mental health as well as the use of tobacco, alcohol and illicit drugs (including non-medical use of prescription drugs) in the United States. NSDUH is sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), an agency of the U.S. Public Health Service within the U.S. Department of Health and Human Services. A random sample of households is selected across the United States, and a professional field interviewer makes a personal visit to each selected household. After answering a few general questions during the in-person visit by the interviewer, residents of the household may be asked to participate. Participants answer most of the interview questions in private by entering their responses directly into a computer. The survey is conducted annually, with state-level data available from 1999-2011, substate-level data available every 2 years from 1999-2010 and national data available 1999-2011. http://www.samhsa.gov/data/nsduh.aspx Important considerations regarding NSDUH data: With the exception of six jurisdictions (Anne Arundel County, Baltimore City, Baltimore County, Charles County, Montgomery County and Queen Anne s County), NSUDH results are reported as aggregate data with several jurisdiction grouped into substate regions. The substate regions are as follows: North Central is comprised of Carroll County and Howard County; North East is comprised Caroline County, Cecil County, Harford County, Kent County, Queen Anne s County and Talbot County; South is comprised of Calvert County, Charles County, Dorchester County, St. Mary s County, Somerset County, Wicomico County and Worcester County; West is comprised of Allegany County, Frederick County, Garrett County and Washington County. State of Automated Record Tracking (SMART): SMART data include treatment admissions from all substance use disorder treatment facilities that receive state alcohol and/or drug agency funds (including Federal Block Grant funds) for the provision of treatment for substance use disorders. SMART does not include data from private or for-profit treatment facilities, hospitals, the state correctional system (unless licensed through the state substance use disorders agency) or federal agencies (the Bureau of Prisons, the Department of Defense, and the Veterans Administration). Data elements in SMART include: reason for admission, 2

primary and secondary substances of use, sociodemographic information, the presence or absence of mental illness and treatment modality. Data are current through 2012. http://adaa.dhmh.maryland.gov/sitepages/smart.aspx Important considerations regarding SMART data: 1. The data are based on fiscal year and not calendar year. 2. The county indicated in the charts refers to the location of the patient s place of residence and may not be the jurisdiction in which the treatment facility is situated. 3. The data are available at the event level rather than individual level. This means that one individual can contribute multiple observations in the data. 4. The charts show the estimated rate of admissions for a specific primary substance problem per 1000 residents in each jurisdiction. 3

JURISDICTION RANKINGS 4

Alcohol-Related Inpatient Hospitalizations Data Source: Health Services Cost Review Commission (HSCRC) Rate of Alcohol-Related Hospitalizations in 2012 per 1000 Events Baltimore City Allegany Cecil Frederick Kent Dorchester Worcester Baltimore County Calvert Harford Queen Anne's Talbot Anne Arundel Prince George's Washington Carroll Wicomico Charles Caroline Montgomery St Mary's Somerset Garrett Howard 59.8 58.9 55.9 54.8 52.7 52.3 48.6 48.3 47.1 46.7 46.6 46.3 45.9 44.9 44.6 4 42.1 4 4 40.7 36.9 35.9 33.8 64.3 90.9 5

Alcohol-Related Emergency Department Visits Data Source: Health Services Cost Review Commission (HSCRC) Rate of Alcohol-Related Emergency Department Visits in 2012 per 1000 Events Baltimore City St Mary's Charles Kent Queen Anne's Calvert Allegany Talbot Anne Arundel Frederick Baltimore County Worcester Dorchester Washington Howard Caroline Montgomery Prince George's Wicomico Carroll Somerset Harford Cecil Garrett 29.7 28.5 27.7 26.5 25.4 24.8 24.3 2 22.2 19.9 19.1 18.3 17.8 16.4 16.4 15.4 34.7 44.8 48.8 47.7 54.8 56.6 81.3 93.8 6

Opioid-Related Inpatient Hospitalizations Data Source: Health Services Cost Review Commission (HSCRC) Rate of Opioid-Related Hospitalizations in 2012 per 1000 Events Baltimore City Cecil Frederick Baltimore County Carroll Allegany Anne Arundel Harford Queen Anne's Washington Caroline Kent Dorchester Wicomico Talbot Somerset Calvert Howard St Mary's Garrett Worcester Charles Montgomery Prince George's 35.6 35.1 34.8 32.3 31.9 27.9 27.6 2 23.6 23.4 22.4 2 20.1 19.6 19.2 18.8 17.4 16.1 13.2 12.8 12.6 10.4 8.7 51.2 88.4 7

Opioid-Related Emergency Department Visits Data Source: Health Services Cost Review Commission (HSCRC) Rate of Opioid-Related Emergency Department Visits in 2012 per 1000 Events Washington Baltimore City Frederick Caroline Baltimore County Calvert Cecil Carroll Worcester Harford Dorchester St Mary's Howard Somerset Talbot Wicomico Anne Arundel Queen Anne's Charles Montgomery Prince George's Allegany Kent Garrett 1.9 1.5 1.2 3.5 8.9 8.6 8.5 8.1 7.4 7.1 6.9 6.8 6.6 5.7 13.9 14.5 15.9 16.5 19.0 21.3 23.8 31.3 8

Treatment Admissions Data Source: State of Automated Records Tracking (SMART) Alcohol Alcohol (Primary Substance) Treatment Admissions in FY2012 per 1000 Population Dorchester Worcester Calvert Garrett Queen Anne's Kent Caroline Talbot St Mary's Cecil Wicomico Somerset Baltimore City Allegany Washington Charles Anne Arundel Overall Carroll Frederick Harford Howard Baltimore County Montgomery Prince George's 0.87 0.71 2.22 2.14 1.85 1.69 1.42 1.31 3.17 2 2.71 3.62 4.47 4.44 4.36 4.36 4 0 5.23 5.59 5.92 7.11 6.96 6.82 6.81 9

Marijuana Marijuana (Primary Substance) Treatment Admissions in FY2012 per 1000 Population Dorchester Wicomico Somerset Baltimore City Kent Calvert Worcester Caroline Talbot Queen Anne's Allegany St Mary's Washington Charles Cecil Garrett Overall Anne Arundel Baltimore County Harford Frederick Prince George's Howard Carroll Montgomery 2.67 2.49 2.28 2.22 1.99 1.92 1.83 1.69 1.66 1.53 1.42 1.38 9 0.95 0.85 0.72 5 2.99 4.44 4.23 3.96 3.71 3.48 3.40 6.10 10

Prescription Opioids Opioids (Primary Substance) Treatment Admissions in FY2012 per 1000 Population Calvert Cecil Caroline Kent Somerset Queen Anne's Garrett Wicomico Worcester St Mary's Dorchester Allegany Charles Harford Anne Arundel Baltimore City Washington Talbot Overall Frederick Carroll Baltimore County Howard Montgomery Prince George's 0.22 0.22 7 1.37 1.21 2 3 0.98 0.95 0.85 0.65 4 0.49 1.64 5 2.72 2.62 2.57 2.53 2.53 2.52 2.49 2.40 4.32 4.23 11

Benzodiazepines Benzodiazepines (Primary Substance) Treatment Admissions in FY2012 per 1000 Population Baltimore City Dorchester Queen Anne's Calvert Cecil Garrett Talbot Wicomico Allegany Anne Arundel Carroll Overall Washington St Mary's Somerset Harford Charles Caroline Baltimore County Worcester Montgomery Frederick Howard Prince George's Kent 07 00 24 97 96 84 81 76 76 69 68 60 60 58 56 47 0.133 0.132 0.132 0.120 0.158 0.188 0.180 0.256 0.245 12

Heroin Heroin (Primary Substance) Treatment Admissions in FY2012 per 1000 Population Baltimore City Queen Anne's Dorchester Caroline Cecil Wicomico Worcester Overall Talbot Anne Arundel Carroll Calvert Somerset Allegany Garrett Baltimore County Frederick Harford Washington Kent St Mary's Howard Charles Montgomery Prince George's 2.55 2.21 2.15 2.10 1.93 1.87 1.80 1.61 1.61 1.44 1.40 1.32 6 6 1 0 0.89 0.83 0.79 0.73 0.44 0.42 0.26 0.13 9.90 13

Crack/Cocaine Crack/Cocaine (Primary Substance) Treatment Admissions in FY2012 per 1000 Population Dorchester Baltimore City Kent Somerset Wicomico Worcester Calvert Queen Anne's Talbot St Mary's Cecil Overall Washington Allegany Frederick Caroline Carroll Anne Arundel Charles Harford Baltimore County Prince George's Montgomery Garrett Howard 0.84 0.82 0.72 0.72 0.71 0.69 7 4 2 1 0.42 0.29 0.29 0.26 0.23 0.18 6 1 3 1.49 1.36 1.74 8 2.77 4 14

Co-Occurring Mental Illness Substance Use Treatment Admissions & Co-Occurring Mental Illness FY2012 % of Cases with Co-Occurring Mental Illness 0 10 20 30 40 50 60 70 Allegany Frederick Montgomery Carroll Washington Cecil Howard Calvert Queen Anne's Harford MARYLAND Wicomico Somerset Patient Residence Provider Jurisdiction Baltimore City Talbot Anne Arundel Dorchester Prince George's Worcester Garrett Kent Baltimore County Caroline St. Mary's Charles 15

Co-Occurring Mental Illness by County of Patient Residence Percent of Co-Occurring Mental Illness Among Cases of Patients Residing in Each Jurisdiction FY2012 Allegany Frederick Montgomery Carroll Washington Cecil Howard Calvert Queen Anne's Harford Wicomico Somerset Baltimore City Talbot Anne Arundel Dorchester Prince George's Worcester Garrett Kent Baltimore County Caroline St. Mary's Charles 32.9 44.3 44.1 43.7 43.3 42.8 42.7 42.6 40.7 4 39.6 39.5 39.4 38.4 36.0 57.5 56.3 54.5 53.3 50.9 49.4 47.8 47.7 47.6 47.5 16

Co-Occurring Mental Illness by County Where the Treatment Facility is Located Percent of Co-Occurring Mental Illness Among Cases of Patients Treated in Each Jurisdiction FY2012 Dorchester Carroll Allegany Kent Montgomery Worcester Washington Frederick Howard Queen Anne's Cecil Calvert Harford Baltimore City St. Mary's Prince George's Anne Arundel Wicomico Talbot Garrett Somerset Charles Baltimore County Caroline 28.0 26.9 55.2 55.1 52.8 51.4 49.4 46.8 44.8 44.3 44.2 43.7 43.7 42.8 4 39.7 38.9 37.1 36.9 35.7 33.9 32.2 60.8 66.5 64.6 17

Alcohol-Impaired Crashes Data Source: Automated Accident Reporting System (MAARS) Impaired crashes are those with at least one driver reported to be under the influence of either 'alcohol' or both 'alcohol and drugs'. All Ages Alcohol or Alcohol and Drug Impaired Crashes as a Percentage of All Motor Vehicle Crashes - All Ages (MAARS 2011) Somerset Kent Caroline Worcester Dorchester Garrett Queen Anne's Carroll Cecil Allegany St. Mary's Frederick Charles Calvert Harford Anne Arundel Washington Talbot Prince George's Howard Baltimore Wicomico Montgomery Baltimore City 2.62 6.68 6.50 6.02 5.80 5.52 5.36 5.12 5.12 5.12 9 4.74 4.62 4.58 4.41 8 3.88 7.56 7.55 7.30 8.20 9.91 9.73 9.39 8.95 18

Aged 16-25 Years Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds (MAARS 2011) Kent Carroll Caroline Worcester Garrett Queen Anne's Allegany Dorchester Cecil Frederick Somerset Saint Mary's Howard Anne Arundel Harford Talbot Charles Montgomery Calvert Prince George's Washington Wicomico Baltimore Baltimore City 2.84 5.95 5.75 5.71 5.68 5.53 5.49 5.42 5.23 0 4.98 8.45 8.01 7.87 7.77 7.66 7.15 6.64 9.24 9.22 9.55 13 13 11 10 19

Marijuana Use Data source: National Survey on Drug Use and Health (NSDUH) Past-Month Use 2008-2010 NSDUH: Marijuana Use in Past Month, by Age Group Anne Arundel 5.5 6.6 Baltimore City 6.1 7.4 Baltimore County 6.4 7.6 Montgomery 4.6 6.6 North Central North East Prince George's 5.1 5.9 6.1 6.6 7.0 7.6 12+ 12-17 South 5.1 6.2 West 6.2 5.7 6.8 0 2 4 6 8 10 % Reporting Use 20

Perceptions of Risk of Smoking Marijuana Perceptions of Great Risk of Smoking Marijuana Once a Month vs Marijuna Use, Aged 12+ Years Anne Arundel 5.5 9.4 30.8 Baltimore City 7.4 13.2 41.4 Baltimore County 6.4 11.4 31.5 Montgomery North Central 4.6 5.1 8.5 9.2 29.1 32.4 Perceptions of Great Risk of Smoking Marijuana Once a Month 12+ Marijuana Use in Past Month 12+ North East 5.9 9.6 30.3 Marijuana Use in Past Year 12+ Prince George's 6.1 11.9 37.1 South 5.1 9.4 35.7 West 8.5 33.5 5.7 10.3 33.8 0 5 10 15 20 25 30 35 40 45 % Reporting 21

Cocaine, Past-Year Use Data source: National Survey on Drug Use and Health (NSDUH) 2008-2010 NSDUH: Cocaine Use in Past Year, by Age Group Anne Arundel 1.8 5.5 Baltimore City Baltimore County Montgomery 1.3 1.6 2.2 2.8 3.9 3.8 12+ 18 to 25 North Central 1.5 North East 1.7 5.6 Prince George's 1.6 2.7 South 4.7 West 1.7 5.2 1.7 4.1 1 2 3 4 5 6 7 % Reporting Use 22

Pain Reliever, Past-Year Non-Medical Use Data source: National Survey on Drug Use and Health (NSDUH) 2008-2010 NSDUH: Nonmedical Use of Pain Relievers in Past Year, by Age Group Anne Arundel 4.1 6.2 11.3 Baltimore City 5.2 8.2 Baltimore County Montgomery 3.3 4.4 4.2 5.9 9.5 10.8 12+ 12 to 17 18 to 25 North Central 4.1 5.3 1 North East 4.7 7.0 12.1 Prince George's 3.5 4.6 7.9 South West 4.5 4.4 6.1 6.5 1 11.6 5.4 1 0 2 4 6 8 10 12 14 % Reporting Use 23

Illicit Drug Use Data source: National Survey on Drug Use and Health (NSDUH) Past-Month Use of Illicit Drugs Other than Marijuana 2008-2010 NSDUH: Illicit Drug Use Other Than Marijuana in Past Month, by Age Group Anne Arundel 2.8 7.2 Baltimore City Baltimore County 3.1 3.5 3.9 4.5 5.6 6.8 12+ 12 to 17 18 to 25 Montgomery 2.7 4.1 6.3 North Central 3.1 3.9 7.1 North East 3.3 4.2 7.8 Prince George's South 2.7 3.4 3.7 4.2 5.2 6.8 West 3.3 4.2 7.6 3.1 4.1 6.5 0 1 2 3 4 5 6 7 8 % Reporting Use 24

Past-Year Needing but Not Receiving Treatment Needing But Not Receiving Treatment for Illicit Drug Use in Past Year vs Illicit Drug Dependence or Abuse, Aged 12+ Years Anne Arundel 2.5 2.9 Baltimore City 3.2 3.3 Baltimore County 2.5 2.9 Montgomery North Central North East 2.1 2.1 2.3 2.5 2.5 2.6 Needing But Not Receiving Treatment for Illicit Drug Use in Past Year Illicit Drug Dependence or Abuse in Past Year Prince George's 2.6 South 2.6 2.8 West 2.3 2.7 2.5 2.8 0 1 2 3 4 % Reporting 25

Alcohol Use Data source: National Survey on Drug Use and Health (NSDUH) Past-Month Use 2008-2010 NSDUH: Past-Month Alcohol Use, by Age Group Anne Arundel 29.3 59.2 Baltimore City 24.6 42.5 Baltimore County 27.9 53.2 12+ Montgomery 22.5 55.7 12 to 20 North Central 27.1 60.7 North East 26.5 55.3 Prince George's 23.9 49.6 South 26.6 50.7 West 28.6 53.9 25.9 5 0 10 20 30 40 50 60 70 % Reporting Use 26

Past-Month Binge Drinking 2008-2010 NSDUH: Past-Month Binge Drinking, by Age Group Anne Arundel 19.7 23.4 Baltimore City 13.8 20.9 Baltimore County Montgomery 15.2 17.5 20.6 20.4 12+ 12 to 20 North Central 17.9 21.4 North East 16.8 20.6 Prince George's 14.3 19.0 South 16.9 21.4 West 17.9 21.7 16.3 20.9 0 5 10 15 20 25 % Reporting Use 27

Past-Year Needing but Not Receiving Treatment vs Abuse or Dependence Needing But Not Receiving Treatment for Alcohol Use in Past Year vs Past-Year Alcohol Dependence or Abuse, Aged 12+ Years Anne Arundel 6.5 6.8 Baltimore City 6.3 6.9 Baltimore County 6.0 6.4 Montgomery 5.3 5.6 Need for alcohol treatment (but not receiving) North Central 5.9 6.2 Past-year alcohol abuse/dependence North East 6.1 6.6 Prince George's 6.1 6.3 South 6.2 6.7 West 6.1 6.5 6.0 6.4 0 1 2 3 4 5 6 7 8 % Reporting 28

JURISDICTION TRENDS 29

Alcohol-Related Inpatient Hospitalizations and Emergency Department Visits Data Source: Health Services Cost Review Commission (HSCRC) Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Allegany 7.0 6.0 5.4 6.2 5.3 5.9 5.4 6.5 5.5 6.4 4.5 2.5 0.8 0.8 1.2 0.8 1.3 0.7 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 30

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Anne Arundel 6.0 5.3 5.4 4.8 5.5 4.6 4.1 4.1 4.1 2.5 1.2 1.2 1.2 1.4 1.3 1.4 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 31

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Baltimore County 6.0 4.2 4.1 5.3 4.5 5.4 4.7 5.5 4.9 2.5 2.8 1.2 1.3 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 32

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Calvert 6.0 4.6 3.9 5.3 4.6 5.4 4.4 5.5 4.8 4.8 2.5 0.8 0.9 1.2 1.2 1.3 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 33

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Caroline 6.0 4.3 3.8 5.3 4.5 5.4 4.2 5.5 4.2 2.5 2.2 0.8 0.9 1.2 0.7 1.3 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 34

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Carroll 6.0 5.3 4.6 5.4 4.8 5.5 4.5 3.7 3.8 2.5 1.2 1.2 1.4 1.3 1.6 1.8 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 35

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Cecil 7.0 6.0 5.8 4.9 5.3 5.6 5.4 5.8 5.5 6.0 2.5 1.4 1.2 1.4 1.3 1.8 1.5 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 36

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Charles 6.0 3.7 3.5 5.3 3.9 5.4 4.3 5.5 4.2 5.7 2.5 0.8 1.4 1.2 1.5 1.3 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 37

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Dorchester 6.0 4.4 4.9 5.3 5.1 5.4 5.5 5.3 2.5 2.5 0.8 1.2 1.3 1.3 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 38

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Frederick 7.0 6.0 4.8 4.6 5.3 5.4 5.4 6.0 5.5 5.9 2.5 2.9 0.9 0.9 1.2 1.3 1.2 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 39

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Garrett 6.0 5.3 5.4 5.5 4.1 3.6 3.5 3.6 2.5 1.2 1.3 0.4 0.3 0.3 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 40

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Harford 6.0 4.2 4.2 5.3 4.5 5.4 4.3 5.5 4.7 2.5 1.2 1.2 1.2 1.4 1.3 1.4 1.6 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 41

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Howard 6.0 5.3 5.4 5.5 3.4 3.2 3.3 3.1 3.4 2.5 2.3 0.9 0.9 1.2 1.3 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 42

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Kent 6.0 3.4 3.8 5.3 4.2 5.4 4.4 5.5 5.6 5.5 2.5 0.8 0.6 1.2 0.7 1.3 0.9 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 43

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Montgomery 6.0 5.3 5.4 5.5 3.4 3.5 3.5 3.6 4.1 0.8 0.9 1.2 0.9 1.3 0.9 2.5 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 44

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Prince George's 6.0 4.3 4.3 5.3 4.9 5.4 4.6 5.5 4.6 2.5 0.6 0.6 1.2 0.8 1.3 0.8 1.9 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 45

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Queen Anne's 6.0 5.3 5.4 5.5 4.7 4.9 3.2 3.5 3.9 4.1 2.5 1.2 1.2 1.3 0.7 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 46

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events St Mary's 9.0 8.0 8.1 7.0 6.0 3.7 3.6 5.3 4.7 5.4 5.5 4.1 2.5 0.8 1.2 1.3 1.3 1.5 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 47

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Somerset 6.0 5.3 5.4 5.5 3.3 3.5 3.5 3.7 2.7 2.5 0.8 1.2 0.9 1.3 0.8 1.6 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 48

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Talbot 6.0 4.1 4.8 5.3 4.6 5.4 4.7 5.5 4.7 3.5 2.5 1.3 1.2 1.3 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 49

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Washington 6.0 4.6 5.3 5.3 4.8 5.4 5.5 4.5 2.1 1.5 1.2 1.6 1.3 1.6 2.5 2.4 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 50

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Wicomico 6.0 3.9 5.3 3.7 5.4 3.8 5.5 4.4 3.1 2.5 1.2 1.2 1.2 1.5 1.3 1.5 1.8 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 51

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Worcester 6.0 4.6 4.9 5.3 5.6 5.4 5.1 5.5 5.2 2.5 2.6 0.9 0.9 1.2 1.3 1.4 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 52

Rate of Alcohol-related Inpatient Hospitalizations and ED Visits per 100 Events Baltimore City 1 9.0 8.6 8.9 9.0 9.2 9.1 9.4 8.0 7.0 6.0 5.3 5.4 5.5 1.3 1.5 1.2 1.5 1.3 1.8 2.5 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 53

Opioid-Related Inpatient Hospitalizations and Emergency Department Visits Data Source: Health Services Cost Review Commission (HSCRC) Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Allegany 3.5 3.2 3.3 3.4 3.4 3.6 3.2 2.5 2.6 2.7 1.5 1.5 1.6 0.9 0.4 0.7 0.6 0.4 0.2 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 54

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Anne Arundel 3.5 3.2 3.3 3.4 3.4 3.6 2.5 2.3 2.5 2.7 2.8 2.8 1.5 0.6 0.8 0.8 0.6 0.7 0.6 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 55

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Baltimore County 3.5 3.2 3.3 3.2 3.4 3.3 3.4 3.2 3.6 3.5 2.5 1.6 1.5 0.6 0.7 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 56

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Calvert 3.5 3.2 3.3 3.4 3.4 3.6 2.5 1.5 0.9 0.7 0.9 0.7 1.7 0.6 0.9 1.9 0.7 1.6 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 57

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Caroline 3.5 3.2 3.3 3.4 3.4 3.6 2.5 2.3 1.9 1.8 1.9 1.5 0.9 0.4 0.2 0.6 1.4 0.7 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 58

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Carroll 3.5 3.2 3.3 3.4 3.1 3.4 3.3 3.6 3.2 2.5 2.3 2.3 1.5 1.6 1.4 0.6 0.9 0.6 0.7 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 59

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Cecil 6.0 4.5 4.2 5.1 3.2 3.3 3.3 3.5 3.4 3.4 3.6 0.6 0.6 0.9 0.6 1.2 0.7 1.4 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 60

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Charles 3.5 3.2 3.3 3.4 3.4 3.6 2.5 1.5 1.2 1.3 0.8 0.9 0.6 0.7 0.6 0.4 0.2 0.3 0.3 0.2 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 61

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Dorchester 3.5 3.2 3.3 3.4 3.4 3.6 2.5 1.5 2.1 1.9 1.4 1.5 1.2 0.9 0.8 0.7 0.6 0.3 0.2 0.2 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 62

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Frederick 3.5 3.2 3.3 3.4 3.4 3.6 3.5 2.9 2.8 2.5 2.2 2.1 1.5 1.4 0.4 0.6 0.7 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 63

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Garrett 0 3.50 3.2 3.3 3.4 3.4 3.6 0 2.50 0 1.50 0 0 0 1.3 1.3 0.7 0.7 0.6 0.2 0.1 0.1 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 Opioid-related emergency department data for Garrett County residents in 2012 were not reported due to small sample size resulting in an unstable estimate. 64

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Harford 3.5 3.2 3.3 3.4 3.4 3.6 2.5 2.2 2.5 2.7 2.8 1.5 0.8 0.6 0.7 0.6 0.8 0.7 0.9 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 65

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Howard 3.5 3.2 3.3 3.4 3.4 3.6 2.5 1.5 0.6 0.7 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 66

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Kent 3.5 3.2 3.3 3.4 3.4 3.6 2.5 1.5 0.6 0.7 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 67

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Montgomery 3.5 3.2 3.3 3.4 3.4 3.6 2.5 1.5 0.6 0.7 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 68

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Prince George's 3.5 3.2 3.3 3.4 3.4 3.6 2.5 1.5 0.9 0.8 0.9 0.1 0.1 0.9 0.7 0.7 0.6 0.1 0.2 0.1 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 69

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Queen Anne's 3.5 3.2 3.3 3.4 3.4 3.6 2.5 2.4 1.5 1.4 0.6 1.7 0.8 1.9 0.6 0.7 0.3 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 70

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events St Mary's 3.5 3.2 3.3 3.4 3.4 3.6 2.5 1.5 1.6 1.4 1.2 0.8 0.7 0.6 0.4 0.2 0.1 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 71

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Somerset 3.5 3.2 3.3 3.4 3.4 3.6 2.5 1.9 1.5 1.2 1.2 1.3 0.4 0.4 0.6 0.6 0.6 0.7 0.7 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 72

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Talbot 3.5 3.2 3.3 3.4 3.4 3.6 2.5 1.5 1.4 1.2 0.9 0.6 0.3 0.4 0.7 0.7 0.1 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 73

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Washington 3.5 3.2 3.3 3.4 3.4 3.6 3.1 2.5 1.5 2.4 1.8 1.6 1.7 0.7 0.7 0.6 0.3 0.1 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 74

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Wicomico 3.5 3.2 3.3 3.4 3.4 3.6 2.5 1.5 0.9 0.3 1.2 0.3 0.9 0.4 1.4 0.6 0.6 0.7 0.7 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 75

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Worcester 3.5 3.2 3.3 3.4 3.4 3.6 2.5 1.5 0.7 0.2 0.2 0.4 0.6 0.7 1.3 0.7 0.9 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 76

Rate of Opioid-related Inpatient Hospitalizations and ED Visits per 100 Events Baltimore City 1 9.0 9.3 9.3 9.0 9.0 8.8 8.0 7.0 6.0 3.2 1.3 3.3 1.2 3.4 3.4 0.6 1.9 3.6 0.7 2.4 Inpatient ED Inpatient ED Inpatient ED Inpatient ED Inpatient ED 2008 2009 2010 2011 2012 77

Substance Use Treatment Admissions Data Source: State of Automated Records Tracking (SMART) 0 Primary Substance Treatment Admissions Trends per 1000 Population 2.50 0 1.50 0 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0 0 FY2008 FY2009 FY2010 FY2011 FY2012 78

6.00 Allegany County Primary Substance Treatment Admissions Trends per 1000 Population 0 0 0 0 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0 0 FY2008 FY2009 FY2010 FY2011 FY2012 79

0 Anne Arundel County Primary Substance Treatment Admissions Trends per 1000 Population 2.50 0 1.50 0 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0 0 FY2008 FY2009 FY2010 FY2011 FY2012 80

0 Baltimore County Primary Substance Treatment Admissions Trends per 1000 Population 1.80 1.60 1.40 1.20 0 0.80 0.60 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0.40 0.20 0 FY2008 FY2009 FY2010 FY2011 FY2012 81

8.00 Calvert County Primary Substance Treatment Admissions Trends per 1000 Population 7.00 6.00 0 0 0 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0 0 0 FY2008 FY2009 FY2010 FY2011 FY2012 82

8.00 Caroline County Primary Substance Treatment Admissions Trends per 1000 Population 7.00 6.00 0 0 0 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0 0 0 FY2008 FY2009 FY2010 FY2011 FY2012 83

0 Carroll County Primary Substance Treatment Admissions Trends per 1000 Population 2.50 0 1.50 0 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0 0 FY2008 FY2009 FY2010 FY2011 FY2012 84

0 Cecil County Primary Substance Treatment Admissions Trends per 1000 Population 4.50 0 3.50 0 2.50 0 1.50 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0 0 0 FY2008 FY2009 FY2010 FY2011 FY2012 85

0 Charles County Primary Substance Treatment Admissions Trends per 1000 Population 4.50 0 3.50 0 2.50 0 1.50 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0 0 0 FY2008 FY2009 FY2010 FY2011 FY2012 86

9.00 Dorchester County Primary Substance Treatment Admissions Trends per 1000 Population 8.00 7.00 6.00 0 0 0 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0 0 0 FY2008 FY2009 FY2010 FY2011 FY2012 87

2.50 Frederick County Primary Substance Treatment Admissions Trends per 1000 Population 0 1.50 0 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0 0 FY2008 FY2009 FY2010 FY2011 FY2012 88

9.00 Garrett County Primary Substance Treatment Admissions Trends per 1000 Population 8.00 7.00 6.00 0 0 0 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0 0 0 FY2008 FY2009 FY2010 FY2011 FY2012 89

1.80 Harford County Primary Substance Treatment Admissions Trends per 1000 Population 1.60 1.40 1.20 0 0.80 0.60 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0.40 0.20 0 FY2008 FY2009 FY2010 FY2011 FY2012 90

1.60 Howard County Primary Substance Treatment Admissions Trends per 1000 Population 1.40 1.20 0 0.80 0.60 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0.40 0.20 0 FY2008 FY2009 FY2010 FY2011 FY2012 91

10 Kent County Primary Substance Treatment Admissions Trends per 1000 Population 9.00 8.00 7.00 6.00 0 0 0 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0 0 0 FY2008 FY2009 FY2010 FY2011 FY2012 92

1.40 Montgomery County Primary Substance Treatment Admissions Trends per 1000 Population 1.20 0 0.80 0.60 0.40 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0.20 0 FY2008 FY2009 FY2010 FY2011 FY2012 93

1.20 Prince George's County Primary Substance Treatment Admissions Trends per 1000 Population 0 0.80 0.60 0.40 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0.20 0 FY2008 FY2009 FY2010 FY2011 FY2012 94

8.00 Queen Anne's County Primary Substance Treatment Admissions Trends per 1000 Population 7.00 6.00 0 0 0 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0 0 0 FY2008 FY2009 FY2010 FY2011 FY2012 95

6.00 St Mary's County Primary Substance Treatment Admissions Trends per 1000 Population 0 0 0 0 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0 0 FY2008 FY2009 FY2010 FY2011 FY2012 96

7.00 Somerset County Primary Substance Treatment Admissions Trends per 1000 Population 6.00 0 0 0 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0 0 0 FY2008 FY2009 FY2010 FY2011 FY2012 97

8.00 Talbot County Primary Substance Treatment Admissions Trends per 1000 Population 7.00 6.00 0 0 0 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0 0 0 FY2008 FY2009 FY2010 FY2011 FY2012 98

0 Washington County Primary Substance Treatment Admissions Trends per 1000 Population 3.50 0 2.50 0 1.50 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0 0 0 FY2008 FY2009 FY2010 FY2011 FY2012 99

6.00 Wicomico County Primary Substance Treatment Admissions Trends per 1000 Population 0 0 0 0 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0 0 FY2008 FY2009 FY2010 FY2011 FY2012 100

10 Worcester County Primary Substance Treatment Admissions Trends per 1000 Population 9.00 8.00 7.00 6.00 0 0 0 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0 0 0 FY2008 FY2009 FY2010 FY2011 FY2012 101

10 Baltimore City Primary Substance Treatment Admissions Trends per 1000 Population 10 8.00 6.00 0 Alcohol Rx Opioids Heroin Benzodiazepines Marijuana Cocaine/crack 0 0 FY2008 FY2009 FY2010 FY2011 FY2012 102

Motor Vehicle Crashes among Residents Aged 16-25 Years Data source: Automated Accident Reporting System (MAARS) Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 1 9.0 8.0 7.6 9.2 7.0 6.0 5.9 5.9 5.6 5.8 5.5 5.4 4.8 5.7 Allegany 2007 2008 2009 2010 2011 103

Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 7.0 6.0 5.9 6.4 6.0 5.9 6.1 6.6 5.7 5.6 5.5 5.4 Anne Arundel 2007 2008 2009 2010 2011 104

Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 7.0 6.0 5.9 5.6 5.5 5.4 5.7 4.8 4.7 4.8 Baltimore County 2007 2008 2009 2010 2011 105

Alcohol or Drug & Alcohol-Impaired Crashes as a Percentage of Total Crashes among 16-25 year olds 9.0 8.5 8.0 7.6 7.4 7.0 6.0 6.2 5.7 5.9 5.6 5.5 5.4 5.5 Calvert 2007 2008 2009 2010 2011 106

Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 18.0 16.0 16.2 17.1 1 1 12.9 1 8.9 1 8.0 Caroline 6.0 5.9 5.6 5.5 5.4 5.7 2007 2008 2009 2010 2011 107

Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 1 1 8.0 8.7 7.8 Carroll 7.2 8.5 1 6.0 5.9 5.6 5.5 5.4 5.7 2007 2008 2009 2010 2011 108

Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 1 9.0 8.5 8.2 8.8 8.0 8.0 7.0 6.8 6.0 5.9 5.6 5.5 5.4 5.7 Cecil 2007 2008 2009 2010 2011 109

Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 7.0 6.0 5.9 6.1 5.5 5.4 5.7 5.7 5.2 5.6 4.9 4.4 Charles 2007 2008 2009 2010 2011 110

Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 1 1 9.5 9.3 1 8.6 8.5 8.0 6.0 5.9 5.6 5.5 5.4 5.7 Dorchester 2007 2008 2009 2010 2011 111

Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 9.0 8.0 7.9 8.0 7.0 6.0 7.1 5.9 6.9 6.2 5.4 5.7 5.6 5.5 Frederick 2007 2008 2009 2010 2011 112

1 Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 10.8 1 9.2 9.5 8.0 7.0 7.6 6.0 5.9 5.6 5.5 5.4 5.7 Garrett 2007 2008 2009 2010 2011 113

Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 8.0 7.0 7.2 7.4 6.0 5.9 5.6 5.5 5.2 5.4 5.7 6.0 Harford 2007 2008 2009 2010 2011 114

Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 9.0 8.0 7.4 7.7 7.6 7.2 7.0 6.3 6.0 5.9 5.6 5.5 5.4 5.7 Howard 2007 2008 2009 2010 2011 115

Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 2 18.0 16.0 Kent 17.8 1 1 14.6 14.1 1 1 8.0 6.3 6.0 5.9 5.6 5.5 5.4 5.7 2007 2008 2009 2010 2011 116

Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 7.0 6.0 6.6 5.5 6.4 5.7 5.7 5.9 5.6 5.5 5.4 5.5 Montgomery 2007 2008 2009 2010 2011 117

Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 7.0 6.0 5.9 5.6 5.5 5.4 5.7 5.3 4.7 5.1 4.6 5.4 Prince George's 2007 2008 2009 2010 2011 118

Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 1 1 11.8 Queen Anne's 1 10.3 8.6 9.2 8.0 6.6 6.0 5.9 5.6 5.5 5.4 5.7 2007 2008 2009 2010 2011 119

Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 9.0 8.0 7.0 7.0 6.5 6.7 7.7 6.0 5.5 5.7 5.9 5.6 5.4 4.7 St Mary's 2007 2008 2009 2010 2011 120

Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 9.0 8.0 8.6 8.3 7.8 7.0 6.8 6.0 5.9 5.9 5.6 5.5 5.4 5.7 Somerset 2007 2008 2009 2010 2011 121

Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 1 1 11.6 Talbot 1 9.8 8.0 8.2 6.9 6.0 5.7 5.7 5.9 5.6 5.5 5.4 2007 2008 2009 2010 2011 122

Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 8.0 7.0 7.0 7.1 6.0 5.7 5.4 5.7 5.9 5.6 5.5 5.2 4.2 Washington 2007 2008 2009 2010 2011 123

Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 9.0 8.0 7.0 7.0 6.5 6.3 7.7 6.0 5.7 5.9 5.6 5.5 5.4 Wicomico 2007 2008 2009 2010 2011 124

Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 1 1 10.3 9.8 1 1 8.0 7.7 6.0 5.9 5.6 5.5 5.4 5.7 Worcester 2007 2008 2009 2010 2011 125

Alcohol or Alcohol and Drug Impaired Crashes as Percentage of Total Crashes among 16-25 year olds 7.0 6.0 5.9 5.6 5.5 5.4 5.7 Baltimore City 2.3 2.2 2.5 2.2 2.8 2007 2008 2009 2010 2011 126