At the beginning of 2003, major changes were introduced to DAWN; this report is the first publication of DAWN data since the redesign altered most features of DAWN. The report begins with a review of the DAWN changes and an explanation for understanding new DAWN findings. The remainder of the report presents 2003 data reported to DAWN by participating medical examiners and coroners. Data for each of the 6 participating States and 32 metropolitan areas is presented separately and the report notes that comparisons of 2003 DAWN data to DAWN data for previous years are not possible due to the redesign of the program. States participating in the 2003 DAWN program included Maine, Maryland, New Hampshire, New Mexico, Utah, and Vermont. Two categories of DAWN cases are profiled in the report: suicide deaths with drug involvement and deaths related to drug misuse or abuse. Participating metropolitan areas reported between 0 and 389 deaths related to drug misuse or abuse in 2003, with Baltimore and Albuquerque reporting the highest numbers of drug misuse deaths. Across the 6 States, the number of deaths from drug misuse or abuse ranged from 74 to 697, with substantial variation in these deaths reported across jurisdictions. Most of the victims of drug misuse or abuse deaths were males. The number of drug-related suicide deaths reported by the 32 metropolitan areas ranged from 2 to 102, with Phoenix and Salt Lake City reporting the highest rates of drug-related suicides. Information is offered on the major substances of abuse where available and on drug combinations in drug misuse and suicide deaths. Tables, figures, appendixes, glossary