Query purpose:
To assist state, local, tribal, territorial, and federal public health practitioners in monitoring emergency department (ED) visits for suspected nonfatal overdoses involving any drug using syndromic surveillance data.
Definition description:
The CDC All Drug Overdose v3 Parsed syndrome definition was designed to be used to identify ED visits for suspected nonfatal drug overdoses of unintentional or undetermined intent. The query relies on data in two fields from ED visit records to identify encounters that meet the definition criteria:
- the chief complaint free text field, which is a processed version of the reported chief complaint and may include terms indicating a drug overdose or poisoning, as well as relevant exclusion terms (e.g., terms indicating withdrawal without acute intoxication, etc., which would exclude ED visit records from this syndrome definition), and
- the discharge diagnosis parsed field, which includes International Classification of Diseases, Clinical Modification, 9th Revision (ICD-9-CM),1 International Classification of Diseases, Clinical Modification, 10th Revision (ICD-10-CM),2 and/or Systematized Nomenclature of Medicine – Clinical Terms (SNOMED-CT)3 diagnosis codes, with descriptive text removed, and which may indicate an acute drug overdose or poisoning of unintentional or undetermined intent.
Within ESSENCE, the syndrome query is applied to the Chief Complaint Discharge Diagnosis (CCDD) Parsed field, which combines these two fields of interest.
How it was developed:
This revision was developed to serve three purposes: (1) Adapt the CDC All Drug Overdose v2 definition5 syntax to query the newly developed CCDD Parsed field which removes extraneous text from the discharge diagnosis portion of CCDD, (2) nest the logic for CDC All Opioid Overdose v3 Parsed, All Stimulant Overdose v4 Parsed, and Benzodiazepine Overdose v2 Parsed definitions within the CDC All Drug Overdose definition to ensure capture of ED Visits for suspected drug overdoses by the All Drug Overdose definition, and (3) revise the query syntax to incorporate corrections to logic and other identified improvements. CDC NSSP staff used R code to update the syntax to meet CCDD Parsed field requirements. The CDC DOSE team reviewed the revisions and compared total visits captured by CCDD and CCDD Parsed versions of the definition, with a focus on diagnostic codes, to ensure correct restructuring.
The CDC All Drug Overdose v2 syntax was reorganized to place exclusion terms with the relevant inclusion terms and group terms drug and overdose terms within the definition. Cannabis terms were removed from query syntax during validation of the definition, as CDC scientists conducting the review determined that cannabis terms in the chief complaint field were associated with intoxication and not poisoning or overdose. The ICD-10-CM code for poisoning by cannabis, T40.711A, was kept. A limited set of synthetic cannabinoid terms, which were determined to be associated with poisonings and which could be present in the chief complaint field, were retained. Drug terms included in the now nested All Opioid Overdose v4 Parsed, All Stimulant Overdose v3 Parsed, and Benzodiazepine Overdose v2 Parsed syndrome definitions were removed from the main body of the All Drug Overdose syntax. The initial All Drug Overdose definition development began with the DOSE team reviewing guidance from the United States Drug Enforcement Administration (DEA), Council of State and Territorial Epidemiologists (CSTE), and the Substance Abuse and Mental Health Services Administration (SAMHSA). First, ICD-9-CM, ICD-10-CM, and SNOMED-CT diagnosis codes indicating an acute drug poisoning were identified; this was followed by overdose terms in the chief complaint text. Finally, drug terms indicating that any type of drug was involved in the overdose were added. The definition was developed to be inclusive of overdoses involving all drug types, including both illegal and prescription drugs.
How it works:
The CCDD Parsed field is used to query both the Discharge Diagnoses Parsed and Chief Complaint Free Text fields.
- Automatic inclusion:
- The ED visit is automatically included in the syndrome definition if the ED visit includes:
- If a diagnosis code indicating an acute unintentional or undetermined intent drug poisoning is present, and/or
- Mention of overdose in the chief complaint text.
- The ED visit is automatically included in the syndrome definition if the ED visit meets one or more of the nested drug overdose definitions:
- CDC All Opioid Overdose v3 Parsed
- CDC All Stimulant Overdose v4 Parsed
- CDC Benzodiazepine Overdose v2 Parsed
- The ED visit is automatically included in the syndrome definition if the ED visit includes:
- Conditional inclusion:
- If the ED visit does not include a diagnosis code for drug poisoning of unintentional or undetermined intent, an overdose term, or meet the criteria for one or more of the nested drug overdose definitions, the visit is captured only if it includes two components and no exclusion terms:
- 1) chief complaint text indicating an overdose or poisoning, AND
- 2) chief complaint text indicating drug involvement
- The exclusion terms are applied to the chief complaint text only when the automatic inclusion criteria are not met.
- If the ED visit does not include a diagnosis code for drug poisoning of unintentional or undetermined intent, an overdose term, or meet the criteria for one or more of the nested drug overdose definitions, the visit is captured only if it includes two components and no exclusion terms:
For consideration:
This definition was developed to capture suspected nonfatal drug overdoses treated in EDs. However, it is subject to both misclassification and under/overreporting for several reasons, including limited point-of-care confirmatory testing to identify the drug(s) involved in the overdose and reliance on self-report, bystander reports, and/or clinical presentations to determine the drug(s) involved in an overdose. The codes provided in the discharge diagnosis field from the ED visit record do not necessarily represent the final diagnosis of a patient and should be considered preliminary. Additionally, some hospitals may enter all diagnosis codes on a patient’s entire medical history that are not indicative of the current visit, thus resulting in overreporting if codes for historical drug use/abuse/dependence are included. Signs and symptoms of drug overdose may present differently depending on the drug(s) used; however, this revision decreases the potential impact of this limitation by nesting sub-queries in the All Drug Overdose v3 Parsed syndrome definition instead of merging all sub-query terms into syndrome definition syntax. It is not possible in syndromic data to determine the primary reason for a patient’s visit, as syndromic data lack a primary diagnosis field. Therefore, all terms and codes are considered equally (i.e., not in any priority) regardless of what order they are in the record. For some records with multiple descriptions and codes of symptoms and diseases, it may not be possible to determine the exact reason why a patient has entered care at an ED; it is dependent on the chief complaint terms and discharge diagnosis codes provided. For example, someone with shortness of breath and drug use may have been treated at an ED for asthma symptoms and used a prescription opioid as directed. This scenario could be captured as a drug overdose; however, these records were relatively uncommon. Future studies where provider triage notes are available may help validate the use of chief complaints and discharge diagnoses to identify drug overdose visits in syndromic data.
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given^,OR,^f[ea]nt[aiyn][nly][aioyl] given^,OR,^f[ea]nt[aiyn][nly] given^,OR,^f[ea]nt[aiyn] given^,OR,^f[ea]nt given^,OR,^gave f[ea]nt^,OR,^got f[ea]nt^,OR,^rec[ei]ved f[ea]nt^,OR,^pta f[ea]nt^,OR,^f[ea]nt[aiyn][nly][aioyl][ln] [ie]n route^,OR,^f[ea]nt[aiyn][nly][aioyl] [ie]n route^,OR,^f[ea]nt[aiyn][nly] [ie]n route^,OR,^f[ea]nt[aiyn] [ie]n route^,OR,^f[ea]nt [ie]n route^,OR,^f[ea]nt[aiyn][nly][aioyl][ln] [ie]nroute^,OR,^f[ea]nt[aiyn][nly][aioyl] [ie]nroute^,OR,^f[ea]nt[aiyn][nly] [ie]nroute^,OR,^f[ea]nt[aiyn] [ie]nroute^,OR,^f[ea]nt [ie]nroute^,OR,^f[ea]nt[aiyn][nly][aioyl][ln] route^,OR,^f[ea]nt[aiyn][nly][aioyl] route^,OR,^f[ea]nt[aiyn][nly] route ^,OR,^f[ea]nt[aiyn] route^,OR,^f[ea]nt route^,OR,^f[ea]nt[aiyn][nly][aioyl][ln] by EMS^,OR,^f[ea]nt[aiyn][nly][aioyl] by EMS^,OR,^f[ea]nt[aiyn][nly] by EMS^,OR,^f[ea]nt[aiyn] by EMS^,OR,^ f[ea]nt by EMS^,OR,^f[ea]nt[aiyn][nly][aioyl][ln] on board^,OR,^f[ea]nt[aiyn][nly][aioyl] on board^,OR,^f[ea]nt[aiyn][nly] on board^,OR,^f[ea]nt[aiyn] on board^,OR,^f[ea]nt on board^,OR,^f[ea]nt[aiyn][nly][aioyl][ln] [123456789][0257][05 ]^,OR,^f[ea]nt[aiyn][nly][aioyl] [123456789][0257][05 ]^,OR,^f[ea]nt[aiyn][nly] [123456789][0257][05 ]^,OR,^f[ea]nt[aiyn] [123456789][0257][05 ]^,OR,^f[ea]nt [123456789][0257][05 ]^,OR,^[123456789][0257][05] f[ea]nt^,OR,^[123456789][05] f[ea]nt^,OR,^[123456789][0257][05] of f[ea]nt^,OR,^[123456789][05] of f[ea]nt^,OR,^doses of f[ea]nt^,OR,^mcg f[ea]nt^,OR,^mcgs f[ea]nt^,OR,^mcg of f[ea]nt^,OR,^mcgs of f[ea]nt^,OR,^mg of f[ea]nt^,OR,^milligram f[ea]nt^,OR,^milligram of f[ea]nt^,OR,^mcq f[ea]nt^,OR,^mcq of f[ea]nt^,OR,^mcf f[ea]nt^,OR,^mcf of f[ea]nt^,OR,^mcb f[ea]nt^,OR,^mcb of f[ea]nt^,OR,^mch f[ea]nt^,OR,^mch of f[ea]nt^,OR,^intranasal f[ea]nt^,OR,^intramuscular f[ea]nt^,OR,^diffent^,OR,^fenton ^,OR,^phantom^,OR,^phentermine^,OR,^phentrimine^,OR,^fentermine^,OR,^phenteramine^,OR,^fanting^,OR,^fanted^,OR,^elephant^,OR,^elphant^,OR,^infant^,OR,^no loss of conscious^,OR,^denie[sd] loss of consciousness^,OR,^negative loss of consciousness^,OR,^with dra^,OR,^withdra^,OR,^withraw^,OR,^detox^,OR,^dtox^,OR,^detos^,OR,^denies sob^,OR,^nodule^,OR,^node^,OR,^accifent^,OR,^signifantly^,OR,^ibuprofent^,OR,^bonfante^,),),OR,(,(,^;9697[01239];^,OR,^;9700;^,OR,^;9708[19];^,OR,^;9709;^,OR,^;E854[23];^,OR,^;E8552;^,OR,^;T436[012349][14]A^,OR,^;296290006;^,OR,^;61803000;^,OR,^;296317006;^,OR,^;296291005;^,),OR,(,(,(,^palp^,OR,^heart pap^,OR,^poison^,OR,^verdo[se][es]^,OR,^overose^,OR,^snort^,OR,^in[gj]est^,OR,^intoxic^,OR,^altered mental status^,OR,^numb^,OR,^diaphoretic^,OR,^racing^,OR,^numb^,OR,^chest pain^,ANDNOT,(,^no chest pain^,OR,^denie[sd] chest pain^,),OR,^tach[iy]^,OR,^not feeling well^,OR,^not right^,),AND,(,^amphetamine^,ANDNOT,^methamphetamine^,OR,^lisdexamfetamine^,OR,^dextroamphetamine^,OR,^levoamphetamine^,OR,^biphetamine^,OR,^dexedrine^,OR,(,(,^adderal^,OR,^aderal^,),ANDNOT,(,^off adderal^,OR,^off aderal^,),),OR,^vyvanse^,OR,^concerta^,OR,^methylin^,OR,^ritalin^,OR,^cathinone^,OR,(,(,^bath salt^,OR,^bathsalt^,),ANDNOT,(,^denie[sd] bathsalt^,OR,^denie[ds] bath salt^,),),OR,^stimulant^,ANDNOT,(,^cardiac stimulant^,OR,^denie[ds] stimulant^,OR,^denie[ds] any stimulant^,),OR,!MDMA!,ANDNOT,(,^history MDMA^,OR,^deny MDMA^,),OR,^e[sc][cs]ta[cs]y^,OR,^e[xsc]ta[sc]y^,OR,^ex[sc]ta[sc]y^,OR,!moly!,OR,!moll[iy]!,ANDNOT,(,^doctor molly^,OR,^private molly^,),OR,^;441527004;^,),),ANDNOT,(,^denie[sd] drug^,OR,^deny drug^,OR,^denying drug^,OR,^denie[sd] any drug^,OR,!with draw!,OR,^withdra^,OR,^deto[sxz]^,OR,^dtox^,),),),OR,(,^;97081;^,OR,^;T405X1A^,OR,^;T405X4A^,OR,^;296321004;^,OR,^;216583009;^,OR,^;290545007;^,OR,^;296325008;^,OR,^;9982009;^,OR,(,(,(,^poison^,OR,^verdo[se][es]^,OR,^over dose^,OR,^overose^,OR,^snort^,ANDNOT,(,^denie[sd] snort^,OR,^no snort^,),OR,^in[gj]est^,OR,^intoxic^,OR,^altered mental status^,OR,^seiz^,ANDNOT,(,^denie[sd] seiz^,OR,^no seiz^,),OR,^high blood^,OR,^abdominal pain^,OR,^racing^,OR,^agitat^,OR,^aggitat^,OR,(,^heart pap^,OR,^palp^,),ANDNOT,(,^denie[sd] heart palp^,OR,^no heart palp^,OR,^denie[sd] heart pap^,OR,^no heart pap^,),OR,^cardi[ao]^,ANDNOT,(,^denie[sd] cardi[ao]^,OR,^no cardi[ao]^,),OR,^heart attack^,OR,^myocard^,OR,^stroke^,OR,^tach[iy]^,OR,^chest pain^,ANDNOT,(,^no chest pain^,OR,^denie[sd] chest pain^,),OR,^squeezing in chest^,OR,^chest tight^,OR,(,(,^chest pressure^,OR,^pressure in chest^,),ANDNOT,(,^no chest pressure^,OR,^denie[sd] chest pressure^,OR,^denie[sd] pressure in chest^,OR,^no pressure in chest^,),),),AND,(,^speedball^,OR,^speed ball^,OR,^coc[ai][ia]ne^,OR,^cocc[ai][ia]ne^,OR,^cocane^,OR,^cocanne^,OR,!coke!,ANDNOT,(,^denie[ds] coke^,OR,^denie[ds] coc[ai][ia]ne^,OR,^coke top^,OR,^coke bottle^,OR,^coke can^,OR,^coke case^,OR,^case of coke^,OR,^bottle of coke^,OR,^bottles of coke^,OR,(,^rum^,AND,^coke^,),OR,^jack and coke^,OR,^diet coke^,OR,^coke tea^,OR,^coffee coke^,OR,^delirium tremens coke^,OR,^drink a coke^,OR,^jack coke^,OR,^dirnking coke^,OR,^coke tab^,OR,^scotch coke^,OR,^drinking coke^,OR,^aspirating on coke^,OR,^coke colored^,OR,^drank coke^,OR,^drank a coke^,),OR,!crack!,ANDNOT,(,^a crack^,OR,^crack in^,OR,^knee crack^,OR,^shoulder crack^,OR,^tooth crack^,OR,^butt crack^,OR,^ankle crack^,OR,^callous crack^,OR,^crack due to^,OR,^pop crack^,OR,^loud crack^,OR,^it crack^,OR,^heard crack^,OR,^felt crack^,OR,(,^rib^,AND,^crack^,),OR,^fell crack^,OR,^snap crack^,OR,^growth plate^,OR,^to crack of^,OR,^crack sidewalk^,OR,^sidewalk crack^,OR,^crack area^,OR,^crack cast^,OR,^back crack^,OR,^crack of^,OR,^crack his^,OR,(,^lip^,AND,^crack^,),OR,^neck crack^,OR,^crack neck^,OR,^my crack^,OR,^glass crack^,OR,(,^buttock^,AND,^crack^,),OR,!crack on!,OR,!crack to!,OR,^foot crack^,),OR,^;F1412^,OR,^;F1422^,OR,^;F1492^,),),ANDNOT,(,^denie[sd] drug^,OR,^deny drug^,OR,^denying drug^,OR,^denie[sd] any drug^,OR,!with draw!,OR,^withdra^,OR,^deto[sxz]^,OR,^dtox^,),),),OR,(,^;T4365[14]A^,OR,(,(,(,^;T5090[14]A^,OR,^;9697[029];^,OR,^;9700;^,OR,^;97089;^,OR,^;9709;^,OR,^;E854[23]^,OR,^;T436[029][14]A^,OR,^;29629000[56];^,OR,^;61803000;^,OR,^abdominal pain^,OR,^agitat^,OR,^aggitat^,OR,^aggressive^,OR,^altered mental status^,OR,^arrhythmia^,OR,^bad reaction^,OR,^bad trip^,OR,^bizz^,OR,^bizar^,OR,^bugs^,OR,^chest pain^,ANDNOT,(,^denies chest pain^,OR,^no chest pain^,),OR,^chest pressure^,OR,^chest tight^,OR,^combat^,OR,^delusion^,OR,^delirium^,ANDNOT,^delirium tremen^,OR,^delirum^,ANDNOT,^delirum tremen^,OR,^diaphoretic^,OR,^disoriented^,OR,^dizz^,OR,^erra[td]ic^,OR,^feels bad^,OR,^feels weird^,OR,^fidg^,OR,^flight of ideas^,OR,^formication^,OR,^hallucinat^,OR,^hearing voices^,OR,^heart attack^,OR,^heart pap^,OR,^heart racing^,OR,^high blood pressure^,OR,^hyperverbal^,OR,^incoh^,OR,^in[gj]est^,OR,^intoxic^,OR,^lightheaded^,OR,^manic^,OR,^nausea^,OR,^not feeling well^,OR,^not right^,OR,^not sleeping^,OR,^numb^,OR,^verdo[se][es]^,OR,^overose^,OR,^over dose^,OR,^palp^,OR,^parano^,OR,^poison^,OR,^racing heart^,OR,^restless^,OR,^seeing snakes^,OR,^seeing things^,OR,^shak^,OR,^shot up^,OR,^shoot up^,OR,^shooting up^,OR,^shoots up^,OR,(,(,^shortness of breath^,OR,^short of breath^,),ANDNOT,(,^denie[sd] short^,OR,^no short^,),),OR,^snort^,OR,^seiz^,OR,^sores all over^,OR,^picking at skin^,OR,^scratching^,OR,^sycho^,OR,^tach[iy]^,OR,^tingl^,OR,^tight chest^,OR,^tremulous^,OR,!tripping!,OR,^trouble sleeping^,OR,^twitch^,or,^vomiting^,OR,^violent^,OR,^weakness^,),AND,(,^desoxyn^,OR,(,(,!meth!,OR,^methamphetamine^,OR,^on mth^,),ANDNOT,(,^meth recovery^,OR,^clean from meth^,OR,^rsh on mth^,OR,^meth gas^,OR,^history of meth^,OR,^stopped smoking meth^,OR,^stopped meth^,OR,^stopped using meth^,OR,^no meth^,OR,^deny meth^,OR,^denie[sd] meth^,OR,^quit meth^,OR,^meth germ^,OR,^meth gmt^,OR,^meth odist^,OR,^meth obstet^,OR,^meth group^,OR,^meth south^,OR,^seen at meth^,OR,^meth gtown^,OR,^went to meth^,OR,^meth north^,OR,^meth univ^,),),OR,(,!crank!,ANDNOT,(,^hand crank^,OR,^doctor crank^,OR,^using a crank^,),),OR,(,(,^gram of ice^,OR,!on ice!,OR,!smoking ice!,OR,!smoked ice!,OR,!line of ice!,OR,!used ice!,OR,!using ice!,OR,!ingested ice!,OR,!ingesting ice!,OR,^admits to ice^,OR,!ice use!,OR,^in[gj]ect^ ice^,),ANDNOT,(,^nose bleeding ice^,OR,^laying on ice^,OR,^bump on ice^,OR,^player on ice^,OR,^iceyhot^,OR,^using ice with no relief^,OR,^using ice with relief^,OR,^on ice with relief^,OR,^no ice used^,OR,^choked on ice^,OR,^ice heat^,OR,^spun around on ice^,OR,^hit face on ice^,OR,^fal on ice^,OR,^lost control on ice^,OR,^walking on ice^,OR,^de icer^,OR,^elevation ice^,OR,^using ice heat^,or,^landed on ice^,OR,^ice melt salt^,OR,^black ice^,OR,^chew^ice^,OR,^ice chip^,OR,^ice cube^,OR,^ice^f[ae]ll^,OR,^f[ae]ll^ice^,OR,^sli[pd]^ice^,OR,^spice^,OR,^appl^ice^,OR,^ice^appl^,OR,^ice pack^,OR,^ice cream^,OR,^ice bath^,OR,^ice coffee^,OR,^ice to area^,OR,^doctor ice^,OR,^smirnoff ice^,OR,^ice skat^,OR,^ice water^,OR,^ice cold^,OR,^pushed down on ice^,OR,^ice hockey^,OR,^head on ice^,OR,^ice patch^,OR,^bag of ice^,OR,^ice machine^,OR,^dry ice^,OR,^ibuprofen^,OR,^vehicle on ice^,),),OR,^overamping^,OR,(,!speed!,ANDNOT,(,^driver speed^,OR,^city speed^,OR,^fast speed^,OR,^dr speed^,OR,^fan speed^,OR,^residential speed^,OR,^slurred speed^,OR,^stand still speed^,OR,^unknown exact speed^,OR,^speed up^,OR,^up to speed^,OR,^car speed^,OR,^speed limit^,OR,^marked speed^,OR,^medium speed^,OR,^unknow speed^,OR,^normal speed^,OR,^changed speed^,OR,^full speed^,OR,^unknwon speed^,OR,^hight speed^,OR,^highway speed^,OR,^MPH^speed^,OR,^speed^heart^,OR,^speed^MPH^,OR,^speed sign^,OR,^low speed^,OR,^moderate speed^,OR,^high speed^,OR,^nknown speed^,OR,^unsure of speed^,OR,^interstate speed^,OR,^practice speed^,OR,^speed process up^,OR,^walking speed^,OR,^speed unk^,OR,^speed bump^,OR,^rate of speed^,OR,^hwy speed^,OR,^uknown speed^,),),OR,(,^tweak^,ANDNOT,(,^tweak^ on left^,OR,^tweak^ on right^,OR,^tweaked^,OR,^tweak^ it^,),),),),ANDNOT,(,^denie[sd] drug^,OR,^deny drug^,OR,^denying drug^,OR,^denie[sd] any drug^,OR,^jail clearance^,OR,!with draw!,OR,^withdra^,OR,^deto[xsz]^,OR,^dtox^,OR,^rehab^,OR,^wants refer^,),),),OR,(,^;9694;^,OR,^;T424X[14]A;^,OR,^;296128004;^,OR,^;216530001;^,OR,^;296129007;^,OR,^;296053004;^,OR,^;712742003;^,OR,^;81914009;^,),OR,(,(,(,^poison^,OR,^verdo[se][es]^,OR,^over dose^,OR,^overose^,OR,^nodding^,OR,!nod!,OR,^snort^,OR,^in[gj]est^,OR,^intoxic^,OR,^unresponsiv^,OR,^loss of consciousness^,OR,^syncop^,OR,^shortness of breath^,OR,^short of breath^,OR,^altered mental status^,),AND,(,!prosom!,OR,!niravam!,OR,!tranxene!,OR,!oxazepam!,OR,!byfavo!,OR,!flurazepam!,OR,![zx]ans!,OR,![zx]anny!,OR,![zx]annies!,OR,!dalmane!,OR,!downers!,OR,![zx]an bar!,OR,![zx]anbar!,OR,!z bar!,OR,!k pin!,OR,!phennies!,OR,!B[ZD][ZD]!,OR,!BZ!,OR,^roofies^,OR,^benzos^,OR,^benzodiazepine^,OR,^benezos^,OR,^clorazepate^,OR,^diaz[aei]pa[mn]^,OR,^clonazepam^,OR,^midazolam^,OR,^alprazolam^,OR,^temaz[aei]pam^,OR,^alprazolam^,OR,^ xan^,OR,xan^,OR,Xan^,OR,^[zx]an[oae]x^,OR,^helex^,OR,^trankimazin^,OR,!onax!,OR,!alprox!,OR,!misar!,OR,!restyl!,OR,!tafil!,OR,!frontin!,OR,!librium!,OR,^solanax^,OR,^[ck]lon[ae]z[ea]p[eoa]m^,OR,^[ck]lon[iao]pin^,OR,^valium^,OR,^valum^,OR,^iktorivil^,OR,^paxam^,OR,^riv[oa]tril^,OR,^antenex^,OR,^apaurin^,OR,^apzepam^,OR,^apozepam^,OR,^hexalid^,OR,^normabel^,OR,!pax!,OR,!ronal!,OR,!vival!,OR,^stesolid^,OR,^stedon^,OR,^valaxona^,OR,^hipnosedon^,OR,^vulbegal^,or^fluscand^,OR,^flunipam^,OR,^rohydorm^,OR,^hypnodorm^,OR,^loraz^,or!ativan!,OR,^zolam^,OR,^bromazepam^,OR,^diazepoxide^,OR,^serax^,OR,^temazepa[nm]^,OR,^restor[aie]l^,OR,^halcion^,OR,^;428406005;^,OR,^;231473004;^,),ANDNOT,(,^ plan to overdose on benzo^,OR,Plan to overdose on benzo^,OR,!plan to overdose on [zx]an[oae]x!,OR,!plan to overdose on Ativan!,OR,!plan to overdose on valium!,OR,^ xanthogranulomatous ^,OR,!acetazolamide!,OR,^placed on ativan^,OR,^placed on valium^,OR,^placed on [zx]an[oae]x^,OR,^ran out of ativan^,OR,^ran out of valium^,OR,^ran out of [zx]an[oae]x^,OR,^ativan prn^,OR,^valium prn^,OR,^[zx]an[oae]x prn^,OR,^treated by ativan^,OR,^treated with ativan^,OR,^given ativan^,OR,^gave ativan^,OR,^ativan given^,OR,^treated by valium^,OR,^treated with valium^,OR,^treated by [zx]an[oae]x^,OR,^treated with [zx]an[oae]x^,OR,^given valium^,OR,^gave valium^,OR,^valium given^,OR,^[zx]an[oae]x given^,OR,^given [zx]an[oae]x^,OR,^gave [zx]an[oae]x ^,OR,^rec[ie][ei]ved ativan^,OR,^does not have any ativan left^,OR,^does not have any valium left^,OR,^does not have any [zx]an[oae]x left^,OR,^stopped using valium^,OR,^stopped using [zx]an[oae]x^,OR,^stopped using ativan^,OR,^out of valium^,OR,^out of [zx]an[oae]x^,OR,^out of ativan^,OR,^benzonatate^,OR,^no loss of consciousness^,OR,^denie[sd] loss of consciousness^,OR,^negative loss of consciousness^,OR,^denies any loss of consciousness^,OR,^denies drug^,OR,^deny drug^,OR,^denied drug^,OR,^denying drug^,OR,^denies any drug^,OR,^ with dra^,OR,^withdra^,OR,^detoxification^,OR,^detos^,OR,^detoz^,OR,^dtox^,),),)