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CDC Benzodiazepine v1

Query purpose:

To assist state, local, tribal, territorial, and federal public health practitioners in monitoring emergency department (ED) visits for suspected benzodiazepine overdoses.

How it was developed:

CDC scientists first started developing the definition using lessons learned from jurisdictions funded by CDC’s Overdose Data to Action and Enhanced State Opioid Overdose Surveillance programs. First, International Classification of Diseases, 10th Revision (ICD-10-CM) and 9th Revision Clinical Modification (ICD-9-CM), and Systematized Nomenclature of Medicine (SNOMED) diagnosis codes indicating acute benzodiazepine use and/or benzodiazepine poisoning were identified; this was followed by identifying and adding overdose terms that could be presented in the chief complaint free text. Finally, the team identified benzodiazepine terms indicating that benzodiazepine was involved in the overdose.

How it works:

The Chief Complaint Discharge Diagnosis field is used to query both the diagnosis codes and chief complaint free text with exclusions (as necessary) to develop the syndrome definition.

  • Automatic inclusion (yes):
    • If a diagnosis code indicating a benzodiazepine poisoning is present, the ED visit is automatically included in the syndrome.
  • Automatic inclusion (no):
    • If the ED visit does not include a diagnosis codes for benzodiazepine poisoning, then the visit is not automatically included.
    • The visit is captured only if it includes two components:
      • 1) chief complaint text indicating an overdose or poisoning and
      • 2) chief complaint text indicating benzodiazepine involvement or a SNOMED code for benzodiazepine dependence or misuse.
    • The list of exclusions is applied to the chief complaint text only when a discharge diagnosis code is not present for benzodiazepine poisoning.

For consideration:

A large number of commonly used benzodiazepine types and names are included. The team attempted to identify most drug names used for benzodiazepines; however, it is likely that some drug names and slang terms should be added to the next version of the definition.

Supporting documentation:

CDC Benzodiazepine Syndrome Definition v1 - Guidance Document

Syndrome Definition

,^[;/ ]969.4[;/ ]^,or,^[;/]9694[;/]^, or,^[;/ ]T42.4X[14]A[;/ ]^,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,^alpra zolam^,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!,o r,!frontin!,or,!librium!,or,^solanax^,or,^[ck]lon[ae]z[ea]p[eoa]m^,or,^[ck]lon[iao]pin^,or,^valium^,or,^valum^,or,^iktoriv il^,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,^fluni pam^,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^,),),)

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