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CDC Stimulant Overdose v3

Query purpose:

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

How it was developed:

CDC scientists first started developing the definition using guidance from the Council of State and Territorial Epidemiologists and the Substance Abuse and Mental Health Services Administration. 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 an acute stimulant 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 stimulant drug terms indicating that a stimulant 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 stimulant poisoning is present, the ED visit is automatically included in the syndrome.
  • Automatic inclusion (no):
    • If the ED visit does not include a diagnosis code for stimulant 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 stimulant involvement.
    • The list of exclusions is applied to the chief complaint text only when a discharge diagnosis code is not present for stimulant poisoning.

For consideration:

With the opioid query, CDC identified several non-poisoning ICD-10-CM codes for inclusion in the syndrome definition (e.g., F11 codes). CDC also explored the inclusion of the stimulant-related F codes (i.e., F14 and F15) in this stimulant definition. However, our analysis showed that these codes were not identifying acute overdose visits and instead were being coded correctly as stimulant abuse. The team attempted to identify most drug names used for stimulants; however, it is likely that some drug names and slang terms should be added to the next version of the definition.

Supporting documentation:

CDC All Stimulant Overdose Definition v3 - Guidance Document

Syndrome Definition

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