CDC All Drug v1

Purpose: States currently funded by CDC’s Enhanced State Opioid Overdose Surveillance (ESOOS) program have been monitoring drug overdose trends in their states. Because CDC had worked with these states to develop syndrome definitions for stimulant, heroin and opioid overdose, they decided to also develop a syndrome definition for all drug overdose.

 

How it was developed: CDC scientists first started developing the definition using guidance from DEA, CSTE and SAMSHA. They then built the query using a similar process to the other drug query development. First, discharge diagnosis codes and SNOMED indicating an acute stimulant poisoning were identified. Next, we used the same “overdose terms” used previously with the opioid and heroin query. Finally, we identified “drug terms” indicating that any type of drug was involved in the overdose. The definition was developed to be inclusive of all drug types, not specifically those that may be illicit versus prescription.

 

How it works: Similar to the stimulant, opioid and heroin queries, we use both the discharge diagnosis codes/SNOMED and chief complaint free text with exclusions (as necessary). If discharge diagnosis code/SNOMED indicating a stimulant poisoning is present, the ED visit is automatically included in the syndrome. If there is no discharge diagnosis code/SNOMED present for stimulant poisoning, the visit is only included if the chief complaint text has both an “overdose” and “drug” term. In addition, the list of exclusions are only applied to the chief complaint text when a discharge diagnosis code is not present.

 

Other things for consideration: The heroin, opioid, and stimulant definitions are nested within the all drug definition. So everything included in those queries is included in the all drug. There are several new poisoning codes (including ICD-9-CM, ICD-10-CM, and SNOMED) and many new drug names with the necessary exclusions (e.g., “PCP” is a drug but also used for “primary care physician”). The team attempted to identify most drug names including some of the popular brand names; however, it’s likely that some drug names and slang terms should be added to a revision definition. This is especially true as new drugs enter the market.

Surveillance System: 
ESSENCE (NSSP)
Syndrome Definition: 

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Attached Syntax Platform: 
ESSENCE
Submitting Author Organization: 
CDC
Submitting Author Email: 
avivolo@cdc.gov
Syndrome Category: 
Jurisdiction: 

October 11, 2018

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