CDC Opioid v1

States currently funded by CDC’s Enhanced State Opioid Overdose Surveillance (ESOOS) program have been asked to monitor opioid overdose trends in their states. In collaboration with our ESOOS partners, CDC staff developed some lessons learned in querying opioid overdose ED visits in syndromic surveillance systems. Based on this preliminary work, CDC developed an opioid overdose syndrome definition that captured all of the lessons learned from ESOOS states. CDC scientists first started developing the definition using lessons learned from ESOOS states and researching guidance documents from other sources including NCHS, CSTE, and SAMSHA. They then built the query using discharge diagnosis codes and SNOMED codes indicating an acute opioid poisoning were identified. Next, we used a set of “overdose terms” along with identified “drug terms” indicating that an opioid was involved in the overdose. We use both the discharge diagnosis codes/SNOMED and chief complaint free text with exclusions (as necessary). If discharge diagnosis code/SNOMED indicating an opioid poisoning is present, the ED visit is automatically included in the syndrome. If there is no discharge diagnosis code/SNOMED present for opioid 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. CDC identified several non-poisoning ICD-10-CM codes for inclusion in the syndrome definition (e.g., F11 codes when “with intoxication” is indicated). Because the differentiation between poisoning and intoxication is unclear, CDC chose to consider the specific F-codes that include “with intoxication.” However, other F11 codes that indicated opioid abuse (without mention of intoxication), may not indicate an overdose. CDC staff explored these codes and determined that the inclusion of those opioid-related F codes were only relevant when the chief complaint text included an “overdose term. The team attempted to identify most drug names used for opioid; however, it’s likely that some drug names and slang terms should be added to a revision definition.

 

What this definition can’t do:

  1. Differentiate prescription from illicit opioid overdose
  2. Tease apart fentanyl and fentanyl analogs from other opioids
Surveillance System: 
ESSENCE (NSSP)
Syndrome Definition: 

(,^narcan^,or,^naloxo^,or,^[;/ ]T40.[012346][X09][14]A^,or,^[;/ ]T40[012346][X09][14]A^,or,^[;/ ]F11.12[0129]^,or,^[;/ ]F11.22[0129]^,or,^[;/ ]F11.92[0129]^,or,^[;/ ]F1112[0129]^,or,^[;/ ]F1122[0129]^,or,^[;/ ]F1192[0129]^,or,^[;/ ]965.00;^,or,^[;/ ]96500;^,or,^[;/ ]965.[0][0],or,^[;/ ]965[0][0],or,^[;/ ]965.01;^,or,^[;/ ]96501;^,or,^[;/ ]965.[0][1],or,^[;/ ]965[0][1],or,^[;/ ]965.02;^,or,^[;/ ]96502;^,or,^[;/ ]965.[0][2],or,^[;/ ]965[0][2],or,^[;/ ]965.09;^,or,^[;/ ]96509;^,or,^[;/ ]965.[0][9],or,^[;/ ]965[0][9],or,^[;/ ]E850.[012]^,or,^[;/ ]E850[012]^,or,^295174006^,or,^295175007^,or,^295176008^,or,^295165009^,or,^242253008^,or,^297199006^,or,^295213004^,) ,or, (,(,(,^poison^,or,^[ao]verdo[se][se]^,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,^altered mental status^,) ,and, (,^her[io][oi]n^,or,^ hod ^,or,^speedball^,or,^speed ball^,or,^dope^,or,^opioid^,or,^op[io][oi]d^,or,^opiate^,or,^opate^,or,^op[iu][ui]m^,or,^opum^,or,^methadone^,or,^suboxone^,or,^oxyco^,or,^oxyi^,or,^percoc^,or,^vicod^,or,^fentan^,or,^hydrocod^,or,^morphin^,or,^cod[ei][ie]n^,or,^codene^,or,^oxymor^,or,^dilaud^,or,^hydromor^,or,^tramad^,or,^suboxin^,or,^buprenorphine^,or,^[;/ ]F11.[129]0^,or,^[; /]F11[129]0^,),) ,andnot, (,^denies her[io][oi]n^,or,^deny her[io][oi]n^,or,^denied her[io][oi]n^,or,^denying her[io][oi]n^,or,^denies drug^,or,^deny drug^,or,^denied drug^,or,^denying drug^,or,^denies any drug^,or,^withdra^,or,^detoxification^,or,^detos^,or,^detoz^,or,^dtox^,),)

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

August 29, 2018

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Surveillance Program

Email:nssp@cdc.gov

The National Syndromic Surveillance Program (NSSP) is a collaboration among states and public health jurisdictions that contribute data to the BioSense Platform, public health practitioners who use local syndromic surveillance systems, Center for Disease Control and Prevention programs, other federal agencies, partner organizations, hospitals, healthcare professionals, and academic institutions.

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