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Drug Poisoning: Trends and Current Status US, England & Wales, Canada

Drug Poisoning: Trends and Current Status US, England & Wales, Canada. Lois A. Fingerhut US, National Center for Health Statistics Clare Griffiths UK, Office of National Statistics Kathryn Wilkins Canada, Statistics Canada. Definitional issues: Drug poisoning mortality. ICD-9 vs ICD-10

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Drug Poisoning: Trends and Current Status US, England & Wales, Canada

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  1. Drug Poisoning: Trends and Current Status US, England & Wales, Canada Lois A. Fingerhut US, National Center for Health Statistics Clare Griffiths UK, Office of National Statistics Kathryn Wilkins Canada, Statistics Canada

  2. Definitional issues: Drug poisoning mortality • ICD-9 vs ICD-10 • Underlying cause: external cause codes (X & Y codes) • Multiple cause: T codes for substances • Mental health “F” codes • Nondependent abuse • Dependent abuse • Alcohol intoxication (not included here) • Adverse effects codes (not included here)

  3. ICD-9 vs ICD-10Substance selection • ICD-9 underlying cause codes for poisoning more specific than ICD-10 codes • ICD-10, to get specific substances • Literals from the death certificate • Code the multiple cause data

  4. ICD mortality coding by country

  5. ICD ‘definitions’ of drug poisoning ICD-9

  6. Drug poisoning death rates: US, 2002

  7. Drug poisoning deaths, ages 35-54

  8. Drug poisoning death rates,males 35-54 years

  9. Drug poisoning death rates, males, 25-34 years

  10. Drug poisoning death rates, females, 35-54 years

  11. Abuse-related (mental health codes) death rates, males 35-54 years

  12. Canada: Leading substance categories based on underlying cause of death: No further specificity available • Opiates and related narcotics • Tranquilizers and other psychotropic agents • Local anaesthetics (includes cocaine)

  13. England & Wales: Leading specified substances mentioned in drug deaths for those 35-54 years: [not ICD coded]: 1993-2002 • Antidepressants (23%) • Paracetamol (22%) • Heroin/morphine (17%) • Methadone (9%) • Benzodiazepines (7%)

  14. US: Leading specified substances mentioned in drug deaths for those 35-54 years: 2002 • Cocaine T40.5: 25% • Other specified opioids T40.2: 21% • Antidepressants T43.0-T43.2: 11% • Alcohol T51: 11% • Carbon Monoxide T58: 8% • Heroin T40.1: 10% • Benzodiazepines T42.4: 9% • Methadone T40.3 10%

  15. Next Steps • Recommend adding certain ICD codes from Mental and Behavioral Disorders (F10-F19) to classification of poisoning deaths • Nondependent abuse? • Dependent abuse? • Alcohol intoxication? • Drug status- legal/illegal use • International variation- a topic to be researched….

  16. Questions… • Lois A Fingerhut: US NCHS LFingerhut@cdc.gov • Clare Griffiths UK ONS Clare.Griffiths@ons.gsi.gov.uk • Kathryn Wilkins Canada Statistics Canada Kathryn.Wilkins@statcan.ca

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