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| This template will go inte __________________________ {{discussion}} we will need short description}} | | This template will go into __________________________ {{discussion}} we will need short description}} |
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| == Sorting Out the Different Options About Problematic Use of Drugs and Substances == | | == Sorting Out the Different Options About Problematic Use of Drugs and Substances == |
| *There are the following different categories of codes:
| | See [[ICD10 Guideline for drugs and susbstances]] for further information when and how to use which drug and substance related codes. |
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| **{{#ask: [[Has ICD10Dx::~"*intoxication, acute"]]
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| |limit=0
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| |format=broadtable
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| |link=all
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| |class=sortable wikitable smwtable
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| |searchlabel= Drug/substance '''intoxication, acute'''...
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| }}
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| ***{{DiscussAllan| Do we need to rename [[Psychoactive substance NOS, acute intoxication]] and [[Alcohol (ethanol) acute intoxication (drunkenness)]] to include in here? Ttenbergen 11:40, 2018 June 19 (CDT)}}
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| **{{#ask: [[Has ICD10Dx::~*"overdose/poisoning"]]
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| |limit=0
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| |format=broadtable
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| |link=all
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| |class=sortable wikitable smwtable
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| |searchlabel= Drug/substance '''overdose/poisoning'''...
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| }}
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| **{{#ask: [[Has ICD10Dx::~*"chronic abuse/dependence/addiction"]]
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| |limit=0
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| |format=broadtable
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| |link=all
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| |class=sortable wikitable smwtable
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| |searchlabel= Drug/substance '''chronic abuse/dependence/addiction'''...
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| }}
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| ***{{DiscussAllan |Do we need to rename [[Tobacco use/abuse, chronic]] so it includes in here? Ttenbergen 11:59, 2018 June 19 (CDT) }}
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| **{{#ask: [[Has ICD10Dx::~*"withdrawal"]]
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| |limit=0
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| |format=broadtable
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| |link=all
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| |class=sortable wikitable smwtable
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| |searchlabel= Drug/substance '''withdrawal'''...
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| }}
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| **{{#ask: [[Has ICD10Dx::~*"used appropriately, adverse effect (reaction, allergy, hypersensitivity)"]]
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| |limit=0
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| |format=broadtable
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| |link=all
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| |class=sortable wikitable smwtable
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| |searchlabel= Drug/substance '''used appropriately, adverse effect (reaction, allergy, hypersensitivity)'''...
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| }}
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| *Regarding confusion between '''intoxication, acute''' vs. '''overdose/poisoning'''
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| **Acute intoxication indicates just that. Being drunk is a good example of acute alcohol intoxication. These generally require just observation, not treatment.
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| **On the other hand, an overdose/poisoning indicates that the patient either has a medical consequence, or is at high risk of getting one -- so that some medical treatment is given. These treatments might include: substance removal via activated charcoal, gastric lavage or dialysis; use of an antidote or neutralizing agent; life support if the overdose caused shock or respiratory failure; or others.
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| **But clearly there can be some overlap. A common example is the drunk person who is felt in the ED to be "not protecting their airway" and so is intubated for this rationale. Because it is so difficult to judge the "need" for such things, the rule we will use to distinguish between them is to use '''intoxication, acute''' if no treatment is given, and to use '''overdose/poisoning''' if treatment is given.
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| *Regarding confusion between '''withdrawal''' vs. '''chronic abuse/dependence/addiction'''
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| **Withdrawal refers to the presence of withdrawal symptoms or signs.
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| **Chronic abuse/dependence/addiction does not necessarily indicate that anything acute is currently occurring.
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| **These 2 codes can be used together, if appropriate.
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| *Regarding confusion between '''used appropriately, adverse effect (reaction, allergy, hypersensitivity)''' vs. '''overdose/poisoning'''
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| **The difference here is that '''used appropriately''' refers to use of a pharmaceutical used in the correct dose. While if that drug is given or taken in excess amount, an '''overdose/poisoning''' can occur.
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| *Regarding confusion between '''used appropriately, adverse effect (reaction, allergy, hypersensitivity)''' vs. '''intoxication, acute'''
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| **These 2 codes can be used together, if a pharmaceutical is used in the correct dose, and that leads nonetheless to acute intoxication.
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| </noinclude>
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| {{DiscussAllan |
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| *AG NOTES TO SELF:
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| **Include here explanations distinguishing between the various types of codes: intoxication, acute; chronic abuse, dependence, addiction; withdrawal, AE used appropriately; overdose/poisoning.
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| **Specially give guidelines for distinguishing acute intox vs. OD/poisoning; and acute vs. chronic
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| }}
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