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

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Presentation transcript:

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

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) Definitional issues: Drug poisoning mortality

ICD-9 vs ICD-10 Substance 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

ICD mortality coding by country ICD-9- UCOD ICD-10- UCOD Substance- specific England and Wales Literals from text files Canada From underlying cause United States Multiple cause coding

ICD ‘definitions’ of drug poisoning ICD-10 Nondependent abuse of drugs F11-16, (not.2) Dependent abuse304F11-16,18-19(.2) UnintentionalE850-E858X40-X44 SuicideE950(.0-5)X60-X64 UndeterminedE980(.0-.5)Y10-Y14 HomicideE962.0X85 [Alcohol intoxication305.0F10.0] ICD-9

Drug poisoning death rates: US, 2002

Drug poisoning deaths, ages 35-54

Drug poisoning death rates, males years

Drug poisoning death rates, males, years

Drug poisoning death rates, females, years

Abuse-related (mental health codes) death rates, males years

Canada: Leading substance categories based on underlying cause of death: No further specificity available 1) Opiates and related narcotics 2) Tranquilizers and other psychotropic agents 3) Local anaesthetics (includes cocaine)

England & Wales: Leading specified substances mentioned in drug deaths for those years: [not ICD coded]: ) Antidepressants (23%) 2) Paracetamol (22%) 3) Heroin/morphine (17%) 4) Methadone (9%) 5) Benzodiazepines (7%)

US: Leading specified substances mentioned in drug deaths for those years: Cocaine T40.5: 25% 2. Other specified opioids T40.2: 21% 3. Antidepressants T43.0-T43.2: 11% 4. Alcohol T51: 11% 5. Carbon Monoxide T58: 8% 6. Heroin T40.1: 10% 7. Benzodiazepines T42.4: 9% 8. Methadone T %

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….

Questions… Lois A Fingerhut: US NCHS Clare Griffiths UK ONS Kathryn Wilkins Canada Statistics Canada