Poisoning Deaths- Time for a new definition?

1
Poisoning Deaths-Time for a new definition?

• Lois A. Fingerhut and Clare Griffiths
• May 2004

2
Counting poisoning deaths as an underlying cause
of death

• ICD-definition in mortality matrix
• Unintentional
• Suicide
• Homicide
• Undetermined

• ICD codes are
• Drug-related
• Alcohol- related
• Gases and vapors

3
Drug-related codes in Mental Health Chapter of ICD

• F10-F19
• Alcohol (F10)
• Opioids (F11)
• Cocaine (F14)
• Other (F12-13, 15-16, 18-19)
• 4th digits..

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4th digits (leading ones in US)

• 0 acute intoxication (primarily alcohol)
• 1 harmful use
• 2 dependence syndrome (primarily alcohol)
• 3-9 other

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ICD definitions of drug poisoning this analysis
ICD-10
Nondependent abuse of drugs 305.2-.9 F11-16, 18-19 (not .2)
Dependent abuse 304 F11-16,18-19(.2)
Unintentional E850-E858 X40-X44
Suicide E950(.0-5) X60-X64
Undetermined E980(.0-.5) Y10-Y19
Homicide E962.0 X85
Alcohol intoxication 305.0 F10.0
ICD-9
6
Drug poisoning deaths, ages 35-54 by intent and
abuse
7
All (??) Poisoning deaths US 2001
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National Academy of Science May 2004

• U.S. Institute of Medicine has recommended that
  WHO should review and reform the ICD codes for
  poisoning
• NCHS should review the methodology of its
  existing surveys to maximize the value.for
  poison prevention and control.
• From Forging a Poison Prevention and Control
  System (2004)