ArticleDrug and alcohol dependence2021
Using ICD-10-CM codes to detect illicit substance use: A comparison with retrospective self-report.
Article in Drug and alcohol dependence, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers.
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Who cites it
35 citing papers in PubMed.
- Estimating the impact of stimulant use on initiation of buprenorphine and extended-release naltrexone in two clinical trials and real-world populations.Addiction science & clinical practice · 2023Trial
- Natural Language Processing Identification of Nonprescribed Fentanyl Use in Electronic Health Records: Algorithm Development and Validation Study.Journal of medical Internet research · 2026Article
- Three-year cardiovascular risk prediction among people who use cocaine or methamphetamine.Drug and alcohol dependence reports · 2026Article
- Long-Term Opioid Therapy Tapering and Risk of Substance Use Disorder and Overdose: Differences by Opioid Dose and Duration.Journal of general internal medicine · 2026Article
- Adolescent outcomes of Post-operative opioid EXposure (APEX): Protocol for a multisite observational study.Journal of substance use and addiction treatment · 2026Article
- High Levels of Substance Use Disorder Among Critically Ill Virginia Medicaid Beneficiaries.Journal of addiction medicine · 2026Article
- Illicit stimulants and ventricular arrhythmias: a longitudinal cohort study.European heart journal · 2025Article
- Racial, ethnic, and sex disparities in buprenorphine treatment from emergency departments by discharge diagnosis.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025Article
- Characterizing Prescription Stimulant Use in Adults with Overdose Involving Psychostimulants.Medical research archives · 2025Article
- Stimulant-Related Emergencies in Older Adults.JAMA network open · 2025Article
- Investigating the demographics, comorbidities, and postoperative complications and impact of a history of cocaine use in patients undergoing total knee arthroplasty.Archives of orthopaedic and trauma surgery · 2025Article
- Hospital Security Searches Among Patients With Substance-Related Encounters.JAMA network open · 2025Article
- Rates and factors for 30-day readmission in patients with substance use disorders during the COVID-19 pandemic.Frontiers in psychiatry · 2025Article
- Pain, Substance Use Disorders, Mental Health, and Buprenorphine Treatment among Patients With and Without HIV.AIDS and behavior · 2024Article
- Prenatal methamphetamine use increases risk of adverse maternal and neonatal outcomes.American journal of obstetrics and gynecology · 2024Article
- U.S. trends in methamphetamine-involved psychiatric hospitalizations in the United States, 2015-2019.Drug and alcohol dependence · 2024Article
- Comorbidity Burden and Health Care Utilization by Substance use Disorder Patterns among People with HIV in Florida.AIDS and behavior · 2024Article
- Association of substance-use disorder with outcomes of major elective abdominal operations: A contemporary national analysis.Surgery open science · 2024Article
- Performance of International Classification of Disease-10 codes in detecting emergency department patients with opioid misuse.Addiction (Abingdon, England) · 2024Article
- Developing a Framework to Infer Opioid Use Disorder Severity From Clinical Notes to Inform Natural Language Processing Methods: Characterization Study.JMIR mental health · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundUnderstanding whether International Classification of Disease, 10th Revision, Clinical Modification (ICD-10-CM) codes can be used to accurately detect substance use can inform their use in future surveillance and research efforts.
methodsUsing 2015-2018 data from a retrospective cohort study of 602 safety-net patients prescribed opioids for chronic non-cancer pain, we calculated the sensitivity and specificity of using ICD-10-CM codes to detect illicit substance use compared to retrospective self-report by substance (methamphetamine, cocaine, opioids [heroin or non-prescribed opioid analgesics]), self-reported use frequency, and type of healthcare encounter.
resultsSensitivity of ICD-10-CM codes for detecting self-reported substance use was highest for methamphetamine (49.5 % [95 % confidence interval: 39.6-59.5 %]), followed by cocaine (44.4 % [35.8-53.2 %]) and opioids (36.3 % [28.8-44.2 %]); higher for participants who reported more frequent methamphetamine (intermittent use: 27.7 % [14.6-42.6 %]; ≥weekly use: 67.2 % [53.7-79.0 %]) and opioid use (intermittent use: 21.4 % [13.2-31.7 %]; ≥weekly use: 52.6 % [40.8-64.2 %]); highest for outpatient visits (methamphetamine: 43.8 % [34.1-53.8 %]; cocaine: 36.8 % [28.6-45.6 %]; opioids: 33.1 % [25.9-41.0 %]) and lowest for emergency department visits (methamphetamine: 8.6 % [4.0-15.6 %]; cocaine: 5.3 % [2.1-10.5 %]; opioids: 6.3 % [3.0-11.2 %]). Specificity was highest for methamphetamine (96.4 % [94.3-97.8 %]), followed by cocaine (94.0 % [91.5-96.0 %]) and opioids (85.0 % [81.3-88.2 %]).
conclusionsICD-10-CM codes had high specificity and low sensitivity for detecting self-reported substance use but were substantially more sensitive in detecting frequent use. ICD-10-CM codes to detect substance use, particularly those from emergency department visits, should be used with caution, but may be useful as a lower-bound population measure of substance use or for capturing frequent use among certain patient populations.
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