ArticleThe American journal on addictions2022
Sensitivity of health records for self-reported nonfatal drug and alcohol overdose.
Article in The American journal on addictions, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed, 3 citations in OpenAlex.
- Examining buprenorphine compared to methadone for likelihood of overdose during pregnancy, 2014-2021.Pregnancy (Hoboken, N.J.) · 2026Article
- Using ICD Codes Alone May Misclassify Overdoses Among Perinatal People.American journal of preventive medicine · 2025Article
- Medications for opioid use disorder: Predictors of early discontinuation and reduction of overdose risk in US military veterans by medication type.Addiction (Abingdon, England) · 2025Article
- The relationship between felt stigma and non-fatal overdose among rural people who use drugs.Harm reduction journal · 2024Article
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
objectivesPublic health surveillance for overdose sometimes depends on nonfatal drug overdoses recorded in health records. However, the proportion of total overdoses identified through health record systems is unclear. Comparison of overdoses from health records to those that are self-reported may provide insight on the proportion of nonfatal overdoses that are not identified.
methodsWe conducted a cohort study linking survey data on overdose from a national survey of Veterans to United States Department of Veterans Affairs (VA) health records, including community care paid for by VA. Self-reported overdose in the prior 3 years was compared to diagnostic codes for overdoses and substance use disorders in the same time period.
resultsThe sensitivity of diagnostic codes for overdose, compared to self-report as a reference standard for this analysis, varied by substance: 28.1% for alcohol, 23.1% for sedatives, 12.0% for opioids, and 5.5% for cocaine. There was a notable concordance between substance use disorder diagnoses and self-reported overdose (sensitivity range 17.9%-90.6%). DISCUSSION AND
conclusionsDiagnostic codes in health records may not identify a substantial proportion of drug overdoses. A health record diagnosis of substance use disorder may offer a stronger inference regarding the size of the population at risk. Alternatively, screening for self-reported overdose in routine clinical care could enhance overdose surveillance and targeted intervention. SCIENTIFIC SIGNIFICANCE: This study suggests that diagnostic codes for overdose are insensitive. These findings support consideration of alternative approaches to overdose surveillance in public health.
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