Analyses of health care utilization and of mortalities resulting from alcohol and drug abuse are reported in chapters 4 and 5. These analyses rely on essentially the same set of diagnostic codes and attribution factors for the analysis of databases. The ICD-9 codes used in this study are presented in table A.1, along with the corresponding attribution factors. The table differentiates between conditions that are definitionally 100 percent caused by alcohol or drug abuse (e.g., drug psychoses) and those conditions for which alcohol or drug abuse are contributing factors.
Note also that the mortality data reported in chapter 5 rely on "E" codes for injuries and poisonings, whereas hospital and ambulatory care data reported in chapter 4 rely instead on the series 800 and 900 codes. The reason for this is that many injuries and poisonings never result in hospitalization–the "E" code assigned in an emergency room, for example, may be the only code that exists. On the other hand, if a patient is admitted or cared for by a physician outside the emergency room, standard diagnostic codes are apt to replace the E code as the primary diagnosis.
Illness or Injury | ICD-9 Code | Percent Attributed in This Study | Age Range |
---|---|---|---|
100% Drug-Caused Conditions | |||
Drug psychoses | 292 | 100 | all |
Drug dependence | 304 | 100 | all |
Nondependent abuse of drugs | 305.2-305.9 | 100 | all |
Polyneuropathy due to drugs | 357.6 | 100 | all |
Narcotics affecting fetus or newborn via placenta or breast | 760.72 | 100 | all |
Hallucinogens affecting fetus or newborn via placenta or breast | 760.73 | 100 | all |
Drug withdrawal syndrome in newborn | 779.5 | 100 | all |
Poisoning by opiates and related narcotics | 965.0 | 100 | all |
Poisoning by sedatives and hypnotics | 967 | 100 | all |
Poisoning by CNS muscle tone depressants | 968.0 | 100 | all |
Poisoning by psychotropic agents | 969 | 100 | all |
Poisoning by CNS stimulants | 970 | 100 | all |
Drug-Related Conditions | |||
Accidental poisoning by drugs, medicaments, and biologicals | E850-858 | NA | |
Agricultural and horticultural chemical and pharmaceutical preparations other than plant foods and fertilizers | E863 | NA | |
Heroin, methadone, other opiates and related narcotics, and other drugs causing adverse effects in therapeutic use | E935.0-E935.2; E937-E940 | NA | |
Injury undetermined whether accidentally or purposely inflicted from poisoning by drugs, medicaments, and other | E980 | NA | |
Homicide and injury purposely inflicted by other persons (age > 15) | E960-E969 | NA | |
Tuberculosis | 010-018 | NA | |
100% Alcohol-Caused Conditions | |||
Alcoholic psychoses | 291 | 100 | all |
Alcohol dependence syndrome | 303 | 100 | all |
Nondependent abuse of alcohol | 305.0 | 100 | all |
Alcoholic polyneuropathy | 357.5 | 100 | all |
Alcoholic cardiomyopathy | 425.5 | 100 | all |
Alcoholic gastritis | 535.3 | 100 | all |
Alcoholic fatty liver | 571.0 | 100 | all |
Acute alcoholic hepatitis | 571.1 | 100 | all |
Alcoholic cirrhosis of liver | 571.2 | 100 | all |
Alcoholic liver damage, unspecified | 571.3 | 100 | all |
Fetal alcohol syndrome | 760.71 | 100 | all |
Excessive blood level of alcohol | 790.3 | 100 | all |
Toxic effects of ethyl alcohol | 980.0 | 100 | all |
Accidental poisoning by alcohol | E860.0, E860.1 | 100 | all |
Alcohol-Related Conditions | |||
Respiratory tuberculosis | 011-012 | 25 | > 35 |
Malignant neoplasm of lip, oral cavity, and pharynx | 140-149 | 50 (men) 40 (women) |
> 35 |
Malignant neoplasm of esophagus | 150 | 75 | > 35 |
Malignant neoplasm of stomach | 151 | 20 | > 35 |
Diabetes mellitus | 250 | 5 | > 35 |
Essential hypertension | 401 | 8 | > 35 |
Cerebrovascular disease | 430-438 | 7 | > 35 |
Pneumonia and influenza | 480-487 | 5 | > 35 |
Diseases of esophagus, stomach, and duodenum | 530-537 (excluding 535.3) |
10 | > 35 |
Chronic hepatitis | 571.4 | 50 | > 35 |
Cirrhosis of liver without mention of alcohol | 571.5 | 50 | > 35 |
Other chronic nonalcoholic liver damage | 571.8 | 50 | > 35 |
Unspecified chronic liver disease without mention of alcohol | 571.9 | 50 | > 35 |
Portal hypertension | 572.3 | 50 | > 35 |
Acute pancreatitis | 577.0 | 42 | > 35 |
Chronic pancreatitis | 577.1 | 60 | > 35 |
Alcohol-Related Injuries/Incidents | |||
Motor vehicle traffic and nontraffic accidents | E810-E825 | 42 | > 15 |
Pedal cycle and other road vehicle accidents | E826,E829 | 20 | > 15 |
Water transport accidents | E830-E838 | 20 | > 15 |
Air and space transport accidents | E840-E845 | 16 | > 15 |
Accidental falls | E880-E888 | 35 | > 15 |
Accidents caused by fires and flames | E890-E899 | 45 | > 15 |
Accidental drowning and submersion | E910 | 38 | > 15 |
Suicide and self-inflicted injury | E950-E959 | 28 | > 15 |
Homicide and injury purposely inflicted by other persons | E960-E969 | 46 | > 15 |
Other injuries and adverse effects | E901, E911, E917, E918, E919, E920, E922, E980 | 25 | > 15 |
Injuries and poisoning* | 800-968, 980-995 (excluding 965.0, 967, 968.0, 980.0) |
10 | > 15 |
Sources: Stinson et al. (1993); Bloss (1995), personal communication.
*Note: A point of departure from the mortality estimates attributed to alcohol by Stinson et al. (1993) is that this study attributes 10 percent of nonfatal accidents and injuries to alcohol. Stinson's research concludes that alcohol caused 16 to 46 percent of certain accidents and injuries in which the victims died before admission to a hospital. This study attributes 10 percent of all nonfatal accidents and injuries that result in hospitalization or outpatient care to alcohol.