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4808.0 - Illicit Drug Use, Sources of Australian Data, 2001  
Latest ISSUE Released at 11:30 AM (CANBERRA TIME) 28/11/2001   
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Contents >> Appendix 3: International Classification of Diseases

Introduction

The World Health Organization (WHO) International Classification of Diseases (ICD) is used to code illness and death to produce Australia's morbidity and mortality statistics. This appendix provides a guide to the ICD-9 and ICD-10 codes which are of interest to researchers and analysts interested in illnesses and deaths attributed directly to the use of illicit drugs. Tables of relevant ICD codes are provided to illustrate the lack of specificity which restricts the information pertaining to individual illicit drugs.

Example of available data

Graph - Deaths of 15-34 Year Olds, By cause: Australia - 1981-1999



Morbidity

The modified versions of ICD used by hospitals for morbidity coding are known as ICD-9-CM (9th Revision, Clinical Modification) and ICD-10-AM (10th Revision, Australian Modification). The structure of these classifications is very similar to that used for mortality coding, but is not necessarily directly comparable. The broad issues identified below for mortality coding will generally apply to morbidity coding as well.


Mortality

All deaths registered from 1979 to 1998 have been coded by the Australian Bureau of Statistics (ABS) to ICD-9, with previous editions being used for deaths prior to 1979. Deaths registered from 1 January 1997 have been coded using the tenth revision, ICD-10. Deaths registered in 1997 and 1998 were dual coded in both ICD-9 and ICD-10 to enable the production of comparability factors between the two series.

For drug-related deaths, the ICD does not focus on the identity of the drug(s) involved, but rather on the circumstance of the death. For example, deaths that were determined to be directly caused by drug use could be classified as being due to external causes (e.g. assault, accident, or suicide) or due to mental or behavioural disorders associated with drug use. As a result of this different focus, the codes assigned may not be unique to any specific drug. For example, in ICD-9, all deaths for which the underlying cause was psychosis due to drug use (whether opioids, amphetamines, barbiturates or other drugs) were coded to 292.

The following tables illustrate the lack of specificity in the ICD codes. In particular, they illustrate the extent to which specific ICD codes can be used to identify individual drugs. This will vary depending on the nature of the death. The tables do not include all the codes, either in ICD-9 or ICD-10, required to identify all drug-related deaths (e.g. in the graph above). Rather they highlight the types of drugs which are relevant to this publication.

Researchers and analysts wishing to obtain data on drug-related deaths from the Causes of Death collection or the National Mortality Database may be guided by the tables. However, to identify the full set of codes most relevant to their requirements, researchers should consult the ICD manuals and/or the experts at ABS or AIHW.


Guide to ICD codes applicable to deaths from illicit drugs

Table A3.1 presents the ICD-9 codes used to classify deaths in Australia which are directly caused by selected groups of drugs including illicit drugs. If evidence of more than one drug was found in the body, the combination codes would be used rather than the more specific codes.

Table A3.2 presents the equivalent codes for ICD-10. Further detail is provided on mental and behavioural disorders by a fourth character which indicates the type of substance use, such as dependence, harmful use, psychosis or withdrawal for those deaths.

The table also presents a list of poison codes which are used to provide further detail on the drug-related deaths coded to an external cause. If more than one drug is found in the body, more than one poison code is assigned. Although ICD-10 does not have a unique poison code for all drugs, many drugs of interest can be identified by cross-tabulating the data using the appropriate external cause code and the poison code. For example, if a coroner determined a death to be an accidental heroin overdose, the death would be assigned ICD codes: X42 (accidental poisoning) and T40.1 (poisoning by heroin). In ICD-10, codes for external causes are presented in Chapter XX while poison codes are in Chapter XIX.

Table A3.3 provides a code descriptor for each of the ICD-10 codes mentioned in Table A3.2, to clarify the classification. Further details of the ICD-10 codes are available from the three volumes of the publication International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, published in 1992, 1993 and 1994 by WHO.


A3.1 CD-9 CODES FOR DEATHS CAUSED BY SELECTED DRUGS
Mental and behavioural disorders
  
Drug type Example/common name Dependence Non-dependent abuse Psychoses
Multiple drug use -3047, 3048 3059 292
Cannabis Grass, Hashish, Pot 3043 3052 292
Cocaine Coke, Crack, White lady 3042 3056 292
Hallucinogens LSD, Mescaline, Psilocybin 3045 3053 292
Opioids Heroin, Morphine, Codeine 3040, 3047 3055 292
Psychostimulants Amphetamine, Ecstasy 3044 3057 292
Barbiturates Barbs, Phenobarbitone 3041 3054 292
Tranquillisers/sedatives Benzodiazepine, Valium, Serepax 3041 3054 292


A3.1 CD-9 CODES FOR DEATHS CAUSED BY SELECTED DRUGS continued
  External causes (poisoning)

Drug type Example/common name Assault Accident Suicide Undetermined intent
Multiple drug use -E9620 E8588 (a) E9504 (a) E9804 (a)
Cannabis Grass, Hashish, Pot E9620 E8541 E9503 E9803
Cocaine Coke, Crack, White lady E9620 E8552 (b) E9504 (c) E9804 (c)
Hallucinogens LSD, Mescaline, Psilocybin E9620 E8541 E9503 E9803
Opioids Heroin, Morphine, Codeine E9620 E8500 E9500 (d) E9800 (d)
Psychostimulants Amphetamine, Ecstasy E9620 E8542 E9503 E9803
Barbiturates Barbs, Phenobarbitone E9620 E8519 E9501 E9801
Tranquillisers/sedatives Benzodiazepine, Valium, Serepax E9620 E852, E853 E9502, E9503 E9802, E9803


(a)    From 1997, deaths from multiple drug use were coded to E8588 (accident), E9504 (suicide), or E9804 (undetermined). Prior to this, only the first mentioned drug on the medical certificate was coded.
(b)    Included with local anaesthetics.
(c)    Included with other specified drugs and medicaments.
(d)    Included with analgesics, antipyretics and antirheumatics.


A3.2 ICD-10 CODES FOR DEATHS CAUSED BY SELECTED DRUGS
External causes (poisoning)
Drug type Example/common name Mental and behavioural disorders(a) Assault Accident Suicide Undetermined
intent
Poison codes
Multiple drug use(b) -F19 X85 X44 X64 Y14 -
Cannabis Grass, Hashish, Pot F12, F19 X85 X42, X44 X62, X64 Y12, Y14 T40.7
Cocaine Coke, Crack, White lady F14, F19 X85 X42, X44 X62, X64 Y12, Y14 T40.5
Hallucinogens LSD, Mescaline, Psilocybin F16, F19 X85 X42, X44 X62, X64 Y12, Y14 T40.8, T40.9
Opioids Heroin, Morphine, Codeine F11, F19 X85 X42, X44 X62, X64 Y12, Y14 T40.0-T40.4, T40.6
Psychostimulants Amphetamine, Ecstasy F15, F19 X85 X41, X44 X61, X64 Y11, Y14 T43.6, T43.8, T43.9
Barbiturates Barbs, Phenobarbitone F13, F19 X85 X41, X44 X61, X64 Y11, Y14 T42.3
Tranquillisers/sedatives Benzodiazepines, Valium, Serepax F13, F19X85X41, X44X61, X64Y11, Y14T42.4, T42.6, T42.7,
T43.3, T43.5


(a)    A fourth character will give the type of substance use e.g. dependence, harmful use, psychoses.
(b)    Includes deaths from multiple drug use involving a combination of drugs from different categories e.g. opiate and tranquilliser.


A3.3 ICD-10 CODE DESCRIPTORS
Cause of death
ICD-10 code

MEDICAL CONDITIONS
Mental and behavioural disorders due to use of  
Opioids
F11
Cannabinoids
F12
Sedatives or hypnotics
F13
Cocaine
F14
Other stimulants including caffeine(a)
F15
Hallucinogens
F16
Multiple drug use and use of other psychoactive substances
F19
 
EXTERNAL CAUSES
Accidental poisoning by and exposure to  
Antiepileptic, sedative-hypnotic, antiparkinsonism and psychotropic drugs n.e.c.
X41
Narcotics and psychodysleptics (hallucinogens) n.e.c.
X42
Other and unspecified drugs, medicaments and biological substances
X44

Intentional self-poisoning by and exposure to
 
Antiepileptic, sedative-hypnotic, antiparkinsonism and psychotropic drugs n.e.c.
X61
Narcotics and psychodysleptics (hallucinogens) n.e.c.
X62
Other and unspecified drugs, medicaments and biological substances
X64

Assault by drugs, medicaments and biological substances
X85

Event of undetermined intent by poisoning and exposure to
 
Antiepileptic, sedative-hypnotic, antiparkinsonism and psychotropic drugs n.e.c.
Y11
Narcotics and psychodysleptics (hallucinogens) n.e.c.
Y12
Other and unspecified drugs, medicaments and biological substances
Y14
 
POISONS
Poisoning by narcotics and psychodysleptics (hallucinogens)  
Opium
T40.0
Heroin
T40.1
Other opioids
T40.2
Methadone
T40.3
Other synthetic narcotics
T40.4
Cocaine
T40.5
Other and unspecified narcotics
T40.6
Cannabis (derivatives)
T40.7
Lysergide (LSD)
T40.8
Other and unspecified psychodysleptics (hallucinogens)
T40.9

Poisoning by antiepileptic, sedative-hypnotic and antiparkinsonism drugs
 
Barbiturates
T42.3
Benzodiazepines
T42.4
Other antiepileptic and sedative-hypnotic drugs
T42.6
Antiepileptic and sedative-hypnotic drugs, unspecified
T42.7

Poisoning by psychotropic drugs, n.e.c.
 
Phenothiazine antipsychotics and neuroleptics
T43.3
Other and unspecified antipsychotics and neuroleptics
T43.5
Psychostimulants with abuse potential (a)
T43.6
Other psychotropic drugs, n.e.c.
T43.8
Psychotropic drug, unspecified
T43.9

(a) Includes amphetamines and ecstasy.


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