Created Dec 2012
Reviewed Dec 2019
We often have documentation of a drug overdose taken in the context of alcohol intoxication, in which the alcohol consumption is documented to be a distinct event from the drug consumption.
An example is a patient who was out drinking with his partner and flatmates. The conversation turned sour and some hours later the patient returned home and took an overdose of Zopiclone. At no point in the clinical record was the alcohol documented as anything other than intoxication.
In these limited circumstances can we code the Zopiclone overdose with alcohol intoxication (F10.0 Mental and behavioural disorders due to use of alcohol, acute intoxication)? Or must we include the alcohol in the list of drugs in the overdose?
In the limited circumstances detailed in the query (i.e. the alcohol consumption is clearly documented to be a distinct event from the drug consumption) it is appropriate to code the alcohol as intoxication (F10.0) and not as poisoning.
The more common scenario is that alcohol is consumed as a part of the overdose and in these cases it is appropriate to assign the poisoning code T51.0 Toxic effect of ethanol.
Note: alcohol poisoning and intoxication should not be assigned together on the same event record.
Where the clinical notes include documentation of a blood alcohol level, a code from Y90.- Evidence of alcohol involvement determined by blood alcohol level may be assigned in addition to the F10.0 Mental and behavioural disorders due to use of alcohol, acute intoxication or T51.0 Toxic effect of ethanol.
Refer to ACS 0503 Drug, Alcohol and Tobacco Use Disorders