a. Alcohol dependence syndrome (Alcoholism). A state, psychic and usually
also physical, resulting from taking alcohol, characterized by behavioral and other
responses that always include a compulsion to take alcohol on a continuous or periodic
basis in order to experience its psychic effects, and sometimes to avoid the discomfort
of its absence. Tolerance may or may not be present.
b. Nondependent abuse of alcohol. Includes individuals whose use of alcohol
has brought them to medical attention. Nondependent abuse of alcohol is applicable to
individuals formerly diagnosed as simple drunkenness cases. It also applies to
individuals not suffering from alcoholism whether or not they are intoxicated when seen
by a physician, after being referred to him in connection with driving-while-intoxicated
charges, altercations involving alcohol, AWOL or absences from work due to overuse of
alcohol, or for similar reasons when these individuals may benefit from available
c. Drug dependence. A state, psychic and sometimes also physical, resulting
from taking a drug, characterized by behavioral and other responses that always include
a compulsion to take a drug on a continuous or periodic basis in order to experience its
psychic effects, and sometimes to avoid the discomfort of its absence. Tolerance may
or may not be present. A person may be dependent on more than one drug.
d. Nondependent abuse of drugs. Includes cases where a person, for whom no
other diagnosis is possible, has come under medical care because of the maladaptive
effect of a drug on which he is not dependent and that he has taken on his own initiative
to the detriment of his health or social functioning.
2. Overdoses. Overdose cases must include sufficient information so that the
following coding principles may be applied:
a. Drug abuse overdoses. These are usually cases in which an individual
abusing drugs inadvertently takes a dose larger than he can tolerate physiologically.
This may happen, for example, when the purity of his usual dose has been increased by
the supplier's inclusion of a smaller proportion of cutting material in the product. Or an
individual may take his previously accustomed dose after his physiological tolerance
has been lowered by a period of abstinence from the drug. The term "overdose" may
also be applied to cases of severe reaction, including sudden deaths, when the drug
abuser may not have exceeded his usual dose.
b. The cause of admission code in drug abuse overdose cases will be the
appropriate poisoning code from the Poisoning by Drugs, Medicaments, and Biological
Substances section of ICD-9-CM (categories 96-979). The appropriate code for drug
abuse will be selected from the drug dependence categories (34) or the
Nondependent Abuse of Drugs category (35) and added as an additional code. The
cause of injury code will be 7 -, with third digit from Appendix B of the DOD coding
guidelines manual (STANAG 25). This code is defined as "Poisoning by ingestion of
toxic substance ..." It should also be used for cases in which the toxic substance was
taken by methods other than ingestion.