Abstract
ObjectiveTo examine the empirical basis for including the diagnostic category of “a single episode of harmful substance use” in the 11th revision of the International statistical classification of diseases and related health problems (ICD-11).MethodsWe used data on patients admitted to emergency departments in 21 countries with alcohol-related injuries (i.e. with drinking within the preceding six hours) who had no sign of alcohol intoxication or withdrawal, no alcohol in blood and no sign of alcohol dependence or harmful drinking as described in the ICD-10. We obtained data on alcohol-related injuries, the patient’s causal attribution of injury to drinking, the alcohol amount consumed, blood alcohol concentration and usual drinking pattern. Patients with and without alcohol dependence or harmful drinking were compared.FindingsWe included a representative sample of 18 369 patients. After adjustment for unequal sampling, 18.8% reported drinking in the six hours before injury and 47.1% of these attributed their injury to drinking; 16.3% of those reporting drinking and 10.3% of those attributing their injury to drinking were not alcohol dependent or harmful drinkers. The majority of these last two groups reported never having had five or more drinks on one occasion during the last year and had a blood alcohol concentration less than 0.05%.ConclusionSome individuals attending emergency departments had alcohol-attributable injuries due to a single episode of drinking but had no history of harmful use or dependence. These findings highlight the public health relevance of including the new diagnostic category in the ICD-11.
Highlights
Alcohol use is among the top 10 risk factors for ill health globally and is one of the five leading risk factors among men, such use accounts for 3.9% to 5.1% of the global disease burden.[1,2] Injury constitutes a major part of this burden: 24.4% to 25.8% of all deaths attributable to alcohol and 30.7% to 33.2% of all alcohol-attributable disability-adjusted life years lost are due to injuries.[2,3] One public health strategy for reducing the disease burden is to ensure that effective interventions targeting alcohol use are provided by health services,[4] especially by emergency departments and trauma centres, because many health conditions presented at admission are associated with alcohol.[5]
The International statistical classification of diseases and related health problems, 10th revision (ICD-10) includes codes for alcohol use disorders that are commonly used for alcoholfocused interventions: acute alcohol intoxication (F10.0), harmful use of alcohol (F10.1) and alcohol dependence (F10.2).[6]
Our analysis included data on a representative sample of 18 369 injured patients who attended 50 emergency departments in 21 countries (Table 1) that took part in the International Collaborative Alcohol and Injury Study, which comprised four international, collaborative research projects on alcohol and injury: the Emergency Room Collaborative Alcohol Analysis Project (ERCAAP) and three studies conducted by the World Health Organization (WHO), the Pan American Health Organization (PAHO) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in the United States of America
Summary
Alcohol use is among the top 10 risk factors for ill health globally and is one of the five leading risk factors among men, such use accounts for 3.9% to 5.1% of the global disease burden.[1,2] Injury constitutes a major part of this burden: 24.4% to 25.8% of all deaths attributable to alcohol and 30.7% to 33.2% of all alcohol-attributable disability-adjusted life years lost are due to injuries.[2,3] One public health strategy for reducing the disease burden is to ensure that effective interventions targeting alcohol use are provided by health services,[4] especially by emergency departments and trauma centres, because many health conditions presented at admission are associated with alcohol.[5]. The International statistical classification of diseases and related health problems, 10th revision (ICD-10) includes codes for alcohol use disorders that are commonly used for alcoholfocused interventions: acute alcohol intoxication (F10.0), harmful use of alcohol (F10.1) and alcohol dependence (F10.2).[6] episodes of alcohol use that cause harm (e.g. alcoholrelated injury) but cannot be described using these codes can neither be diagnosed nor classified using the ICD-10. To facilitate the identification of patients in whom substance use has caused a health condition but who have no clear clinical manifestations of substance intoxication or substance dependence. To encourage the provision of substance-focused interventions for these patients, such as brief interventions, in diverse health-care settings, including emergency departments
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
