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The Economic Costs of Alcohol and Drug Abuse in the United States - 1992

Appendix A

Health Disorder Codes

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.

ICD-9 Diagnostic Codes Specific and Related to Drug and Alcohol Abuse and Dependence and Associated Causality Factors

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


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.

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