|Submitted By: Julia Skapik / National Association of Community Health Centers (NACHC)|
|Data Element Information|
|Use Case Description(s)|
|Use Case Description||Collection information on alcohol and illicit drug is a routine part of a clinician's comprehensive history taking of patients. The prevalence of substance abuse and dependence remains high in America, wherein approximately 21.6 million Americans, or 8.2% of persons aged 12 years and older, were classiﬁed with a substance abuse or dependence disorder, including 14.7 million people with alcohol abuse or dependence, 2.6 million with alcohol and illicit drug abuse or dependence, and 4.3 million with illicit drug abuse or dependence in 2013.
Abuse of prescribed pain medications is also increasing, now numbering about 1.9 million people.
Roughly 28% of Americans aged 12 years or older report binge or heavy drinking, and almost 3%, or 7 million, have used prescription drugs for nonclinical reasons, especially pain relievers, stimulants, and antidepressants.
The high prevalence of alcohol, drug, and substance abuse makes it is essential to standardize collection of this data as part of USCDI.
1. Cole S, Bogenschutz M, Hungerford M. Motivational interviewing and psychiatry: use in addiction treatment, risky drinking and routine practice. Focus. 2011;IX:42.
2. Substance Abuse and Mental Health Services Administration, Department of Health and Human Services. Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings. Available at http://www.samhsa.gov/data/sites/ default/files/NSDUHresultsPDFWHTML2013/Web/ NSDUHresults2013.pdf. Accessed January 15, 2015.
3. Medline Plus, National Institutes of Health. Prescription drug abuse: a fast-growing problem. Available at http://www.nlm.nih. gov/medlineplus/magazine/issues/fall11/articles/fall11pg21.html. Accessed January 19, 2015.
4. National Institute on Drug Abuse. Screening for drug use in general medical settings. Updated March 2102. Available at http:// www.drugabuse.gov/publications/resource-guide-screening- drug-use-in-general-medical-settings/nida-quick-screen. Accessed January 19, 2015.
5. Smith PC, Schmidt SM, Allensworth-Davies D, et al. A single- question screening test for drug use in primary care. Arch Intern Med. 2010;170:1155.
|Estimated number of stakeholders capturing, accessing using or exchanging||Almost all healthcare institutions and providers are currently capturing and accessing these data, but exchanging this data can be a challenge due to differences in HIS/EHR/EMR capture and standard terminology support. These information are electronically submitted to CMS for different quality measurement purposes.
All users and institutions that one of ONC's 2015 Edition certified health IT products
|Link to use case project page||https://confluence.nachc.org/display/USCDIv2/Alcohol+and+Drug+Use+Data+Elements+Use+Cases|
|Maturity of Use and Technical Specifications for Data Element|
Value Sets and Related Codes:
1. Alcohol and Drug Dependence OID: 2.16.840.1.113883.3.464.1003.106.12.1001 (ICD-10CM and SNOMED CT codes)
Includes only relevant concepts associated with alcohol and drug abuse and dependence.
2. Drug Use [IV Evidence] (SNOMED) OID: 2.16.840.1.1137126.96.36.1996.1071
disorders or findings related to Drug IV usage
3. Finding of alcohol intake (finding) - SNOMED: 3659670054.
4. Finding relating to alcohol drinking behavior (finding) - SNOMED: 228273003
5. Finding relating to drug misuse behavior (finding) - SNOMED: 228366006
|Current Use||Extensively used in production environments|
|Number of organizations/individuals with which this data element has been electronically exchanged||5 or more. This data element has been tested at scale between multiple different production environments to support the majority of anticipated stakeholders.|
|Restrictions on Standardization (e.g. proprietary code)||Some EHR vendors may code for these data elements using internal proprietary code that is mapped to standard terminologies.|
|Restrictions on Use (e.g. licensing, user fees)||None|
|Privacy and Security Concerns||There may be discrimination or inherent bias against patients who are identified as alcohol or drug users, which may lead to possible trouble with police.|
|Estimate of Overall Burden||Very low burden as these information are captured routinely by all trained healthcare professionals.|
Information from the submission form
Indicates the use and/or abuse of alcohol