Assessments of a health-related matter of interest, importance, or worry to a patient, patient’s family, or patient’s healthcare provider that could identify a need, problem, or condition.

Data Element
Substance Use
Description

Evaluation of a patient's reported use of drugs or other substances for non-medical purposes or in excess of a valid prescription.

Examples include but are not limited to substance use disorder score, and substance use knowledge assessment. 

Applicable Vocabulary Standard(s)

Applicable Standards
  • Logical Observation Identifiers Names and Codes (LOINC®) version 2.74
Submitted By: Jessica Cotto / National Institute on Drug Abuse
Data Element Information
Use Case Description(s)
Use Case Description According to the 2019 National Survey on Drug Use and Health (NSDUH), 20.2% of people ages 12 or older reported past month cigarette use. In addition, 8.1% reported past month cigar use, 4.2% used smokless tobacco and 13% used illicit drugs. In total, nearly 36 million people ages 12 or older reported past month use of illicit drugs in 2019 and 58 million reported use of tobacco in the past month.
Estimate the breadth of applicability of the use case(s) for this data element U.S. primary health care providers: The U.S. Preventive Services Task Force (USPSTF) recommends screening for unhealthy drug use in adults aged 18 years and older, with a Grade B recommendation:
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/drug-use-illicit-screening.
Link to use case project page https://www.samhsa.gov/data/report/2019-nsduh-annual-national-report The National Survey on Drug Use and Health.
Healthcare Aims
  • Improving the health of populations
Maturity of Use and Technical Specifications for Data Element
Applicable Standard(s) Elements were recently submitted for inclusion in LOINC.


https://loinc.org/
Additional Specifications NIDA Screening Tools API Gateway, TAPS API found at: https://api.drugabuse.gov/prod/taps/
Current Use This data element has been used at scale between multiple different production environments to support the majority of anticipated stakeholders
Supporting Artifacts This data element has been used at scale and reviewed for maximum stakeholder impact. Our internal analysis of web traffic to the TAPS website (https://www.drugabuse.gov/taps/ ) in Q3 this year exceeded 6,000 unique page views.

McNeely, J., Wu, L.T., Subramaniam, G., Sharma, G., Cathers, L.A., et al. (2016). Performance of the Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) Tool for Substance Use Screening in Primary Care Patients. Annals of Internal Medicine, 2016 Nov 15;165(10):690-699.
Angéline Adam, Robert P Schwartz, Li-Tzy Wu, Geetha Subramaniam, Eugene Laska, Gaurav Sharma, Saima Mili, Jennifer McNeely. Electronic self-administered screening for substance use in adult primary care patients: feasibility and acceptability of the tobacco, alcohol, prescription medication, and other substance use (myTAPS) screening tool. Addict Sci Clin Pract. 2019 Oct 15;14(1):39.

https://cde.drugabuse.gov/instrument/29b23e2e-e266-f095-e050-bb89ad43472f
Extent of exchange 5 or more. This data element has been tested at scale between multiple different production environments to support the majority of anticipated stakeholders.
Supporting Artifacts There are 10 registered users for the TAPS Tool API, and we have received about 5 additional inquiries expressing interest in EHR/EMR system integration. None of the registered users are currently active.
Potential Challenges
Restrictions on Standardization (e.g. proprietary code) None known.
Restrictions on Use (e.g. licensing, user fees) None known.
Privacy and Security Concerns None known.
Estimate of Overall Burden Minimal -- for more information, see “Frequently Asked Questions About Screening” at https://www.drugabuse.gov//taps/#/.

The tool is designed to be brief and should take fewer than 5 minutes to administer, but may be completed quicker if the patient does not endorse recent substance use. Clinicians may wish to identify local providers and or specialty care SUD programs to which to refer patients with higher risk levels well before beginning systematic screening. This will greatly assist with finding a suitable referral when the need arises
Other Implementation Challenges There is no additional information on challenges.

Comment

Submitted by pwilson@ncpdp.org on

NCPDP Comments on USCDI draft v5

NCPDP recommends the use of SNOMED CT codes as the NCPDP SCRIPT Standard utilizes these codes.

Submitted by pwilson@ncpdp.org on

NCPDP Comment

NCPDP supports the use of LOINC codes for assessments and observations for substance use. NCPDP utilizes LOINC codes in the HL7/NCPDP Pharmacist eCare Plan.

NCPDP recommends the use of RxNorm and SNOMED CT codes in addition to LOINC codes as the NCPDP SCRIPT Standard utilizes these codes.

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