ICD-11 Criteria for Disorders Due to Use of Other Specified Psychoactive Substances, Including Medications (6C4E)
ICD-11 Criteria for Disorders Due to Use of Other Specified Psychoactive Substances, Including Medications (6C4E)
Disorders due to use of other specified psychoactive substances, including medications are characterised by the pattern and consequences of psychoactive substances that are not included among the major substance classes specifically identified. Examples include khat, anabolic steroids, corticosteroids, antidepressants, medications with anticholinergic properties (e.g., benztropine), and some antihistamines.
6C4E.0 Episode of Harmful use of Other Specified Psychoactive Substance
An episode of use of a specified
psychoactive substance or medication that is not included in the other
substance classes specifically identified under Disorders Due to Substance Use
that has caused damage to a person’s physical or mental health or has resulted
in behaviour leading to harm to the health of others. Harm to health of the
individual occurs due to one or more of the following: (1) behaviour related to
substance intoxication or psychoactive medication use; (2) direct or secondary
toxic effects on body organs and systems; or (3) a harmful route of
administration. Harm to health of others includes any form of physical harm,
including trauma, or mental disorder that is directly attributable to behaviour
related to substance intoxication or psychoactive medication use on the part of
the person to whom the diagnosis of single episode of harmful use of other
specified psychoactive substance applies. This diagnosis should not be made if
the harm is attributed to a known pattern of use of the specified psychoactive
substance.
Exclusions:
- Harmful pattern of use of other specified psychoactive substance (6C4E.1)
- Other specified psychoactive substance dependence (6C4E.2)
6C4E.1 Harmful Pattern of use of Other Specified Psychoactive Substance
A pattern of use of a specified
psychoactive substance or medication that is not included in the other
substance classes specifically identified under Disorders Due to Substance Use
that has caused damage to a person’s physical or mental health or has resulted
in behaviour leading to harm to the health of others. The pattern of substance
use is evident over a period of at least 12 months if use is episodic or at
least one month if use is continuous (i.e., daily or almost daily). Harm to
health of the individual occurs due to one or more of the following: (1)
behaviour related to intoxication; (2) direct or secondary toxic effects on
body organs and systems; or (3) a harmful route of administration. Harm to
health of others includes any form of physical harm, including trauma, or
mental disorder that is directly attributable to behaviour related to
intoxication due to the specified substance or medication on the part of the
person to whom the diagnosis of Harmful pattern of use of other specified
psychoactive substance applies.
Exclusions:
- Other specified psychoactive substance dependence (6C4E.2)
- Episode of harmful use of other specified psychoactive substance (6C4E.0)
6C4E.10 Harmful Pattern of use of other Specified Psychoactive Substance, Episodic
A pattern of episodic or
intermittent use of a specified psychoactive substance or medication that is
not included in the other substance classes specifically identified under Disorders
Due to Substance Abuse that has caused damage to a person’s physical or mental
health or has resulted in behaviour leading to harm to the health of others.
The pattern of episodic substance use is evident over a period of at least 12
months. Harm to health of the individual occurs due to one or more of the
following: (1) behaviour related to intoxication; (2) direct or secondary toxic
effects on body organs and systems; or (3) a harmful route of administration.
Harm to health of others includes any form of physical harm, including trauma,
or mental disorder that is directly attributable to behaviour related to
intoxication due to the specified substance or medication on the part of the
person to whom the diagnosis of Harmful pattern of use of other specified
psychoactive substance applies.
Exclusions:
- Episode of harmful use of other specified psychoactive substance (6C4E.0)
- Other specified psychoactive substance dependence (6C4E.2)
6C4E.11 Harmful Pattern of use of Other Specified Psychoactive Substance, Continuous
A pattern of continuous (daily or
almost daily) use of a specified psychoactive substance or medication that is
not included in the other substance classes specifically identified under
Disorders Due to Substance Use that has caused damage to a person’s physical or
mental health or has resulted in behaviour leading to harm to the health of
others. The pattern of continuous substance use is evident over a period of at
least one month. Harm to health of the individual occurs due to one or more of
the following: (1) behaviour related to intoxication; (2) direct or secondary
toxic effects on body organs and systems; or (3) a harmful route of
administration. Harm to health of others includes any form of physical harm,
including trauma, or mental disorder that is directly attributable to behaviour
related to intoxication due to the specified substance or medication on the
part of the person to whom the diagnosis of Harmful pattern of use of other
specified psychoactive substance applies.
Exclusions:
- Episode of harmful use of other specified psychoactive substance (6C4E.0)
- Other specified psychoactive substance dependence (6C4E.2)
6C4E.1Z Harmful Pattern of use of Other specified Psychoactive Substance, Unspecified
6C4E.2 Other Specified Psychoactive Substance Dependence
Other specified psychoactive
substance dependence is a disorder of regulation of use of a specified
substance arising from repeated or continuous use of the specified substance.
The characteristic feature is a strong internal drive to use the specified
substance, which is manifested by impaired ability to control use, increasing
priority given to use over other activities and persistence of use despite harm
or negative consequences. These experiences are often accompanied by a
subjective sensation of urge or craving to use the specified substance.
Physiological features of dependence may also be present, including tolerance
to the effects of the specified substance, withdrawal symptoms following
cessation or reduction in use of the specified substance, or repeated use of
the specified substance or pharmacologically similar substances to prevent or
alleviate withdrawal symptoms. The features of dependence are usually evident
over a period of at least 12 months but the diagnosis may be made if use of the
specified substance is continuous (daily or almost daily) for at least 3
months.
Exclusions:
- Episode of harmful use of other specified psychoactive substance (6C4E.0)
- Harmful pattern of use of other specified psychoactive substance (6C4E.1)
6C4E.20 Other specified psychoactive substance dependence, current use
Current Other specified
psychoactive substance dependence, with use of the specified psychoactive
substance within the past month.
Exclusions:
- Episode of harmful use of other specified psychoactive substance (6C4E.0)
- Harmful pattern of use of other specified psychoactive substance (6C4E.1)
6C4E.21 Other Specified Psychoactive Substance Dependence, Early full Remission
After a diagnosis of Other
specified psychoactive substance dependence, and often following a treatment
episode or other intervention (including self-help intervention), the
individual has been abstinent from the specified substance during a period
lasting from between 1 and 12 months.
Exclusions:
- Episode of harmful use of other specified psychoactive substance (6C4E.0)
- Harmful pattern of use of other specified psychoactive substance (6C4E.1)
6C4E.22 Other Specified Psychoactive Substance Dependence, Sustained Partial Remission
After a diagnosis of Other
specified psychoactive substance dependence, and often following a treatment
episode or other intervention (including self-help intervention), there is a
significant reduction in consumption of the specified substance for more than
12 months, such that even though intermittent or continuing substance use has
occurred during this period, the definitional requirements for dependence have
not been met.
Exclusions:
- Episode of harmful use of other specified psychoactive substance (6C4E.0)
- Harmful pattern of use of other specified psychoactive substance (6C4E.1)
6C4E.23 Other Specified psychoactive Substance Dependence, Sustained full Remission
After a diagnosis of Other
specified psychoactive substance dependence, and often following a treatment
episode or other intervention (including self-intervention), the person has
been abstinent from the specified substance for 12 months or longer.
Exclusions:
Episode
of harmful use of other specified psychoactive substance (6C4E.0)
Harmful pattern of use of other specified psychoactive substance (6C4E.1)
6C4E.2Z Other Specified Psychoactive Substance Dependence, Unspecified
6C4E.3 Other Specified Psychoactive Substance Intoxication
Other specified psychoactive
substance intoxication is a clinically significant transient condition that
develops during or shortly after the consumption of a specified psychoactive
substance or medication that is characterised by disturbances in level of
consciousness, cognition, perception, affect, behaviour, or coordination. These
disturbances are caused by the known pharmacological effects of the specified
psychoactive substance and their intensity is closely related to the amount of
the specified psychoactive substance consumed. They are time-limited and abate
as the specified substance is cleared from the body.
Coding Note: Code aslo the causing condition
6C4E.4 Other Specified Psychoactive Substance Withdrawal
Other specified psychoactive
substance withdrawal is a clinically significant cluster of symptoms,
behaviours and/or physiological features, varying in degree of severity and
duration, that occurs upon cessation or reduction of use of the specified
substance in individuals who have developed dependence or have used the
specified substance for a prolonged period or in large amounts. Other specified
psychoactive substance withdrawal can also occur when prescribed psychoactive
medications have been used in standard therapeutic doses. The specific features
of the withdrawal state depend on the pharmacological properties of the
specified substance.
Coding Note: Code aslo the causing condition
6C4E.40 Other specified psychoactive substance withdrawal, uncomplicated
The development of a withdrawal
state not accompanied by perceptual disturbances or seizures following
cessation or reduction of use of the specified substance.
Coding Note: Code aslo the causing condition
6C4E.41 Other specified psychoactive substance withdrawal, with perceptual disturbances
The development of a withdrawal
state accompanied by perceptual disturbances but not by seizures following
cessation or reduction of use of the specified substance.
Coding Note: Code aslo the causing condition
6C4E.42 Other specified psychoactive substance withdrawal, with seizures
The development of a withdrawal
state accompanied by seizures but not by perceptual disturbances following
cessation or reduction of use of the specified substance.
Coding Note: Code aslo the causing condition
6C4E.43 Other specified psychoactive substance withdrawal, with perceptual disturbances and seizures
The development of a withdrawal
state accompanied by both perceptual disturbances and seizures following
cessation or reduction of use of the specified substance.
Coding Note: Code aslo the causing condition
6C4E.4Z Other specified psychoactive substance withdrawal, unspecified
Coding Note: Code aslo the causing condition
6C4E.5 Delirium induced by other specified psychoactive substance including medications
Delirium induced by other
specified psychoactive substance is characterised by an acute state of
disturbed attention and awareness with specific features of delirium that
develops during or soon after substance intoxication or withdrawal or during
the use of a specified psychoactive substance. The amount and duration of use
of the specified substance must be capable of producing delirium. The symptoms
are not better explained by a primary mental disorder, by use of or withdrawal
from a different substance, or by another health condition that is not
classified under Mental, behavioural and neurodevelopmental disorders.
Coding Note: Code aslo the causing condition
6C4E.6 Psychotic disorder induced by other specified psychoactive substance
Psychotic disorder induced by
other specified psychoactive substance is characterised by psychotic symptoms
(e.g., delusions, hallucinations, disorganised thinking, grossly disorganised
behaviour) that develop during or soon after intoxication with or withdrawal
from a specified psychoactive substance. The intensity or duration of the
symptoms is substantially in excess of psychotic-like disturbances of
perception, cognition, or behaviour that are characteristic of intoxication
with or withdrawal from a specified psychoactive substance. The amount and
duration of use of the specified psychoactive substance must be capable of
producing psychotic symptoms. The symptoms are not better explained by a
primary mental disorder (e.g., Schizophrenia, a Mood disorder with psychotic
symptoms), as might be the case if the psychotic symptoms preceded the onset of
the use of the specified psychoactive substance, if the symptoms persist for a
substantial period of time after cessation of the use of the specified
psychoactive substance or withdrawal from the specified psychoactive substance,
or if there is other evidence of a pre-existing primary mental disorder with
psychotic symptoms (e.g., a history of prior episodes not associated with the
use of the specified psychoactive substance).
Coding Note: Code aslo the causing condition
6C4E.7 Certain other specified psychoactive substance-induced mental or behavioural disorders
Coding Note: Code aslo the causing condition
6C4E.70 Mood disorder induced by other specified psychoactive substance
Mood disorder induced by other
specified psychoactive substance is characterised by mood symptoms (e.g.,
depressed or elevated mood, decreased engagement in pleasurable activities,
increased or decreased energy levels) that develop during or soon after
intoxication with or withdrawal from a specified psychoactive substance. The
intensity or duration of the symptoms is substantially in excess of mood
disturbances that are characteristic of intoxication with or withdrawal from a
specified psychoactive substance. The amount and duration of use of the specified
psychoactive substance must be capable of producing mood symptoms. The symptoms
are not better explained by a primary mental disorder (e.g., a Depressive
disorder, a Bipolar disorder, Schizoaffective disorder), as might be the case
if the mood symptoms preceded the onset of the use of the specified
psychoactive substance, if the symptoms persist for a substantial period of
time after cessation of the use of the specified psychoactive substance or
withdrawal from the specified psychoactive substance, or if there is other
evidence of a pre-existing primary mental disorder with mood symptoms (e.g., a
history of prior episodes not associated with the use of the specified
psychoactive substance).
Coding Note: Code aslo the causing condition
6C4E.71 Anxiety disorder induced by other specified psychoactive substance
Anxiety disorder induced by other
specified psychoactive substance is characterised by anxiety symptoms (e.g.,
apprehension or worry, fear, physiological symptoms of excessive autonomic
arousal, avoidance behaviour) that develop during or soon after intoxication
with or withdrawal from a specified psychoactive substance. The intensity or
duration of the symptoms is substantially in excess of anxiety symptoms that
are characteristic of intoxication with or withdrawal from a specified
psychoactive substance. The amount and duration of use of the specified
psychoactive substance must be capable of producing anxiety symptoms. The
symptoms are not better explained by a primary mental disorder (e.g., an Anxiety
and fear-related disorder, a Depressive disorder with prominent anxiety
symptoms), as might be the case if the anxiety symptoms preceded the onset of
the use of the specified psychoactive substance, if the symptoms persist for a
substantial period of time after cessation of the use of the specified
psychoactive substance or withdrawal from the specified psychoactive substance,
or if there is other evidence of a pre-existing primary mental disorder with
anxiety symptoms (e.g., a history of prior episodes not associated with the use
of the specified psychoactive substance).
Coding Note: Code aslo the causing condition
6C4E.72 Obsessive-compulsive or related disorder induced by other specified psychoactive substance
Obsessive-compulsive or related
disorder induced by other specified psychoactive substance is characterised by
either repetitive intrusive thoughts or preoccupations, normally associated
with anxiety and typically accompanied by repetitive behaviours performed in
response, or by recurrent and habitual actions directed at the integument
(e.g., hair pulling, skin picking) that develop during or soon after
intoxication with or withdrawal from a specified psychoactive substance. The
intensity or duration of the symptoms is substantially in excess of analogous
disturbances that are characteristic of intoxication with or withdrawal from
the specified psychoactive substance. The amount and duration of the specified
psychoactive substance use must be capable of producing obsessive-compulsive or
related symptoms. The symptoms are not better explained by a primary mental
disorder (in particular an Obsessive-compulsive or related disorder), as might
be the case if the symptoms preceded the onset of the specified psychoactive
substance use, if the symptoms persist for a substantial period of time after
cessation of use or withdrawal of the specified psychoactive substance, or if there
is other evidence of a pre-existing primary mental disorder with
obsessive-compulsive or related symptoms (e.g., a history of prior episodes not
associated with specified psychoactive substance use).
Coding Note: Code aslo the causing condition
6C4E.73 Impulse control disorder induced by other specified psychoactive substance
Impulse control disorder induced
by other specified psychoactive substance is characterised by persistently
repeated behaviours in which there is recurrent failure to resist an impulse,
drive, or urge to perform an act that is rewarding to the person, at least in
the short-term, despite longer-term harm either to the individual or to others
(e.g., fire setting or stealing without apparent motive, repetitive sexual
behaviour, aggressive outbursts) that develop during or soon after intoxication
with or withdrawal from a specified psychoactive substance. The intensity or
duration of the symptoms is substantially in excess of disturbances of impulse
control that are characteristic of intoxication with or withdrawal from the
specified psychoactive substance. The amount and duration of the specified
psychoactive substance use must be capable of producing disturbances of impulse
control. The symptoms are not better explained by a primary mental disorder
(e.g., an Impulse control disorder, a Disorder due to addictive behaviours), as
might be the case if the impulse control disturbances preceded the onset of the
specified psychoactive substance use, if the symptoms persist for a substantial
period of time after cessation of use or withdrawal of the specified
psychoactive substance, or if there is other evidence of a pre-existing primary
mental disorder with impulse control symptoms (e.g., a history of prior
episodes not associated with specified psychoactive substance use).
Coding Note: Code aslo the causing condition
6C4E.Y Other
specified disorders due to use of other specified psychoactive substances,
including medications
6C4E.Z Disorders
due to use of other specified psychoactive substances, including medications,
unspecified
REFERENCE:
International Classification of Diseases Eleventh Revision (ICD-11). Geneva: World Health Organization; 2022. License: CC BY-ND 3.0 IGO.
https://creativecommons.org/licenses/by-nc-nd/3.0/igo/
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