Disorders Due To Multiple Psychoactive Substances – ICD 11 Codes

Definition of Disorders due to use of multiple specified psychoactive substances including medications: Disorders due to use of multiple specified psychoactive substances, including medications are characterised by the pattern and consequences of multiple psychoactive substances. Although this grouping is provided for coding purposes, in most clinical situations it is recommended that multiple specific disorders due to substance use be assigned rather than using categories from this grouping.

ICD 11 Codes For Disorders due to use of multiple specified psychoactive substances including medications

  6C4F  Disorders due to use of multiple specified psychoactive substances including medications

6C4F.0 Episode of harmful use of multiple specified psychoactive substances

Definition of Episode of harmful use of multiple specified psychoactive substances: An episode of use of multiple specified psychoactive substances or medications that are not included in the other substance classes specifically identified under Disorder 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 multiple 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 due to multiple substance intoxication or psychoactive medication use on the part of the person to whom the diagnosis of single episode of harmful use of multiple specified psychoactive substances applies. This diagnosis should not be made if the harm is attributed to a known pattern of use of the multiple psychoactive substances.

Exclusions:

  • Harmful pattern of use of multiple specified psychoactive substances (6C4F.1)
  • Multiple specified psychoactive substances dependence (6C4F.2)

6C4F.1 Harmful pattern of use of multiple specified psychoactive substances

Definition of Harmful pattern of use of multiple specified psychoactive substances: A pattern of use of a multiple specified psychoactive substances or medications that are 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 multiple 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 multiple substance intoxication or psychoactive medication use on the part of the person to whom the diagnosis of Harmful pattern of use of multiple specified psychoactive substances applies.

Exclusions:

  • Episode of harmful use of multiple specified psychoactive substances (6C4F.0)
  • Multiple specified psychoactive substances dependence (6C4F.2)

6C4F.10 Harmful pattern of use of multiple specified psychoactive substances episodic

Definition of Harmful pattern of use of multiple specified psychoactive substances 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 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 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 multiple specified psychoactive substances (6C4F.0)
  • Multiple specified psychoactive substances dependence (6C4F.2)

6C4F.11 Harmful pattern of use of multiple specified psychoactive substances continuous

Definition of Harmful pattern of use of multiple specified psychoactive substances continuous: A pattern of continuous (daily or almost daily) use of a multiple 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 multiple 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 multiple substance intoxication or psychoactive medication use on the part of the person to whom the diagnosis of Harmful pattern of multiple specified psychoactive substances applies.

Exclusions:

  • Episode of harmful use of multiple specified psychoactive substances (6C4F.0)
  • Multiple specified psychoactive substances dependence (6C4F.2)

6C4F.1Z Harmful pattern of use of multiple specified psychoactive substances unspecified

6C4F.2 Multiple specified psychoactive substances dependence

Definition of Multiple specified psychoactive substances dependence: Multiple specified psychoactive substance dependence is a disorder of regulation of use of multiple specified substances arising from repeated or continuous use of the specified substances. The characteristic feature is a strong internal drive to use the specified substances, 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 substances. Physiological features of dependence may also be present, including tolerance to the effects of the specified substances, withdrawal symptoms following cessation or reduction in use of the specified substances, or repeated use of the specified substances 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 substances is continuous (daily or almost daily) for at least 3 months.

Exclusions:

  • Episode of harmful use of multiple specified psychoactive substances (6C4F.0)
  • Harmful pattern of use of multiple specified psychoactive substances (6C4F.1)

6C4F.20 Multiple specified psychoactive substances dependence current use

Exclusions:

  • Episode of harmful use of multiple specified psychoactive substances (6C4F.0)
  • Harmful pattern of use of multiple specified psychoactive substances (6C4F.1)

6C4F.21 Multiple specified psychoactive substances dependence early full remission

Exclusions:

  • Episode of harmful use of multiple specified psychoactive substances (6C4F.0)
  • Harmful pattern of use of multiple specified psychoactive substances (6C4F.1)

6C4F.22 Multiple specified psychoactive substances dependence sustained partial remission

Exclusions:

  • Episode of harmful use of multiple specified psychoactive substances (6C4F.0)
  • Harmful pattern of use of multiple specified psychoactive substances (6C4F.1)

6C4F.23 Multiple specified psychoactive substances dependence sustained full remission

Exclusions:

  • Episode of harmful use of multiple specified psychoactive substances (6C4F.0)
  • Harmful pattern of use of multiple specified psychoactive substances (6C4F.1)

6C4F.2Z Multiple specified psychoactive substances dependence unspecified

6C4F.3 Intoxication due to multiple specified psychoactive substances

Definition of Intoxication due to multiple specified psychoactive substances: Intoxication due to multiple specified psychoactive substances is a clinically significant transient condition that develops during or shortly after the consumption of multiple specified substances or medications that is characterised by disturbances in consciousness, cognition, perception, affect, behaviour, or coordination. These disturbances are caused by the known pharmacological effects of the multiple specified psychoactive substances and their intensity is closely related to the amount of the substances consumed. They are time-limited and abate as the multiple specified substances are cleared from the body.

Coding Note:

  • Code also the causing condition

6C4F.4 Multiple specified psychoactive substances withdrawal

Definition of Multiple specified psychoactive substances withdrawal: Multiple specified psychoactive substance withdrawal is a clinically significant cluster of symptoms, behaviours and physiological features, varying in degree of severity and duration, that occurs upon cessation or reduction of use of multiple specified substances in individuals who have developed dependence or have used the specified substances for a prolonged period or in large amounts. Multiple 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 substances and their interactions.

Coding Note:

  • Code also the causing condition

6C4F.40 Multiple specified psychoactive substances withdrawal uncomplicated

Coding Note:

  • Code also the causing condition

6C4F.41 Multiple specified psychoactive substances withdrawal with perceptual disturbances

Coding Note:

  • Code also the causing condition

6C4F.42 Multiple specified psychoactive substances withdrawal with seizures

Coding Note:

  • Code also the causing condition

6C4F.43 Multiple specified psychoactive substances withdrawal with perceptual disturbances and seizures

Coding Note:

  • Code also the causing condition

6C4F.4Y Other specified multiple specified psychoactive substances withdrawal

Coding Note:

  • Code also the causing condition

6C4F.4Z Multiple specified psychoactive substances withdrawal unspecified

Coding Note:

  • Code also the causing condition

6C4F.5 Delirium induced by multiple specified psychoactive substances including medications

Definition of Delirium induced by multiple specified psychoactive substances including medications: Delirium induced by multiple specified psychoactive substances 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 multiple specified substances. The amount and duration of use of the multiple specified substances must be capable of producing delirium. The symptoms are not better explained by a primary mental disorder, by use of or withdrawal from a substance other than those specified, or by another health condition that is not classified under Mental, behavioural and neurodevelopmental disorders. Note that this diagnosis applies only to those situations in which delirium is present but it cannot be determined which of multiple psychoactive substances is the cause of the delirium. In cases of multiple psychoactive substance use in which more than one specific substance can be identified as a cause of the delirium, the corresponding specific substance-induced delirium diagnoses should be given instead.

Coding Note:

  • Code also the causing condition

6C4F.6 Psychotic disorder induced by multiple specified psychoactive substances

Definition of Psychotic disorder induced by multiple specified psychoactive substances: Psychotic disorder induced by multiple specified psychoactive substances 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 multiple specified psychoactive substances. 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 multiple specified psychoactive substances. The amount and duration of use of the multiple specified psychoactive substances 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 multiple specified psychoactive substances, if the symptoms persist for a substantial period of time after cessation of the use of the multiple specified psychoactive substances or withdrawal from the multiple specified psychoactive substances, 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 multiple specified psychoactive substances).

Coding Note:

  • Code also the causing condition

6C4F.7 Certain multiple specified psychoactive substances-induced mental or behavioural disorders

Coding Note:

  • Code also the causing condition

6C4F.70 Mood disorder induced by multiple specified psychoactive substances

Definition of Mood disorder induced by multiple specified psychoactive substances: Mood disorder induced by multiple specified psychoactive substances 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 multiple specified psychoactive substances. The intensity or duration of the symptoms is substantially in excess of mood disturbances that are characteristic of intoxication with or withdrawal from multiple specified psychoactive substances. The amount and duration of use of the multiple specified psychoactive substances 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 multiple specified psychoactive substances, if the symptoms persist for a substantial period of time after cessation of the use of the multiple specified psychoactive substances or withdrawal from the multiple specified psychoactive substances, 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 multiple specified psychoactive substances).

Coding Note:

  • Code also the causing condition

6C4F.71 Anxiety disorder induced by multiple specified psychoactive substances

Definition of Anxiety disorder induced by multiple specified psychoactive substances: Anxiety disorder induced by multiple specified psychoactive substances 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 multiple specified psychoactive substances. The intensity or duration of the symptoms is substantially in excess of anxiety symptoms that are characteristic of intoxication with or withdrawal from multiple specified psychoactive substances. The amount and duration of use of the multiple specified psychoactive substances 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 multiple specified psychoactive substances, if the symptoms persist for a substantial period of time after cessation of the use of the multiple specified psychoactive substances or withdrawal from the multiple specified psychoactive substances, 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 multiple specified psychoactive substances).

Coding Note:

  • Code also the causing condition

6C4F.72 Obsessive-compulsive or related disorder induced by multiple specified psychoactive substances

Definition of Obsessive-compulsive or related disorder induced by multiple specified psychoactive substances: Obsessive-compulsive or related disorder induced by multiple specified psychoactive substances 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 multiple specified psychoactive substances. The intensity or duration of the symptoms is substantially in excess of analogous disturbances that are characteristic of intoxication with or withdrawal from the multiple specified psychoactive substances. The amount and duration of the multiple specified psychoactive substances 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 use of multiple specified psychoactive substances, if the symptoms persist for a substantial period of time after cessation of the multiple specified psychoactive substance use or withdrawal, 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 multiple specified psychoactive substances use).

Coding Note:

  • Code also the causing condition

6C4F.73 Impulse control syndrome induced by multiple specified psychoactive substances

Definition of Impulse control syndrome induced by multiple specified psychoactive substances: Impulse control disorder induced by multiple specified psychoactive substances 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 multiple specified psychoactive substances. 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 multiple specified psychoactive substances. The amount and duration of the multiple specified psychoactive substances 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 use of multiple specified psychoactive substances, if the symptoms persist for a substantial period of time after cessation of the multiple specified psychoactive substance use or withdrawal, 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 multiple specified psychoactive substances use).

Coding Note:

  • Code also the causing condition

6C4F.Y Other specified disorders due to use of multiple specified psychoactive substances including medications

6C4F.Z Disorders due to use of multiple specified psychoactive substances including medications unspecified

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