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Illicit opioid use

Lewer D, Padmanathan P, Arfeen A, Denaxas S, Forbes H, Gonzalez-Izquierdo A, Hickman M

Type
Lifestyle Risk Factor
ID
PH343
Version ID
686
Data Sources
Valid event data range
01/03/2020-05/04/2020
Sex
Female, Male
Agreement Date
Coding system
Med codes PROD codes
Tags /Collections
Phenotype Library

Definition

We selected patients by identifying product codes indicating a prescription of OAT and clinical codes indicating a history of illicit opioid use, such as ‘heroin dependence’ (see extended data for a full code list23). We prioritised specificity over sensitivity, aiming to use codes that are only applied to the target population.

We used keywords to search CPRD dictionaries to find Read and SNOMED clinical codes that may illicit opioid use (methadone; buprenorphine; abus; addict; ependen; drug user; heroin; inject; misus*; opiate; opioid; overdose). Our search identified 1,098 Read codes and 1,800 SNOMED codes. Two authors (DL and PP)

screened the codes for relevance, with conflicts resolved through discussion.

Where codes were likely to indicate illicit opioid use, but did not specifically mention opioids, we classified them as ‘probable’. Some clinical codes described prescriptions, tests or adverse reactions relating to methadone and buprenorphine.

Implementation


Publications

  • Lewer D, Padmanathan P, Qummer ul Arfeen M et al. Healthcare use by people who use illicit opioids (HUPIO): development of a cohort based on electronic primary care records in England [version 1; peer review: awaiting peer review]. Wellcome Open Res 2020, 5:282. 10.12688/wellcomeopenres.16431.1

Clinical Code List

Rows: 308
Code Description Data-base Read or SNOMED term Status Meth/ bupe Type
x10045241000033110 Buprenorphine 1mg sublingual tablets sugar free AURUM - Definite B Prodcode
x10045441000033111 Buprenorphine 6mg sublingual tablets sugar free AURUM - Definite B Prodcode
x10045641000033113 Buprenorphine 4mg sublingual tablets sugar free AURUM - Definite B Prodcode
x100632 Methadone therapy GOLD xZ1Q6212 Definite - Medcode
x10077 Subutex 2mg sublingual tablets (Indivior UK Ltd) GOLD - Definite B Prodcode
x101377 H/O weekly opiate misuse GOLD x1TD1.00 Definite - Medcode
x103842 Clinical opiate withdrawal scale GOLD x38G1.00 Probable - Medcode
x103991 [X]Mental and behav dis due to use opioids: amnesic syndrome GOLD xEu11600 Definite - Medcode
x10538 [X]Drug addiction - opioids GOLD xEu11211 Definite - Medcode
x106342 H/O infrequent methadone misuse GOLD x1T12.00 Definite - Medcode
x106705 Does not share drug injection equipment GOLD x1V3A.00 Probable - Medcode
x107780 Neck injector GOLD x1V32.00 Probable - Medcode
x108251 Opioid substitution therapy monitoring GOLD x66c4.00 Definite - Medcode
x109730 Drug addiction maintenance therapy - naltrexone GOLD x8B23000 Definite - Medcode
x109966 Drug addiction maintenance therapy - lofexidine GOLD x8B23100 Definite - Medcode
x111551 Groin injector GOLD x1V33.00 Probable - Medcode
x11722 Methadone 10mg/ml oral solution sugar free GOLD - Definite M Prodcode
x11789141000033119 Buprenorphine 2mg oral lyophilisates sugar free AURUM - Definite B Prodcode
x11789241000033114 Buprenorphine 8mg oral lyophilisates sugar free AURUM - Definite B Prodcode
x11789341000033116 Espranor 2mg oral lyophilisates (Martindale Pharmaceuticals Ltd) AURUM - Definite B Prodcode
x11789441000033110 Espranor 8mg oral lyophilisates (Martindale Pharmaceuticals Ltd) AURUM - Definite B Prodcode
x1220925010 Heroin poisoning AURUM x13187008 Probable - Medcode
x13031 Subutex 0.4mg sublingual tablets (Indivior UK Ltd) GOLD - Definite B Prodcode
x1485129010 Failed heroin detoxification AURUM x391102000 Definite - Medcode
x16243 Opioid type drug dependence GOLD xE240.00 Definite - Medcode
x16374 Methadone dependence GOLD xE240.12 Definite - Medcode
x1655941000033119 Methadone 10mg/ml oral solution sugar free AURUM - Definite M Prodcode
x1656041000033112 Methadone 20mg/ml oral solution sugar free AURUM - Definite M Prodcode
x1715481000000114 Drug addiction maintenance therapy - naltrexone AURUM x768691000000103 Definite - Medcode
x1715521000000114 Drug addiction maintenance therapy - lofexidine AURUM x768711000000101 Definite - Medcode
x174241000033111 Buprenorphine 400microgram sublingual tablets sugar free AURUM - Definite B Prodcode
x1772531000006119 Clinical Opiate Withdrawal Scale AURUM x1772531000006103 Probable - Medcode
x1774961000000119 Clinical opiate withdrawal scale AURUM x763699005 Probable - Medcode
x1835341000033111 Buprenorphine 2mg sublingual tablets sugar free AURUM - Definite B Prodcode
x1835441000033117 Buprenorphine 8mg sublingual tablets sugar free AURUM - Definite B Prodcode
x1835541000033116 Subutex 0.4mg sublingual tablets (Indivior UK Ltd) AURUM - Definite B Prodcode
x1835641000033115 Subutex 2mg sublingual tablets (Indivior UK Ltd) AURUM - Definite B Prodcode
x1835741000033112 Subutex 8mg sublingual tablets (Indivior UK Ltd) AURUM - Definite B Prodcode
x1880021000006116 Opioid substitution therapy monitoring AURUM x1880021000006100 Definite - Medcode
x1971421000006118 Mental and behav dis due to use opioids: withdrawal state, uncomplicated AURUM x1971421000006102 Definite - Medcode
x1971441000006113 Mental and behav dis due to use opioids: withdrawal state, with convulsions AURUM x1971441000006109 Definite - Medcode
x1971451000006110 Men & behav dis due opioid: withdrawl state with delirium, without convulsions AURUM x1971451000006106 Definite - Medcode
x1971461000006112 Men & behav dis due opioid: withdrawl state with delirium, with convulsions AURUM x1971461000006108 Definite - Medcode
x1971471000006117 Mental & behav dis due to use opioids: psychotic disorder, schizophrenia-like AURUM x1971471000006101 Definite - Medcode
x1971501000006112 Mental & behav dis due to use opioids: psychotic disorder, predominantly delusional AURUM x1971501000006108 Definite - Medcode
x1971521000006119 Mental & behav dis due to use opioids: psychotic disorder, predominantly hallucinatory AURUM x1971521000006103 Definite - Medcode
x1971531000006116 Mental & behav dis due to use opioids: psychotic disorder, predominantly polymorphic AURUM x1971531000006100 Definite - Medcode
x1971571000006118 Mental & behav dis due to use opioids: psychotic disorder, predominantly depressive symptoms AURUM x1971571000006102 Definite - Medcode
x1971601000006113 Mental & behav dis due to use opioids: psychotic disorder, predominantly manic symptoms AURUM x1971601000006109 Definite - Medcode
x1971631000006117 Mental & behav dis due to use opioids: psychotic disorder, mixed AURUM x1971631000006101 Definite - Medcode
x1971651000006112 Mental & behav dis due to use opioids: resid & late-onset psychot dis, flashbacks AURUM x1971651000006108 Definite - Medcode
x1971671000006119 Mental & behav dis due to use opioids: resid & late-onset psychot dis, personality or behaviour disorder AURUM x1971671000006103 Definite - Medcode
x1971681000006116 Mental & behav dis due to use opioids: resid & late-onset psychot dis, residual affective disorder AURUM x1971681000006100 Definite - Medcode
x1971701000006118 Mental & behav dis due to use opioids: resid & late-onset psychot dis, dementia AURUM x1971701000006102 Definite - Medcode
x1971711000006115 Mental & behav dis due to use opioids: resid & late-onset psychot dis, other persisting cognitive impairment AURUM x1971711000006104 Definite - Medcode
x1971741000006116 Mental & behav dis due to use opioids: resid & late-onset psychot dis, late-onset psychotic disorder AURUM x1971741000006100 Definite - Medcode
x1976281000006111 Mental & behav dis due to use opioids: acute intoxication, uncomplicated AURUM x1976281000006107 Definite - Medcode
x1976301000006110 Mental & behav dis due to use opioids: acute intoxication, with trauma or other bodily injury AURUM x1976301000006106 Definite - Medcode
x1976331000006119 Mental & behav dis due to use opioids: acute intoxication, with other medical complications AURUM x1976331000006103 Definite - Medcode
x1976351000006114 Mental & behav dis due to use opioids: acute intoxication, with delirium AURUM x1976351000006105 Definite - Medcode
x1976421000006111 Mental & behav dis due to use opioids: acute intoxication, with perceptual distortions AURUM x1976421000006107 Definite - Medcode
x1976441000006116 Mental & behav dis due to use opioids: acute intoxication, with coma AURUM x1976441000006100 Definite - Medcode
x1976471000006112 Mental & behav dis due to use opioids: acute intoxication, with convulsions AURUM x1976471000006108 Definite - Medcode
x1976501000006117 Mental and behav dis due to use opioids: dependence syndr, currently abstinent AURUM x1976501000006101 Definite - Medcode
x1976531000006113 Mental and behav dis due to use opioids: dependence syndr, currently abstinent, but in a protected environment AURUM x1976531000006109 Definite - Medcode
x1976551000006118 Mental and behav dis due to use opioids: dependence syndr, currently on a clinically supervised maintenance or replacement regime [controlled dependence] AURUM x1976551000006102 Definite - Medcode
x1976581000006114 Mental and behav dis due to use opioids: dependence syndr, currently abstinent, but receiving treatment with aversive or blocking drugs AURUM x1976581000006105 Definite - Medcode
x1976591000006112 Mental and behav dis due to use opioids: dependence syndr, currently using the substance [active dependence] AURUM x1976591000006108 Definite - Medcode
x1976611000006118 Mental and behav dis due to use opioids: dependence syndr, continuous use AURUM x1976611000006102 Definite - Medcode
x1976621000006114 Mental and behav dis due to use opioids: dependence syndr, episodic use [dipsomania] AURUM x1976621000006105 Definite - Medcode
x2000491000006110 Does not use opioids on top of substitution therapy AURUM x2000491000006106 Definite - Medcode
x2000501000006119 Uses other opioids on top of substitution therapy AURUM x2000501000006103 Definite - Medcode
x2003041000033115 Methadone 1mg/ml oral solution sugar free AURUM - Definite M Prodcode
x20458 Heroin poisoning GOLD xSL50100 Probable - Medcode
x2052541000033112 Methadone Hydrochloride Diluent Oral Solution Sugar Free AURUM - Definite M Prodcode
x20962 Episodic opioid dependence GOLD xE240200 Definite - Medcode
x21562 Physeptone 1mg/ml oral solution sugar free (Martindale Pharmaceuticals Ltd) GOLD - Definite M Prodcode
x22059 Morphine dependence GOLD xE240.13 Definite - Medcode
x22079 Injecting drug user GOLD x13c0.00 Probable - Medcode
x2267741000033115 Methadone Hydrochloride Oral Solution, Sugar Free, Tartrazine Free 1 mg/1 ml AURUM - Definite M Prodcode
x2296901000000113 Opioid substitution therapy monitoring AURUM x891951000000109 Definite - Medcode
x24441 Opioid drug dependence NOS GOLD xE240z00 Definite - Medcode
x2474734017 [V]Personal history of drug abuse by injection AURUM x371435006 Probable - Medcode
x2548992019 Previously injecting drug user AURUM x416479009 Probable - Medcode
x2549886016 Abstinent from drug misuse on maintenance replacement AURUM x712545004 Probable - Medcode
x25527 [X]Cold turkey, opiate withdrawal GOLD xEu11311 Definite - Medcode
x26061 Combined opioid with other drug dependence GOLD xE248.00 Definite - Medcode
x26277 Physeptone 1mg/ml mixture (Martindale Pharmaceuticals Ltd) GOLD - Definite M Prodcode
x2639961000000113 Opioid analgesic dependence AURUM x1047881000000106 Probable - Medcode
x26831 Nondependent opioid abuse GOLD xE255.00 Definite - Medcode
x27652 [X]Men & beh dis due opioids: resid & late-onset psychot dis GOLD xEu11700 Definite - Medcode
x27960 Opioid dependence in remission GOLD xE240300 Definite - Medcode
x28710 [X]Overdose - heroin GOLD xU205.11 Probable - Medcode
x28976 Drug addiction detoxification therapy - methadone GOLD x8B2N.00 Definite - Medcode
x295153014 Unspecified opioid dependence AURUM x75544000 Definite - Medcode
x295154015 Continuous opioid dependence AURUM x191819002 Definite - Medcode
x295155019 Episodic opioid dependence AURUM x191820008 Definite - Medcode
x295156018 Opioid dependence in remission AURUM x191821007 Definite - Medcode
x295157010 Opioid drug dependence NOS AURUM x75544000 Definite - Medcode
x2952 Methadone 1mg/ml oral solution GOLD - Definite M Prodcode
x295228015 Combined opioid with other drug dependence AURUM x191865004 Definite - Medcode
x295229011 Combined opioid with other drug dependence, unspecified AURUM x191865004 Definite - Medcode
x295230018 Combined opioid with other drug dependence, continuous AURUM x191867007 Definite - Medcode
x295231019 Combined opioid with other drug dependence, episodic AURUM x191868002 Definite - Medcode
x295232014 Combined opioid with other drug dependence in remission AURUM x191869005 Definite - Medcode
x295233016 Combined opioid with other drug dependence NOS AURUM x191865004 Definite - Medcode
x295290016 Nondependent opioid abuse AURUM x191909007 Definite - Medcode
x295293019 Nondependent opioid abuse, unspecified AURUM x191909007 Definite - Medcode
x295295014 Nondependent opioid abuse, continuous AURUM x191912005 Definite - Medcode
x295296010 Nondependent opioid abuse, episodic AURUM x191913000 Definite - Medcode
x295297018 Nondependent opioid abuse in remission AURUM x191914006 Definite - Medcode
x2957141000033113 Physeptone 1mg/ml oral solution sugar free (Martindale Pharmaceuticals Ltd) AURUM - Definite M Prodcode
x2957241000033118 Physeptone 1mg/ml mixture (Martindale Pharmaceuticals Ltd) AURUM - Definite M Prodcode
x295803018 [X]Mental and behavioural disorders due to use of opioids AURUM x14784000 Definite - Medcode
x298101000000113 Buprenorphine maintenance therapy AURUM x198021000000102 Definite - Medcode
x30251 Intravenous drug user GOLD x13c1.00 Probable - Medcode
x302981000000113 Drug addiction detoxification therapy - methadone AURUM x200021000000100 Definite - Medcode
x303011000000111 Drug addiction maintenance therapy - methadone AURUM x200031000000103 Definite - Medcode
x30565 Failed heroin detoxification GOLD x146C.00 Definite - Medcode
x30598 Opiate dependence detoxification GOLD x8BAd.00 Definite - Medcode
x3064 Buprenorphine 400microgram sublingual tablets sugar free GOLD - Definite B Prodcode
x30694 Drug addiction maintenance therapy - methadone GOLD x8B2P.00 Definite - Medcode
x30711 [V]Personal history of drug abuse by injection GOLD xZV11500 Probable - Medcode
x309921000000119 Heroin misuse AURUM x202991000000100 Definite - Medcode
x314821000000113 Opiate dependence detoxification AURUM x205231000000102 Definite - Medcode
x316901000000118 Drug addiction maintenance therapy - buprenorphine AURUM x206121000000104 Definite - Medcode
x316931000000112 Drug addiction detoxification therapy - buprenorphine AURUM x206131000000102 Definite - Medcode
x32709 Previously injecting drug user GOLD x13cJ.00 Probable - Medcode
x32804 Opium dependence GOLD xE240.14 Definite - Medcode
x328544015 Accidental poisoning by heroin AURUM x216463005 Probable - Medcode
x33068 Methadone 10mg/1ml solution for injection ampoules GOLD - Definite M Prodcode
x33832 Methadone 1mg/ml oral solution (Martindale Pharmaceuticals Ltd) GOLD - Definite M Prodcode
x339576014 Injecting drug user AURUM x226034001 Probable - Medcode
x342465012 Intravenous drug user AURUM x228388006 Probable - Medcode
x342466013 Groin injector AURUM x228389003 Probable - Medcode
x342468014 Drug injection behaviour AURUM x228391006 Probable - Medcode
x342473015 Sharing of drug injecting equipment AURUM x228395002 Probable - Medcode
x342474014 Does not share drug injection equipment AURUM x228396001 Probable - Medcode
x34249 [X]Mental and behav dis due to use opioids: dependence syndr GOLD xEu11200 Definite - Medcode
x346947018 Heroin dependence AURUM x231477003 Definite - Medcode
x346949015 Methadone dependence AURUM x231478008 Definite - Medcode
x346950015 Morphine dependence AURUM x231479000 Definite - Medcode
x346951016 Opium dependence AURUM x231480002 Definite - Medcode
x35169 Suboxone 8mg/2mg sublingual tablets (Indivior UK Ltd) GOLD - Definite B Prodcode
x35170 Suboxone 2mg/500microgram sublingual tablets (Indivior UK Ltd) GOLD - Definite B Prodcode
x35681 Buprenorphine 2mg / Naloxone 500microgram sublingual tablets sugar free GOLD - Definite B Prodcode
x35682 Buprenorphine 8mg / Naloxone 2mg sublingual tablets sugar free GOLD - Definite B Prodcode
x361941000006116 [X]Accidental poisoning with heroin AURUM x216463005 Probable - Medcode
x36241 [X]Mental and behav dis due to use opioids: withdrawal state GOLD xEu11300 Definite - Medcode
x371181000006118 [X]Cold turkey, opiate withdrawal AURUM x87132004 Definite - Medcode
x37527 Adverse reaction to heroin, diamorphine GOLD xTJ50.00 Probable - Medcode
x37568 [X]Mental and behav dis due to use of opioids: harmful use GOLD xEu11100 Definite - Medcode
x379281000006110 [X]Drug addiction - opioids AURUM x75544000 Definite - Medcode
x38034 Unspecified opioid dependence GOLD xE240000 Definite - Medcode
x388831000006113 [X]Heroin addiction AURUM x75544000 Definite - Medcode
x397161000006110 [X]Men & beh dis due opioids: resid & late-onset psychot dis AURUM x943071000000104 Definite - Medcode
x397231000006112 [X]Men & behav dis due opioid: withdrawl state with delirium AURUM x91388009 Definite - Medcode
x397261000006115 [X]Men & behav dis due to use opioids: oth men & behav dis AURUM x14784000 Definite - Medcode
x397451000006116 [X]Ment & behav dis due use opioids: unsp ment & behav dis AURUM x91388009 Definite - Medcode
x397651000006119 [X]Mental & behav dis due to use opioids: acute intoxication AURUM x77721001 Definite - Medcode
x397661000006117 [X]Mental & behav dis due to use opioids: psychotic disorder AURUM x943071000000104 Definite - Medcode
x397901000006111 [X]Mental and behav dis due to use of opioids: harmful use AURUM x5602001 Definite - Medcode
x397921000006118 [X]Mental and behav dis due to use opioids: amnesic syndrome AURUM x91388009 Definite - Medcode
x397931000006115 [X]Mental and behav dis due to use opioids: dependence syndr AURUM x75544000 Definite - Medcode
x397941000006113 [X]Mental and behav dis due to use opioids: withdrawal state AURUM x87132004 Definite - Medcode
x4010641000033111 Buprenorphine 2mg / Naloxone 500microgram sublingual tablets sugar free AURUM - Definite B Prodcode
x4010741000033119 Buprenorphine 8mg / Naloxone 2mg sublingual tablets sugar free AURUM - Definite B Prodcode
x4010841000033112 Suboxone 2mg/500microgram sublingual tablets (Indivior UK Ltd) AURUM - Definite B Prodcode
x4010941000033116 Suboxone 8mg/2mg sublingual tablets (Indivior UK Ltd) AURUM - Definite B Prodcode
x40536 Nondependent opioid abuse, unspecified GOLD