Substance Use, Misuse, Abuse (in process)

OVERVIEW

This page is used to organize CRG work on clinical findings and observable entities related to substance use, misuse, and abuse.

Concepts within the scope of this work include:

Concepts related to the substances themselves (substance, illegal substance, controlled substance, psychoactive substance, recreational drug, street drug, prescription drug, etc.)
Concepts related to way in which the substance is used (substance use, substance misuse, substance abuse, recreational substance use, illegal substance use)
Concepts related to medical, social, and legal norms about appropriate use of a substance (prescription substance abuse, use of an illegal substance)

MAJOR FUNCTION, PROCESS, AND OTHER OBSERVABLE ENTITY CONCEPTS

Major Concepts	Commonly Used Terms	Working Definitions	Example
Substance	substance, drug, medication
Psychoactive substance
Prescribed substance
Controlled substance
Substance of abuse		Any substance commonly used for a reason other than prevention or treatment of a health condition.
Use of substance	taking medication, use of medication, taking drugs, using drugs, substance use,	Any use of a substance.
Use of substance for reason other than prescribed health indication		Use of a substance for a reason other prevention or treatment a health condition.
Misuse and/or abuse of substance	problem drug use, substance abuse
Substance addiction	chemical dependency,
Use of substance in a place or context prohibited by law			Drinking alcohol while driving, smoking a cigarette in the bathroom on an airplane,
Use of a substance in a manner prohibited by law
Under the influence of a substance in a place or context that is prohibited by law			Driving while under the influence of alcohol, performing surgery while under the influence of alcohol

STAKEHOLDER GROUPS AND SUBJECT MATTER EXPERTS

Name	Type	Description
International Society of Addiction Medicine (ISAM)	Professional Society (International)
International Society of Substance Use Professionals (ISSUP)	Professional Society (International)
National Institute on Drug Abuse (NIDA)	National Government (North America, US)
Substance Abuse and Mental Health Services Administration (SAMHSA)	National Government (North America, US)
American Society of Addiction Medicine (ASAM)	Professional Society (North America, US)
European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)	Regional Organization (Western Europe)	scientific publications, best practices, guidelines, early warning system on new psychoactive substances, databases
World Health Organization (WHO) Alcohol, Drugs and Addictive Behaviours Unit Topics: Substance Abuse	International

RESOURCES

TERMINOLOGIES AND ONTOLOGIES

Name	Type	Description	Notes
DSM-I, DSM-II, DSM-III, DSM-III-R, DSM-IV, DSM-IV-R	Nosology	Previous editions of the the Diagnostic and Statistical Manual of Mental Disorders (DSM)	Useful for understanding the evolution concepts and specific terms used at different points in time
DSM-5, DSM-5 SCID	Nosology	Current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM)	Useful for understanding terms and concepts as they are currently designed to be used by clinicians
ICD-10, ICD-10-CM	Nosology	Preview editions of the the International Classification of Disorders (ICD)	Useful for understanding the evolution concepts and specific terms used at different points in time
ICD-11	Nosology	Current edition of the the International Classification of Disorders (ICD)	Useful for understanding terms and concepts as they are currently designed to be used by clinicians
UMLS	Meta-Terminology	Unified Medical Language System (UMLS)

PROJECT MILESTONES AND STATUS

ID	Objective	Action Item
1	Define scope of work	Identify the major concept(s) around which to organize a manageable project (scope of work) (artifact: mabh-crg concept plan) Complete the major concept table and iteratively update as project progresses (CRG to finalize the definition for SNOMED once all research has been completed)
2	Understand uses cases	Identify any non-standard use cases or pain points in research domain (artifact: mabh-crg use case document) Identify any non-standard use cases or pain points in clinical domain (artifact: mabh-crg use case document)
3	Understand major conceptualizations of the concept	Perform environmental scan to identify major theoretical models of construct/concept domain (artifact: mabh-crg theoretical model document) Perform environmental scan to identify disorders and clinical variables relevant to the concept domain (artifact: mabh-crg clinical model document) Perform environmental scan to identify existing explicit representations of concepts in the domain in terminologies (nomenclatures, nosologies, classification systems, controlled vocabularies, and ontologies) (artifact: mabh-crg umls analysis matrix, mabh-crg terminology matrix)
4	Establish contact with key stakeholders and other potential project contributors	Perform and environmental scan to Identify key stakeholders in the basic research, clinical research, clinical practice, and patient advocacy domain (artifact: mabh-crg stakeholder document) Create and implement a plan for engaging stakeholders willing to participate in the CRG for the duration of the specific concept review, either on calls or via discussion forum, or to provide the following: Stakeholder experience related to specific pain points or use cases in the domain Copies or screenshots of note templates, clinical notes, flowsheets, order sets, research protocols, other
5	Understand how concepts in the domain are currently represented in SNOMED	Review concepts in observable entity hierarchy Create dot diagram of current state Create observable entity spreadsheet Review concepts in clinical finding hierarchy Create dot diagram of current state Create observable entity spreadsheet
6	Perform gap analysis	Analyze concepts in observable entity hierarchy Create observable entity spreadsheet Create dot diagram of current state Perform review of dot diagram to identify potential duplicate, outdated, missing or inaccurately modeled concepts Update spreadsheet with changes including all defining relationships Analyze concepts in clinical finding hierarchy Create observable entity spreadsheet Create dot diagram of current state Perform review of dot diagram to identify potential duplicate, outdated, missing or inaccurately modeled concepts Update spreadsheet with additions or changes to concepts, including all defining relationships Identify missing concepts in other hierarchies (e.g., qualifier value, body structure) required to completely and accurately model observable entity and clinical finding concepts Create explicit, narrative definitions for all concepts
7	Create new and modify existing concepts in SNOMED	Submit request for changes through CRS system or via template worksheet
8	Disseminate information about changes to SNOMED for concepts in the domain

LINKS TO SITE MATERIALS

WORK PAGES

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OVERVIEW

MAJOR FUNCTION, PROCESS, AND OTHER OBSERVABLE ENTITY CONCEPTS

STAKEHOLDER GROUPS AND SUBJECT MATTER EXPERTS

RESOURCES

PROJECT MILESTONES AND STATUS