Other medical conditions. Individuals with substance use disorders, including other (or unknown) substance use disorder, may present with symptoms of many medical dis- orders. These disorders also may occur in the absence of other (or unknown) substance use disorder. A history of little or no use of other or unknown substances helps to exclude other (or unknown) substance use disorder as the source of these problems.
Substance use disorders, including other (or unknown) substance use disorder, are com- monly comorbid with one another, with adolescent conduct disorder and adult antisocial personality disorder, and with suicidal ideation and suicide attempts.
A. The development of a reversible substance-specific syndrome attributable to recent in- gestion of (or exposure to) a substance that is not listed elsewhere or is unknown.
B. Clinically significant problematic behavioral or psychological changes that are attribut- able to the effect of the substance on the central nervous system (e.g., impaired motor coordination, psychomotor agitation or retardation, euphoria. anxiety, belligerence, mood lability, cognitive impairment, impaired judgment, social withdrawal) and develop during, or shortly after, use of the substance.
C. The signs or symptoms are not attributable to another medical condition and are not bet- ter explained by another mental disorder, including intoxication with another substance.
Coding note: The lCD-9-CM code is 292.89. The lCD-10-CM code depends on whether there is a comorbid other (or unknown) substance use disorder involving the same sub- stance. If a mild other (or unknown) substance use disorder is comorbid, the |CD-10-CM code is F19.129, and it a moderate or severe other (or unknown) substance use disorder is comorbid, the |CD-10-CM code is F19.229. If there is no comorbid other (or unknown) sub- stance use disorder involving the same substance, then the ICD-10-CM code is F19.929.
Note: For information on Risk and Prognostic Factors, Culture-Related Diagnostic Issues, and Diagnostic Markers, see the corresponding sections in other (or unknown) substance use disorder.
Other (or unknown) substance intoxication is a clinically significant mental disorder that develops during, or immediately after, use of either a) a substance not elsewhere ad- dressed in this chapter (i.e., alcohol; caffeine; cannabis; phencyclidine and other halluci- nogens; inhalants; opioids; sedatives, hypnotics, or anxiolytics; stimulants; or tobacco) or b) an unknown substance. If the substance is known, it should be reﬂected in the name of the disorder upon coding.
Application of the diagnostic criteria for other (or unknown) substance intoxication is very challenging. Criterion A requires development of a reversible “substance-specific syndrome," but if the substance is unknown, that syndrome usually will be unknown. To resolve this conflict, clinicians may ask the individual or obtain collateral history as to whether the individual has experienced a similar episode after using substances with the same ”street” name or from the same source. Similarly, hospital emergency departments sometimes recognize over a few days numerous presentations of a severe, unfamiliar in- toxication syndrome from a newly available, previously unknown substance. Because of the great variety of intoxicating substances, Criterion B can provide only broad examples of signs and symptoms from some intoxications, with no threshold for the number of symptoms required for a diagnosis; clinical judgment guides those decisions. Criterion C requires ruling out other medical conditions, mental disorders, 01' intoxications.
The prevalence of other (or unknown) substance intoxication is unknown.