Disorders due to use of multiple specified psychoactive substances, including medications

The categories in this grouping are provided for coding purposes. However, in most clinical situations it is recommended that multiple categories from Disorders Due to Substance Use be assigned if these can be discerned rather than using categories from this grouping. Doing so will provide more useful information for both clinical and coding purposes.

Diagnostic Categories that Apply to Multiple Specified Psychoactive Substances, Including Medications

Following is a list of specific diagnostic categories of that apply to multiple specified psychoactive substances:

• 6C4F.0 Episode of Harmful Use of Multiple Specified Psychoactive Substances, Including Medications
• 6C4F.1 Harmful Pattern of Use of Multiple Specified Psychoactive Substances, Including Medications
• 6C4F.2 Multiple Specified Psychoactive Substances Dependence
• 6C4F.3 Intoxication Due to Multiple Specified Psychoactive Substances
• 6C4F.4 Multiple Specified Psychoactive Substances Withdrawal
• 6C4F.5 Delirium Induced by Multiple Specified Psychoactive Substances Including Medications
• 6C4F.6 Psychotic Disorder Induced by Multiple Specified Psychoactive Substances
• 6C4F.70 Mood Disorder Induced by Multiple Specified Psychoactive Substances
• 6C4F.71 Anxiety Disorder Induced by Multiple Specified Psychoactive Substances
• 6C4F.72 Obsessive-Compulsive or Related Disorder Induced by Multiple Specified Psychoactive Substances
• 6C4F.73 Impulse Control Disorder Induced by Multiple Specified Psychoactive Substances
• 6C4F.Y Multiple Specified Disorder Due to Use of Multiple Specified Psychoactive Substances, Including Medications
• 6C4F.Z Disorder Due to Use of Multiple Specified Psychoactive Substances, Including Medications, Unspecified

The first three diagnoses listed above (Episode of Harmful Use of Multiple Specified Psychoactive Substances, Harmful Pattern of Use of Multiple Specified Psychoactive Substances, and Multiple Specified Psychoactive Substance Dependence) describe the pattern of synthetic cannabinoid use. One of these three diagnoses, or Disorder Due to Use of Multiple Specified Psychoactive Substances, Unspecified, for cases in which the use pattern in unknown at the time of evaluation, is considered to be the primary diagnosis. That is, one of these four diagnoses should be assigned when making a diagnosis of a Disorder Due to Multiple Specified Psychoactive Substance Use.

The remaining diagnoses reflect the impact of the pattern of synthetic cannabinoid use and are thus considered to be associated with one of the primary use pattern diagnoses. These diagnoses should therefore be assigned together with the relevant primary diagnosis. For example, 6C4F.1/ 6C4F.5 is Harmful Pattern of Use of Multiple Specified Psychoactive Substances associated with Multiple Specified Psychoactive Substance-Induced Psychotic Disorder, 6C4F.2/6C4F.70 is Multiple Specified Psychoactive Substance Dependence associated with Multiple Specified Psychoactive Substance-Induced Mood Disorder, 6C4Z/6C4F.3 is Disorders Due to Substance Use, Unspecified associated with Multiple Specified Psychoactive Substance Intoxication (i.e., the pattern of use in this last case is unknown).

Multiple Specified Psychoactive Substance-induced Mental Disorders are characterized by psychological, cognitive, or behavioural symptoms that develop during or soon after multiple specified psychoactive substance intoxication or withdrawal or use or discontinuation of a psychoactive medication. The duration or severity of the symptoms is substantially in excess of the characteristic syndrome of Multiple Specified Psychoactive Substance Intoxication or Multiple Specified Psychoactive Substance Withdrawal.