Parental substance misuse

1 Overview

Domain / Phenotype

Parental substance misuse (SM)

Sex

Both

Age Range

Parent (Adults)

Individual

Parent

Coding System

READ SNOMED CT ICD-10 ICD-9 HES-AE speciality field HES-OP speciality field CPRD GOLD speciality field

Data Sources

CPRD Aurum CPRD GOLD HES-APC HES-AE HES-OP

2 Definition

The DSM-5 defines a substance use disorder as a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problem.

For parental substance misuse, we included any consumption of alcohol/drugs meeting the threshold for harmful or addictive levels. This encompasses codes mentioning "dependence", "specialist/enhanced treatment", class A through C drugs (e.g. A: heroin, cocaine, ecstasy, LSD), self-report measures (≥35 alcohol units per week higher risk drinking), and validated measures with higher cut-off scores (e.g., ≥20 AUDIT score, SADQ ≥31 scores).

Indicators for alcohol consumption are also validated and available via the HDR UK CALIBER phenotype library.

3 Clinical Codelist

Download SM Codelist (2682 codes)

See the ACEsinEHRs Control documentation for code processing rules and release information.

Indicator Structure & Taxonomy

Domain	Indicator Code	Indicator Name	No. Codes
SM	SM1	Drug misuse, severe (dependence levels)	564
SM	SM2	Drug misuse, moderate (all other)	213
SM	SM3	Parental drug prescription for opioid dependence, multipurpose usage	21
SM	SM4	Family substance misuse (i.e. unspecified family member)	19
SM	SM5	Alcohol misuse, severe (incl. self-report measures/≥35 alcohol units per week)†	273

Browse & Search Clinical Codelist (Preview)

Parental substance misuse | ALL CODING SYSTEMS

Code	Description	Coding System	Indicator
F11.2	Mental and behavioural disorders due to use of opioids: dependence syndrome	ICD-10	SM1
SN5602001	Alcohol dependence	SNOMED CT	SM5
E23..	Drug dependence	READ	SM1

4 Implementation

Specific indicators within this domain require rule-based algorithms to accurately incorporate questionnaire cut-offs and consumption thresholds.

Algorithm 1 Alcohol Misuse Severe (Continuous Data Cut-offs)

Include if continuous data meets the cut-off assigned to each code (see code list). For example: AUDIT: ≥20; AUDIT-PC: ≥10; SADQ: ≥31; ≥35 alcohol units per week (analogous to higher-risk drinking/harmful drinking/alcohol dependence; see NICE guidelines); >200 mg alcohol per 100 ml blood is classed as potential high-risk offender when driving in England/Wales (applies to hospital admission codes in this study).

R Script / Logic

# Include cases exceeding continuous score cut-offs for severe alcohol misuse
msm_alcohol <- merged_data %>% 
  filter(Domain=="MSM" & Indicator_1=="Alcohol misuse" & scale=="1" & data1 > cut_off)