Use to record summary or persistent information about the typical use of a specific substance or class of substances that may harm an individual's health or social well-being.
This archetype has been designed as a framework for objectively documenting the use or administration of a single substance. While it supports the recognition of abuse and dependence, it is not intended exclusively for this purpose.
Substances that fall within the scope of this archetype include harmful or potentially addictive substances as well as medications that are misused. Misuse may involve administration without clinical supervision, use for non-recommended purposes, or consumption in quantities or frequencies that exceed safe dosages. Examples of substances that may be recorded using this archetype include but are not limited to:
- caffeine;
- nicotine and other clinically significant components of vaping liquid;
- psychostimulants;
- barbiturates;
- cannabis;
- hallucinogens;
- opioids;
- GHB;
- MDMA;
- sniffing of hydrocarbons or other solvents;
- "bath salts"; and
- medication administration, such as a laxative for purposes other than relief of constipation, beta blockers to reduce the heart rate in elite athletes and anabolic steroids in weight lifters.
On the other hand, substances that are commonly recorded in health records, have a well-documented harm profile and are recorded using existing purpose-specific archetypes, are excluded from the scope of this archetype, including:
- tobacco smoking;
- smokeless tobacco use;
- vaping;
- alcohol consumption; and
- medication administration according to established medical guidelines and standards, including the correct dosage and appropriate indication, timing and route of administration.
This archetype is intended to be used to record information about both current and previous substance use behaviour patterns and can be updated over time.
The 'Episode' Cluster allows the recording of details within a specified period of time. Triggers for closing one episode and commencing a new one will largely reflect local data collection preferences, however, a new instance of the ‘Episode’ CLUSTER should be used if:
- the typical amount used or administered, the pattern of use or the route of administration changes significantly; or
- the individual quits for a significant period of time.
Vaping is a complex concept that requires attention to both the behaviour and the substances inhaled. In that context, use this archetype to record amounts of clinically significant ingredients of vaping liquid, such as 'Nicotine', and use EVALUATION.vaping_summary to record the patterns of vaping behaviour. In some cases, both archetypes may be required.
Use a separate instance of this archetype to record each substance.
Organisation: Atomica Informatics
Email: heather.leslie@atomicainformatics.com
Date originally authored: 2020-02-13
Organisation: Atomica Informatics
Email: heather.leslie@atomicainformatics.com
Date originally authored: 2020-02-13
- Licence: This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/.
- Custodian Organisation: openEHR Foundation
- Current Contact: Heather Leslie, Atomica Informatics, heather.leslie@atomicainformatics.com
- Original Namespace: org.openehr
- Original Publisher: openEHR Foundation
- Custodian Namespace: org.openehr
- MD5-CAM-1.0.1: 871F6A0869B1769754FFE382C7D24243
- Build Uid: b726155f-9bef-4199-af5a-cdea40e38d22
- Revision: 1.0.1
For example: local information requirements; or additional metadata to align with FHIR.
Include:
All not explicitly excluded archetypes
Coding with an external terminology is preferred, where possible.
- Never used [The individual has never used the identified substance.]
- Current user [The individual is currently using the identified substance.]
- Former user [The individual has previously used the identified substance.]
This element can also be used to incorporate the narrative descriptions of substance use habits within existing or legacy clinical systems.
Can be a partial date, for example, only a year.
Can be a partial date, for example, only a year. For example, this date could represent when the individual commenced using the substance every Friday night or at parties.
Can be a partial date, for example, only a year.
For example: '2' as the second episode within a sequence of episodes; 'Lifelong' if recording typical overall use; '1995-2000' or 'At university' for an interval of time; or 'Pregnancy with twins' if describing the substance use during a health event such as a specific pregnancy.
Choice of:
Count
min: >=0
Text
Can be a partial date, for example, only a year.
The recorded entry in the 'Substance name' may be duplicated if the specific substance has already been identified. However if the 'Substance name' data element identified a grouping or a class of substance, this data element may be used to identify a specific substance and justify a separate episode.
- Used [The individual used the identified substance during this episode.]
- Not used [The individual has not used the identified substance during this episode.]
This element is repeatable to allow multiple ways of recording the pattern of use. The typical pattern of use can be made more granular by coding with a terminology or a local value set, or using the quantity data type, in a template.
Choice of:
- Text
Coded Text- Daily [Using the substance at least once every day.]
- Not daily [Not using the substance every day.]
Quantity
Units:- >=0.0 1/d
- >=0.0 1/wk
- >=0.0 1/mo
- >=0.0 1/a
For example: as a quantity of '6 g/wk'; or as narrative text, such as 'irregular amount of use depending on stress levels, ranging from 1-10 grams per week'.
Choice of:
- Quantity
Units:- >=0.0 mg/d
- >=0.0 g/d
- >=0.0 mg/wk
- >=0.0 g/wk
- >=0.0 mg/mo
- >=0.0 g/mo
- >=0.0 ug/d
- >=0.0 ug/wk
- >=0.0 ug/mo
- Text
Coding with an external terminology is preferred, where possible.
Can be a partial date, for example, only a year. This data field will be empty if the episode is current and ongoing.
min: >=0
Include:
All not explicitly excluded archetypes
Include:
All not explicitly excluded archetypes
Can be a partial date, for example, only a year.
Vebjørn Arntzen, Oslo University Hospital, Norway (openEHR Editor)
Silje Ljosland Bakke, Helse Vest IKT AS, Norway (openEHR Editor)
SB Bhattacharyya, Bhattacharyyas Clinical Records Research & Informatics LLP, India
Randi Brendberg, Helse Nord RHF, Norway
Hugo Claudio Briceño García, Catsalut, Spain
Clara Calleja Vega, CatSalut. Servei Català de la Salut., Spain
Fatemeh Chalabianloo, Helse Bergen, Norway
Julio de Sosa, Servei Català de la Salut, Spain
Giovanni Delussu, crs4, Italy
Gunn Elin Blakkisrud, DIPS ASA, Norway
Kåre Flø, DIPS ASA, Norway
Grant Forrest, Lunaria Ltd, United Kingdom
Astrid Gjelstad, Antidoping Norge, Norway
Rosane Gotardo, Systema Ltda., Brazil
Atle Hansen, Universitetssykehuset Nord-Norge, Norway
Amanda Herbrand, University Hospital Basel, Switzerland
Evelyn Hovenga, EJSH Consulting, Australia
Mika Kiviaho, Tietoevry, Finland
Peter Krajci, OUS, Norway
Ronald Krawec, Alberta Health Services, Canada
Anjali Kulkarni, Karkinos, India
Jörgen Kuylenstierna, eWeave AB, Sweden
michel laji!, Karolinska Institutet, Sweden
Liv Laugen, Oslo universitetssykehus, Norway (Nasjonal IKT redaktør)
Heather Leslie, Atomica Informatics, Australia (openEHR Editor)
June Marie Knappskog, Helse Nord IKT AS, Norway (Nasjonal IKT redaktør), Norway
Ian McNicoll, freshEHR Clinical Informatics, United Kingdom
John Meredith, openEHR International, United Kingdom
Christine Mikalsen, Helse Nord IKT, Norway
Laura Moral Lopez, Sistema de Salut de Catalunya, Spain
Mikael Nyström, Cambio Healthcare Systems AB, Sweden
Jayashree Panickar, Karolinska Institute, Sweden
Mari Sandlund, Oslo Universitetssykehus, avdeling for teknologi og e-helse, Norway
Benjamin Senst, Germany
Ingrid Skard, DIPS AS, Norway
Norwegian Review Summary, Norwegian Public Hospitals, Norway
Erik Sundvall, Karolinska Institutet + Karolinska University Hospital, Region Stockholm + Linköping University, Sweden
Venkatesh Thoppae, Dedalus, United Kingdom
John Tore Valand, Helse Vest IKT, Norway (Nasjonal IKT redaktør)