Substance-Induced Disorders 487
In addition, normal functionin g in the presence of high bl ood levels of a substance sug-
gests considerable tolerance.
Development and Course
Individuals ages 18–24 years have relatively hi gh prevalence rates for the use of virtually
every substance. Intoxication is usually the initial substance-related disorder and often be-
gins in the teens. Withdrawal can occur at any age as long as the relevant drug has been
taken in sufficient doses over an extended period of time. 
Recording Procedures for Intoxication and Withdrawal
The clinician should use the code that applies to the class of substances but record the
name of the specific substance.  For example, the clinician sh ould record 292. 0 (F13.239) seco-
barbital withdrawal (rather than sedative, hypnotic, or anxiolytic withdrawal) or 292.89
(F15.129) methamphetamine intoxication (rathe r than stimulant intoxication). Note that
the appropriate ICD-10-CM diagnostic code fo r intoxication depends on whether there is
a comorbid substance use diso rder. In this case, the F15.129 code for methamphetamine in-
dicates the presence of a comorbid mild methamphetamine use disorder. If there had been
no comorbid methamphetamine use disorder , the diagnostic code would have been
F15.929. ICD-10-CM coding rules require th at all withdrawal codes imply a comorbid
moderate to severe substance use disorder fo r that substance. In the above case, the code
for secobarbital withdrawal (F13.239) indicates the comorbid presence of a moderate to se-
vere secobarbital use disorder . See the coding note for the substance-specific intoxication