In our point of view the difference between these 2 concepts is not clear (“diminished control of mental, physiological, or physical functioning” indicates that the cause is “harmful to health” so we are a little bit confused.
1149322001 |Intoxication (disorder)|
Interference in normal bodily functions caused by exposure through ingestion, inhalation, absorption, or injection of a substance (e.g. medicinal product, household product, industrial chemical, or plant or animal derivatives) in quantities that cause diminished control of mental, physiological, or physical functioning.
75478009 |Poisoning (disorder)|
Interference in normal bodily functions caused by exposure through ingestion, inhalation, absorption, or injection of a substance (e.g. medicinal product, household product, industrial chemical, or plant or animal derivatives) in quantities that are harmful to health.
In the “Medical Dictionary of the Academy of Medicine” the definition is the following:
intoxication (French)
intoxication, poisoning (English)
The action exerted on the body by a toxic substance, a poison. Also refers to all the disorders caused by this substance.
Syn. Empoisonnement => “poisoning »
For French, in “MedDRA Introduction Guide Version 28.1” it is written : “Since the words “poisoning” and “toxicity” are used interchangeably in English, no distinction is made between these concepts in MedDRA.”
I mentioned in Antwerpen that for alcohol, it does make sense to distinguish between the two as intoxication would be “berusning” (only used of alcohol) with synonym inebriation in English, but alcoholic poisoning would be “alkoholförgiftning”, and the difference is measured in promille (toxication: +4.5 promille for women and +5 promille for men).
The problem is with all other drugs. As of now, we have used “intoxikation” for all in order to be consistent. One alternative in Sweden, however, is to use “rus” for intoxication, which is a more general word with the same meaning as “berusning”. “Rus” is a bit wider in usage compared to “berusning”, but only for amphetamin, cannabis and alcohol. Intoxication is very clinical and not the most natual choice for health care personnel.
Just like with the French example, the linguistic difference between the two is not very clear, but when it come sto treatment and severity level, the difference is more clear. Maybe we could suggest a definition which focuses on severity and treatment?
[I also noted that ICD-11 in Swedish uses “förgiftning” (poisoning) as the translation of intoxication, except for alcohol where “berusning” was used.]
Regarding using another term instead of re-using intoxication in our native languages for some drugs:
“rus” [English: intoxication], a state with influence on judgement, psychomotor activities and reactivity due to the influence of the drug. “Rus” is a common effect from the misuse of psychoactive drugs and a strongly contributing cause for developing a dependence. “Rus” is mainly used in expressions like ”alkoholrus”, “cannabisrus” and “amfetaminrus”. The expression ”berusning” is primarily associated with alcohol. You are not ”berusad” by amphetamin or cannabis, instead concepts like ”affected” or the more colloquial ”high on” are used for these. [source. Swedish Nationalencyklopedin, ne.se, my own translation]
According to the Norwegian Medical Encyclopedia, “intoksikasjon” has two meanings:
1 in medicine: poisoning (=forgiftning)
2 in mental health: “A condition caused by the intake of a substance that affects the psyche (psychoactive substance), resulting in disturbances in consciousness, thinking, perception, emotions, behavior, or other bodily functions and reactions. The disturbance is directly related to the substance’s effect on the brain and is completely reversible, except when tissue damage or other complications occur. Examples include acute intoxication, trance states under the influence of drugs, and “bad trips.” (translated based on DeepL, but with adjustments)
This definition is quite close the the definition of 1149322001 |Intoxication (disorder)|. But while SNOMED CT stresses “diminshed control” as a consequence, the Norwegian definition states “disturbances”. This doesn’t make it a different concept, though.
According to meaning 2, “intoxication” = “intoksikasjon” in Norwegian. However, it is problematic that “intoxication” also might have the meaning of “poisoning” in Norwegian.
Looking at our ICD-10 translation, “intoksikasjon” is used for F10.0 ,F11.0, F12.0, F13.0, F14.0, etc.
The definitions and the position in the hierarchy were changed in response to a CRS request Jira from the TUG. Based on the CRS request, further clarification with the submitter, and consultation with Chief Terminologist, agreement was reached hence SI reversed the relationship between the two concepts and added the updated definition to “intoxication”.
In a clinical sense, the distinction is relevant when determining whether a patient is merely intoxicated (a non-critical, self-limiting state) or poisoned (a toxic, critical state requiring immediate life support). This differentiation fundamentally shifts the clinical focus from observation to emergency resuscitation.
Intoxication/intoxicatie and poisoning/vergiftiging are, at least I would say so, synonyms of one another. Medical dictionaries mention one or the other and even the national center for information about poisoning/vergiftiging uses intoxicatie as a synonym at some points.
At the Dutch NRC, we have - for now at least - decided to follow the English FSNs in our own translations, although this distinction is artificial. We also provide a synonym of intoxicatie for poisoning/vergiftiging concepts.
Maybe intoxication could be suitable for a translation such as: ‘under influence of (substance)’. However, the issue remains that being under the influence of something is not equivalent to what you would call in English intoxicated, at least to my understading.
We could also translate poisoning as ‘life-threatening (your term)’ or ‘severe (your term)’, as that is what the difference in the international edition is based on according to what Monica has provided.