Key Points Question Are medication monitoring programs within a hospital associated with more accurate identification of patients with opioid use disorder through the use of proxy Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) ( DSM-5) criteria for opioid use disorder extracted from electronic health records? Findings This cross-sectional study demonstrated that DSM-5 criteria for opioid use disorder can be extracted through review of electronic health records and that patients who are part of a drug monitoring program had a higher mean prevalence of opiod use disorder and a higher mean number of psychiatric comorbidities associated with opioid use disorder. Meaning Proxy measures that rely on multiple sources of data, including prescription drug history and notes in the electronic health record, may help identify patients with opioid use disorder who have not received a diagnosis.

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A thyroid storm is a rare but life-threatening manifestation of thyrotoxicosis. It still remains a diagnostic challenge as there are no specific laboratory investigations or universally accepted criteria for diagnosing thyroid storms. Diagnosis is mainly based on clinical findings, evidence of hyperthyroidism, and lifethreatening symptoms. A thyroid storm has a high risk of mortality mostly due to multi-organ failure and heart failure. Cardiovascular manifestations are the most common presentation of hyperthyroidism; cardiac involvement also has the potential to be the most serious complication. Management of cardiovascular manifestations should be managed aggressively to prevent long-term myocardial damage. A high index of suspicion should be maintained in young adults presenting with heart failure and arrhythmia. We present a case of potentially life-threatening cardiovascular effects of thyroid storm and management in the ICU.