As with your question in the other post, if the two conditions are separate and unrelated, then you can disregard the excludes1 notes. The excludes1 note at the beginning of section R78 indicates that you would not code for 'findings of drugs and other substances, not normally found in blood' if you are coding for a related substance use condition that you are also coding with F10-F19. In other words, you would never code, for example, R78.0 for alcohol found in blood if you are also coding F10.10 for alcohol abuse. Unfortunately when excludes1 notes are placed at the beginning of a section instead of on individual codes, the software edits that are built around these notes will capture everything in the category, whether pertinent or not.