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Chronic Use of Opioid Medications Before and After Bariatric Surgery Supplementary Online Content Raebel MA, Newcomer SR, Reifler LM, et al. Chronic use of opioid medications before and after bariatric surgery. JAMA. doi:10.1001/jama.2013.278344 eFigure. Opioid Dispensings in 60 Days Before and 60 Days After Bariatric Surgery eTable 1. Opioid Classification and Morphine Equivalents Conversion Factors for Opioids Administered by Tablet, Capsule, Liquid, Transdermal Patch, and Transmucosal Formulations eTable 2. ICD-9 Codes for Comorbid Diagnosis of Substance Abuse, Anxiety, Posttraumatic Stress Disorder, and/or Depression eTable 3. ICD-9 Codes for Inclusion and Exclusion of Chronic Pain Diagnoses eTable 4. Therapeutic Classes, Generic Names, and Selected Brand Names of Covariate Medications eTable 5. Types of Opioids Dispensed During the Year Before and the Year After Bariatric Surgery Among Presurgery Chronic Opioid Users eTable 6. Types of Opioids Used Before and After Bariatric Surgery Among 933 Individuals With Chronic Opioid Use Before Bariatric Surgery eTable 7. Unadjusted Characteristics of Chronic Opioid Users According to Whether or Not Both Presurgery and Postsurgery Body Mass Indexes (BMIs) Data Were Available eTable 8. Presurgery and Postsurgery Use of Opioids and Selected Other Analgesic and Adjunctive Pain Medication Classes Among Presurgery Chronic Opioid Users With Presurgery Chronic Pain Diagnoses This supplementary material has been provided by the authors to give readers additional information about their work. © 2013 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/27/2021 eFigure. Opioid Dispensings in 60 Days Before and 60 Days After Bariatric Surgery Downloaded From: https://jamanetwork.com/ on 09/27/2021 3 eTable 1. Opioid Classification and Morphine Equivalents Conversion Factors for Opioids Administered by Tablet, Capsule, Liquid, Transdermal Patch, and a Transmucosal Formulations Opioid Conversion Factor Comments per mg Opioid Short-acting, Schedule II Codeine sulfate 0.15 Hydromorphone 4 Meperidine hydrochloride 0.1 Morphine sulfate 1 Oxycodone (with or without 1.5 acetaminophen, ibuprofen, aspirin) Oxymorphone 3 Fentanyl citrate, transmucosal (lollipop, 0.125 Assumes 50% bioavailability lozenges) Long-acting, Schedule II Morphine sulfate, sustained release 1 Fentanyl, transdermal 2.4 Assumes one patch delivers the dispensed micrograms/hour over each 24-hour day for three days Methadone 3 Oxycodone hydrochloride, controlled 1.5 release Oxymorphone, sustained release 3 Levorphanol tartrate 11 Non-Schedule II Butalbital and codeine (with or without aspirin, ibuprofen, acetaminophen) 0.15 Codeine+(acetaminophen, ibuprofen, aspirin, or carisoprodol) 0.15 Dihydrocodeine (with or without aspirin, No dihydrocodeine products were ibuprofen, acetaminophen) 0.25 dispensed in this study Hydrocodone+(acetaminophen, ibuprofen, aspirin, or homatropine) 1 Pentazocine (with or without aspirin, ibuprofen, acetaminophen) 0.37 Propoxyphene (with or without acetaminophen, ibuprofen, aspirin) 0.23 No tapentadol products were Tapentadol 2.5 dispensed in this study Tramadol with or without aspirin 0.1 a Adapted from Von Korff M, Saunders K, Ray GT, et al. De facto long-term opioid therapy for noncancer pain. Clin J Pain. 2008;24:521–7. © 2013 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/27/2021 4 eTable 2. ICD9 Codes for Comorbid Diagnosis of Substance Abuse, Anxiety, Post- Traumatic Stress Disorder, and/or Depression a ICD9 Code Category Description 291.x Substance abuse Alcohol induced mental disorders 292.x Substance abuse Drug induced mental disorders 303.x Substance abuse Alcohol dependence syndrome 304.x Substance abuse Drug dependence 305.x Substance abuse Nondependent abuse of drugs 300.x Anxiety Anxiety, dissociative, and somatoform disorders 309.81 PTSD Posttraumatic stress disorder 296.2 Depression Major depressive disorder, single episode 296.3 Depression Major depressive disorder, multiple episodes 300.4 Depression Dysthymic disorder 309.0 Depression Adjustment disorder with depressed mood 309.1 Depression Prolonged depressive reaction 309.28 Depression Adjustment disorder with mixed anxiety and depressed mood 311.x Depression Depressive disorder, not elsewhere classified 296.0 Bipolar Bipolar I disorder, single manic episode 296.4 Bipolar Bipolar I disorder, most recent episode (or current) manic 296.5 Bipolar Bipolar I disorder, most recent episode (or current) depressed 296.6 Bipolar Bipolar I disorder, most recent episode (or current) mixed 296.7 Bipolar Bipolar I disorder, most recent episode (or current) unspecified 296.8x Bipolar Other and unspecified bipolar disorders a Cohort members were considered to have any of these conditions if they had at least one recorded diagnosis code in any setting in the year prior to bariatric surgery. © 2013 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/27/2021 5 eTable 3. ICD9 codes for Inclusion and Exclusion of Chronic Pain Diagnoses ICD9 Codes for Inclusion of Chronic Pain Diagnoses a, b ICD9 Code Category 550.x, 551.x, 552.x, 553.x, 789.0x Abdominal pain/hernia 274, 274.0, 274.00, 274.01, 274.02, 274.03, Arthritis 714, 714.0x, 714.1x, 714.2x, 714.3x, 714.4x, 714.5x, 714.6x, 714.7x, 714.8, 714.89, 714.9x, 715.x, 716.x, 719.3, 731.2 720.x, 721.2, 721.3, 721.41, 721.42, 721.5, 721.6, Back pain 721.7, 721.8, 721.9, 721.90, 721.91, 722.1, 722.10, 722.11, 722.2, 722.30, 722.31, 722.32, 722.39, 722.5, 722.51, 722.52, 722.6, 722.7, 722.70, 722.71, 722.72, 722.73, 722.8, 722.80, 722.82, 722.83, 722.9, 722.90, 722.92, 722.93, 724, 724.0, 724.00, 724.01, 724.02, 724.09, 724.1, 724.2, 724.3, 724.4, 724.5, 724.6, 724.7, 724.70, 724.71, 724.79, 724.8, 724.9, 737.x, 738.4, 738.5, 739.2, 739.3, 739.4, 756.1, 756.11, 756.12, 805, 805.2, 805.4, 805.6, 805.8, 839.2, 839.20, 839.21, 839.42, 846, 846.0, 846.1, 846.2, 846.3, 846.8, 846.9, 847.1, 847.2, 847.3, 847.4, 847.9, 848.5 354, 354.0, 354.00 Carpal tunnel 733.6, 786.52, 848.3, 848.4 Costochronditis and intracostal muscle injury 729, 729.1 Fibromylagia 800.x, 801.x, 802.x, 803.x, 804.x, 805.x, 806.x, 807.x, Fractures and contusions 808.x, 809.x, 810.x, 811.x, 812.x, 813.x, 814.x, 815.x, 816.x, 817.x, 818.x, 819.x, 820.x, 821.x, 822.x, 823.x, 824.x, 825.x, 826.x, 827.x, 828.x, 829.x, 920.x, 921.x, 922.x, 923.x, 924.x 307.89, 338, 338.2, 338.21, 338.22, 338.28, 338.29, General chronic pain 338.4, 739.9, 780.9, 780.96 574.x, 592.x Kidney/gall stones 354.4, 713.5, 718.45, 718.46, 718.47, 718.51, 723.4, Limb extremity pain 724.03, 724.3, 726.12, 726.5, 726.71, 726.72, 726.73, 726.9, 726.90, 726.91, 727, 727.0x, 727.1x, 727.2x, 727.3x, 727.4x, 727.5x, 727.6, 727.60, 727.62, 727.63, 727.64, 727.65, 727.66, 727.67, 727.68, 727.69, 727.7x, 727.8x, 727.9x, 728.71, 729.2, 729.5, 739.6, 739.7, 755.67, 755.9, 831.01, 838.04, 840.9, 842.1, 842.12, 843.8, 843.9, 844.8, 844.9, 845, 845.09, 845.1, 845.13 625, 625.0x, 625.1x, 625.2x, 625.3x, 625.4x, 625.5x, Menstrual pain 625.7x, 625.8x, 625.9x 346.x Migraines 721, 721.0, 721.1, 722, 722.0, 722.4, 722.81, 722.91, Neck pain 723.x, 728.85, 739.1, 805.0, 805.00, 805.01, 805.02, 805.03, 805.04, 805.05, 805.06, 805.07, 805.08, 847, 847.0 353.x, 354.x, 355.x, 356.x, 357.x, 337.0 Neuropathy 715.x Osteoarthritis © 2013 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/27/2021 6 ICD9 Code Category 306, 648.73, 710.5, 725, 728.89, 729.4, 733.6, 739.8, Other CMP 786.52, 831.04, 848.3, 848.41, 848.8 711.x, 717.2, 717.3, 717.5, 717.7, 717.83, 717.9, Pain in joint 718.1, 718.31, 718.81, 718.84, 718.87, 719, 719.06, 719.4, 719.40, 719.41, 719.42, 719.43, 719.44, 719.45, 719.46, 719.47, 719.48, 719.49, 726, 726.0, 726.1, 726.10, 726.11, 726.19, 726.2, 726.30, 726.31, 726.32, 726.33, 726.39, 726.4, 726.6, 726.60, 726.61, 726.62, 726.64, 726.65, 726.69, 726.7, 726.70, 726.79, 726.8, 727.61, 831, 835, 836, 836.1, 836.3, 839.69, 839.8, 840, 840.3, 840.4, 840.5, 840.6, 840.7, 840.8, 841.9, 842, 842.01, 842.09, 844.1, 844.2 307.81, 339.1, 339.11, 339.12, 339.22, 784, 784.0, Tension headache 784.00 524.6x, 526.9x, 784.9x, 830.0x, 830.1x TMD/TMJ ICD9 Malignant Cancer, Dementia, and Psychosis Codes that Precluded Classification of Chronic Pain Diagnoses c 140-208 d Malignant cancer 290.0x, 290.1, 290.10 Dementia and psychosis 290.4x–290.9x 291.2x 294.1, 294.10, 294.11 295.x 297.x 298.x 299.x 300.12–300.15 315.0x, 315.1x, 315.2x, 315.3x, 315.5x 317.x, 318.x, 319.x 331.x 292.82 a The goal of including this list of diagnoses in the definition of chronic pain diagnoses is to maximize the sensitivity of identifying individuals with chronic pain prior to bariatric surgery.
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