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Home , Butalbital, Codeine, Dihydrocodeine, Ethylmorphine, Hydrocodone, Nalbuphine

Supplementary Online Content Ladapo JA, Larochelle MR, Chen A, et al. Physician prescribing of to patients at increased risk of overdose from use in the . JAMA Psychiatry. Published online April 12, 2018. doi:10.1001/jamapsychiatry.2018.0544

eTable 1. Multum Lexicon Generic Codes and NCHS Generic Codes (5-Digit Code Assigned to Each Official Generic Name Assigned to Every Drug Entity by the United States Pharmacopeia)

eTable 2. Rate of New Prescriptions in US Population, 2005-2015 (Sensitivity Analysis in Which up to 30 Were Assessed)

eTable 3. -Related Reasons for Visit and Diagnoses

eTable 4. Rate of New Opioid Prescriptions in US Population, 2005-2015 (Sensitivity Analysis Limiting Data to NAMCS Only, Without NHAMCS/Community Health Center Data)

This supplementary material has been provided by the authors to give readers additional information about their work.

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eTable 1. Multum Lexicon Generic Drug Codes and NCHS Generic Codes (5-Digit Code Assigned to Each Official Generic Name Assigned to Every Drug Entity by the United States Pharmacopeia)

Opioids and List Drug Drug Notes Drug Drug Notes Code Code Acetaminophen, a11047 w/ 04855 , , Codeine DC Expectoran Acetaminophen, 00280 Acetaminophen Brompheniramine, a11065 Codeine with Codeine Codeine, , Phenylephrine, Phenylpropanolamine Acetaminophen, 32915 no. 2 with 10386 Butrans Codeine Codeine Acetaminophen, 32920 Tylenol no. 3 with Buprenorphine HCL 60265 Buprenex Codeine Codeine Acetaminophen, 32925 Tylenol no. 4 with Buprenorphine HCL 95036 Buprenorphine Codeine Codeine Acetaminophen, 32930 Tylenol with Buprenorphine HCL 50711 Buprenorphine Codeine Codeine Acetaminophen, 32935 Tylenol with Buprenorphine, 10166 Codeine Codeine Naloxone Acetaminophen, 23680 Phenaphen with Buprenorphine, 03276 Suboxone Codeine Codeine Naloxone Acetaminophen, d03423 Acetaminophen Buprenorphine, 13141 Zubsolv Codeine with Codeine Naloxone Acetaminophen, 00283 Buprenorphine, d04819 Naloxone Acetaminophen, 12046 Percocet Buprenorphine- 10166 Oxycodone Naloxone Acetaminophen, 23385 Percocet-5 , 95178 Fioricet with Oxycodone Acetaminophen, Codeine Caffeine, and Codeine Phosphate Acetaminophen, 07252 Percocet 7.5 Butalbital, d03425 Fioricet with Oxycodone Acetaminophen, Codeine Caffeine, and Codeine Phosphate Acetaminophen, 07251 Percocet 10 Butalbital, n08029 Oxycodone Acetaminophen, Caffeine, Codeine Acetaminophen, 99114 Endocet Butalbital, ASA, 10238 Oxycodone Caffeine, Codeine Butalbital, d03425 Fioricet with Butalbital, ASA, 12570 Trade name © 2018 American Medical Association. All rights reserved.

Downloaded From: https://jamanetwork.com/ on 09/30/2021 Acetaminophen, Codeine Caffeine, Codeine Fiorinal With Caffeine, and Codeine Codeine #3 Phosphate Butalbital, n08029 Butalbital, ASA, d03426 Acetaminophen, Caffeine, Codeine Caffeine, Codeine Butalbital, ASA, 10238 01021 Butorphanol Caffeine, Codeine Tartrate Butalbital, ASA, 12570 Trade name Butorphanol 29285 Stadol Caffeine, Codeine Fiorinal With Codeine #3 Butalbital, ASA, d03426 Butorphanol 50740 Butorphanol Caffeine, Codeine Tartrate Butorphanol 01021 Butorphanol Chlorpheniramine, d03416 Zutripro Tartrate , Pseudoephedrine Butorphanol 29285 Stadol Codeine 07180 Butorphanol 50740 Butorphanol Codeine 51340 Tartrate Butorphanol d00838 Butorphanol Codeine d00012 Tartrate Chlorpheniramine, 06244 ZTuss Expectorant Codeine Phosphate 07185 Guaifenesin, Hydrocodone, , Pseudoephedrine Chlorpheniramine, a11760 ZTuss Expectorant Codeine, Guaifenesin 13838 Guaifenesin, Hydrocodone, Phenylalanine, Pseudoephedrine Chlorpheniramine, 08228 Chlorpheniramine Codeine, Guaifenesin 95044 Robitussin w/ Hydrocodone Hydrocodone Codeine Chlorpheniramine, 04256 Hydrocodone GF Codeine, Guaifenesin d03393 Hydrocodone Chlorpheniramine, d03356 Chlorpheniramine Codeine, 25430 Hydrocodone Hydrocodone Phenylephrine, VC with Promethazine Codeine Chlorpheniramine, 08452 Tussionex Codeine, d03364 Promethazine Hydrocodone, Polistirex Pennkinetic Phenylephrine, VC with Promethazine Codeine Chlorpheniramine, 09147 Tussicaps Codeine, Promethazine 25432 Promethazine Hydrocodone, Polistirex with Codeine Chlorpheniramine, 11402 Zutripro Codeine, Promethazine 23798 Phenergan with Hydrocodone, Codeine is trade Pseudoephedrine name © 2018 American Medical Association. All rights reserved.

Downloaded From: https://jamanetwork.com/ on 09/30/2021 Codeine, Promethazine d03357 Promethazine with Codeine, Promethazine 25390 Promethazine Codeine Expectorant with Codeine Codeine, 32558 Codeine, Promethazine 25415 Promethazine Pseudoephedrine, Pseudophed with HCl with Triprolidine Codeine Codeine Expectorant Codeine, d03363 Triprolidine Hydrocodone 89038 Hydrocodone Pseudoephedrine, Pseudophed with Bitartrate with Triprolidine Codeine APAP Codeine-Sulfate 07190 Hydrocodone Bitartrate 98036 Norco Codeine-Sulfate 70360 Hydrocodone Bitartrate 70217 Hydrocodone Bitartrate with APAP 57046 Dalgan Hydrocodone Bitartrate 14770 Hycodan and Methylbromide 09574 Hydrocodone 32855 Tussionex Polistirex, Chlorpheniramine Dihydrocodeine 52647 Hydrocodone 70599 Tussionex Polistirex, Chlorpheniramine Dihydrocodeine d03168 Hydrocodone a10956 Tussionex Polistirex, Chlorpheniramine Dihydrocodeine, 70405 Trezix Hydrocodone, 89039 Bitartrate / Acetaminophen Acetaminophen, Caffeine, Dihydrocodeine Dihydrocodeine, d04269 Trezix Hydrocodone, 92041 Hydrocodone Bitartrate / Acetaminophen compound Acetaminophen, Caffeine, Dihydrocodeine 52165 Hydrocodone, 34110 Vicodin Acetaminophen 94188 Fentanyl Hydrocodone, 00251 Vicodin ES Acetaminophen Fentanyl 52225 Fentanyl Hydrocodone, 08354 Vicodin HP Acetaminophen Fentanyl d00233 Fentanyl Hydrocodone, 98104 Vicodin Tuss Acetaminophen Fentanyl Citrate 60565 Fentanyl Citrate Hydrocodone, 01268 Lorcet Plus Acetaminophen © 2018 American Medical Association. All rights reserved.

Downloaded From: https://jamanetwork.com/ on 09/30/2021 Fentanyl Citrate 70452 Fentanyl Citrate Hydrocodone, 93089 Lorcet Acetaminophen Fentanyl transdermal 92024 Duragesic Hydrocodone, 02132 Lorcet HD system (Fentanyl Acetaminophen Transdermal) Fentanyl Transmucosal 02067 Actiq Hydrocodone, 92180 Lortab Lozenge Acetaminophen Fentanyl Transmucosal 70731 Actiq Hydrocodone, 02314 Lortab elixir Lozenge Acetaminophen Guaifenesin, d03396 Hydrocodone, 02082 Maxidone Hydrocodone Acetaminophen Homatropine, 05223 Homatropine- Hydrocodone, 96028 Acetaminophen- Hydrocodone Hydrocodone Acetaminophen Hydrocodone Homatropine, d03340 Homatropine- Hydrocodone, d03428 Hydrocodone Hydrocodone Acetaminophen Homatropine, Methyl a10897 Hydrocodone, 09751 , Hydrocodone Hydrocodone 14955 Hydrocodone Hydrocodone, 98043 Vicoprofen Ibuprofen Hydrocodone 52650 Hydrocodone Hydrocodone, d04225 Ibuprofen Hydrocodone d03075 Hydrocodone 15005 Hydromorphone 53475 Methadone Hydromorphone 11229 Exalgo Methadone d00050 Methadone Hydromorphone 52670 Hydromorphone 19650 Morphine Hydromorphone d00255 Hydromorphone Morphine 19655 Morphine & Hydromorphone HCL 09600 Dilaudid Morphine 53760 Morphine Hydromorphone HCL 09595 Dilaudid Syrup Morphine d00308 Morphine Hydromorphone HCL 70623 Dilaudid Morphine Sulfate 99123 17362 Levorphanol Tartrate (Levo- Dromoran) Morphine Sulfate 12008 Morphine ER Levorphanol 53055 Levorphanol Tartrate (Levo- Dromoran) Morphine Sulfate 41420 Roxanol Levorphanol d00825 Levorphanol Tartrate (Levo- Dromoran) Morphine Sulfate 19699 MS-Contin Meperidine 18760 Meperidine Morphine Sulfate 03228 Avinza Meperidine 96405 Demerol Morphine Sulfate 98144 Kadian Meperidine 53335 Meperidine Morphine Sulfate 70044 Meperidine d00017 Meperidine 60990 Nalbuphine HCL Meperidine HCL 00200 Meperidine HCL Nalbuphine 21550 Nubain Meperidine HCL 70267 Meperidine HCL © 2018 American Medical Association. All rights reserved.

Downloaded From: https://jamanetwork.com/ on 09/30/2021 Nalbuphine 53855 Nalbuphine HCL Methadone 18985 Methadone Nalbuphine d00839 Nalbuphine HCL Methadone 10130 Dolophine Naloxone d00311 Naloxone 53865 Narcan 20310 Naloxone HCl 60995 Oxycodone 12028 11270 Oxycodone 96109 Oxycontin Oxymorphone HCl 07117 Opana Oxycodone 09582 Oxycodone CR Oxymorphone HCl 07223 Opana ER Oxycodone 05081 OxyIR 23285 Oxycodone 54094 Pentazocine 70591 Pentazocine HCl Oxycodone d00329 Pentazocine 54290 Oxycodone HCL 22303 Pentazocine d00334 Oxycodone HCL 08246 Oxycodone ER Pentazocine, 07701 Acetaminophen Oxycodone HCL 02333 Roxicodone Pentazocine, 30513 Talacen Acetaminophen Oxycodone HCL 70269 Pentazocine, 70951 Acetaminophen Oxycodone HCL, 22305 Oxycodone HCL Pentazocine, d03682 Acetaminophen & Acetaminophen Acetaminophen Oxycodone 70582 Pentazocine, Naloxone 13117 Terephthalate Oxymorphone 54135 Pentazocine, Naloxone 04538 Talwin Nx Oxymorphone d00833 Pentazocine, Naloxone 30535 Talwin Pentazocine, Naloxone d03676 d07453 Phenylpropanolamin, 14960 Hydrocodone PA 96041 Tramadol Hydrocodone Syrup Citrate 50040 Sufenta Tramadol 95050 Ultram Sufentanil Citrate 55583 Sufenta Tramadol 08329 Ultram ER Tapentadol 09286 Tramadol 57160 Tramadol Tapentadol 11121 Nucynta Tramadol d03826 Tramadol Tramadol HCL d04766 Tramadol HCL Tramadol HCL 03319 Tramadol HCL Tramadol, 09651 Tramadol HCL 12448 Conzip Acetominophen Tramadol, 01124 Ultracet Tramadol HCL 70282 Tramadol HCL Acetominophen Cough medicines were excluded: Brompheniramine w/ Codeine DC Expectoran; Chlorpheniramine, Guaifenesin, Hydrocodone, Phenylalanine, Pseudoephedrine; Chlorpheniramine, Hydrocodone; Chlorpheniramine, Hydrocodone, Polistirex; Chlorpheniramine, Hydrocodone, Pseudoephedrine; Codeine, Guaifenesin; Codeine, Guiatussin; Codeine, Phenylephrine, Promethazine; Codeine, Promethazine; Codeine, Pseudoephedrine, Triprolidine; Homatropine, Hydrocodone; Hydrocodone Bitartrate and Homatropine Methylbromide; Hydrocodone Polistirex, Chlorpheniramine; Phenylpropanolamin, Hydrocodone. Benzodiazepine List Drug Drug Notes Drug Drug Notes

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Downloaded From: https://jamanetwork.com/ on 09/30/2021 Code Code 91062 Alprazolam d0014 Diazepam 8 Alprazolam 03185 Xanax XR Diazepam 51695 Diastat Alprazolam 35023 Xanax 12810 Flurazepam Alprazolam 50113 Alprazolam Flurazepam 08390 Dalmane Alprazolam d00168 Alprazolam Flurazepam 52350 Flurazepam ; 01532 Flurazepam d0023 Flurazepam 8 Amitriptyline; 17530 Limbitrol 17888 Lorazepam chlordiazepoxide Amitriptyline; d03462 Lorazepam 02900 Ativan chlordiazepoxide Chlordiazepoxide 06495 Chlordiazepoxide Lorazepam 53145 Lorazepam Chlordiazepoxide 17450 Librium Lorazepam d0014 Lorazepam 9 Chlordiazepoxide 51055 Chlordiazepoxide HCL 93262 Midazolam HCL Chlordiazepoxide d00189 Chlordiazepoxide Midazolam HCL 12007 Midazolam HCL Chlordiazepoxide 17440 Librax Midazolam HCL 53716 Midazolam Clidinium HCL Chlordiazepoxide d03492 Librax Midazolam HCL d0030 Midazolam Clidinium 1 HCL Chlordiazepoxide HCL 06500 22242 Oxazepam Chlordiazepoxide HCL 70356 Oxazepam 27855 Serax 06980 Clonazepam Oxazepam 54085 Oxazepam Clonazepam 60790 Klonopin Oxazepam d0004 Oxazepam 0 Clonazepam 51270 Clonazepam 92148 Quazepam Clonazepam d00197 Clonazepam Quazepam 92022 Doral 06993 Clorazepate Quazepam 55028 Quazepam Clorazepate 51280 Clorazepate 30756 Temazepa m Clorazepate d00198 Clorazepate Temazepam 26453 Restoril Clorazepate Dipotassium 02129 Temazepam 55668 Temazepa m Clorazepate Dipotassium 31945 Tranxene Temazepam d0038 Temazepa 4 m Clorazepate Dipotassium 70470 93419 Triazolam Diazepam 33555 Valium Triazolam 13999 Halcion Diazepam 09370 Diazepam Triazolam 55928 Triazolam Diazepam 99213 Diastat Triazolam d0039 Triazolam 7

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eTable 2. Rate of New Opioid Prescriptions in US Population, 2005-2015 (Sensitivity Analysis in Which up to 30 Medications Were Assessed)

Annual Visits, Weighted No. New Opioid Visits per 1,000 Population Rate Rate diff, diff, 2005- 2009- 2014- 2005- P 2011- P 2005-2006 2009-2010 2014-2015 2006 2010 2015 2010 95% CI value 2015 95% CI value

Characteristics Adults not Using a Benzodiazepine 13,155,000 16,651,000 14,428,000 65 79 67 14 ( -2 to 30) 0.081 -12 ( -33 to 8) 0.246 Adults Using a Benzodiazepine 1,004,000 2,449,000 1,762,000 137 289 135 152 (27 to 278) 0.018 -154 (-276 to -32) 0.013

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Downloaded From: https://jamanetwork.com/ on 09/30/2021 eTable 3. Pain-Related Reasons for Visit and Diagnoses

Description Diagnosis Codes Back Pain RFV: 19000, 19001, 19002, 19050, 19051, 19052, 19053, 19055, 19056, 19100, 19101, 19102, 19105, 19106, 51050, 51100, 55150 ICD9: 720.1, 721.90, 722.10, 722.30, 722.31, 722.32, 722.39, 722.51, 722.52, 722.90, 722.91, 722.92, 722.93, 724.00, 724.01, 724.02, 724.09, 724.70, 724.71, 724.79, 737.10, 737.11, 737.12, 737.19, 737.20, 737.21, 737.22, 737.29, 737.30, 737.31, 737.32, 737.33, 737.34, 737.39, 737.40, 737.41, 737.42, 737.43, 756.10, 756.11, 756.12, 721.0, 721.2, 721.3, 721.6, 721.8, 722.0, 722.2, 722.4, 722.5, 722.6, 723.0, 723.1, 723.2, 723.3, 723.4, 723.5, 723.7, 723.8, 724.1, 724.2, 724.3, 724.4, 724.5, 724.6, 724.8, 724.9, 737.0, 737.8, 737.9, 739.1, 739.2, 739.3, 739.4, 846.0, 846.1, 846.2, 846.3, 846.8, 846.9, 847.0, 847.1, 847.2, 847.3, 847.4, 847.9 RFV: 12100, 23650, 30781 ICD9: 307.81, 346.00, 346.01, 346.10, 346.11, 346.20, 346.21, 346.80, 346.81, 346.90, 346.91, 784.0 Malignancy RFV: 21300, 21260, 21250, 21200, 21150, 21100, 21050, 21000, 21350 ICD9: 140.0, 141.0, 142.0, 143.0, 144.0, 145.0, 146.0, 147.0, 148.0, 149.0, 150.0, 151.0, 152.0, 153.0, 154.0, 155.0, 156.0, 157.0, 158.0, 159.0, 160.0, 161.0, 162.0, 163.0, 164.0, 165.0, 166.0, 167.0, 168.0, 169.0, 170.0, 171.0, 172.0, 174.0, 175.0, 176.0, 177.0, 178.0, 179.0, 180.0, 181.0, 182.0, 183.0, 184.0, 185.0, 186.0, 187.0, 188.0, 189.0, 190.0, 191.0, 192.0, 193.0, 194.0, 195.0, 196.0, 197.0, 198.0, 200.0, 201.0, 202.0, 203.0, 204.0, 205.0, 206.0, 207.0, 208.0, 199.0, 199.1 Injury RFV: 50050, 50100, 50150, 50200, 50250, 50300, 50350, 50400, 50450, 50500, 51050, 51100, 51150, 51200, 51250, 51300, 52050, 52100, 52150, 52200, 52250, 52300, 53050, 53100, 53150, 53200, 53250, 54050, 54100, 54150, 54200, 54250, 54300, 55050, 55100, 55150, 55200, 55250, 55300, 55350, 55400, 55450, 55500, 55550, 55600, 55650, 55700, 55750, 57050, 57100, 57150, 57200, 58000, 58050, 5815 Musculoskeletal RFV: 19003, 19005, 19006, 19103, 19150, 19151, 19152, 19153, 19155, 19156, 19200, 19201, 19202, 19203, 19205, 19206, 19250, 19251, 19252, 19253, 19255, 19256, 19300, 19301, 19302, 19303, 19305, 19306, 19350, 19351, 19352, 19353, 19355, 19356, 19400, 19401, 19402, 19403, 19405, 19406, 19450, 19451, 19452, 19453, 19455, 19456, 19500, 19501, 19502, 19503, 19505, 19506, 19550, 19551, 19552, 19553, 19555, 19556, 19600, 19601, 19602, 19603, 19605, 19606, 19620, 19650, 19651, 19652, 19653, 19655, 19656, 19700, 19701, 19702, 19703, 19705, 19706, 19750, 19752, 19800 Other RFV: 10500, 10501, 10503, 10550, 10551, 10552, 10553, 10554, 10600, 10601, 10602, 12650, 12752, 13201, 13203, 13550, 13551, 13552, 14052, 14101, 14551, 14552, 14851, 15001, 15002, 15053, 15101, 15104, 15151, 15350, 15450, 15451, 15452, 15453, 16051, 16101, 16500, 16651, 16701, 17001, 17151, 17452, 17651, 17751, 17901, 18000, 18650, 18701, 22010, 22100, 23500, 24500, 25450, 26550, 26600, 26751, 26754, 26755, 58180

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Downloaded From: https://jamanetwork.com/ on 09/30/2021 eTable 4. Rate of New Opioid Prescriptions in US Population, 2005-2015 (Sensitivity Analysis Limiting Data to NAMCS Only, Without NHAMCS/Community Health Center Data)

Annual Visits, Weighted No. New Opioid Visits per 1,000 Population Rate Rate diff, diff, 2005- 2009- 2014- 2005- P 2011- P 2005-2006 2009-2010 2014-2015 2006 2010 2015 2010 95% CI value 2015 95% CI value

Characteristics Adults not Using a Benzodiazepine 19,005,000 23,544,000 16,989,000 78 93 79 15 ( -3 to 33) 0.095 -14 ( -39 to 10) 0.249 Adults Using a Benzodiazepine 1,665,000 3,576,000 2,584,000 189 351 198 162 (29 to 295) 0.017 -153 (-286 to -21) 0.023

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