Table 4.

Prescription opioid exposures as risk factors for opioid overdose and adjusted odds ratios (exposed vs non-exposed)

Year	Adjusted odds ratios [95% CI]
	2009	2010	2011	2012	2013	2014	2015	2016	2017	Overall
Agonist
Morphine	1.58**** [1.41–1.76]	1.31**** [1.15–1.48]	1.36**** [1.26–1.47]	1.36**** [1.28–1.45]	1.33**** [1.25–1.42]	1.49**** [1.42–1.56]	1.56**** [1.49–1.63]	1.53**** [1.46–1.60]	1.59**** [1.51–1.67]	1.44**** [1.42–1.47]
Fentanyl	1.05 [0.94–1.17]	1.22** [1.07–1.38]	1.23**** [1.14–1.33]	1.24**** [1.16–1.32]	1.56**** [1.45–1.68]	1.27**** [1.22–1.33]	1.33**** [1.27–1.39]	1.47**** [1.40–1.54]	1.51**** [1.42–1.60]	1.22**** [1.20–1.25]
Oxycodone	1.72**** [1.54–1.92]	1.68**** [1.49–1.90]	1.74**** [1.60–1.88]	1.60**** [1.50–1.71]	1.78**** [1.66–1.91]	1.73**** [1.65–1.82]	1.82**** [1.74–1.91]	1.89**** [1.80–1.98]	1.90**** [1.80–2.01]	1.70**** [1.67–1.73]
Hydromorphone	1.97**** [1.74–2.23]	1.66**** [1.45–1.91]	1.88**** [1.73–2.04]	1.64**** [1.54–1.75]	1.71**** [1.59–1.83]	1.76**** [1.68–1.84]	1.79**** [1.71–1.87]	1.95**** [1.86–2.04]	1.89**** [1.80–1.99]	1.81**** [1.77–1.84]
Hydrocodone	1.24** [1.08–1.42]	1.01a [0.85–1.20]	1.19*** [1.08–1.30]	1.31**** [1.22–1.41]	1.17**** [1.08–1.27]	1.26**** [1.20–1.33]	1.23**** [1.17–1.30]	1.25**** [1.18–1.33]	1.18**** [1.10–1.27]	1.12**** [1.09–1.15]
Meperidine	1.23 [0.94–1.61]	0.98a [0.64–1.50]	1.09 [0.96–1.24]	1.13* [1.02–1.30]	1.15* [1.02–1.30]	1.07 [0.99–1.15]	1.08* [1.00–1.16]	1.14** [1.05–1.23]	1.01a [0.93–1.11]	1.09**** [1.06–1.13]
Tramadol	3.70**** [3.10–4.41]	3.47**** [2.86–4.20]	3.01**** [2.68–3.38]	2.69**** [2.45–2.95]	2.11**** [1.91–2.34]	2.21**** [2.08–2.36]	2.16**** [2.03–2.30]	1.88**** [1.76–2.01]	1.50**** [1.36–1.65]	2.20**** [2.14–2.27]
Codeine	0.96 [0.75–1.22]	0.81 [0.58–1.13]	0.96 [0.79–1.15]	0.95 [0.81–1.12]	0.71*** [0.58–0.85]	0.89 [0.78–1.01]	0.89* [0.78–1.00]	0.69**** [0.60–0.80]	0.73** [0.60–0.89]	0.78**** [0.74–0.83]
Loperamide	2.08**** [1.57–2.75]	1.41 [0.95–2.10]	2.20**** [1.85–2.61]	2.16**** [1.87–2.49]	2.11**** [1.80–2.47]	2.12**** [1.92–2.35]	2.17**** [1.98–2.39]	1.96**** [1.77–2.17]	1.63**** [1.44–1.85]	2.03**** [1.94–2.12]
Diphenoxylate	1.63* [1.01–2.64]	1.69 [0.98–2.93]	2.06**** [1.56–2.72]	1.88**** [1.45–2.43]	1.57** [1.16–2.12]	1.33** [1.10–1.62]	1.39*** [1.16–1.67]	1.69**** [1.37–2.09]	1.79**** [1.38–2.32]	1.48**** [1.36–1.61]
Methadone	7.86**** [6.34–9.74]	6.36**** [4.88–8.28]	7.12**** [6.10–8.32]	7.07**** [6.23–8.03]	6.59**** [5.66–7.67]	6.78**** [6.14–7.49]	6.47**** [5.86–7.1]	6.53**** [5.85–7.30]	5.46**** [4.78–6.22]	6.51**** [6.23–6.80]
Partial agonist
Nalbuphine	0.38**** [0.26–0.57]	0.38**** [0.25–0.60]	0.46**** [0.34–0.61]	0.54**** [0.43–0.66]	0.63**** [0.50–0.79]	0.46**** [0.39–0.54]	0.57**** [0.50–0.66]	0.52**** [0.45–0.60]	0.91**** [0.78–1.07]	0.56**** [0.53–0.60]
Butorphanol	0.19**** [0.09–0.44]	0.08*** [0.02–0.34]	0.10**** [0.05–0.19]	0.13**** [0.06–0.29]	0.06**** [0.03–0.14]	0.11**** [0.08–0.17]	0.05**** [0.03–0.08]	0.11**** [0.06–0.18]	0.08**** [0.04–0.16]	0.09**** [0.07–0.11]
Buprenorphine	3.14**** [1.80–5.46]	1.90 [0.78–4.61]	2.33**** [1.58–3.44]	3.37**** [2.48–4.60]	5.14**** [3.73–7.10]	3.35**** [2.73–4.11]	2.77**** [2.19–3.49]	2.56**** [2.05–3.21]	1.74**** [1.29–2.35]	2.89**** [2.63–3.19]
Antagonist
Naloxone	6.40**** [5.70–7.19]	5.70**** [5.00–6.51]	4.19**** [3.85–4.55]	3.93**** [3.68–4.20]	2.80**** [2.61–3.01]	3.50**** [3.34–3.67]	3.13**** [3.00–3.28]	2.49**** [2.38–2.61]	2.53**** [2.3–2.67]	3.24**** [3.18–3.31]

CI confidence interval

*p < 0.05, **p < 0.01, ***p < 0.001, ****p < 0.0001

^aPower less than 80%