An Exploratory Assessment of Substances Used as Adjuncts or Alternatives to Prescription Opioids

Data To Support Social and Behavioral Research as Used by the Food and Drug Administration

Appendix B - List of Prescription Opioids

An Exploratory Assessment of Substances Used as Adjuncts or Alternatives to Prescription Opioids

OMB: 0910-0847

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OMB Control No. 0910-0847

Expiration Date: 12/31/2022


Attachment B

Prescription Opioids

Please check all the brand names you recall using during the past 12 months. If you do not recall the brand name, just check the generic name.

Generic Names

Brand Names

Please check if you have used during 12 months prior to beginning treatment

Hydrocodone



Anexia


Hysingla ER


Lortab


Lorcet


Norco


Reprexain


Vicodin


Vicoprofen


Zohydro ER


Oxycodone



Oxaydo


Oxycet


Oxycontin


Percocet


Percodan


Roxicet


Roxicodone


Xartemis XR


Xtampza ER


Morphine



Astramorph PF (injectable)


Duramorph (injectable)


Embeda


Infumorph (injectable)


Kadian


Morphobond


MS Contin


Pharmaceutical Fentanyl



Abstral



Actiq



Duragesic



Fentora



Ionsys



Lazanda



Onsolis



Sublimaze



Subsys




Generic Names

Brand Names

Please check if you have used during 12 months prior to beginning treatment

Codeine



Floricet with codeine


Florinal with codeine


Tylenol #3


Tylenol #4


Methadone



Dolophine


Methadose


Tramadol



Conzip


Ultracet


Ultram


Ultram ER


Oxymorphone



Opana


Opana ER


Hydromorphone



Dilaudid



Dalaudid-HP



Exalgo


Buprenorphine



Belbuca



Bunavail



Buprenex



Butrans



Suboxone



Zubsolv


Tapentadol



Nucynta



Nucynta ER


Meperidine



Demerol


Butorphanol

(no brand name)


Pentazocine



Talwin


Alfentanil



Alfenta


Remifentanil



Ultiva


Sufentanil



Dsuvia



Sufenta


Dihydrocodeine



Synalgos-DC




First Name: ________ Date/Time of Full Interview with MHA: _______________________

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AuthorMark Herring
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