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T40.1X* (heroin), T40.2X* (opioid), T40.41* (fentanyl), T40.60* (opiate) Alcohol: a billing or encounter diagnosis with ICD-10-CM code F10.12*, F10.22*, F10.92*, T51.0X* Stimulants: a billing or encounter diagnosis with ICD-10-CM code T43.62* or F15.[129]2* Sedative/hypnotics: a billing or encounter diagnosis with ICD-10-CM code T42.3X*, T42.4X*, or F13.[129]2* Cannabinoid: a billing or encounter diagnosis with ICD-10-CM code T40.71*, T40.72*, F12.[129]2* Cocaine: a billing or encounter diagnosis with ICD-10-CM code T40.5X* or F14.[129]2* Hallucinogens: a billing or encounter diagnosis with ICD-10-CM code T40.8X*, T40.99*, or F16.[129]2* GLP-1 An outpatient prescription or historical medication for a glucagon-like peptide-1 receptor agonist (e.g., semaglutide, liraglutide, dulaglutide, tirzepatide, exenatide) Confounders Evaluated sex Age group: 1834, 3549, 5064, 6574, 75+ Race and ethnicity : non-exclusive flags for Black or African American and Hispanic or Latino Social Vulnerability Index quintile RUCA (rural-urban commuting area) BMI classification Type 2 diabetes: any diagnosis with ICD-10-CM code E11* Mental health diagnoses (any prior to censor): anxiety (ICD-10-CM code F40*, F41*, F06.4*, F93.0*, F94.0*)

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