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To assess whether naloxone prescribing in clinical contexts targeted pain patients most at risk for opioid overdose. A retrospective cohort study using data from the Health Facts Database. Over 600United States healthcare facilities. Three patient groups were followed for 2years during 2009 to 2017 individuals with shoulder or long bone fractures (n=252 424), chronic pain syndrome (CPS) (n=76 141), or non-traumatic low back pain (n=792 956) who received an opioid prescription. Groups were chosen based on previous work. The outcome was o