Author Affiliation: Tufts School of Medicine, Boston, Massachusetts (email@example.com).
To the Editor: Dr Bohnert and colleagues alerted the medical community to the dangers of higher opioid doses and their association with overdose death.1 Their study most likely missed cases of cardiac deaths from QTc prolongation, as the primary cause, methadone, was excluded from their investigation. However, the other major etiology of opioid-related death is ventilatory suppression via opioid-induced central sleep apnea.
Geller AS. Opioid Overdose-Related Deaths. JAMA. 2011;306(4):379-381. doi:10.1001/jama.2011.1036