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To the Editor Dr Dowell and colleagues1 discussed the recent increase in opioid-related deaths and attributed it primarily to increased opioid prescribing for chronic, nonmalignant pain. The authors stated that long-term opioid therapy ultimately leads to tolerance and this in turn triggers opioid dose escalation, which is the major risk factor for opioid overdose.
Chwistek M. Risks Associated With Opioid Use. JAMA. 2013;310(16):1737. doi:10.1001/jama.2013.277305