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May 6, 2009

Prescription Opioids and Overdose Deaths—Reply

JAMA. 2009;301(17):1766-1769. doi:10.1001/jama.2009.581

In Reply: We agree with the emphasis by Ms Graham and colleagues on methadone. According to mortality data reported by the National Center for Health Statistics, methadone appears to be involved in more drug-overdose deaths than heroin or any other prescription opioid.1 We also appreciate the need for surveillance systems that can provide more timely and detailed data on drug overdoses than those from existing systems. Despite the rapid reporting of basic information on drug-related deaths in a few states, including Florida,2 obtaining just as timely and more detailed data nationwide will be challenging because of the existing demands on coroners and medical examiners and the notoriously low reporting rates in passive public health surveillance systems.3 Establishment of uniform data elements and electronic records systems for coroners and medical examiners might circumvent these barriers.

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