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July 27, 2011

Reducing Opioid Abuse and Diversion—Reply

Author Affiliations

Author Affiliations: National Institute on Drug Abuse, Bethesda, Maryland (Dr Volkow) (nvolkow@nida.nih.gov); and Penn Center for Substance Abuse Solutions, University of Pennsylvania School of Medicine, Philadelphia (Dr McLellan).

JAMA. 2011;306(4):381-383. doi:10.1001/jama.2011.1043

In Reply: The letters highlight the importance and complexity of reducing inappropriate availability of pharmaceutical opioids without jeopardizing access to appropriately prescribed pain medication.

Dr Fitzgibbons identifies a significant gap in a medical education curriculum that leaves students ill prepared to recognize and handle patients who abuse drugs. However, she regards our recommendation for monitoring of patients' medical records naive in the face of criminal intent. On the contrary, we believe that emerging technologies will enhance the deployment and usefulness of monitoring instruments within and across states. This will require policy changes designed to regulate the use of these mandatory programs and support databases that can be accessed promptly.