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July 27, 2011

Opioid Overdose-Related Deaths

Author Affiliations

Author Affiliation: University of Maryland School of Pharmacy, Baltimore (sdoyon@rx.umaryland.edu).

JAMA. 2011;306(4):379-381. doi:10.1001/jama.2011.1037

To the Editor: In the report on opioid overdose-related deaths, Dr Bohnert and colleagues1 stated in the methods that “The opioid analgesic medications dispensed by VHA pharmacies during FY2004 through FY2008 were codeine, morphine, oxycodone, hydrocodone, oxymorphone, and hydromorphone,” suggesting that all these opioids were studied. However, the authors also stated that “Semisynthetic opioids were not included because they correspond with ICD-10 T-code 40.4.” Data in tables were expressed in morphine equivalencies only. Oxycodone, hydrocodone, oxymorphone, and hydromorphone are semisynthetic opioids.2 Were these semisynthetic opioids included or excluded from the study?