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July 27, 2011

Opioid Overdose-Related Deaths

Author Affiliations

Author Affiliations: VA Cooperative Studies Program, Veterans Affairs Boston Healthcare System, Boston, Massachusetts (john.hermos@va.gov).

JAMA. 2011;306(4):379-381. doi:10.1001/jama.2011.1038

To the Editor: In the study by Dr Bohnert and colleagues about opioid prescribing patterns and opioid overdose-related deaths in Veterans Health Administration patients, the comparatively low risk of opioid overdoses among black patients compared with white patients was noted but not further analyzed or discussed.1 Black patients represented 16.4% of the sample of patients receiving opioid therapy but only 6.9% of the overdose fatalities; white patients represented 71.7% of the sample and 83.3% of the opioid-related overdose fatalities. Black patients in this study were approximately one-third less likely to die of an opioid-related overdose than were white patients and had markedly lower adjusted risks of overdose in the noncancer chronic pain, substance abuse, and acute pain subgroups. These data are consistent with findings of studies from clinical and national samples that indicate that black individuals receive and misuse prescribed opioids and other psychoactive prescription drugs to a considerably lesser extent than do white individuals.2-5