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Editor's Correspondence
April 8, 2013

Dependence Is Not Addiction and “Tolerance” Declares Addiction—Reply

Author Affiliations

Author Affiliations: Departments of Anesthesiology and Pain Medicine (Dr Ballantyne) and Psychiatry and Behavioral Sciences (Dr Sullivan), University of Washington School of Medicine, Seattle; and Department of Psychiatry, Maimonides Medical Center, Brooklyn, New York (Dr Kolodny).

JAMA Intern Med. 2013;173(7):595-596. doi:10.1001/jamainternmed.2013.3207

In reply

It is true that the relationships between tolerance, dependence, and addiction are poorly understood, as they have been for decades. However, Dr Geller's portrayal does not help us to understand why opioid-treated pain patients dose escalate, lose control over their medication use, and die in alarming numbers.1-3

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