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Editor's Correspondence
March 28, 2011

Correcting Several Oversimplifications of Chronic Opioid Therapy—Reply

Author Affiliations

Author Affiliations: Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle.

Arch Intern Med. 2011;171(6):597-598. doi:10.1001/archinternmed.2011.85

In reply

We appreciate Dr Geller's comments on the complexities of prescription opioid pharmacology and additional factors of consideration in the safety and abuse of these medications. We believe he has a valid point in noting that the DEA schedules concern abuse potential and this only approximates to potency. However, most opioid-dosing tables and calculators consider oxycodone to be 1.5 times the potency of hydrocodone.1 Our choice of categorization by DEA schedule is consistent with the terminology used by practicing physicians, in current and proposed state and federal regulations,2,3 and in clinical guidelines.4 The specific medications categorized as schedule II short acting, schedule II long acting, and non–schedule II are listed in a table in our prior article.5

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