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A. Thomas McLellan, PhD; Barbara Turner, MD, MsEd

JAMA. 2008;300(22):2672-2673.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The study of overdose deaths in West Virginia by Hall and colleagues in this issue of JAMA¹ revealed that opioid analgesics contributed to 93% of those deaths and most of these potentially avoidable deaths occurred in younger persons (aged 18-44 years). These disturbing findings are certain to raise questions about physician prescribing practices, the safety and adverse effect profiles of opioid medications, and the appropriate management of pain. These findings also raise several important questions for physicians who are trying to balance their duty to relieve pain in individual patients and their obligation to prevent the broader public health problems of addiction and overdose death.

First, do these overdose deaths suggest excessive opioid prescribing practices? The 2006 death rate from unintentional overdose by prescription drugs in West Virginia was 16.2/100 000 population, more than 2 times higher than the US average of 5.6/100 000 . . . [Full Text of this Article]

Author Affiliations: The Treatment Research Institute (Dr McLellan); and the Departments of Psychiatry (Dr McLellan) and Medicine (Dr Turner), University of Pennsylvania School of Medicine, Philadelphia.

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