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To the Editor: Because of a rapid increase in drug-related deaths, Dr Hall and colleagues¹ studied deaths from unintentional overdose in West Virginia in 2006 and found that most involved prescription opioid analgesics. In their editorial focusing on physician responsibility, Drs McLellan and Turner² noted that the number of opioid prescriptions increased nationally, and especially in West Virginia, from 2000 to 2005.

By 2005, the 16 faculty and 56 resident physicians in our general internal medicine practice at West Virginia University were seeing increasing numbers of patients who were taking opioids for chronic nonmalignant pain. Based on input from individual faculty surveys, a faculty task force developed a policy that included requiring a new pain management agreement (contract) for all patients receiving prescriptions for any schedule II or III opioid except codeine with acetaminophen. After the policy was implemented, a number of patients stopped using opioid analgesics and some left . . . [Full Text of this Article]

Richard D. Layne, MD
rlayne@hsc.wvu.edu

Ronald J. Pellegrino, MD; Nathan M. Lerfald, MD
Section of General Internal Medicine and Geriatrics
West Virginia University School of Medicine
Morgantown

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