• Last week we published a letter from Moira Smith criticising media overreaction to deaths caused by pain killers (27 March, p 30). The letter was a response to our article about methadone deaths in the US (6 March, p 14).
We did not make it clear enough in our article that the figures we reported (61 deaths in 2001 and 123 in 2002) are not comprehensive for the whole country – such figures do not exist. The US Federal Drug Administration’s MedWatch database logs reports of adverse reactions to drugs and medical devices sent in voluntarily by medical professionals. It is therefore not a systematic reporting system, but is used to flag up emerging problems. As we reported, the increase is reflected in more systematic data from individual states. For example, in Florida there were 357 methadone-related deaths in 2001 and 556 in 2002.
