Fatal Overdose Notification Letters from Medical Examiners to Physicians

In 2018, a randomized trial showed that a notification letter to a physician from the county medical examiner about a patient's fatal scheduled-drug overdose — within 1 year of a prescription issued to that patient — resulted in fewer high-dose and new opioid prescriptions (Science 2018; 361:588). Those researchers now have assessed the effects of the same intervention on benzodiazepine prescribing.

All prescribers to a given decedent (grouped in a “decedent cluster”) were randomized to receive a death notification letter that also contained a statement to prescribe safely (intervention) or to not receive any notification (control). The intervention and control groups each had about 80 clusters and nearly 400 prescribers. The most commonly p…