RT Journal A1 Katz MH T1 A true believer’s flawed analysis—reply JF Archives of Internal Medicine JO Archives of Internal Medicine YR 2011 FD May 9 VO 171 IS 9 SP 867 OP 868 DO 10.1001/archinternmed.2011.167 UL http://dx.doi.org/10.1001/archinternmed.2011.167 AB To be clear: I did not express, nor do I feel, frustration in caring for patients with complex pain and substance use issues. I have chosen to work in a county hospital caring for people with human immunodeficiency virus, many of whom have mental illness and/or substance addiction, because I find the work satisfying and rewarding. What I was trying to express was my concern that the model of pain treatment I was taught and have practiced is harming our patients. Indeed, in 2007 there were more deaths in the United States from unintentional drug overdoses due to opioids than heroin and cocaine combined.1