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David P. Phillips, PhD; Gwendolyn E. C. Barker, BA

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

In reply

We thank Dr Lu for his interest in our study¹ and for his useful comments. We have often reflected on the issues he raises. In our article, we demonstrated a steep 360% increase in the US death rate from FMEs between 1983 and 2004. We also showed an even steeper 3196% increase in the FME death rate when the FME occurred at home in combination with the use of alcohol and/or street drugs.

We suggested that the increased FME death rate resulted at least partly from changes in the delivery of medical care: "Medical care has increasingly shifted from inpatient to outpatient settings; thus, medications that once were consumed and monitored in clinical settings are increasingly taken outside the hospital, with reduced professional oversight."^1(p1561)

We noted that various mechanisms could mediate between decreased professional oversight and increased deaths from . . . [Full Text of this Article]

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