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January 19, 2005

Physicians With Opioid Dependence

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2005;293(3):294. doi:10.1001/jama.293.3.294-a

To the Editor: I would like to raise some points concerning the Clinical Crossroads article on opioid dependence by Dr Knight,1 based on more than 2 decades of interest in physician impairment and addiction.2 First, intervention can be tremendously stressful for all involved. Further, whether or not the outcome is successful, the subject is at risk of self-harm immediately afterward due to the dissolution of self-deception and denial, and a weekend at home “thinking things over” may be dangerous. Second, while drugs are usually diverted for self-administration, when the amounts are substantial resale becomes a possibility, with serious legal consequences.

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