Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
To the Editor: In Dr Knight’s discussion
of a physician caught in opiate addiction,1 the
treatment options included only residential care, 12-step support, and individual
counseling, all of which are important and may be successful. However, for
many people (including physicians) the price of these options is exorbitant,
and there are many who cannot leave home for such extended periods. For these
reasons, I believe methadone maintenance therapy should have been included
in this discussion. It produces rapid relief from the pains of withdrawal
and a rapid return to normal function. In well-motivated patients it can be
used together with a 12-step program and any psychotherapeutic approach, without
extended absence or high cost. Additionally, the implication that only those
in abstinence-based programs are in “recovery” needs to be corrected.
Melcher M. Physicians With Opioid Dependence. JAMA. 2005;293(3):294. doi:10.1001/jama.293.3.294-b