Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
In Reply: I agree with Dr Ward that direct
referral to treatment is more desirable than a weekend at home “thinking
things over” in some acute situations. However, when direct referral
is impractical, careful assessment should be made of potential for self harm
and, if safety can be reasonably assured, the physician may be given time
to carefully consider the options for treatment and to discuss them with significant
others. Regarding possible diversion of prescription medications for profit,
it is true that physicians may face legal prosecution when large amounts of
medications are found missing. However, I have found diversion for profit
to be quite rare among physicians with substance use disorders.
Knight JR. Physicians With Opioid Dependence—Reply. JAMA. 2005;293(3):294. doi:10.1001/jama.293.3.294-c