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January 19, 2005

Physicians With Opioid Dependence—Reply

Author Affiliations

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

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

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.

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