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.
Ward CF. Physicians With Opioid Dependence. JAMA. 2005;293(3):294. doi:10.1001/jama.293.3.294-a
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