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Physicians With Opioid Dependence—Reply
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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.
Regarding Dr Melcher’s comments, I agree that methadone maintenance therapy is a valuable therapeutic option for patients with opioid dependence. However, the Massachusetts Physician Health Services program has never monitored a physician receiving methadone maintenance therapy. Inquiry through . . . [Full Text of this Article]
John R. Knight, MD
john.knight@childrens.harvard.edu
Children’s Hospital
Boston, Mass
RELATED LETTER
A 35-Year-Old Physician With Opioid Dependence
John R. Knight
JAMA. 2004;292(11):1351-1357.
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Physicians With Opioid Dependence
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A 35-Year-Old Physician With Opioid Dependence
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