Lynn Malinoff, EdD
Acknowledgment: Dr. Malinoff wrote this letter in collaboration with her husband, Herbert Malinoff, MD. He helped edit and revise the letter and contributed to the content.
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0181.
Malinoff L. The Seductress. Ann Intern Med. 2014;161:376. doi: 10.7326/L14-5017
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Published: Ann Intern Med. 2014;161(5):376.
TO THE EDITOR:
Johnson (1) passionately shares his experience working with a heroin addict. What his essay lacks is acknowledgment that addiction is a disease that, like cancer, is best left to professionals who know how to treat it. Far too often, physicians and other helpers impede recovery by their kindness and enabling behavior.
The goal in treating patients with addiction is to form a therapeutic relationship to support them in a process of engaging in behaviors that they do not yet believe in, understand, or think will work in their particular case. Neither an authoritarian, angry approach nor an overtly codependent stance is beneficial. Addiction is cunning, baffling, and powerful. It is a disease that takes hostages, runs on fear, and results in a set of skills in manipulation and denial that humbles those of us who live or have lived with the active disease.
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