Opiate Withdrawal: Discomforting or Deadly?

Kevin D. Williamson is mistaken as to the severity of withdrawal from opiates (“From Oxy to Overdose,” February 29). The withdrawal can be brutal, sometimes worse than is depicted in movies and books, and I’ve seen people die. Ultimately, the withdrawal aspect of addiction is a relatively small part of the picture, regardless of its severity (unless it kills you, which sucks).

I disagree with your idea that treatment will necessarily cost a lot of money. I’ve worked with addicts in various settings and circumstances for many years, and the money and programs mean very little. Recovery doesn’t happen until a person is ready to go to any lengths to get it — but once ready, “it” is free. Addiction differs from other “diseases” in that its treatment calls for a level of willingness and honesty that isn’t germane in, say, the treatment of cancer.

John Meyers, M.D. New Canaan, Conn.

Kevin D. Williamson responds: There is nothing in the clinical literature to support these dramatic claims about opiate withdrawal. Death from opiate withdrawal is practically unheard of, though there have been a few deaths from secondary health problems exacerbated by the stress of withdrawal, the main symptoms of which are insomnia and discomfort. I would point Dr. Meyers to Drugs of Abuse and Addiction: Neurobehavioral Toxicology, and repeat my recommendation of Theodore Dalrymple’s excellent Romancing Opiates, which cites, among other findings, a review of nearly a century’s worth of opiate-addiction data in which not a single case of death from withdrawal is documented.

The Best is Yet to Croon

Stipulated: Jousting over musical preferences is generally pointless — but your recent squib (“The Week,” December 3) lauding Frank Sinatra as “quite simply the best American pop singer ever” flatly overwhelms any reticence I maintain about debating the subject. Sinatra: a commercially successful entertainer? Clearly. A uniquely consequential figure in the history of modern music? No doubt. But — the “best American pop singer ever”? Preposterous. I won’t even bother listing those who could challenge ol’ blue eyes on that claim — a certain swivel-hipped phenom out of Mississippi favored by the late founder of this publication comes to mind — because specifically what other bard merits the honorific “the best” is fodder for another squabble.

Steve Pauwels Londonderry, N.H.

Correction

In “The Champ and Mr. X” (Feb. 29), the paragraph beginning “Haley manipulated . . .” was a quotation from the book, by Randy Roberts and Johnny Smith, that James Rosen was reviewing. It was, however, mistakenly printed in the same format as the rest of the review rather than identified as a quotation. We regret the error.