Responsibility for coping with serious public health problems such as drug abuse, can and should be broadly shared. Unfortunately, the profession and the addict have long had an uneasy and infrequent relationship. So, too, have enforcement agencies and medical practitioners. The authority to define legitimate medical practice with addicts has been at issue. Between 1921 and the present, law enforcement has exercised the de facto primacy and prudent physicians avoided prolonged treatment of the average addict who today prototypically lives out of our sight, oscillating between the streets and jail. The time has come to begin to confront definitions which for the past 50 years have been so obscured.
In so doing, we should note that the physician who delivers services has a key obligation and role. Whatever the legalistic constraints, the reliable governance of the giving and getting of any drug is embedded in medical diagnosis and rests upon