U. S. Public Health Service Hospital,
Lexington, Kentucky.

March 31, 1938.

Dre Lioyd H. Ziegler,
Milwaukee Sanitarium,
Wauwatosa, Yisconsin.

Dear Dr. Ziegler:

Answering the question propounded in your letter of March 24, 1938,
concerning the granting of four or five days’ leave by a doctor to an
addict patient to go to a nearby city to attend a conference and supply~
ing him with morphine while away, my judgment is that such handling of
the cases would in et least 95 per cent of the cases be a mistake. There

' are several reasons for this opinion. In the first place, a patient who

comes in for treatment presumably wents to be cured end is ready to go
through with it. If a short time later during the withdrawal he esks for
such leave it indicates inmearly ali cases that he has weakened and needs
to be bolstered up by firmness or was not sincere and is using the leave
as a ruse to continue with drugs end get some from the doctor. If the
conference had been so important he could have stayed out in the first
place until it was over.

I think that a firmer attitude towerds such patients will produce
better results. It might result in causing some who would retum and
continue the treatment to leave permanently, but I doubt whether ea good
prospect for cure would ever act that way.

Sanitarium patients are, of course, in a different position from
the voluntary patients that we treat here. There would never be any
question about the motive of one of our patients who wanted to go out
for a conference during withdrawel,.

One has to think in these matters about what the Federal narcotic
enforcement officers might do. They should of course have no right to
question the motives of an honest sanitarium physician in giving nar
eotics to one of his patients to whom he had granted leave for a few
days. But the motives of physicians are often questioned end if a patient
such as you refer to should happen to share his narcotics with some one
else as they some times do or even sell a grain of it, they could mike
things very embarrassing for the physician. This, of course, has noth-
ing to do with the treatment angle but it is an angle that everyone who
handles narcotics has to think about.
-~2B-

I expect to mske my reservation in a day or so for the San Francisco
trip and will then let you know about it so that if you happen to be leav-
ing the same time we may get on the same train. I will probably go from
Chicago and stop by the Grand Canyon, timing myself so as to reach Frisco
on the evening of June 5. I am not going on the special train largely
for the reason that I haven't been able to get infomation about the two
trips that have been planned.

Sincerely yours,

Lawrence Kolb,