I go two ways with this issue. No, I don’t think a doc should be prescribing drugs to addicts (and I think that most docs try to deal with these issues.)

At the same time, both Michael and Anna were adults, making adult decisions. It’s paternalistic to think that a doctor has the obligation to step between an addict and her addiction.

Maybe it doesn’t help that I don’t have much sympathy for either Michael or Anna. The “poor little rich kid” syndrome doesn’t elicit much empathy from me either.

I suppose a doc should try to limit prescribing addictive meds to addicts, but what if the person would benefit from the drugs? If someone is anxiety ridden to the point of non-functioning and taking xanax would allow for some semi-functioning, how are you to say they shouldn’t have the med?

Also, what is your idea of screening for addiction? Its not a visible thing and most people I’ve ever know with drug problems are really good at hiding them.

My experience, as an addict and alcoholic, is that there are plenty of screening tools a physician/therapist can use to screen for substance abuse. None of the doctors I have visited during my 50 years on the planet ever screened me for substance abuse. The most I ever saw was a question on the new patient questionnaire that asked whether i drank and how much. Of course, many addicts/alcoholics will lie on that question. However, there are many other questions which – asked face-to-face – would give a physician a fairly good idea whether a person was lying.

The problem has been that until recently, there was no Medicaid screening code for substance abuse screening – which meant doctors could not bill for substance abuse screening. Even though the code is now exists and doctors can get paid for the screening, many still don’t because addicts/alcoholics are not exactly model patients and take up a lot of a doctor’s time.

As for prescribing a drug, such as Xanax, to an addict/alcoholic – there are other medications that can be used to treat anxiety – especially in combination with therapy. When a doctor decides there is no other choice but to prescribe a benzo to a patient she knows is an addict/alcoholic, there should be frequent follow-up visits and no refills on the prescription until the patient has proven to be responsible with the medications.

Also, physicians should be aware that it is common protocol in treatment centers and 12-step programs that recovering addict/alcoholics notify their sponsor or another person aware of their prescription to help monitor the use of the drug. Responsible doctors would ask their patients – who they know are addicts/alcoholics – whether they have set up this support system.

This may sound like a lot of work for a physician. But when you consider the cost of addiction/alcoholism to our society – illness, lost wages, incarceration, homelessness, divorce and the emotional devastation to loved ones – I do not think this level of care is burdensome.

I agree doctors have to be much more cautious, and for the most part I think many are. But mental illnesses are still “left in the dust” so to speak and even some doctors treat depression and anxiety as the poor cousins of say cancer or heart disease. Better education needs to happen all the way around of these serious illnesses. If I met someone who was suffering from alcohol abuse and/or substance abuse I’d absolutely want to talk to the person about any co-existing illnesses/conditions. I’d assume they are depressed, frankly.

As for adults taking responsibility for themselves with regard to medications and testing, we aren’t specialists treating ourselves and no specialist should. We go to physicians for their expertise and implicit in that is that they will do the appropriate testing, screening and be highly knowledgable about all aspects of these health problems. I’d expect no less from a qualified specialist.

I think we also need to have compassion for anyone who has suffered or is suffering. I wasn’t a Michael Jackson but I do know a lot about psychological trauma. Michael Jackson was severely affected developmentally, emotionally, by the time he was a young boy with the clear abuse he experienced from his abusive, sadistic father, who went further and exploited the hell out of him. His threats and intimidation, beatings, locking him in closets, etc. would have taken an extreme toll on anyone and I believe this manifested in multiple co-morbid conditions that Jackson suffered from. He was not a well man. If people seem strange it’s easy to write someone off but suffering is suffering. I always prefer to explore and make notice of mental illness and discuss it to make more and more people aware of it and take it as seriously as it ought to be taken – as I said, some doctors are morons when it comes to knowing what people with depression experience. They think “thinking” a little different will do the job. We still have quite a ways to go in acceptance.

I’m surprised that you don’t mention his chronic medical conditions. When you have an illness like lupus, doctors often have to weigh quality of life versus the addictive properties of medication. That does not mean the doctor is irresponsible.

Jackson was gearing up for a huge tour and his insomnia would have been intolerable (as a lupus sufferer who has chronic insomnia myself, I feel qualified to make that claim). I think it’s quite a leap to call his doctor irresponsible when you’re not privy to all of Jackson’s medical records.

As for your claim that Jackson had Body Dysmorphic Disorder, yes he had plastic surgeries. So do many other people who don’t have body image disorders. But if you’re referring to his weight loss and skin colour, those are directly related to his chronic health conditions.

I guess I’m just saying: Don’t be so quick to dub somebody an addict or diagnose them with a psychological condition based on media speculation. And don’t be so quick to judge his doctor based on it, either.

inexcusable on physicians prescribing harmful drugs to celebs. and why do they do it? For their own selfish gain. If they had the celeb in mind then they would have opted to abide by the hypocratic oath to do no harm. If you have enough money, you will find a physician who will feed your addiction.