Bill J. sits in front of me, 45 years old, athletically built, dressed in an expensive suit, married with two children and making his first visit to a psychiatrist. Bill did not use his real name when making the appointment, would not give any insurance information and had numerous questions regarding our policies on confidentiality. He specifically requested the last appointment of the day and asked if there was a private entrance to my office suite. (His name has been changed for confidentiality reasons.)

A successful attorney with a family and an impressive list of clients, Bill leads a life more complicated than it first appears: Bill is addicted to OxyContin, a powerful painkiller. He knew that his $400-a-day habit needed to stop — preferably, immediately — but he also knew that with demanding clients and a never-ending “to do” list, dropping out of society to check into rehab was not a realistic option. He also knew that simply stopping “cold turkey” on his own is very difficult and could be accompanied by serious medical consequences such as seizures.

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