Re the "Hotel Detox" article (Sept. 27), I feel compelled to respond by saying that David Kipper has been my GP for several years and I don't know of a better or more caring physician. The unfavorable picture your reporters attempted to paint of him, based on the "opinions" of a relapsed rock star heroin addict (for whom Kipper's program didn't happen to work) and a couple of resentful doctors running alternative treatment centers of their own, is diametrically opposed to the man I know.
As one of his regular, noncelebrity, nonaddicted patients, I have no lurid stories of detox hell to fill your pages, but I can tell you that he's the only doctor in the last 30 years who actually paid me a weekend house call. It was after I had had an allergic reaction to penicillin, and after the visit, he refused any kind of payment for his services.
The article details the questionable practice of treating affluent addicts in luxury hotels, which translates into apparently lucrative practices for physicians, "catering to the entertainment industry's rich and celebrated."
Whereas the focus of any article on luxury treatment for addicts may point to criticisms regarding effectiveness, there are broader implications for all substance abuse assessment and intervention efforts. Why are there programs such as Sierra Tucson and Betty Ford, which actually can do excellent work with detox and rehabilitation? They exist because third-party reimbursement in the form of mental health/substance abuse benefits has been diluted one too many times for psychiatric inpatient units to provide top-quality, comprehensive care.
When assessment and treatment efforts for substance abuse begin to take non-stardard delivery routes such as in hotels or homes, it is important to recognize that this is likely the end result of a more insidious process--the erosion of a once quality-oriented versus currently cost-obsessed health care delivery system.
As a continuation of the denial of need with an emphasis on cost containment, Gov. Pete Wilson vetoed a measure that would have required mental health coverage for patients in managed health care plans (Sept. 30). The interaction between substance abuse and psychological disorder is highly significant.
MARC D. SKELTON