In Reply:-I am sorry that Drs. Markowitz and Solomon misinterpreted my editorial comments. I meant to say that we really do not have any idea about the mechanism by which general anesthesia facilitates detoxification from opioid addiction. Is the mechanism, as stated, a rapid passage through withdrawal while unconscious? If that is the mechanism of action, we should see a recidivism rate after this therapy equal to that with other treatment-not a happy prospect.

The real potential of this therapy is the possibility that general anesthesia may facilitate a change in basic brain biochemistry or teach us something new about the mechanisms of addiction. Much research remains to be done in this area.

Michael F. Roizen, M.D.

Chairman, Department of Anesthesia and Critical Care; Professor of Internal Medicine; University of Chicago; Chicago, Illinois

(Accepted for publication September 1, 1998.)