Editor's Note: For reasons of public health, readers should be aware that this letter has been "heavily and uncritically cited" as evidence that addiction is rare with opioid therapy. Leung et al. (https://www.nejm.org/doi/full/10.1056/NEJMc1700150) describe its history.
To the Editor: Recently, we examined our current files to determine the incidence of narcotic addiction in 39,946 hospitalized medical patients1 who were monitored consecutively. Although there were 11,882 patients who received at least one narcotic preparation, there were only four cases of reasonably well documented addiction in patients who had no history of addiction. The addiction was considered major in only one instance. The drugs implicated were meperidine in two patients,2 Percodan in one, and hydromorphone in one. We conclude that despite widespread use of narcotic drugs in hospitals, the development of addiction is rare in medical patients with no history of addiction.