And that is what many in the addiction field think we should remember: not that Dr. Karcher didn’t have advantages — she did — but that she got the kind of treatment that more substance abusers should get. Physicians in New York State have some of the best outcomes in the country, according to Brad Lamm.

“It’s not that they’re better people or better addicts,” he says. “It’s just that the oversight board gives you more leverage” over their behavior. Mr. Lamm treats a number of physicians at his Breathe Life Healing Center in West Hollywood, Calif., and says that given their access to opiates, he doesn’t want to treat them unless an oversight board is involved. California doesn’t have one like New York’s; Mr. Lamm believes New York City should be the model nationwide.

Dr. Karcher has nothing but praise for the Committee for Physicians Health and the Office of Professional Medical Misconduct, which oversees medical malfeasance. “Somebody has to look out for the public interest,” she says. “You know, when I went up to see them in Albany, they asked, ‘Have you ever been arrested?’ and I was like, ‘Are you kidding me? A SWAT team came to my office!’ and the woman said, ‘I know, but believe it or not I’ve had doctors look me in the eye and say no.’”

Dr. Karcher is unequivocal that doctors who are using should lose their licenses, but there has to be a road back. “Some states are more progressive, more understanding and more educated than others,” she says. “Nobody asks for this disease. Nobody wants to be addicted. But the good news is there’s a way out. And it can really turn a life into one of great gratitude, humility and joy. I wouldn’t trade my life for anyone else’s.”

It’s been a lesson not just in breaking addiction, she says, but in overcoming shame. She had to fight the urge to isolate herself, to disappear from friends and colleagues and wallow.

These days, Dr. Karcher is not only back in the white-on-white office of Dr. Sadick, but she has also opened her own practice, offering “bespoke cosmetic care” in the Fifth Avenue digs of Dr. Virginia Wade, an anesthesiologist for plastic surgeons. It was Dr. Wade who took her in when no one else would. Even Dr. Sadick, her champion, would not let her practice in his office until she was cleared of all charges.