There is a middle ground ... I have had success using an approach like the one found in this Python library: http://pypi.python.org/pypi/validate_email
It performs regex validation, and if that passes, tries to get the SMTP server to validate the user's presence. Quite useful for when a user might fat-finger their username in the address.
So, for compliant mail servers, sending an email without verifying receipt via some confirmation token is no more reliable than this method (if it will falsely validate the user, it will probably falsely digest the message as well).