“Is your Doctor an Addict?”

The website Impaired Physicians, reports a rate of 13-15% of alcohol dependence among physicians. 15% of them abuse drugs, and up to 20% suffer from major depression or bipolar disorder. According to the data of Serebrenic Jungerman et al (2012), anesthesiologists most often abuse alcohol (50%), but their misuse of anesthetic agents is a greater concern among them. These substances have high dependence potential, and the consequences of use are often fatal.

The most common drugs they abuse are opiates (33%, such as fentanyl and sufentanil, propofol and inhalation anesthetics, but also stimulants (8%) and other substances (9%). They report impairment among physicians to be at 10 to 12%. According to estimates, 14% of the doctors become addicted to alcohol or drugs during their professional life. A study with 904 participating physicians who were monitored for drug abuse, reported that more than half of them were from five specialties; namely family medicine, anesthesiology, internal medicine, psychiatry and emergency medicine.

A study examining anesthesiology residency programs between 1991 and 2001 reported that 80% of the programs had experience with impaired residents, and 19% of them reported at least one fatality. Although preventive strategies exist, the mortality rate is still between 10 and 19%.

According to Lembke (2012), there are 2.4 million opioid abusers in the United States. Physicians, who often know that the patients abuse these medications, prescribe sixty percent of the substances. Scottish data shows an increase in the problematic use of opiates and benzodiazepines. The prevalence in the general population is 2%. The guidelines of UK Department of Health acknowledge the complex needs of illicit drug users and advocate a multidisciplinary approach to address the problem. (Grafham, Matheson and Bond, 2004)

According to the data of TCHP (2006), approximately 10% of medical students use illicit drugs, in most cases marijuana, and 6% of them use heavy drugs. The percentage of residents using illicit drugs is between 10 and 14%. Practicing physicians, dentists and optometrists have an 8-14% percentage of illicit drug use, but almost 20% of them used illicit drugs during the past year. Illicit drug use among nurses and nurse aides is 5.5%, but in recent years, illicit drug use is significantly higher (12.8%). The data about their heavy drug use suggests an increase of 2.8 percent in the nurse population.

Ten to eighteen percent of pharmacists use illicit drugs. Health care professionals typically start to use substances at their late teen years or in their early 20s. This is similar to the general population. However, an average impaired physician gets treatment 5-10 years later than someone does from the general population. In recent times, 60,000-75,000 physicians are considered dependent on illicit drugs or alcohol in the USA. The most commonly abused drug is alcohol among health care workers. Higher levels of prescription drug abuse, especially opiates and benzodiazepines, but lower levels of street drug abuse, such as cocaine, marijuana or heroin, also characterize this population.

Medical students tend to use alcohol and marijuana, but to a lower extent than their peers. Residents have less illicit drug use compared to peers, but this is the time when the use of opiates and benzodiazepines begins. Among practicing physicians, the use of opiates and benzodiazepines is five times higher than in general population. Anesthesiologists have the highest rate of drug related deaths compared to other health care workers.

Dentists are most likely to use inhaled anesthetics. Pharmacists tend to experiment with mind altering or potentially addictive drugs, with about 50% of them reported to have used such substances without consulting a doctor. Health care workers use substances for recreational use, performance enhancement, self-treatment of pain, to treat depression or anxiety.

Shaw et al (2004), conducted research with 90 participants. The results allowed a comparison between nurses and physicians who sought treatment for substance use disorders. There are several important differences between the two groups, like gender distribution and unique roles in the medical system, but their initial clinical characteristics, treatment utilization patterns, and post-treatment functioning are comparable. However, there are important differences observable as well.

Physicians tend to be male and working in group practice, they tend to be referred for treatment by a physician assistance program, and they primarily used alcohol or prescription opiates. Their functioning was lower at the initial presentation, but reported less subjective distress following treatment.

**This article is taken from the e-book “Addicted Physicians: Healing the Healer.” by Dr. Richard L. Travis.

“Addicted Physicians: Healing the Healer”, http://www.amazon.com/dp/B00JZ22BAG

www.RLTPublishing .com, www.LivingWellSeries.com, www.DRRichardTravis.com

This article is part of a series of books called “Dr. T’s Living Well Series,” by Dr. Richard L. Travis. The series contains books for Parents of Teens and Pre-Teens on ADHD, Anxiety, Depression, Obesity, Anger, Drug and Alcohol Problems, Low Self-Esteem, and Trauma and Loss. There are also books on Addictions in different careers, Sexual Identity, and Gay Relationships. Visit www.LivingWell Series.com to see more information on these books.