Substance Use and Addictive Behaviors Among Physicians

Abstract

Health care personnel experience rates of substance-use disorders (abuse and dependence) that are comparable to the general public. Unlike the general population, however, physicians are more likely than nonphysicians to misuse prescription drugs and to do so for reasons of self-treatment. There are a number of nonspecific signs and symptoms that might suggest a problem, and being familiar with these is important for all physicians. If there is a problem, intervening as early as possible is important, both for the health of the physician and for his or her patients. The best approach for intervening with physicians is one that is highly structured. Residential programs of 2–3 months in duration are often recommended, but there is scant evidence that these extended stays produce better outcomes than shorter stays. If a physician has undergone extended inpatient treatment, aftercare plans generally include monitoring by a state physician health program. These programs can provide advocacy for physicians who have maintained abstinence and complied with all aspects of their monitoring agreements. Success rates for physicians who undergo substance-use disorders treatment and/or monitoring are generally very high, probably because the costs of failure and the rewards of success are both very high for doctors. Many physicians who have been caught in the grips of a substance-use disorder recover fully and return to the successful practice of medicine, and might even be better physicians given their newfound focus on their own health and well-being.