Medical Professionals and Addiction

Perhaps counterintuitively, health professionals – doctors, nurses, dentists, technicians and others working in the healthcare sector – have one of the highest rates of addiction in the workforce. A stressful – sometimes traumatic – working environment, comparatively easy access to certain drugs, and – in certain cases – a high level of disposable income can combine to create the ideal conditions for substance abuse and addiction.

Research shows that around 10-14% of health professionals are dealing with an addiction to one substance or another. The groups of health workers most likely to abuse drugs include anesthesiologists, doctors, psychiatrists and emergency room workers – but the reality is that no corner of the sector is completely free of abuse, with potentially tragic consequences for addicts, their patients, their families and their colleagues.

Why Medical Professionals are Likely to Abuse Substances

If you work in healthcare, there are many aspects of your profession that make it different from many other occupations. You face stress constantly, work long hours and are surrounded by medications that can seem like an easy solution to a minor problem.

You have easy access to medications and may be able to write prescriptions for yourself. Knowing the effects of these medications increases the curiosity to experience the euphoric ‘high’ and temporary relaxation some substances provide. At the same time, the guilt and other negative emotions that affect your mental state when you lose a patient or at other difficult junctures can lead to substance abuse.

It wasn’t until the 1970s that western governments took the problem of drug addiction amongst health professionals seriously. Prescription drug abuse amongst doctors had been growing since at least the middle of the 19th century, with scientific literature in 1869 detailing “habit of intemperance”. The major drugs abused were analgesics and anaesthetics (the two painkiller agents used for surgery and post-surgery).

Today, the most abused drugs amongst health professionals are opioids and benzodiazepines – two addictive substances with disturbing withdrawal effects if you don’t receive proper addiction treatment.

Nevertheless, some signs of possible addiction include:

  • Falling asleep either between shifts or ‘on the job’
  • Changing jobs regularly
  • Becoming anxious when you have to work extra shits
  • Always volunteering to administer medications to patients
  • Preferring shifts with little supervision, such as night shifts
  • Glassy eyes and dilated pupils
  • Taking frequent bathroom breaks
  • Wearing long sleeves in hot weather
  • Personality change such as mood swings, lack of impulse control, depression and anxiety
  • Repeated errors in paperwork and uncharacteristic charting

Types of Substances Medical Professionals Often Use: Legal and Illegal

Common substances abused by medical professionals include illegal drugs (such as cannabis, cocaine and amphetamines) as well as legal ones such as alcohol and, especially, prescription drugs: these are particularly common causes of addiction in the healthcare profession thanks to their easy availability in the workplace.

Tips for Medical Professionals Abusing or Addicted to Substances

Find a confidant to talk to about your addiction. As is the case for any addict, the most difficult part of addiction for health professionals is often to admit their problem. Most are content to live in denial until it’s too late. Your job is to care for others, but sometimes, you need help too. Admitting the problem is the first step in treatment.

Reach out to your local professional addiction help programme. Many treatment centres have programmes targeted towards medical professionals. These programmes are designed to be anonymous, so you don’t have to worry about your identity being exposed.

Attend rehab for healthcare workers. There are rehab programmes and facilities where medical doctors, nurses and other health workers will benefit from specialised care geared towards your unique addiction needs. If you choose to go back to work in a hospital or clinic, you’ll be surrounded by drugs. Therefore, it’s critical that you learn how to work in that particular setting without abusing drugs.

Join and participate in community-based support groups. Options include Narcotics Anonymous, SMART Recovery and Alcoholics Anonymous.

Take time to recover before returning to work. Part of what you’ll learn in treatment is to recognise triggers. It’s risky to return before you’re ready, because you’ll be surrounded by triggers. The smallest temptation might cause you to falter.

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Problems That Addicted Health Care Professionals Cause Patients

The risk of spreading contagious diseases is a major concern when medical professionals caring for patients are dealing with addiction. Some nurses and doctors use the same needles to inject patients and themselves. It might seem like a smart way to give the patient half a dose and keep the rest for yourself, but this runs the risk of infecting the patient.

Drug diversion is another issue, whereby medical doctors and nurses divert some of the medications meant for patients towards their own needs. The patient who is suffering intense pain doesn’t get the full dose they need to alleviate their suffering. In some cases, the outcome is severe.

A doctor under the influence of alcohol and drugs could make quick decisions when treating a patient or make grave errors during surgery. Many things can go wrong, which is why medical professionals have to be 100% stable and mentally fit to treat patients.

Access Plays a Big Role in Addiction amongst Medical Professionals

Doctors are entrusted with the care of patients, some of whom include people with substance use disorder. Therefore, the public assumes doctors are least likely to abuse drugs. However, the NHS warns that the number of medical practitioners seeking help for mental health and substance use disorder is increasing.

Self-Medication Is Common Practice

Everyone has issues that may cause stress and push them to abuse drugs as a temporary reprieve from difficult situations. Doctors might know the risks associated with drug abuse, but they are not exempt from self-medicating.

During periods such as residency, emergency long hours, back-to-back shifts, heavy workload and poor patient outcome, some doctors turn to drugs for comfort. Researchers who studied doctors suffering from substance use disorder found that 69% of doctors abuse prescription medication to relieve emotional and physical pain.

Who Helps Addicted Health Professionals when they Need Assistance?

Most addicted doctors usually receive addiction treatment only in the later stages, when risks of treatment are higher. Fear of losing your license, family and reputation keep you from reaching out.

There are specialised drug rehab centres where medical professionals can receive treatment without fearing exposure. These treatment centres have a confidentiality clause that protects all your personal details. Based on the severity of addiction, treatment begins with detox to remove harmful drugs from your body and transitions to rehab for psychotherapy. Other options include employee assistance programmes and peer organisations.

The Ethics of Reporting Substance Abuse in a Fellow Medical Professional

Impairment caused by substance abuse represents a major problem for patients, medical professionals and society as a whole. The increase in the number of doctors and nurses abusing alcohol and prescription medication is about the same as that of the general public.

When you suspect a colleague of being impaired, you have an ethical obligation to report this to the appropriate channels for action. The hospital’s first obligation is to the patient, and you put all patients at risk when you allow an impaired colleague to continue practising medicine. You don’t have to report this to the authorities. You could call your local physician health programme and they can intervene privately.

Delaying help for a person with substance use disorder is dangerous. As addiction worsens, the ability to make sound judgments is affected – and in the case of many health professionals this can be literally a matter of life and death. It is your moral duty to help your colleague, who whilst under the influence of drugs is unable to see the dangers they pose to themselves and the patient.

Addiction Treatment for those in the Medical Profession

There are treatment programmes that cater to healthcare professions. These consider the unique challenges you face while carrying out your duties. Treatment begins with medically supervised detox/withdrawal to physically stabilise you and remove all addictive substances from your system. Next, you’ll enter rehab, where psychotherapists help to identify biological, psychological and environmental factors that might trigger a relapse.

Knowing your triggers makes it easier to identify warning signs and apply your relapse prevention plan. Specialised addiction treatment for medical professions understands stress factors that lead to addiction and equips you with tools to help you maintain life-long abstinence from drugs when you return to medical practice.

Many health professionals are unwilling to seek treatment, except when caught or forced to enter rehab as a condition to keep their license. Your colleagues are afraid to report you, because they want to protect your livelihood and don’t want to anger you.

If you suspect someone of using drugs for non-medical purposes, show concern. Hold an intervention to encourage them to seek help for addiction.

Alcohol, Drug and General Addiction Rehab for Medical Professionals: the Aftermath

Everything changes once you’ve received treatment. The burden of addiction is lifted. You don’t have to hide substance abuse or loathe yourself for using drugs. The fear of inadvertently harming – even killing – your patients as a result of a terrible decision made under the influence of drugs also passes. You are healthy, stable and mentally fit to work. The skills you learn in rehab will help you stay abstinent from drugs and learn positive habits that encourage drug-free living.


FAQs

What is Addiction and why are Medical Professionals at Risk?

Addiction is a mental health disorder, characterised by several symptoms such as loss of control over drug use, an inability to stop abusing drugs and continued use when you know the risk. Medical professionals are at risk because they are surrounded by triggers of addiction including stress; burnout; loss of someone you care for; and working in an environment where drug use is common.

What if Physician Addiction is Suspected?

If you suspect your colleague or doctor of abusing drugs, you have an ethical and legal obligation to either hold an intervention or report the physician to the authorities should intervention fail. Leaving them to practice medicine is dangerous, as addiction only worsens over time and innocent lives could be lost during that period.

What does Intervention Involve?

Intervention in this context involves confronting the addict to persuade them to submit to a drug test. It requires logistical support and planning for smooth sailing. Do not approach the addict alone. Instead, involve supervisors and security who’ll arrange for the suspected addict to be transported to a clinic, where their addiction will be evaluated.

Could Physical Pain be a Factor in Physicians’ Drug and Alcohol Use?

Physicians spend a lot of time on their feet, running between patients and bending to perform surgical procedures on patients. Doctors can be tempted to use prescription painkillers to cope with the physical pain and stress on their body.

What is Chemical Dependency Treatment?

Chemical dependency is an addiction to chemical substances such as alcohol, illicit drugs and prescription medicine. Treatment options for chemical dependency include inpatient and outpatient rehab clinics. During treatment, you’ll detox from drugs, understand the reasons why you abused substances initially and learn how to live a drug-free life.

Should the Addicted Physician return to Practice?

While addiction is not uncommon amongst physicians, they have an outstanding rate of 74%-90% success after treatment. Many doctors return to practice medicine after completing treatment and engaging in aftercare programmes such as support groups, individual therapy and group counselling.

Why do Doctors Fear Disclosing their Addictions?

Fear of losing a license or position in a hospital can prevent health professionals from seeking help. As with all addicts, factors such as pride, a fear of hurting or losing loved ones, a state of denial and an inability to recognise addiction can all play a part.

Is a Lack of Sleep Contributing to Doctors’ Substance Abuse Problems?

Many doctors are sleep-deprived, which can lead to errors in treatment. Some turn to prescription medication to stay awake and function properly.

Should Doctors and Nurses with Addictions be Afraid of Losing Their Medical Licenses?

Yes. In some cases, doctors lose their license to practice. However, in other cases they are allowed to return after a period of addiction treatment and rehabilitation.

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