Doctors and Substance Abuse

While it may be chilling to think of the family physician or specialist you see having a problem with drugs or alcohol, the reality is that doctors are no more immune to substance abuse than the general public. In general, according to various studies, the rates of illicit drug use among doctors is less than that in the general public. With prescription drugs, however, the rate of misuse is five times higher than that of the general public.
 

Some may argue – and there’s ample evidence to back up the claims – that drug problems in doctors are related the medical specialties where they’re regularly in contact with addictive drugs. Ease of access, lack of early detection, stress, and the link with physician- suicide are other problems associated with physician drug use. Studies have found that up to 15 percent of healthcare professionals will battle substance abuse at some point during their careers.

But, just as with anyone who’s experiencing a problem with substance abuse, treatment can help. Thanks to treatment programs specifically geared toward professionals (including physicians), addicted doctors can successfully overcome substance abuse.

Impaired Physician Program

What happens when a physician is so impaired that he or she starts making costly – even fatal – errors in patient care? Intervention on a professional level is usually mandated formally by a licensing board, hospital, malpractice or other agency, or informally by employers, colleagues, and family members.

The emergence of a professional program to treat doctors with substance use, the so-called impaired physician program or physician health programs has resulted in thousands of doctors being able to reclaim their lives. Physician health programs are an effective alternative to punishing drug-addicted doctors. In essence, they are special programs that combine referral to treatment, monitoring, and rapid responses to doctor noncompliance.

The Impaired Physician Program (http://impairedphysican.com/) at the University of Florida College of Medicine uses state-of-the-art evidenced-based methods that have been widely reported in the medical literature. As reported in the Journal of Substance Abuse Treatment (JSAT), participation in a treatment program such as the Impaired Physician Program, when coupled with long-term monitoring, results in five-year return to work and recovery rates of more than 80 percent for physician addicts.

Scott Teitelbaum, M.D., is the Medical Director of the University of Florida’s Florida Recovery Center (FRC). The FRC is one of the country’s largest academic facilities and includes M.D.s, Ph.D.s, and counselors and others who are dedicated to the recovery of the physician addicts and their families.

As Dr. Teitelbaum said in a 2009 interview in Gainesville Today (http://www.gainesvilletoday.com/2009/06/2072/Discovery_to_Recovery/), “Research provides the new treatments and approaches. Additional research tests the treatments and makes them evidence-based.”

At FRC, new treatments were discovered to make detoxification easier. As Dr. Teitelbaum explains, “By itself detoxification is not treatment. Clean air, avoiding smoking, smoked drugs or alcohol, vigorous exercise, healthy eating and diet, and rigorous, long-term treatment, including peer recovery groups, follow from our work… and provide much of the evidence for the FRC’s successful programs and outcomes.”

What happens at the FRC when a physician-addict enters the program? The FRC offers comprehensive screening and evaluation of patients with substance abuse disorders and treats patients of all ages. As one of the only academic, university or college-of-medicine-based programs, the center is a leading choice for the treatment of business and medical professionals who are struggling with drug or alcohol problems, offering specialized recovery groups to focus on their unique needs. The FRC has successfully treated hundreds of these professionals, allowing them to get their careers and lives back on track.

Long-Term Monitoring Required

The key to effectively overcoming addiction to alcohol and/or drugs by physicians is long-term monitoring, say the experts. It’s more than the threat of what can happen with non-compliance that motivated doctors to stick with impaired physician or physican health programs. Eventually, the doctors gravitate toward wanting to change their behaviors.

So, in a simplified way of looking at it, what works is a little of the carrot and stick approach. If doctors relapse, they may face losing their medical licenses for good. If they stick with it, they may be able to beat their addiction and be in effective recovery for the long-term.

Such monitoring involves frequent and random urine testing (to detect the presence of alcohol or drugs). While programs for treating addicted doctors may differ, in general, program measures include group and individual therapy, residential and outpatient programs, surprise workplace visits from monitors, and links to 12-step programs such as Alcoholics Anonymous and Narcotics Anonymous. In addition, doctor-patients receive treatment not just for drug problems, but also for accompanying medical or psychiatric disorders. In most cases, the doctors pay for their treatment, drug tests and follow-up care.

Dr. Gregory House – Fictional Example of an Addicted Doctor

For those familiar with the Fox television show, House, the title-character, Dr. Gregory House, battled an addiction to prescription painkillers during last season. The sight of Dr. House with his cane hobbling through the hospital was always followed by him popping Vicodin or another potent painkiller to alleviate pain from his leg surgery. It didn’t take long for him to become dependent upon and then addicted to the drugs. The situation got so bad that the doctor was hallucinating and incapable of doing his job effectively. Concerned for his safety – and that of his patients – his co-worker and best friend encouraged House (as he’s called on the show) to get professional help. After denying he had a problem for months (weeks, during two seasons), House asked his friend to drive him to a drug rehab center.

Thus began House’s journey to recovery. As with all prescription drug-addicted patients, the climb back from addiction wasn’t easy for House. But he did stick with the program, learned about his disease, and how to combat the cravings and urges that would plague him on and off following his discharge from treatment. He continued to go to counseling with his therapist and gradually became more confident in his ability to abstain from painkillers.

What this television show brought home to millions of viewers is how insidious addiction is and the fact that anyone can become addicted. It takes a great deal of courage and determination to overcome addiction, but with treatment anyone – doctors included – can do it.