Addiction Among Medical Professionals
Healthcare professionals have a hard and stressful job. We count on them to help us heal, and in some cases save our lives. But if they are suffering, they might have a hard time asking for help—even when it is pressing.
An estimated 1 in 10 physicians and 1 in 5 nurses will develop a Substance Use Disorder during their careers. This number may in fact be low, as healthcare workers tend to underreport substance use for fear of professional repercussions. A 2013 study in the Journal of Addiction Medicine found that 69% of doctors abused prescription medication. One in six surgeons show signs of an Alcohol Use Disorder. From 2007 to 2012, the number of healthcare professionals in the US with past-month illicit drug use rose from an average of 164,600 a year to 168,400 a year. This seems to relate to stressful changes in the healthcare industry. Increasingly, staff are expected to work faster and to see more patients a day. The problem is not limited to practicing physicians or to the United States. An estimated 37% of medical students in India prescribe drugs to themselves. Substance use in that country among medical students is reported to be as high as 81.2%.
While addiction affects professionals across the healthcare system, there are specialties with particularly high rates of Substance Use Disorders. -Anesthesiology In physician addiction recovery programs, anesthesiologists enter treatment at 2.5 times the rate of other physicians. While the majority of healthcare practitioners enter treatment for alcohol addiction, anesthesiologists are more likely to be addicted to intravenous opioids. These drugs are often procured from work. It has been hypothesized that anesthesiologists have second-hand exposure to drugs through inhalation. This affects the reward pathways in the brain, increasing the likelihood of substance abuse. This is on top of having a stressful job and easy access to controlled substances. -Emergency Medicine Emergency Physicians are close to three times more likely to be enrolled in a physician treatment program than other healthcare workers. 36% of Emergency Medical Service Workers suffer from depression, and more than 20% from PTSD. This puts people working in Emergency Medicine at greater risk for Substance Use Disorders. -Psychiatry Psychiatrists are more likely to abuse benzodiazepines. This is because they have ready access to those types of drugs. In one study, 43% of psychiatrists surveyed said they would self-medicate if they suffered from mild to moderate depression.
Why do Healthcare Workers Have High Rates of Substance Use Disorders?
People who work in healthcare deal with the stress of a very difficult job, while having access to potent medications. More specifically, some of the reasons physicians might have high rates of addiction are: -Stress and burnout 35-54% of physicians in the US experience significant burnout. That number goes up to 60% for medical students and residents. -Long Hours Physicians often work long hours. 60-65% of nurses work 12-hour shifts. Less than one-third work 8-hour shifts, and the remaining group work 10-hour or rotating shifts. Physicians are also increasingly expected to squeeze in larger quantities of patients, which increases stress levels and affects performance. -Feeling responsible for people’s lives Many healthcare professionals witness illness and death on a daily basis. One-third of physicians report having a strong emotional reaction to the death of a patient, even if the death was expected. Work-related grief is one of the strongest predictors of physician burnout. Doctors or nurses may develop relationships with patients, but even if it’s a new patient, difficult feelings can arise. However, physicians often don’t have much time to process those feelings as they happen. The next patient is always waiting. -Diverting Medicine According to The Journal of Addictive Diseases, “Physicians generally have considerable access to drugs of abuse because they are able to write prescriptions for controlled medications, obtain free medication samples, and access hospital drug supplies.” The most commonly reported method is stealing prescription drugs from office or hospital inventories. Physicians can obtain state medical licenses that allow them to order drugs in bulk for their medical practices. Those with a Substance Use Disorder may divert some of these drugs for their own personal use.
Some of the warning signs that a healthcare professional is facing addiction are if they: -Have increased absences -Regularly stay late, as this could be an attempt to have easier access to medications -Elicit more complaints from patients -Show a decrease in job performance or start making poor medical decisions -Incorrectly chart or write prescriptions -Show a decrease in productivity or efficiency -Become more irritable or aggressive -Regularly disappear for significant periods of time during the workday -Have an erratic job history
Dangers to Patients
Doctors impaired by substance abuse might make misdiagnoses, administer the wrong dosage or type of medication, miss their shift, and cause infection. Physicians with a Substance Use Disorder may endanger both their own lives and the lives of their patients.
Difficulties in Seeking Treatment
-Fear of loss of license Many healthcare workers with a Substance Use Disorder keep it secret for fear of having their license revoked. Studies have shown that instead of seeking help, some physicians will try to treat themselves. Additionally, colleagues who notice a problem may not come forward, in order to protect the physician from these professional repercussions. -High Performance Misleading to Colleagues According to the medical journal Mayo Clinic Proceedings, “Physicians’ addictive disease (when compared with the general public) is typically advanced before identification and intervention. This delay in diagnosis relates to physicians’ tendency to protect their workplace performance and image well beyond the time when their life outside of work has deteriorated and become chaotic.” Physicians may also be inclined to protect their work performance in order to maintain access to the substance of abuse. If people are still performing well at work, their colleagues may not realize they have a problem until the addiction has progressed. -Stigma Doctors and nurses are often expected to be competent above all else, and are sometimes labeled as heroes. This puts a lot of pressure on people in the healthcare profession to bury their own struggles. Under these circumstances, it can be difficult to admit to needing help.
Success Rates in Treatment
Despite the difficulty in seeking help, when physicians do enter treatment, they have high success rates. 74-90% of healthcare workers remain abstinent after treatment. This may be due to the long-term monitoring required to maintain professional licensure. According to The Mayo Clinic Proceedings, “…the high abstinence rates for addicted physicians who complete an appropriate treatment program support a rehabilitation model, not a punitive stance.” As previously mentioned, when physicians fear punitive measures such as loss of license, they are less likely to seek help. This has repercussions for both the individual and the general population.
Get Help at Amatus Recovery Centers
Are you—or do you know someone who is—a healthcare professional battling with an addiction to drugs or alcohol? It is never shameful to admit that you are struggling, and could in fact save lives. At Amatus Recovery Centers across the country, we will give you the tools to build towards long-term recovery. You have devoted your life to helping others; it is okay, and brave, to admit that you too need help.