Substance Abuse in Medical Professionals: Easy Access Equals Trouble

For medical professionals battling substance abuse, going back to work can make them the proverbial kid in the candy store. It’s the equivalent to sending a recovering alcohol back to their job as a bartender. This factor is believed to play a role in the increased relapse rates among healthcare professionals. After all, they’re surrounded by the very substances that were the problem in the first place.

“Having a coexisting psychiatric illness or family history of a substance use disorder or having used a major opioid are key factors that can increase the likelihood of a substance use disorder relapse among healthcare professionals,” according to a study in the March 2008 issue of JAMA.

The prevalence of chemical dependency (excluding nicotine) among physicians has been estimated to be 10 percent to 15 percent. While that number is similar to chemical dependency rates in the general population, it can be easier for doctors to hide their addiction because of their accessibility to legal drugs. Of those medical professionals who do seek treatment for their addiction and complete a program, the study showed that recovery is best achieved through continuing group therapy and regular attendance at mutual help groups.

Possibility of Releapse

In the study of 292 health care professionals enrolled in the Washington Physicians Health Program, Karen B. Domino, M.D., M.P.H., of the University of Washington, Seattle and her colleagues conducted a study to identify factors that might predispose individuals to relapse. Here are some of their more interesting findings:

• Twenty-five percent had at least 1 relapse.
• A family history of a substance use disorder increased the risk of relapse 2.3 times.
• The use of a major opioid increased the risk of relapse significantly in the presence of a coexisting psychiatric disorder (5.8 times increased risk) but not in the absence of a coexisting psychiatric disorder.
• The presence of all three factors — major opioid use, dual diagnosis (presence of a coexisting psychiatric disorder) and family history — increased the risk of relapse 13.3 times.