How Substance Abuse in Medical Professionals Impacts Patients
Substance Abuse in Medical Professionals
Medical professionals (including physicians, nurses, health aides, and technicians) often suffer from extreme work responsibilities, physical pain, sleep deprivation, fatigue, and intense work-related stress stemming from constant exposure to illness, death, and trauma. And like many people outside of their profession, this may lead them to turn to drugs or alcohol as a form of coping and self-medication.
The overall rate of substance abuse in medical professionals is not much different from that of the general population. It is estimated that 10%-15% of all medical professionals in the United States will misuse drugs or alcohol at some point during their career.1 Medical professionals are more likely to abuse prescription medications, with higher rates of abuse frequently seen with benzodiazepines and opioid narcotics.2-3
How Does Addiction in Healthcare Workers Impact Patients?
According to the latest data from the U.S. Substance Abuse and Mental Health Services Administration, at least 100,000 medical professionals struggle with a substance abuse disorder.4 Such widespread substance abuse by medical professionals raises many concerns, including the threat to patient care. Providers under the influence of substances or experiencing withdrawal symptoms are more likely to make mistakes and errors, such as botched surgeries, wrong diagnoses, and administration of improper medications.
Another concern of medical professionals with addiction is their access to prescription drugs. Not surprisingly, the theft of narcotics from patients is a major issue. This illegal transfer of prescribed controlled substances from the patient (for whom it was prescribed) to another person for illicit use, referred to as drug diversion, is just one way that medical professionals struggling with addiction can harm their patients.
Perhaps the most notorious example of patients receiving substandard care due to drug diversion is the case of David Kwiatkowski.5 This traveling radiology technologist injected himself with the painkiller fentanyl and then used the same syringes on patients after refilling them with saline. In addition to his patients suffering from pain that they did not know was being untreated, his utter negligence caused a multistate outbreak of hepatitis C. In 2013 he was sentenced to 39 years in prison for stealing drugs and infecting at least 45 patients with hepatitis C, including one who died.5 Unfortunately, this is not an isolated case; according to a recent study conducted by the Centers for Disease Control and Prevention, nearly 30,000 people may have been exposed to hepatitis C over a 14-year period by infected hospital employees using narcotics intended for patients.6
In addition to the increased risks of making mistakes and errors, healthcare workers suffering from addiction can also pose less direct threats to the well-being of patients. A recent study published in the journal PLOS One describes the link between how patients perceive the wellness of their physicians (through things such as demeanor and physical appearance) and the care they receive. A negative view of a physician hurts the doctor-patient relationship and hinders patient actions such as following care plans.7
Treatment and Recovery
Medical professionals with substance abuse or addiction problems are a great risk to their patients, as well as to themselves. It is only a matter of time until their negligence towards patient care is noticed and results in malpractice. These healthcare workers will then inevitably face consequences such as:
- Legal issues (lawsuits, arrests)
- Financial burden (lost pay during suspension from work)
- Professional disciplinary actions (loss of license, loss of career)
Fortunately, assistance is available for those seeking help with their addiction. Treatment is usually very effective, and many programs also assist with reentry into clinical practice once the medical professional has undergone successful recovery.
- Baldisseri, M.R. (2013). Impaired healthcare professional. Critical Care Medicine, 35(2 Suppl), S106-S116.
- Merlo, L., & Gold, M. (2008). Prescription opioid abuse and dependence among physicians: hypotheses and treatment. Harvard Review of Psychiatry, 16(3), 181–94.
- Merlo, L. J., Trejo-Lopez, J., Conwell, T., & Rivenbark, J. (2013). Patterns of substance abuse initiation among healthcare professionals in recovery. The American Journal on Addictions, 22, 605–612.
- Bush, D.M., & Lipari, R.N. (2015). Substance Use and Substance Use Disorder by Industry. Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Rockville, MD.
- Eichenwald, K. (2015). When Drug Addicts Work in Hospitals, No One is Safe.
- Schaefer, M.K., & Perz, J.F. (2014). Outbreaks of infections associated with drug diversion by US health care personnel. Mayo Clinic Proceedings, 89(7), 878-87.
- Lemaire, J.B., Ewashina, D., Polachek, A.J., Dixit, J., & Yiu, V. (2018). Understanding how patients perceive physician wellness and its links to patient care: A qualitative study. PLoS One, 13(5), e0196888.