Substance Abuse Treatment Options for Doctors
Substance Abuse Among Doctors
Just like those of us in the general population, doctors tend to suffer from work-related stress. Long work hours and immense responsibilities often lead to physical pain, emotional distress, sleep deprivation, and overall fatigue. Doctors also turn to drugs and alcohol as a means for coping and self-medication. Studies show that between 10%-15% of all medical professionals in the United States go through substance abuse at some point during their career.1
A nationwide study of substance use disorders in a large sample of physicians showed that alcohol is the most commonly abused substance among doctors in the United States.2 The misuse of prescription drugs, particularly opioids, is also very prevalent.3 Overall, the rate of prescription drug abuse among doctors is about 5 times higher than in the general population.4 Greater access to prescription drugs may help to explain why self-medication is so common among doctors.Substance abuse and addiction in doctors raises many concerns, including their inability to practice medicine with reasonable skill and safety. This is a direct threat to the safety and well-being of patients, and it is therefore essential for doctors with substance abuse problems to receive immediate treatment before safely returning to work.
Treatment for Doctors
The first step towards recovery is acknowledging the need for help. For many reasons, doctors battling addiction find this to be especially difficult. Combined with the fear of professional, legal, and financial repercussions, doctors are usually hesitant to publicly acknowledge their addiction. Therefore, the burden usually falls upon family and colleagues to identify and refer these doctors to treatment programs.
Treatment programs specific to the needs of doctors are essential, as there are many unique challenges in treating doctors. Some of the specific difficulties facing doctors suffering from substance abuse and addiction include:
- Immense guilt and shame due to their role as caregivers
- Reluctance to seek help
- Inability to take on the role of patient
- Easy access to prescription drugs
- Fear of social stigmas associated with substance abuse
- Fear of career consequences (loss of license to practice)
Substance abuse treatment options for doctors are different from those available to the general population. Treatment is typically overseen by a physician health program (PHP). These state-based organizations provide the coordination, monitoring, expertise, and resources required to effectively care for doctors with substance abuse problems.
PHPs ensure that doctors receive the necessary treatment and long-term monitoring needed for them to be able to safely return to medical practice. After an initial assessment and evaluation, the PHP will typically refer doctors to an abstinence-oriented residential treatment (usually 60-90 days) which is followed by 12-step-oriented outpatient treatment. Physicians are then subject to randomly scheduled drug testing, with status reports sent to employers, insurers, and state licensing boards.
A national survey of PHPs managing the care of addicted physicians showed very positive outcomes. After completion of rehab treatment, 78% of doctors remained drug-free after 5 years and 71% retained their license and employment after 5 years.5 In addition to providing very effective treatment for addiction, these programs also assist doctors with reentry into clinical practice once they have undergone successful recovery.
- Baldisseri, M.R. (2013). Impaired healthcare professional. Critical Care Medicine, 35(2 Suppl), S106-S116.
- Oreskovich, M.R., Shanafelt, T., Dyrbye, L.N., Tan, L., Sotile, W., Satele, D., … & Boone, S. (2015). The prevalence of substance use disorders in American physicians. The American Journal on Addictions, 24(1), 30-8.
- McLellan, A.T., Skipper, G.S., Campbell, M., & DuPont, R.L. (2008). Five year outcomes in a cohort study of physicians treated for substance use disorders in the United States. BMJ, 337(a2038), 1-6.
- Merlo, L., & Gold, M. (2008). Prescription opioid abuse and dependence among physicians: hypotheses and treatment. Harvard Review of Psychiatry, 16(3), 181–94.
- DuPont, R.L., McLellan, A.T., Carr, G., Gendel, M., & Skipper, G.E. (2009). How are addicted physicians treated? A national survey of Physician Health Programs. Journal of Substance Abuse Treatment, 37(1), 1-7.