Yes. Surveys and statistics suggest that their substance abuse rates are roughly as much as the rest of the population. One reason is their accessibility to addictive drugs.
Table of Contents
- Do Doctors Get Drug Tested?
- Why Is Drug Testing Necessary?
- How Effective Is Drug Testing?
- Substance Abuse: A Huge Problem Amongst The Physicians
- Medical Board Policies
- Doctor’s Drug Abuse Treatment
- Risks Factor for Alcohol, Drug and Substance Abuse Amongst Healthcare Workers
- Substance Abuse Statistics by Specialty
Why Is Drug Testing Necessary?
Most states have programs that help monitor participants by evaluating their needs and treatment, which is fairer than taking disciplinary actions.
Regulatory efforts should be made to aid healthcare workers. These actions are time-sensitive and take a toll on the physician’s control over their drug abuse.
How Effective Is Drug Testing?
Due to it being a less expensive and relatively higher level of accuracy, the urine test is a reliable drug test, which can detect around ten or more drugs; Marijuana can be found within 30 days of use. Drugs like Cocaine and Amphetamine can be reported within four days, alcohol for 12 hours at the most. A 12-panel drug test is comprehensive and a periodic drug test limits drug abuse amongst physicians.
Substance Abuse: A Huge Problem Amongst The Physicians
- Several doctors have been in the news headlines for substance abuse, leading to severe health hazards in the patient’s ward. In a recent well-known case, a medical school Dean of USC, Dr. Carmen Puliafito, had his license revoked for using methamphetamine and heroin.
- Another reported case involved David Kwiatkowski, a medical technician, who used to exchange patient’s fentanyl syringes with saline, which ultimately led to the contamination of 45 people with hepatitis C over ten years. It also resulted in the death of two people
Medical Board Policies
Colorado is the first state to create a policy regarding medical marijuana. Like the Medical Board of California, others follow federal law to keep a check on the same. In the year 2017-2018, the board took action against 59 physicians with drug problems by revoking licenses of 9 people, putting 29 on probation and 17 surrenders.
California: Drug Testing For Doctors
In November 2014, Proposition 46, which was laid for California voters to vote yes/no, meant that doctors would require random drug and alcohol tests. Almost all the doctors, hospitals, and medical insurance companies denounced Prop 46, making California the first state to pass such a law. The issue projected was much larger than the drug cause, which the medical industry defeated with the sound pay of a $35 million campaign.
According to the medical industry, the law would have increased the malpractices given the attorney’s ulterior motives would lead them to benefit from the trial lawyers who would be gaining from the cases as there are false positives too, which accounts for around 5% to 10% and about 10% to 15% false negatives. It will probably have enough potential to ruin a physician’s career. Thus the drug test policy would become an invasion of their privacy. Even the hospitals consent as they do not look for defiling their relationship with the staff and facility by imposing a clear policy.
Massachusetts General Hospital
In 2004, the hospital enacted the requirement for a drug test for their anesthesiology residents, which showed a very good result for the next ten years in eliminating positive tests, which implies that drug test ties in with substance abuse.
As per a study published in BMJ in 2008, 802 doctors were monitored by the testing programs for five years, resulting in 65% of the doctors remaining sober and clean without substance use. They also checked for any relapse, which indicated that a continued testing program is essential to help look for backsliders.
Alcohol Abuse Amongst Doctors
A 5-year cohort study of health programs for physicians stated that alcohol is the primary substance of abuse in most doctors. Several doctors got themselves enrolled in these support and monitoring programs. The study also shows data in which 12.9% and 21.9% of male and female physicians respectively abuse alcohol which is more than the US population aged 18 years or older with the same disorder.
Prescription Drug Abuse Among Doctors
Opioids and Benzodiazepines are the prescription drugs that are particularly prevalent amongst doctors. It has been known by research that around 36% of physicians suffer from opioid abuse. It is mainly due to their ease of accessibility to prescription drugs. Especially anesthesiologists are recorded to be amongst the frequent drug abuser mostly using fentanyl, an opioid painkiller.
Doctor’s Drug Abuse Treatment
Doctor’s treatment options for substance abuse are different from the rest of the population. They require long-term monitoring and guidance as they must return safely with self-control over backsliding. Physical health programs designed for them ensure proper advocacy and services that direct physicians to proper treatment.
The national survey on substance abuse treatment programs and their effectiveness has found that the programs have been more successful than the treatment options. It states that around 78% of PHP participants remained substance-free, and 71% have retained their license; both were determined after a 5-year follow-up.
Monitoring Drug Abuse
As per the experts, drug abuse amongst doctors can be curbed down by strict surveillance and tracking around the drug storage and maintenance area. State health treatment programs can help and monitor physicians with substance abuse. Studies showed great results where the doctors who were monitored found great results with the prolonged monitoring program.
Risks Factor For Alcohol, Drug And Substance Abuse Amongst Healthcare Workers
The environment of the healthcare professional faces immense responsibilities, including lack of workforce, exposure to illness, death, and trauma, which causes sleep deprivation. Therefore, after attending to these many situations in their work-life, most of them turn to drugs and alcohol as their escape plan.
- Access to Prescription Drugs – Around 87% of physicians self-medicate, and around half of the other healthcare professionals have written prescriptions of painkillers for themselves. The access is so smooth for the healthcare professional that they mostly resort to drug abuse to appease their addictions.
- Burnout – Emotional exhaustion due to prolonged work stress may lead to burnout. Since the situations arise for the senior and highly experienced professionals, the circumstances like low self-esteem, overworking, insomnia, etc., may lead to early burnout, making them sink with alcohol and drug use.
- Professional Characteristics – The professionals are linked with drug abuse due to many given characteristics and environment. Some of them include:
- Early use of tobacco or alcohol
- Genetically predisposed or family history of substance use disorder
- Initial experimentation with substance or other psychiatric illness with exposure
- Feeling of invincibility to the addictive drug effect
Substance Abuse Statistics By Specialty
At some point in the career, all the physicians are exposed to the drugs. Due to various stress factors and easy accessibility to drugs, different disciplines will have a varied impact due to substance usage.
The majority are addicted to intravenous opioids such as sufentanil or fentanyl. They are closest to the operation room, where all kinds of highly addictive drugs are stored.
Statistics show that over 40% of anesthesiologists enrolled in physician’s healthcare programs are for drug abuse, and only 10% were for alcohol abuse.
As compared to other specialties, surgeons account for a lower number of drug abuse, except for alcohol and smoking. The highest rate of women physicians was found to abuse alcohol when compared to the total population of the US adult population with the same disorder.
Psychiatrists are inclined to stress, burnout, and suicide. They are more like to abuse benzodiazepines. Their stressors include:
- Negative patient’s characteristics
- Posttraumatic stress arising during patient treatments such as when a patient attempts or commits suicide
- Professional hassles, conflicts between staff members, shortfall of resources
- Job dissatisfaction due to prolonged working hours
- Intense and unpredictability in terms of responsibility
- Less credibility or appreciation
4. Emergency Medicine Physicians
Emergency medicine physicians are only 3% of all the physicians. About 7% to 18% of the physicians are enrolled in Physical Health Programs for substance abuse management. Study shows that nearly half of them were treated for alcohol addiction, around 38% for opioids and 10% for other stimulants. They are known to use more illicit substances such as Marijuana when compared to other specialties. The emergency doctors have to deal with unpredictable situations and a more demanding job. Due to their front-line care, they burnout at a higher rate (60%) when compared to other specialty physicians. Due to their constant encounters with unpredictable and stressful situations, they self-medicate with alcohol and opioids, leading to dependency.
It is a relief to know that pediatricians account for the lowest rates of substance abuse. They, too, face work-related stressors, including HER documentation, non-clinical activities, updating medical knowledge periodically, etc. These physicians are less likely to resort to substance use as compared to other specialties.
A physician plays a vital role in understanding their patients’ concerns, including diagnosing, treating, and providing ongoing care to cure or prevent any illness. Physicians undergo job-related stressors, and some physicians go out of their way to self-medicate, leading to substance or alcohol abuse.
Practicing physicians with substance abuse issues may have trouble in decision-making or trouble diagnosing and providing proper treatments to their patients. Misdiagnosing may also put the patients at risk. Hence, such physicians should enroll themselves in substance abuse programs, get treated, and start their career life drug-free since no patient would want to go to a doctor who has substance abuse problems.