Identifying the Problem
The rate of physician addiction among current practitioners is between 10 and 15 percent, similar or higher than the general population. As with the general population, alcohol is the most commonly abused substance; but not surprising, there is an increased level of addiction to prescription opioids, benzodiazepines, and stimulants due to ease of access. Additional factors facing the physician such as rigorous education and training, heavy workloads, and dealing with patient care issues can all contribute to high levels of stress, and addictive behaviors as a way of coping¹.
In their article, Chemical Dependency and the Physician (p.625)², Berge et al wrote,
“With physicians, addictive disease ‘is typically advanced before identification and intervention’ due to their ‘tendency to protect their workplace performance’ even as their lives become chaotic outside of it"
Contributing Factors
Several factors may contribute to this delay in addressing the problem:
- Support of addictive behaviors by not reporting a colleague: Professional “courtesy”
- Reluctance to seek help for a problem due to fear of loss of prestige, or even their license.
- As with colleagues, the physician’s family members keep silent. An added fear for them is loss of economic security.
- With elevated social status, the fear of stigma may be greater; leading to a delay in recognizing or dealing with a problem. Consequently, the practitioner may feel very isolated and fearful.
The Impact of Addictive Behaviors
Other compulsive behaviors like workaholism, overspending, gambling, sexual compulsivity and so on may also become problematic. As with substance abuse, these compulsive behaviors can become an overwhelming part of life: harming or even destroying a family and other relationships, health, financial stability; or even leading to death (e.g. overdose, suicide, impaired driving). There may be consequences stemming from criminal behavior (e.g. stealing to access funds for gambling, or a conviction for solicitation of prostitution for a sex addict); or civil law action (e.g. sexual harassment charge, malpractice suit, personal injury suit).
Getting Help
Berge et al reminds us that help is available and effective; and ignoring a problem does not make it go away. In fact, “turning a blind eye” supports the ever-increasing possibility of disastrous consequences for the physician, their family and patients. The authors suggest each organization have clear policies and procedures in place for addressing potential substance abuse problems. For situations where next steps are unclear, the state Physicians Health Program (PHP) can be a source of help and information3. A link to a list of state PHPs is found below.
Helping Resources and Screening Tools
Alcohol Screening
http://www.alcoholscreening.org/Home.aspx
Drug Screening
http://www.drugscreening.org/
Gambling
Screening tools and diagnostic criteria from the National Council on Problem Gambling. http://www.ncpgambling.org/help-treatment/screening-tools/
Sexual Compulsivity
There are a number of screening tools at Sexhelp.com including the Sexual Addiction Risk Assessment, Internet Sex Screening Test, Sexual Addiction Screening Test, and Partner Sexuality Survey. https://www.sexhelp.com/am-i-a-sex-addict/
Physician Health Programs
Federation of State Physician Health Programs provides links to PHP by state. http://www.fsphp.org/state-programs
We Can Help
Are you are struggling with addictive behaviors or relationship concerns? We are available to help anytime, day or night. As part of the Physician Well Being Resources program from VITAL WorkLife, members have unlimited telephonic consultations with consultants who can provide solid advice on developing healthier relationships. For more focused work in this area, Peer Coaching is great solution. Members can speak with a consultant or be referred to a Peer Coach by calling us at 877.731.3949.
All VITAL WorkLife EAP and Physician Well BeingResources members have access to assistance. Whether you are a colleague, family, friend, leader or a provider yourself concerned about substance abuse or other problematic behavior, let VITAL WorkLife help through one or more of the following services:
- 24/7 telephonic consultations.
- Information and referral to helping resources such as specialized counseling, treatment programs, self-help groups, organizations, reading materials and so on.
- Free face-to-face counseling for family or others concerned about another individual’s problem.
- Free substance use assessments and/or counseling for a physician or provider (or their family member) with a possible problem.
- Consultation with leaders, managers or colleagues regarding a concerning physician or employee.
- Onsite or web based training for your organization regarding drug and alcohol abuse or other problems, customized for your needs.
Many with a concern about substance use or other behaviors know intellectually that people can and do get their lives back with the right support and help, but need a little extra assistance to take the first step towards changing themselves. Of course, the ideal time is now, and before experiencing extreme negative consequences or “hitting rock bottom.” If you are ready for change but are having difficulty getting started, the following real-life stories of physicians getting their lives back may help.
Stories of Addiction and Recovery
When Doctors Get Sick: Three Stories of Addiction
http://www.medpagetoday.com/psychiatry/addictions/54910
A Personal Story of Addiction
http://www.massmed.org/Physician_Health_Services/Helping_Yourself_and_Others/A_Personal_Story_of_Addiction/#.WZHYF9GQwdV
A GP’s story of Sex Addiction
http://www.mirror.co.uk/news/real-life-stories/im-gp-life-most-would-8855705
PCP with Drug Addiction
http://www.latimes.com/opinion/op-ed/la-oe-grinspoon-addicted-doctors-20160605-snap-story.html
Contact Us Today
MEMBERS
If you are a member of one of our solutions, give us a call to speak with a representative; we’re available anytime, day or night.
- EAP members: call 800.383.1908
- Physician Well Being Resources members: call 877.731.3949
FOR MORE INFORMATION
For more information about our comprehensive suite of well being solutions, call 800.383.1908.
Sources:
1 Addiction Treatment for Doctors. Physician Health Program. http://www.physicianhealthprogram.com/. Accessed August 14, 2017.
2, 3 Berge KH, Seppala MD, Schipper AM. Chemical Dependency and the Physician. Mayo Clinic Proceedings. 2009;84(7):625-631. doi:10.4065/84.7.625.
