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"
Several factors may contribute to this delay in addressing the problem:
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).
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.
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
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:
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.
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
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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.