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Substance abuse among physicians: Addiction behind the white coat

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Alcohol and drug abuse affects people of all colors, ages, professions and backgrounds. Addiction does not discriminate and there is a hidden underworld of physicians who are addicted to prescription medications, alcohol and even illegal drugs. Treating another human being while addicted to an illicit substance can potentially harm the patient and physician, costing the physician’s career and potentially the patient’s life.

Every primary care physician is taught and trained to screen for alcohol and drug abuse during an outpatient visit. When asking “how many drinks a week do you consume?” physicians have been trained to triple the patient’s response to this question. Three beers really means nine beers. Four shots equals 12 shots. Patients might feel as if they are being judged by their physician, but many physicians are alcoholics themselves and, those who are not, know someone who is. Doctors also treat many hospital patients for alcohol or drug withdrawal.

When it comes to substance abuse, doctors share most of the same risk factors as anyone else. For example, they are no more or less likely to have a family history of dependence or an undiagnosed mental health condition than, say, a plumber or a banker. However, the very nature of medicine and the health care workplace may exacerbate the potential for a problem.

More prone to alcohol and drug use

Doctors are overwhelmed with the time-consuming demands of electronic medical records, regulatory requirements, administrative paperwork and patient care. They are constantly harangued to control medical spending. Collectively, these pressures contribute to an unprecedented level of burnout. Physicians’ access to potent prescription medications represents another distinction between doctors and the general public.

Ironically, doctors may be attuned to signs of their patients’ substance abuse issues, but they may not be as adept at recognizing and addressing their own or their colleagues’ problem. According to the article, “Prevalence of Alcohol Use Disorders Among American Surgeons,” published in the February 2012 issue of JAMA Surgery, 10 to 15 percent of U.S. physicians have a substance use disorder, a rate slightly higher than that of the U.S. population as a whole. But physicians struggling with abuse or addiction differ from the rest of the public in one critical respect: They have taken an oath to care for others.

Medicine attracts many high-achieving, compulsive, perfectionistic individuals who derive a strong sense of self-worth from their jobs. If a doctor’s commitment morphs into overwork, exhaustion and work/life imbalance, alcohol and other drugs may become a dangerous relief. Physicians’ perfectionistic tendencies enable them to perform well in the workplace even as their marriages fail, their personal lives crumble and their substance abuse becomes deeply entrenched. Physicians are very good at hiding their problems. Because they have been through rigorous training and long work hours, they become mentally and emotionally blunted.

Seeking help

The man or woman in the white coat could be undergoing the same addiction to alcohol as the disheveled person carrying a brown paper bag with a bottle inside. Yet society tends to portray the latter image of an alcoholic or a drug addict, while the former image has a higher chance of becoming one due to the stress of his or her career. Physicians have the advantage of knowing about the withdrawal effects from drugs and alcohol as well as the treatment for these side effects, often leading to self-medicating.

Alcoholism and drug addiction is a worldwide problem and every person who goes down the rabbit hole will need to get out one way or another. If you or someone you know is battling with drug or alcohol addiction, Sovereign Health Group may be able to help. Sovereign helps individuals minimize the risk of relapse by customizing programs with cutting-edge, evidence-based treatment. Sovereign offers programs accredited by The Joint Commission, and several facilities that are dually licensed to treat mental health disorders and substance abuse. To learn more about Sovereign’s programs and enrollment, call the admissions team at 855-683-9756.

Written by Kristen Fuller, M.D., Sovereign Health Group writer

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