When we arrive at our dentist’s office for an appointment, not one of us would expect—or want—to find out he or she is under the influence of alcohol or drugs, right? Yet according to Michel A. Sucher, MD, medical director of the Arizona State Board of Dental Examiners’ Monitored Aftercare Treatment Program, “About 10 to 12 percent of the general population becomes addicted to alcohol or drugs at some point in their lives. For dentists and physicians, the prevalence is probably 12 to 19 percent.”
These statistics indicate that somewhere between 1 in 8 and 1 in 5 dentists will eventually face a substance use disorder (aka addiction to alcohol or drugs). While this is certainly alarming, it must be emphasized that dentists are humans, too; and given addiction is a disease, it can indeed afflict anyone. In fact, the “disease” nature of addiction is borne out in its definition, per the American Society of Addiction Medicine:
“(Addiction is)…a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.”
One might imagine—correctly—the individual costs and dangers involved with substance abuse and addiction are substantially greater for dentists. Eric Z. Shapira, DDS, MAGD, points out, “Depending on the drug, the risks of addiction include loss of license, malpractice lawsuits, cardiac arrest, infection, financial ruin, increased depression, divorce, loss of family and social connections, increased despair, and the possibility of death.”
Nonetheless, dentists of all walks of life do become addicted, and therefore the opportunities for their receiving treatment and ongoing recovery services are made available via various forms of “dental well-being programs” throughout the country.
In Dr. Sucher’s experience, dentists’ drugs of choice are typically alcohol, opiates – mostly hydrocodone and oxycodone – and nitrous oxide. Research conducted by John W. Drumm, DMD, chair of the District of Columbia Dental Society’s Well Being Program, concluded that alcohol is the drug of choice for 37 percent of dentists with substance abuse problems, while prescription drugs (particularly opiates such as hydrocodone and anti-anxiety agents such as benzodiazepines) are used by 31 percent, nitrous oxide by 5 percent, and street drugs (including cocaine) by 10 percent.
While hereditary, physiological and lifestyle influences may affect a dentist’s predisposition to substance use disorder, Dr. Shapira notes that external stressors can contribute to addiction, as well. “Dentist addiction is often attributed to stress. Dentists may not be able to handle the financial burden of a practice or they have family problems and find that drugs ease their emotional and physical pain.”
(By the way, the National Institute on Drug Abuse also cites exposure to stress as one of the most powerful triggers of substance abuse in vulnerable individuals.)
According to Dr. Drumm’s research, over three-fourths of dentists are sole proprietors, therefore significantly more isolated from their peers than other healthcare professionals. Coupled with frequent long work hours of focused concentration in direct patient contact, this “leads to fatigue, as does the stress of competition. We see other dentists as competitors, instead of colleagues. This is a perception that results in pressure to be better than our peers.”
The dental office itself can provide easy access to an “escape” from the stress via drug use. Nitrous oxide is readily available, they have ready access to narcotic drugs, and they can write their own prescriptions.
Given a substance use disorder (aka addiction or chemical dependency) is treatable, the key is for the dentist afflicted by such to feel encouraged and hopeful about the options in front of him or her. If you (or someone you know) are in the field of dentistry and have an addiction to alcohol or drugs, help is available in the form of addiction treatment centers nationwide whose goal is to support any dentist who wants to recover.
In Part two of this 2-part blog-post, we’ll take a look at how dentists can best deal with colleagues who’re struggling with a substance use disorder, as well as the benefits to be gained from going into treatment and getting supportive aftercare monitoring.
 Academy of General Dentistry, 2010
 Academy of General Dentistry, 2010