The Challenges Addicted Doctors & Nurses Face Require Specialized Diagnosis and Treatment – PART ONE
Most people in the U.S. consider doctors and nurses to be representatives of healthy habits and lifestyles, and indeed research has shown that assumption is generally true. Those in the healthcare field tend to smoke less and exercise more.[1]
However, that same research indicates the proportion of healthcare professionals experiencing a substance use disorder (i.e., addiction to alcohol or drugs) is the same as the general public.[2] And that increases 5-fold when looking at rates of opioid or benzodiazepine abuse.[3]
The risks and problems associated with having doctors practicing in the field while under the influence of a substance are many, not the least of which is a serious lack of safety. And lest one thinks physicians are the only healthcare professionals facing addiction issues, studies indicate nurses have similar challenges with substance use disorders.
In 2010, about one third of all disciplinary actions taken against nurses by the Texas Board of Nursing involved alcohol or drug use.[4]
While there has been no single cause identified for the higher rate of substance use by doctors and nurses, especially opioid abuse, a variety of theories have been presented and studies conducted to validate them.
One of the least surprising findings is that having increased access to prescription drugs is a contributing factor to healthcare professionals’ higher rates of substance use disorders. And while it may seem reasonable to know that, according to research, 87% of doctors have prescribed medications for themselves,[5] it is indeed startling to find out more than half of all healthcare professionals who have a prescription for painkillers wrote the prescription themselves.[6]
Research using self-report surveys indicate many doctors and nurses began their abuse of prescription drugs after having gained the privilege of writing prescriptions.[7]
The role of higher-than-normal job stress has also been studied as a contributing factor to healthcare professionals increased rate of addiction to alcohol or drugs, as has been their increased exposure to sickness, trauma and death. Similarly, higher rates of sleep deprivation have been posited as having an influence on doctors’ and nurses’ abuse of substances.
It should be noted, however, that it’s been found self-report studies can have less-than-valid results, due to the reticence of some healthcare professionals to report their use of alcohol or drugs as “aids” to their managing stress, be it work-related or personal.
Still, these hypotheses have been generally accepted to explain why there is a higher rate of substance use disorder in doctors and nurses, especially when combined with other risk factors, including family background/genetic predisposition, previous use/experimentation with drugs, etc.[8]
In PART TWO of this 2-part blog-post, we’ll take an in-depth look at treating healthcare professionals for substance use disorders.
[1] Merlo, L., & Gold, M. (2008). Prescription opioid abuse and dependence among physicians: Hypotheses and treatment. Harvard Review of Psychiatry, 16(3), 181–94.
[2] Ibid.
[3] Merlo, L. J., Trejo-Lopez, J., Conwell, T., & Rivenbark, J. (2013). Patterns of substance abuse initiation among healthcare professionals in recovery. The American Journal on Addictions, 22, 605–612.
[4] https://www.texastribune.org/2010/03/17/texas-nurses-battle-drug-addictions/
[5] Merlo, L., & Gold, M. (2008). Prescription opioid abuse and dependence among physicians: Hypotheses and treatment. Harvard Review of Psychiatry, 16(3), 181–94. Bennett, J., & O’Donovan, D. (2001). Substance misuse by doctors, nurses, and other healthcare workers. Current Opinion in Psychiatry, 14, 195–199.
[6] Merlo, L., & Gold, M. (2008). Prescription opioid abuse and dependence among physicians: Hypotheses and treatment. Harvard Review of Psychiatry, 16(3), 181–94.
[7] Hughes, P. H., Conrad, S. E., & Baldwin, D. C. (1991). Resident physician substance abuse in the United States. JAMA, 265, 2069–2073.
[8] Merlo, L., & Gold, M. (2008). Prescription opioid abuse and dependence among physicians: Hypotheses and treatment. Harvard Review of Psychiatry, 16(3), 181–94
Hughes, P. H., Conrad, S. E., & Baldwin, D. C. (1991). Resident physician substance abuse in the United States. JAMA, 265, 2069–2073.
