Based on factors a person encounters in the course of doing their job—such as stress level, how hazardous or labor-intensive it is, the amount of pressure is involved or the ease of access to alcohol or drugs—one profession may have greater risk factors for substance abuse than another.
Construction workers and miners, as well as people in the food service and hospitality industries, all rank in the highest percentiles of workers facing the most risk factors for substance use disorders.[1]
Perhaps contrary to what one might believe, our nation’s physicians—whose job it is to provide quality healthcare for people—have a “combo platter” of risk factors that puts them at greater exposure than many other professions.
According to a literature review, published in Critical Care Medicine, presenting the findings of research studies on substance use disorders in healthcare professionals, between 10 – 15 % of physicians will, at some point in their medical careers, experience issues with substance abuse.[2]
Due to the variety of significant stressors and ease of access to particular pharmaceutical drugs in specific fields of medicine, the risk factors for physicians in different specialties will be different. Here are some of the unique risk factors for substance abuse in three physician specialties.
SURGEONS
Interestingly, U.S. surgeons exhibit generally lower rates of substance abuse, except when it comes to alcohol.[3] Significantly high rates of alcohol use and dependency by practicing surgeons were indicated in a study by Oreskovich, et al., with over 25% of women surgeons reporting alcohol abuse or dependence problems, while nearly 14% of men surgeons presented with such.
Some reasons surgeons turn to alcohol include the high stress level, often long hours and intense responsibilities that are inherent every day with their job – for example, operating on patients and not having any guarantee they will live following any given procedure. Many surgeons turn to alcohol as a coping mechanism to unwind and de-stress at day’s end.
ANESTHESIOLOGISTS
Because of their having easy access to powerful prescription opioids, such as fentanyl and sufentanil, anesthesiologists have a higher risk factor for use of these drugs and becoming addicted to them than other doctor’s specialties.[4] Other risk factors for this field of medicine include:
- Proximity to potent drugs in the operating room;
- Their ability to divert such drugs from their patients for their own use; and,
- The amount of stress involved in their day-to-day work environment.[5]
EMERGENCY MEDICINE PHYSICIANS
As the old saying goes, “Numbers don’t lie.” What’s noteworthy when observing the statistics regarding emergency medicine physicians in the U.S., they account for only 3% of all physicians, yet they make up 7-18% of doctors enrolled in Physician Health Programs for substance abuse issues.[6]
Additionally, one study reported that emergency medicine doctors use and abuse illicit drugs at a higher rate than other physician specialties.[7]
Some of the risk factors facing emergency medicine physicians include their being front line healthcare workers and therefore needing to face and address oftentimes harrowing, if not urgent and uncertain circumstances. Trying to deal with the amount of stress and/or physical pain on a regular basis, as well as long shifts and few days off, may lead these doctors to use and become dependent upon alcohol, opiates or stimulants.
On a perhaps related note, the burnout rates for emergency medicine doctors is the highest among all physician specialties: 60%.[8]
THE GOOD NEWS
Fortunately, addiction treatment for doctors has been found to have high success rates. Upon successful completion of addiction treatment, more than 75% of physicians remain free of drug use after five years and 78% of doctors remained drug-free after 5 years and 71% maintain their medical license and practice after 5 years.[9]
[1] Substance Use and Substance Use Disorder by Industry (samhsa.gov); Construction workers and miners are the most likely to use opioids – CBS News;
[2] Impaired healthcare professional – PubMed (nih.gov)
[3] Hughes, P.H., Storr, C.L., Brandenburg, N.A., Baldwin, D.C., Anthony, J.C., & Sheehan, D.V. (1999). Physician substance use by medical specialty. Journal of Addictive Diseases, 18(2), 23-37.
[4] Kintz, P., Villain, M., Dumestre, V., & Cirimele, V. (2005). Evidence of addiction by anesthesiologists as documented by hair analysis. Forensic Science International,153(1), 81-4.
[5] Gold, M.S., Byars, J.A., & Frost-Pineda, K. (2004). Occupational exposure and addictions for physicians: case studies and theoretical implications. Psychiatric Clinics of North America, 27(4), 745-53.
[6] McLellan, A.T., Skipper, G.S., Campbell, M., & DuPont, R.L. (2008). Five year outcomes in a cohort study of physicians treated for substance use disorders in the United States. BMJ, 337, a2038.
[7] Hughes, P.H., Storr, C.L., Brandenburg, N.A., Baldwin, D.C., Anthony, J.C., & Sheehan, D.V. (1999). Physician substance use by medical specialty. Journal of Addictive Diseases, 18(2), 23-37
[8] Shanafelt, T.D., Boone, S., Tan, L., Dyrbye, L.N., Sotile, W., Satele, D., … & , Oreskovich, M.R. (2012). Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Archives of Internal Medicine, 172(18), 1377-1385.
[9] uPont, R.L., McLellan, A.T., Carr, G., Gendel, M., & Skipper, G.E. (2009). How are addicted physicians treated? A national survey of Physician Health Programs. Journal of Substance Abuse Treatment, 37(1), 1-7.
