One in ten physicians develops a problem with alcohol or drugs at some point during their career. As in other professional occupations, superior levels of responsibility, accountability, and performance are typically demanded from doctors. Frequently, they hold the lives, livelihood, and future of their patients in their hands.
Consequently, it is not uncommon for physicians to turn to drugs and alcohol to handle the pressures of high expectations and work-related stress. Great responsibilities and long working hours can lead to burnout, a recognized problem among doctors.
While the prevalence of alcohol use disorder among physicians is about the same as in the population as a whole, “prescription drug misuse and dependence rates are far higher. Addiction impairs more physicians than any other disease,” write Lisa Merlo, PhD, and Mark Gold, MD, on psychiatrictimes.com.
Misuse of alcohol quickly impairs a doctor’s ability to function and is more easily detected whereas prescription drug misuse can be kept secret for quite some time since medical professionals know what dosage to use and have access to unadulterated drugs as well as clean needles and syringes to inject them.
The easier the access to potent narcotics, the higher the addiction risk. “In the medical world, three specialists account for a substantially higher proportion [of addicts] than other specialties: anesthesiologists, emergency room specialists, and psychiatrists,” writes Kent Sepkowitz on thedailybeast.com.
Because they are skilled at dosing and administering powerful drugs, physicians often believe for a long time that they are in control of their substance use. The concept of “high-functioning” addicts was endorsed in a 2007 study by scientists at the National Institute on Alcohol Abuse and Alcoholism, which is part of the National Institutes of Health. The study described five distinct subtypes of alcoholism, one of which was the “functional” subtype, said to comprise about one-fifth of American alcoholics. The concept has been applied to drug addiction as well. But substance use while “high functioning” is only the initial phase of the disease of addiction. The addict is living on borrowed time with potentially disastrous consequences. Since users don’t recognize the problem, they will not seek help early enough.
It is often said that doctors are the worst patients. That is certainly not true in addiction treatment. Once they realize that their substance use is out of control and they are facing career-ending consequences, doctors frequently become highly motivated recovery patients. In most cases, diverting drugs or neglecting patients because of an addiction leads to the suspension of the medical license, which can only be reinstated if the physician agrees to go to treatment and submit to a regime of drug tests.
Fortunately, they can often rely on the support of a professional network. “Such physician health programs are pretty effective, helping around 80 percent of doctors recover from their problems,” reports Patrick Skerrett on the Harvard Health Blog. Although those programs can be perceived as coercive because physicians are likely to lose their license to practice medicine permanently if they refuse to cooperate, physician health programs also provide much-needed structure for early recovery.
Professionals Program at Farley
Chances for a successful recovery are optimized in a cohort-specific setting. The Farley Center at Williamsburg Place has a proud history of treating professionals, including doctors, lawyers, and airline pilots. Farley is recognized as one of the pioneering treatment facilities in the country helping licensed individuals with sophisticated defense mechanisms learn how to cope with life stressors without the use of drugs and alcohol.
Treating these individuals confidentially in a program addressing the specific needs of professionals can help ease the fear of disclosure and facilitates repairing damage incurred by substance-related behaviors. In order to build skills to deal with circumstances that surround demanding careers, the Farley team treats the substance use disorders and co-occurring conditions of professional patients comprehensively while acknowledging concerns regarding their professional status.