The objective of the article is to present the available data from the literature on substance use disorders in healthcare professionals. Prevalence, risk factors, treatment options, and reentry into clinical practice are discussed.
Impairment of a healthcare professional is the inability or impending inability to practice according to accepted standards as a result of substance use, abuse, or dependency (addiction). The term substance use disorder can be divided into substance abuse and dependence (addiction). Substance abuse results in adverse social and professional consequences. Addiction manifests as physiologic and behavioral symptoms related to a maladaptive pattern of substance use.
It is estimated that approximately 10% to 15% of all healthcare professionals will misuse drugs or alcohol at some time during their career. Although the rates of substance abuse and dependence are similar to those of the general population, the prevalence is disturbing because healthcare professionals are the caregivers responsible for the general health and well-being of the general population. Healthcare professionals have higher rates of abuse with benzodiazepines and opiates. Specialties such as anesthesia, emergency medicine, and psychiatry have higher rates of drug abuse, probably related to the high-risk environment associated with these specialties, the baseline personalities of these healthcare providers, and easy access to drugs in these areas. Drugs and alcohol are mostly used for “recreational” purposes by medical students. Residents and attending physicians use drugs of abuse for performance enhancement and as self-treatment for various reasons, such as, pain, anxiety, or depression.
Institutional, local, and statewide impaired-physician programs are now available for the active treatment and rehabilitation of impaired healthcare professionals. Many of these programs are also designed to assist the clinician with reentry into clinical practice. Rarely is punitive action taken when the healthcare provider undergoes successful treatment and ongoing follow-up management. Overall recovery rates for impaired healthcare professionals seem to be higher compared with other groups, particularly with intensive inpatient management and subsequent follow-up care.
From Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
The author has not disclosed any conflicts of interest.