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Reasons for Misuse of Prescription Medication Among Physicians Undergoing Monitoring by a Physician Health Program

Merlo, Lisa J. PhD, MPE; Singhakant, Supachoke MD; Cummings, Simone M. PhD, MHA; Cottler, Linda B. PhD, MPH

doi: 10.1097/ADM.0b013e31829da074
Original Research

Objectives: Substance-related impairment of physicians is a small but serious problem, with significant consequences for patient safety and public health. The purpose of this study was to identify reasons for prescription drug misuse among physicians referred to a physician health program for monitoring because of substance-related impairment, to develop better mechanisms for prevention and intervention.

Methods: A total of 55 physicians (94.5% male) who were being monitored by their State physician health program because of substance-related impairment participated in guided focus group discussions. Participation was anonymous. Discussions were transcribed from 9 separate focus groups, lasting 60 to 90 minutes each. Qualitative analyses were conducted to examine themes.

Results: All participants were diagnosed with substance dependence, and 69.1% of them endorsed a history of misusing prescription drugs. Participants documented the following 5 primary reasons for prescription drug misuse: (1) to manage physical pain, (2) to manage emotional/psychiatric distress, (3) to manage stressful situations, (4) to serve recreational purposes, and (5) to avoid withdrawal symptoms.

Conclusions: Our results emphasize the importance of self-medication as a leading reason for misusing prescription medications, although recreational use was also an important factor. Prevention efforts targeting prescription drug misuse among physicians should be initiated during medical training, with continuing education requirements throughout the physicians’ careers.

From the University of Florida and Professionals Resource Network, Inc (LJM), Gainesville, FL; Mahidol University (SS), Bangkok, Thailand; Numerof & Associates (SMC), St. Louis, MO; and University of Florida (LBC), Gainesville, FL.

Send correspondence and reprint requests to Lisa J. Merlo, PhD, MPE, McKnight Brain Institute, Box 100183, Gainesville, FL 32610. E-mail:

Supported by NIDA R01-DA20791 (PI, Cottler), with additional support provided by the Professionals Resource Network, Inc, an integral arm of the Florida Medical Association. Dr Merlo was supported in part by NIDA training grant T32-DA07313-10 (PI, Cottler).

The authors declare no conflicts of interest.

Received April 12, 2013

Accepted May 25, 2013

© 2013 American Society of Addiction Medicine