The Prevalence and Dangers of Substance Abuse in Healthcare Professionals

An estimated 10% to 15% of healthcare practitioners will suffer from addiction in their lifetime.¹ That may not seem like a very large number to some, but it is substantial when doctors fear punishment for seeking treatment. Although lawmakers and officials are beginning to recognize addiction as a disease and are treating it as such, physicians are still feeling stigmatized. Some would argue that doctors need to be held to a higher standard because they have people’s lives in their hands. While we can’t disregard the danger of injuring or killing a patient when a doctor is impaired, we also can’t ignore the lack of support and awareness of substance abuse in healthcare professionals.

The Dangers of Addiction in Healthcare Professionals

Because of their access to powerful pharmaceuticals and high-stress work conditions, healthcare professionals, such as doctors, nurses, and pharmacists, are not immune to the risk of addiction.

Impaired judgment and performance among healthcare professionals are one of the main issues with substance abuse. It can impair a healthcare professional’s capacity to make wise choices, stay focused, and offer patients safe and effective care. When medical personnel use drugs or alcohol, it can lead to medication errors, incorrect diagnoses, and poor patient management. Serious consequences, such as patient injury, disability, or even death, can also result from these errors.

Addiction can result in misconduct and unethical behavior in the workplace. To maintain their addiction, healthcare workers with drug abuse issues may commit fraud, such as stealing medications or fabricating documents. Patient safety is at risk, and the healthcare system as a whole loses credibility and trust as a result. Additionally, addiction can harm the mental and physical health of healthcare professionals, increasing their risk of burnout, mental health issues, and suicide.

It is also worth considering that when instances of addiction among healthcare personnel are revealed, the reputation of the entire healthcare industry may be damaged. In addition to raising questions about the safety and caliber of care being delivered, it erodes public confidence in the healthcare system. Patients may lose faith in seeking necessary medical care if they begin to doubt the competence and dependability of their healthcare professionals.

Moreover, a culture of complacency and enablement can develop among medical staff members who are addicted. Whether they are ignorant of the issue or want to preserve the reputation of the employee or the company, coworkers and superiors may ignore warning indications of substance misuse. Because there was no intervention, the addiction persisted and got worse, which increased the risk for both the healthcare provider and their patients.

Physician Substance Abuse by Specialty 

Due to different stressors and access to drugs, the specialty of the physician often has an impact on the substances they use. Below are different types of substance abuse in healthcare professionals according to their specialty.   

Anesthesiologists

The vast majority of anesthesiologists with substance use disorders are addicted to potent opioids that are administered intravenously, such as morphine, fentanyl, and sufentanil. Studies have shown that over 40% of anesthesiologists were enrolled in treatment programs for intravenous (IV) drug use compared to only 10% for alcohol use. These drugs are taken directly from the workplace, often from individual patients.

Factors such as proximity to highly addictive drugs in the operating room, ease of diverting drugs from patients, and a stressful work environment are all contributors to drug abuse among anesthesiologists. There’s also evidence that second-hand exposure to aerosolized intravenous anesthetics at work can sensitize the reward pathways in the brain, making it more likely that anesthesiologists, as well as surgeons, will abuse opioids.

Surgeons

Surgeons have the overall lowest rates of substance abuse compared to other medical professionals, except for alcohol and tobacco use. One study on alcohol use among surgeons in the U.S. found relatively high rates of alcohol abuse and dependence. The highest rates were found among women, with 25.6% of female surgeons having alcohol abuse problems compared to 13.9% of male surgeons.

Surgeons may turn to alcohol because their jobs are one of the most stressful occupations out there, as they’re responsible for operating on people in life-and-death situations every day. Routine surgeries can present unforeseen complications, and even minor mistakes can have devastating outcomes. Therefore, alcohol is often used as a coping tool for dealing with the stress of this demanding position.

Psychiatrists

Psychiatrists are more likely to abuse benzodiazepines than any other substance, according to research. Research has also shown that psychiatrists are especially prone to stress, burnout, and suicide. Contributing factors to addiction in psychiatrists include:

• Administrative problems
• Events leading to post-traumatic stress (such as patient suicidal attempts or suicide)
• Intense responsibility
• Lack of control
• Lack of positive feedback
• Long work hours
• Low levels of job satisfaction
• Constant exposure to patient trauma
• Resource deficits
• Staff conflicts
• Job unpredictability

Emergency Medicine Physicians (EMPs)

Although emergency medicine physicians only make up 3% of all physicians, they account for 7% to 18% of physicians who receive drug or alcohol addiction treatment. A recent study found that emergency medicine physicians treated by a Physician Health Program showed that nearly half were treated for alcoholism, 38% for opioid abuse, and almost 10% for stimulant abuse.  

Emergency medicine physicians constantly have to deal with demanding and unpredictable situations. Unsurprisingly, any position involved with emergency medicine can be stressful and demanding. These doctors experience burnout rates of 60%, the highest among all physician specialists.

Link Between Doctors and Substance Abuse 

There are various aspects of being a healthcare professional that make them more likely than other professionals to turn to drugs and alcohol. A common reason that medical professionals may be tempted to abuse drugs like oxycodone and fentanyl is due to having easy access to them at work. There’s also the matter of coping with the stress of their positions, which is why many healthcare professionals abuse drugs and alcohol.

These individuals work exhausting hours and have to make spur-of-the-moment decisions regarding their patients’ health and well-being. Complications and devastating outcomes can also have a significant impact on their emotions.

Signs of Addiction in Medical Professionals  

Recognizing substance abuse in healthcare professionals can be difficult because many are considered to be high-functioning addicts. These are individuals who can function normally and carry out their day-to-day tasks despite their drug or alcohol problems.

Common signs of addiction in medical professionals include: 

• An unusually friendly relationship with doctors that prescribe medications
• Anxiety about working overtime or extra shifts
• Extreme financial, relationship, or family stress
• Falling asleep on the job or in-between shifts
• Frequent bathroom breaks or unexplained absences
• Glassy eyes or small pupils
• Incomplete charting or repeated errors in paperwork
• Preferring night shifts, where there is less supervision and more access to medication
• Slurred speech and disorientated behavior
• Smelling of alcohol or excessively using breath mints or mouthwash
• Volunteering often to administer narcotics to patients

Not only can substance abuse among medical professionals damage their lives, but it also places all their patients at risk. For these reasons, those battling addiction need to get professional care, even if they are usually professionals. Our Massachusetts rehab offers medically monitored detox and addiction treatment for all kinds of substances, including alcohol and narcotics, that can help.

Stigma and Addiction Treatment for Physicians

More will argue that fear is created by a lack of knowing their options. Doctors simply have no awareness of treatment resources available to them for their drug and alcohol problems. Some professionals have said the Medical Boards in each state were created for such issues.

What they fail to realize is this. When a doctor enters a PHP (Physician Health Program), they are instructed to sign a consent form with the medical board if they want to keep their license. This consent form not only implies their intent to stay sober but also stays on their record for 5 years. Although the form’s intention is good, it’s almost always perceived negatively by hiring professionals.

The stigma of addiction, which is frequently perceived as a moral character issue and not a disease, is still alive and well in some professional fields. The problem lies in the limited amount of training and education on how to treat addiction. Although medical schools are beginning to recognize the importance of this issue, it may take an entire generation to change the perception of addiction as a disease and not a choice.

It seems apparent that when a doctor is an addict, they are stuck between a rock and a hard place. On the one hand, they are at risk of hurting not only themselves but others, and on the other, they worry about facing harsh measures and losing it all. No addict should ever fear seeking treatment. It is already difficult to ask for help. We do not need to make it harder for physicians.

Addiction Treatment for Physicians at Clearbrook 

For over 4 decades, Clearbrook Treatment Centers has helped a large variety of individuals, some of those being healthcare professionals. Our programs for Massachusetts substance abuse treatment are some of the best out there, providing expert support to people from all walks of life. If you work in the healthcare field and have a problem with drugs and alcohol, we could help. We will treat you with dignity and respect and give you the best quality care for your addiction.

For more information about our Massachusetts inpatient drug rehab, call Clearbrook today at 570-536-9621 or send us your contact information, and one of our admissions specialists will reach out to you right away.

Sources:

1. NIH – Impaired healthcare professional 
2. NIH – Anesthesiologists with substance use disorders: a 5-year outcome study from 16 state physician health programs 
3. NIH – Second-hand and third-hand drug exposures in the operating room: a factor in anesthesiologists’ dependency on fentanyl 
4. NIH – Physician substance use by medical specialty 
5. NIH – Prevalence of alcohol use disorders among American surgeons 
6. NIH – Burnout and satisfaction with work-life balance among U.S. physicians relative to the general U.S. population 

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Detoxing From Drugs While Pregnant: How We Can Help