When physicians face addiction

I strongly recommend that any medical student spend time doing psychiatric consults in the hospital. I had so many cases of cognitive deficits masquerading as mood disorders; requests to review psychiatric meds; investigating the cause of a patient’s delirium, that I felt much more confident with all my other patients that year.

But there was one patient who unnerved me. Why? She was a medical student at my school.

She had been admitted for possible suicide attempt. Her friends called the police when they suspected something was wrong, which led to her being admitted. She was under a lot of external stress and had a history of alcoholism and depression.

I may sound naive when I say that I never expected to find one of my colleagues in this situation. To be directly reminded that my colleagues, too, abuse substances. All I can think is that she was lucky she had friends who came to check on her. You can never understand the importance of friends and loved ones nearby until something like this happens.

Our team’s social worker described her as being at a “vulnerable intersection” for substance abuse:  her personal history + high stress + personality. Vulnerable, I repeated to myself that day. It sounded funny on my tongue.

A review called the “Impaired Healthcare Professional” revealed the should-have-been obvious fact that rates of addiction in doctors mirror that of the general population.  Most doctors who abuse substances do so before high school, and the same risk factors apply: family history of substance abuse, impulsive personality, and external stresses. The difference is that we, as healthcare workers, have greater access to said substances. Certain subspecialties are at greater risk than others, obviously (read: anesthesia). There’s also a strong denial response in doctors and reluctance to turn in impaired colleagues, given the stigma on substance abuse within the world of medicine.

Substance abuse is like a “dirty little secret” that until we put it out in the open, cannot be fairly and adequately treated.

Have you or someone you know who is a healthcare professional struggled with substance abuse? What strategies were used to treat the condition, and what could have gone better?

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About the friendly intern

Ask a question: The Friendly Intern My personal blog: Pathos and Pathology
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