Impaired professionals due to prescription drug abuse or misuse is a serious problem. The number of impaired physicians, for example, may be small but the consequences for their patients and public health in general can be significant. A recent1 sought to understand why physicians abuse prescription drugs. The doctors studied were referred to an impaired professionals program because they had been practicing medicine while under the influence of a mood altering substance. Impaired professional programs are frequently used to provide assistance to professional’s with substance abuse problems, often involving prescription drug abuse.
Participants in this impaired professional program were 55 anonymous physicians, the vast majority being male (94.5%) who were required to be monitored by their state licensing board as a result of their substance abuse. They enrolled in a physician health program because they’d been caught practicing medicine while impaired. They all participated in focus group discussions that lasted from 60 to 90 minutes each. These discussions were recorded and transcribed so that they could be analyzed. Frequent themes related to physician substance abuse were uncovered and are as follows:
- Everyone participating was diagnosed with substance dependence
- 100% of those admitting to prescription drug abuse also had a history of alcohol abuse and/or illegal drug abuse.
- 69.1% had a history of abusing prescription medication
- 94% had abused alcohol
- 88% had relied on prescription opiate drugs
- 73% had abused prescription sedatives
- 68% had used marijuana
- 62% had used illegal stimulants
- 58% reported using cocaine
- 47% said they used hallucinogens
- 46% admitted to using prescription stimulants
- 36% said they had used club drugs
- 20% said they had used non-prescription opioids
Opiates and sedatives were the most common types of prescription drug abuse used by the physicians in this study. This was also true in previous studies on physician substance abuse among impaired professionals.
The following reasons for physician prescription drug abuse were found:
- For the management of physical pain
- To cope with emotional or psychological problems
- To alleviate stress
- For recreational use
- To avoid the symptoms of withdrawal
The reasons physicians reported abusing prescription drugs ran the gamut from alleviating severe chronic pain which was caused by trauma or a surgical procedure to trying to “detox” themselves from either alcohol or other drugs. They engaged in prescription drug abuse to relieve stress from their work or personal situations. Some also said they just wanted to get high.
This study showed how prevalent prescription drug abuse and self-medication is among physicians. The study recommendations included prevention by initiating coursework in medical school and requiring continuing education on the topic of prescription drug abuse and impaired professional programs. Doctors need to be encouraged and supported in seeking other means of coping with their problems from a qualified health care provider, whether it is pain control, psychiatric or emotional issues or stressors related to their work. They should not minimize the danger involved in treating themselves. According to research done previously, 78% of physicians who were treated in an impaired physicians program succeeded in remaining free of drugs or alcohol abuse, with no relapse, after 5 years.
Because our substance abuse treatment center relies on evidence based practices, our Substance Abuse Intensive Outpatient Program shares many common methods with other successful rehab programs in the treatment of prescription drug abuse. The foundations of our dual diagnosis treatment program for substance abuse also rely on the principles of harm reduction, motivational interviewing, stages of change and cognitive behavioral therapy to promote recovery from alcohol abuse and drug treatment, including prescription drug abuse. In fact, our Intensive Outpatient Program in Memphis, TN that has been proven to be effective in the alcohol abuse treatment and drug abuse treatment in peer reviewed treatment outcome studies. Our treatment center provides services to those who need more treatment than one hour a week, but less than 24 hour care, by providing three hours of treatment per day, three to five days per week, in an intensive outpatient setting. If you or a loved one is an impaired professional showing signs of alcohol abuse or needs drug treatment rehab, they should be assessed by a trained mental health professional who can help design a substance abuse treatment plan that can result in recovery. Treatment for substance abuse can be highly successful. Call us at 901-682-6136 to schedule an appointment.
1.Merlo, Lisa J. PhD, MPE; Singhakant, Supachoke MD; Cummings, Simone M. PhD, MHA; Cottler, Linda B. PhD, MPH. Reasons for Misuse of Prescription Medication Among Physicians Undergoing Monitoring by a Physician Health Program. J Addict Med. 2013 Sep-Oct;7(5):349-53.
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