Physicians at Very High Risk of Substance Use Disorder

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Physicians with substance use disorder who are actively using drugs can be a huge risk to themselves and their patients, especially with the high level of access to prescription medications that physicians enjoy. Over the last 15 years research has been done that makes it clear that physicians are more likely than the general population to suffer from substance use disorder, with opiate use disorder being of particularly high concern. Certain specialties within the medical field have even higher rates of addiction than other physicians, and these include anesthesiologists and surgeons. I have some ideas of why this would be the case, but research has been done which shows us some of the risk factors that doctors face in their careers. 

I talk often about the practices used at the best drug rehabs in both Florida and Alabama. I work with one of the best drug treatment facilities in the country, Florida Springs Wellness, and Recovery in Panama City, Florida. Our medical director at Florida Springs, Dr. Raymond Pomm, was instrumental in formulating a hypothesis that physicians who use fentanyl and propofol for anesthesia are at risk of being accidentally exposed to aerosolized propofol and fentanyl. That study, from 2005, went as far as testing for and finding small amounts of aerosolized propofol and fentanyl in the air around a patient who has been given those substances for anesthesia. That study goes on to suggest that these low dose exposures to powerful opiates could increase the risk of substance use disorder in later life for those doctors who are exposed. I felt it was important to include some possible factors that are less obvious, as my reasoning, as a layman, for why a doctor would be more likely to suffer from substance use disorder leads to, perhaps, more obvious areas. Doctors have unique access to powerful narcotics, and they often have close friends who are also doctors and have the same access, so that even if one doctor cannot write him or herself a prescription, a friend might be able to do it for him/her. Doctors are just as likely to experience pain and injuries throughout life as the rest of us, but they are probably more likely than others to be workaholics. If they experience a back injury, or any other injury that threatens to interfere with work, simply taking a pill, maybe a pill that a drug rep left as a sample, could seem to be an easier solution than making an appointment to see a specialist and missing time at work. That drug representative portion is an important note because doctors’ offices are bombarded by drug reps with samples of drugs. Those samples are not tracked in the same ways that prescriptions are tracked, so samples of drugs could be a dangerous entry point for physicians into a substance abuse problem. 

There are always the general risks that could be associated with the average lifestyle enjoyed by doctors. Doctors are well paid compared to the general population, meaning the ability to pay for drugs is not a barrier for most doctors. As I mentioned the issue of doctors being workaholics earlier, we should also note that stress from work is a risk factor for developing substance use disorder. Furthermore, substance use disorder is a genetic disease. If the son or daughter of a doctor is more likely to be a doctor, we could also say that person might be more likely to be inheriting the predisposition for substance use disorder, because we know that doctors suffer from SUD more than most people and that was probably also the case in previous generations. 

As I stated previously, I work for one of the best drug rehabs in Florida or anywhere, Florida Springs in Panama City, Florida. We see doctors at our facility, but not as often as we might think based on the research that I have seen. My theory is that because of access to money and because of the intense pressure not to hurt their own medical career, doctors who need professional help for substance use disorder are not getting that help at the rate that they should. I hope that the stigma of this disease can be lifted and that doctors can get the help they need, as it is not their fault that they work in an environment with so much more risk for people with any predisposition for substance use disorder. Doctors must do their best every day to help patients who have been affected by the ongoing opioid epidemic, but we can also see that doctors must also help other doctors with the same issue. If you or a loved one needs support or is looking for treatment options, visit the programs page on this website for more information on the best drug rehab center in Florida, located in the Florida Panhandle region. 

By T.A. Cannon (Contact me at TACannonWriting@gmail.com)