The emotions and stress that physicians carry or the need to stay up during a 24-hour (sometimes longer) shift, can lead them to drink alcohol and/or use drugs. Due to the easy access of high quantities of narcotics, there is an increase in physician narcotic usage and addiction (Juergens, 2019). About 12% of physicians develop a substance abuse disorder throughout their career (Berge, Seppala, & Schipper, 2009).
Part of my job, working as an anesthesia technologist, is to make sure the anesthesiologists are disposing their narcotics appropriately. The hospital where I work at has a strict narcotic wastage policy. They have to log down the amount of narcotics given to the patient and have a nurse witness their wastage of what is left of the medication. Many physicians find this unnecessary as they believe that they have a moral compass, however, these policies are put into place to make sure that all prescription medications are accounted for. It’s surprising how many drugs go missing in a health care setting. As of 2005, fentanyl was the top abused narcotic by anesthesiologists, followed by Sufentanil, Propofol, and ketamine (Bryson & Silverstein, 2008).
Moreover, physician health is very important to think about going into medical school. In the future, you may come across your coworker resident or colleague who is addicted or becomes addicted to some kind of prescription medication. Physicians with substance abuse disorders are not only hurting themselves but, they are also putting the wellbeing of their patients at risk (Juergens, 2019). This does not only pertain to physicians, there are many incidences of nurses and physician assistances who become addicted to narcotics as well. As aspiring healthcare professionals, we need to be aware of the mental toll this career can bring us, and we need to take care of our mental health in order to serve our community.
References
Juergens, J. (2019, October 22). Addiction in Medical Professionals - Addiction Center. Retrieved from https://www.addictioncenter.com/addiction/medical-professionals/.
Berge, K. H., Seppala, M. D., & Schipper, A. M. (2009). Chemical dependency and the physician. Mayo Clinic proceedings, 84(7), 625–631. doi:10.1016/S0025-6196(11)60751-9
Bryson, E. O., & Silverstein, J. H. (2008). Addiction and substance abuse in anesthesiology. Anesthesiology, 109(5), 905–917. doi:10.1097/ALN.0b013e3181895bc1
Your blog post reminded me of an incident that occurred while I was working as a medical scribe in general surgery. The small town I was working in only had two general surgeons, and both of them were constantly overwhelmed with patients. They often worked 70 to 80 hour weeks, and all hospital staff consistently praised them for their quality of work. One of the operating room nurses witnessed a surgeon remove narcotics from storage areas on several occasions, and became suspicious that the surgeon was abusing the narcotic medications. The nurse hesitated to report the surgeon, because this incident could result in termination and the loss of a great surgeon. She convinced herself that the physician was only obtaining the medications for the patient and brushed off the incidents. Luckily, a traveling operating nurse witnessed the surgeon remove narcotics multiples times within several days and reported the surgeon using appropriate channels. After further investigation, the surgeon found to be abusing narcotics and was terminated.
ReplyDeleteThe statistics for drug and alcohol abuse among physicians has been increasing. One study found that 19% of physician engaged in “high risk” alcohol use and an additional 3% engaged in “high risk” drug use (Sørensen et al., 2015). Another study found that 12.9% of male physicians and 21.4% of female physicians have an alcohol abuse disorder (Oreskovich et al., 2015). It is even more concerning that medical professionals do not find this abuse problematic. Sørensen et al. (2015) also found that only 25% of medical professionals engaging in high risk alcohol and drug use thought these behaviors were concerning. However, over 50% of the colleguages of physicians with substance abuse disorder wished to encourage the physician to seek treatment (Sørensen et al., 2015). Unfortunately, substance abuse disorder are compounded by many factors. Many cases of substance abuse have been linked to physician burnout, emotional exhaustion, depersonalization, and low levels of personal accomplishment (Oreskovich et al., 2015; Penderson et al., 2016). Since so many substance abuse cases are linked to mental health, there should be a push for mental health programs for physicians. Mental health programs could help physicians cope with the stress of their occupation and prevent impairment due to substance abuse which can be detrimental to patients as well.
References
Oreskovich, M. R., Shanafelt, T., Dyrbye, L. N., Tan, L., Sotile, W., Satele, D., ... & Boone, S. (2015). The prevalence of substance use disorders in American physicians. The American journal on addictions, 24(1), 30-38. doi: 10.1111/ajad.12173
Pedersen, A. F., Sørensen, J. K., Bruun, N. H., Christensen, B., & Vedsted, P. (2016). Risky alcohol use in Danish physicians: Associated with alexithymia and burnout?. Drug and alcohol dependence, 160, 119-126. doi: 10.1016/j.drugalcdep.2015.12.038
Sørensen, J. K., Pedersen, A. F., Bruun, N. H., Christensen, B., & Vedsted, P. (2015). Alcohol and drug use among Danish physicians. A nationwide cross-sectional study in 2014. Danish medical journal, 62(9), A5132.
Sørensen, J. K., Pedersen, A. F., Vedsted, P., Bruun, N. H., & Christensen, B. (2016). Substance use disorders among Danish physicians: an explorative study of the professional socialization and management of colleagues with substance use disorders. Journal of addiction medicine, 10(4), 248-254.
Kirsten,
ReplyDeleteI found this to be a very interesting topic especially since I was not expecting to learn that narcotics are used by medical professionals. My sense of surprise mainly stems from the notion that medical students and indeed medical practitioners have undergone years of medical training to understand that downsides of addictive drugs and their affects on human physiology. However, the more I reflect on the data 2019 data you site, the more it seems to make sense as to why such highly accomplished and learned individuals may seek an escape via a pharmaceutical launch pad. Physicians are constantly moving from patient to patient, under an immense time crunch, buried in bureaucratic electronic/paper work, and expected to make little to no mistakes. This is in some cases about 60 hours per week. Any misstep could potentially alter patient status. In addition to the immense responsibility, physicians must also care for the person, rather cure/alleviate the symptom. One example of this is, if the best medication/course of treatment is too expensive so the patient then other options must be explored. This in itself is extremely inconvenient with respect to quality of life as well as efficacy.
It is my belief that hospitals should be required to afford assistance to physicians by possibly rearranging the way patients are triaged, hiring more workers, in an effort to alleviate some of the miscellaneous work that physicians are faced with on a daily business. Hospitals must work in conjunction with state and federal government to deliver this change rather than figuring out ways to maximize their profits at the expense of their workers. I hope that this topic gains more traction in the upcoming years so that future professionals such as ourselves are exposed to an improved workplace environment. Meaning more focus on our patients, rather than miscellaneous tasks.