Doctors Vulnerable to Prescription Drug Abuse

Prescription drug abuse is a staggering problem in the United States. Some wind up addicted to painkillers they were prescribed following surgery, others use sedatives too often and too long. Young people abuse prescription drugs because they are easy to get and have an aura of safety. Older people can become dependent simply because they have trouble remembering when and how many pills to take. But there is another group of people who have a problem with prescription drug abuse – the doctors who prescribe them.

Research has shown that doctors have problems with drug and alcohol abuse at nearly the same rate as the rest of us, which is somewhere between 10-15 percent over a lifetime. However, when it comes to prescription drugs, physicians abuse at a higher rate than average according to a study done by University of Florida associate professor Lisa Merlo.

Merlo and colleagues assigned 55 doctors with a history of alcohol or drug abuse to focus groups. Each doctor was actively participating in a physician health program (PHP) which provided them with substance abuse treatment, random drug testing and monitoring for up to five years. The physicians were asked how their problem started, how they got their drugs and how abusing prescription drugs made them feel.

Most of the doctors said they did not use prescription drugs recreationally. Instead, the majority reported using them to manage stress. The doctors most often abused prescription painkillers and sedatives. In most cases they had been given a legitimate prescription for medication by another doctor. Some talked about getting narcotics following dental surgery to deal with real pain. However, when their personal or professional life became stressful they turned to drugs in order to cope. This much, at least, looks very much like what happens with others who abuse drugs.

The doctors reported taking more of the drugs than they had been prescribed. Sometimes they took the medication beyond the original time span on the script. What started as a once-in-a-while palliative grew into something bigger. This is a common pattern.

Like others with a prescription drug addiction, the doctors eventually resorted to duplicity in order to get more drugs. Contrary to what many may think, doctors do not have unfettered access to medications. They must have a nationally registered drug number in order to prescribe, and then must have a medically valid reason for prescribing controlled substances. Furthermore, it is illegal for physicians to self-prescribe scheduled drugs. Doctors may self-prescribe non-controlled drugs, but even that is discouraged.

So when doctors develop an addiction to prescription drugs they often must convince a fellow doctor to prescribe them medication. Failing that, doctors have told of stealing drugs from the hospital dispensary and even from their patients. Again, this mirrors the habits of other drug abusers.

Merlo and her team say that doctors are unique in a couple of ways. First, they tend to use stronger drugs – doctors are comfortable with the medications, so they might be less inhibited about abusing heftier prescriptions. Secondly, doctors wait longer to get treatment. This probably has to do with potentially career-crushing repercussions. When doctors do come forward, many PHPs require them to participate in residential treatment.

Lastly, doctors have unique access. While it’s true that their access is not without checks and balances, it is easier for them than for non-medical professionals. And though doctors should not self-prescribe, many of them do.

Medical school training spends very little time preparing doctors to resist the temptations of the trade. Doctors may or may not be more vulnerable to prescription drug abuse, but so far no one disputes their unique situation of unusual access and relaxed use of stronger drugs.

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