Social Drinking and Doctors: When It Becomes a Problem

Relaxing and unwinding from a stressful practice may involve having a drink or two, especially in the company of others, but when does social drinking by physicians cross the line from being sociable to becoming a problem?

According to the National Institutes on Alcohol Abuse and Alcoholism (NIAAA), there is a threshold for unhealthy drinking – 14 alcoholic drinks per week for a man and more than 7 drinks per week for a woman. This is for men who are not yet senior citizens, while for women, it is for those who are not pregnant or trying to conceive a child.

Statistically, according to actuarial tables, unhealthy drinking is that which makes it increasingly likely that the individual will develop either an injury or an illness brought about by alcohol consumption. The fact is that abusing alcohol sneaks up on a person and may lead to impairment over time.

When drinking goes beyond unhealthy – that is, a pattern of consistent alcoholic consumption, binge drinking, and consequences associated with drinking and medical or other issues – it should be cause for concern by the physician engaging in the drinking and others who observe such a pattern of behavior.

Self-Monitoring Is A Start

A little introspection may help stave off a gradual decline due to abusing alcohol. Yet it may be hard for a doctor to observe what’s going on when he’s actually doing it. In other words, having several drinks at a cocktail party or gathering of friends and/or colleagues doesn’t seem dangerous in and of itself. It’s hard to believe that you can’t control what you consume or know when to quit.

Yet that’s exactly what can happen when alcohol begins to take a position of centrality in a doctor’s life. Needing to have that drink to overcome stress, forget about problems and wipe away thoughts about overcrowded schedules, massive paperwork, burgeoning healthcare rules and regulations, not to mention declining payments for services is a sure sign of dependence.

Drinking instead of pursuing other healthier activities is another warning sign that physicians should pay attention to.

If drinking is negatively affecting your general medical or mental health status, it’s time to either seek professional help or actively take steps to curtail drinking.

Consider that you’d counsel your own patients against excessive drinking. Why would you not take your own advice?  Exceeding the alcoholic guidelines set by the NIAAA means you are taking a risk that you shouldn’t. You could be endangering the lives of others with your harmful drinking patterns.

When Social Drinking Becomes Addiction

True alcohol addiction affects some 10 percent of doctors, according to surveys. While physicians who are aware of their colleagues’ alcoholic consumption are supposed to approach them about it, according to medical ethics, sometimes doctors tend to look the other way, not wanting to make waves or intrude on a fellow physician’s personal life.

Some state statutes require physicians to report colleagues whose behavior with respect to drinking is putting patients at risk. These “impaired physicians” are supposed to be reported to an entity that can appropriately intervene, such as a hospital credentials committee or a state licensure board.

Physician health programs (PHPs), on the other hand, are preferable to reporting a physician. They’re non-disciplinary and offer the kind of treatment and support that the impaired physicians need. All but four states (California, Georgia, Nebraska and Wisconsin) have them. In non-PHP states, doctors need to find the motivation to seek out treatment on their own.

PHPs are also obligated to notify state licensure boards when they determine that a physician has an active health problem (alcohol addiction) that could pose a safety risk to patients if they were to see them.

Getting Help for Substance Abuse, Depression and Burnout

Another benefit of PHPs – and another reason why physicians are continuing to seek help – is that they offer valuable treatment for doctors with depression, any kind of substance abuse and those suffering from burnout.

Some of the best states PHPs are reporting that 50 percent of the physicians entering treatment are self-referrals.

Is your social drinking veering into dangerous territory? A PHP may be the right place to start getting help to overcome this unhealthy behavior. A PHP creates structure and accountability, offers support, long-term monitoring and management, advocacy and other assistance to impaired physicians and other health care professionals.

Approximately 75 to 85 percent of recovering doctors are able to return to work and remain abstinent. Only a very small percentage of physicians will not be able to return to medical practice.

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