Time to Get Serious About Physician Drug Abuse

Time to Get Serious About Physician Drug AbuseIt’s becoming more and more common to read about a nurse, physician, anesthesiologist or other medical health professional overdosing and dying (or nearly so) from prescription drug abuse, specifically opioid pain relievers. The stories are disquieting and tragic, all the more so because these overdoses and deaths can be prevented.

According to a USA Today study of government data, more than 100,000 doctors, nurses, medical technicians and other health professionals struggle with drug abuse or addiction. Various studies put the number much higher. Is it time to get serious about physician drug abuse (and, by extension, others in the medical profession) and do something about it?

Look Around Our Own Backyard

When reading accounts of medical professionals overdosing and dying from various prescription drugs, often mention is made by those who knew the victim that they had “no idea” such behavior was going on. These weren’t stumble-down individuals, nor were they necessarily depressed. From outward appearances, everything was just fine.

Doesn’t this make us wonder what may be happening in our own backyard, in our practice, at the hospitals where we have privileges, even among our colleagues and friends?

While opiate prescription drug abuse is certainly not unique to the medical profession, what is unique is the easy access to these intensely and rapidly addicting drugs, such as fentanyl and mizadolam. Not only are the drugs convenient to obtain, so are the clean needles and syringes with which to inject them.

Calls For Action Increasing

Patient groups and law enforcement are urging states to require medical institutions to alert authorities when a caregiver is thought to be stealing or abusing drugs. Many of these groups, including California-based Consumer Watchdog Campaign USA, are pushing for mandatory random drug testing.

A ballot initiative in California called the Troy and Alana Pack Patient Safety Act, or Pack Act, if it makes it on the November ballot, will be under the heading “Drug and Alcohol Testing of Doctors/Medical Negligence Lawsuits.”

This initiative has three components: to mandate drug testing for doctors to prevent physician substance abuse, require physicians to use a state prescription drug database to catch drug addicts consulting multiple doctors, and eliminate the 38-year-old malpractice cap in California, currently at $250,000 for children and other non-wage earners.

Not everyone is supportive of the ballot initiative. The California Medical Association opposes it. The nonpartisan Legislative Analysts’ office said that implementation of the bill could result in higher taxes and insurance premiums and increase California’s health costs by nearly $10 billion per year. If enacted, California will be the first state to require random physician drug testing.

Disciplinary action should also be stepped up, say advocates for reform. In the USA Today review of the National Practitioner Data Bank public file, from 2010 to 2013, only about 750 physicians in the U.S. lost hospital privileges or had licenses revoked for being unable to practice safely due to drug or alcohol abuse.

In California, between 2008 and 2013, 104 California physicians were disciplined for DUIs and an additional 149 for abuse of alcohol or drugs. Twenty-seven were discovered to be under the influence at work.

But others looking at ways to halt this escalation in physician drug abuse, many who may agree with all of the recommendations for prevention and curbing prescription drug abuse by the medical profession, also agree that it’s time to educate practitioners about preventing addiction and spotting potential professional impairment. Whether it’s a close friend, colleague or other staff or practice employee, signs of addiction can generally, but not always, be detected.

Addiction Treatment Works

Professional addiction treatment programs and state physician health programs (PHPs) do work. Various studies report excellent outcomes for addicted physicians and anesthesiologists who are monitored by PHPs. If we suspect or know of a colleague or staff member who is abusing prescription drugs, we should be motivated to encourage them to get professional help. This may include residential treatment or intensive outpatient treatment, followed by long-term support and regular counseling, attendance at 12-Step meetings, and monitoring that includes random drug testing.

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