11 March 2017

Doctors Are Human Too: Addiction & the Medical Profession

Sometimes, it is the people that really should know the dangers of drugs and alcohol better than anyone who get addicted. That is the case with the medical profession, with 1 in 6 doctors in the UK facing drug or alcohol addiction.

While addiction amongst medical professionals is a known and well researched fact in the US, in the UK this issue was brought into the limelight last year when around 80 medical staff in Scotland were temporarily banned for drug or alcohol addiction, with 20 being fired and a further 54 facing disciplinary action.

While this punitive approach to addiction is clearly wrong footed (and again – the NHS really should know better), it was the largest action the NHS had taken to tackle addiction in hospitals, and even then it was solely at a regional level. It is said that as many as 15000 doctors have struggled with addiction at one point, with little to no figures available for nurses.

The repercussions for the British public are enormous. Drug and alcohol abuse causes doctors to be “impaired” in conducting their duties. The US has experienced horrific examples of this; in 2013, one doctor was sentenced to 39 years in prison for passing on Hepatitis C to 45 patients, after stealing and using syringes filled with fentanyl, refilling them with saline and putting them back for use by patients.

The question is why does this happen in a profession placed under the auspices of self-control and the Hypocratic oath?

Stress and Access

While there are causes typical to any addiction cases, irrespective of the professional environment, there are factors that healthcare professionals are exposed to more than other; stress being one of them. Long hours, extended work schedules, anxiety caused by patient care can accentuate the stress a job where somebody’s life is often at stake.

Recent statistics suggest that 80 percent of doctors consider early retirement citing stress as a reason with 1 in 3 junior doctors feeling affected by stress. The latter figure is particularly interesting when considering that a third of male junior doctors and a fifth of female junior doctors confessed to drug and alcohol abuse to cope with the pressure.

As a result, medical staff often choose to self-medicate their problems with drugs and alcohol.

But while stress may well be a trigger, the access to addictive substances is what seems to facilitate addiction for doctors. Over the past years, stories of medical professionals using hospital supplies prescribe themselves a fix have made their way into the mainstream press. This was the case of GP Emily Heinzman, who developed an addiction to codeine and prescribed herself around 4000 tablets, eventually being expelled from the General Medical Council. It’s also the case of seasoned Liverpool based cardiologist John Royle, who was sentenced to four months in jail and fined around 6000 GBP for prescribing himself Tramadol using the names of colleagues and next of kin.

The mass sanction of NHS staff in Scotland that happened last year revealed that these were more than public scandals; they were case studies of a much bigger problem.

How to Fix It

Many advocate harsher penalties and closer monitoring of the medical supplies. US physician Dr. Stephen Lloyd, himself in recovery, is a strong advocate for on the job drug and alcohol testing, motivating that the medical system in general lacks “the culture or ability to self-police. Nurses report to doctors. Other doctors see themselves as colleagues. There is incredible professional pressure not to snitch.”

But perhaps there is something else to be done apart from policing. Many suggest that peer support in dealing with stress and addiction is probably more important. One organisation that offers such a support is the Sick Doctors Trust, set up by doctors in recovery themselves to help doctors acknowledge and fight their addiction.

Dr Michael Wilks, chairman for the organisation says that one of the biggest challenges is dealing with the strong sense of denial medical professionals have regarding their addiction. He explained in the Daily Mail that: “to ask for help, you have to climb down off your pedestal and admit you have a problem. Doctors don’t want to reach out for that help – because they don’t understand that a real alcoholic cannot help themselves.”

Dealing with stress and mental health in general may be the key to alleviating the impact of addiction in hospitals and clinics. In 2010, it was discovered that out of the 184 patients admitted into the NHS’ first clinic dedicated to treating addicted healthcare professionals, nearly two thirds of those were experiencing mental health issues as well.

Though there is still a lot of research that needs to be done, we can see that the healthcare sector has an addiction problem. It is essential to understand that addiction is an illness that anyone can suffer from, regardless of class, race, profession or gender. Only then can we truly focus on treating the disease.

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