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Doctors Abuse Drugs, Too

Stricter controls and education don't seem to ease problem, study finds

FRIDAY, Sept. 27, 2002 (HealthDayNews) -- Even doctors aren't immune to drug addiction.

Despite increasing education and tighter regulation of narcotics, the rate of physician addiction has remained steady for the past 30 years, says a new study in the October issue of Anesthesia and Analgesia.

"We discovered that the incidence of drug abuse is around one [percent] to one and half percent among anesthesiologists," says study author Dr. John Booth, an anesthesiologist at Duke University Medical Center. Booth notes that figure doesn't include alcohol abuse.

About 3.5 million Americans are dependent on illicit drugs, according to the National Institute on Drug Abuse. That's around 1.25 percent of the U.S. population. Another 14.8 million report using drugs at least once a month.

The researchers sent an anonymous survey to more than 100 academic medical centers; the chairs of 123 anesthesiology programs responded. They reported that about 1 percent of their faculty members had a substance abuse problem, while 1.6 percent of the anesthesiology residents were addicted to drugs.

Fentanyl, a strong narcotic, was the most commonly abused drug. Like similar medications, a tolerance is built up over time to the drug, and more and more is needed to achieve the same effect.

That may explain why overdose was one of the most common ways a substance abuse problem was discovered. Booth says almost 20 percent of those caught were discovered by an overdose that caused death or a near-death event. Another way physician drug abuse was uncovered was through tracking of medication use among doctors.

Almost two thirds of the academic centers reported adding new methods of tracking narcotics or new controls to the dispensing of these medications. Nearly 50 percent said they had increased substance abuse education programs. Less than 10 percent, however, currently use random drug testing, though 60 percent think it's a good idea.

Booth says what was particularly discouraging about this study was that prevention education and tighter controls on narcotics dispensing seemed to have little effect on the rate of addiction.

One bright spot in the research was that it appeared the physicians who were abusing drugs were doing it on their own time, and not while they were in the operating room. There were no problems with patient care resulting from drug addiction, according to the study.

"Physicians are harming themselves and their families more than others," Booth says.

One thing the study makes clear, Booth says, is that a different approach is needed to address the problem. He says a national database to track the true extent of the problem would be very helpful, as would a more aggressive form of substance abuse education.

Michael Nuccitelli, executive director of SLS Health, a provider of drug and alcohol rehabilitation in New York, wasn't surprised by the findings.

"Drug addiction is a pervasive disorder that isn't discretionary for race, gender, or profession," Nuccitelli says.

He says the study's findings don't necessarily mean education doesn't work, just that the methodology of the education programs may need to be changed, or physicians may need increased time in education. Also, he adds, the best treatment programs for physicians with a substance abuse problem are ones geared specifically toward professionals.

What To Do

To learn about treating drug addiction, go to the National Institute on Drug Abuse or the American Academy of Family Physicians.

SOURCES: John Booth, M.D., anesthesiologist, Duke University Medical Center, Durham, N.C.; Michael Nuccitelli, Ph.D., executive director, SLS Health, Brewster, N.Y.; October 2002 Anesthesia and Analgesia
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