As a society, how do you think we should address this problem?

Cultural reform that involves changing our perception of healthcare professionals to consider them people just like anyone else who “make mistakes… and are not immune to substance abuse” (CODA report, 2009). Our society must discard the idea that addiction is a “personal weakness or moral failing” and recognize the reality of substance abuse and addiction which is a disease process presented with physiologic changes just like any other disease rampant in our society today such as diabetes or hypertension (McBeth & Ankel,2006).

Pop culture may be one reason why substance abuse among healthcare professionals is an issue today. Brian Mcbeth, MD and Felix K. Ankel, MD suggest in their article, “Don’t Ask, Don’t Tell: Substance use by resident physicians,” that a “barrier to the diagnosis of the chemically impaired resident is related to the culture of residency,” where “alcohol and even drug use is accepted as a reasonable method of dealing with the stress of residency training (so called self-treatment)” (McBeth & Ankel, 2006) Medical drama television series such as ER and Grey’s Anatomy and popular novels such as Samuel Shem’s House of God contribute to this “culture” that McBeth and Ankel speak of as they show residents and other hospital staff drinking alcohol to deal with the stress of a long shift, cope with a patient trauma that has caused distress, and personal life issues (McBeth & Ankel, 2006). Our society can address this issue by bringing an end to such media that portrays acceptance of substance abuse among healthcare professionals as a way to relieve stress and instead provides examples of intervention and professionals seeking treatment.

Brian D. McBeth, MD and Felix K. Ankel, MD have suggested a “three-pronged approach” to address the issue of substance abuse among healthcare providers (McBeth & Ankel, 2006). The first component to address this problem involves a greater investment in research. The government has attempted to identify high risk groups, and understand the prevalence of substance abuse to best employ diagnosis and treatment resources by “investing in ongoing annual studies of representative populations” (McBeth & Ankel, 2006). McBeth and Ankel suggest that this approach also be used to focus on substance abuse among healthcare professionals. In their article, they state that an “ongoing anonymous annual survey that looks at representative groups of residents across specialties is needed” (McBeth & Ankel, 2006). McBeth and Ankel speak directly to groups of residents, but this approach could be applied to all groups of healthcare professionals. Resources should be directed toward developing ways to study the trends of substance abuse among healthcare providers which would in turn allow for more effective prevention strategies and treatment options.

Delayed recognition and diagnosis of substance abuse among healthcare providers is a huge barrier to timely treatment. The second component of the three-prong approach by McBeth and Ankel addresses this barrier by suggesting improvements in education (McBeth & Ankel, 2006). The Council On Drug Abuse (CODA) report published in May 2009 also addresses the necessity of improvements in education as an important part of prevention, early identification and intervention of substance abuse among providers. The CODA report states that, “medical and nursing school curricula should cover topics pertaining to substance abuse among the profession. As well, hospital and professional organizations should put programs in place to acknowledge the need of education about substance abuse among health-care professionals” (CODA report, 2009). For example, it should be taught that the behavior of a healthcare professional who abuses substances may be different from the behavior evident among non-healthcare providers. Typically, a drug abuser would be frequently absent from work. However, a healthcare provider who is abusing substances might not be frequently absent from work because the workplace is generally where the healthcare provider who abuses substances is getting his drug supply. “A change in their personal relationships and a decrease in community involvement” are typical, early signs of a healthcare provider who abuses substances (CODA report, 2009).

The third component of the three-prong approach involves making clinical treatment for healthcare providers available at every institution. Most large institutions have a 24-hour hotline that can provide counseling services to healthcare professionals in time of crisis. Smaller institutions that do not have this service accessible can contract with larger institutions to make this service and others such as specialists in addiction medicine to aid with intervention and treatment available to healthcare providers (McBeth & Ankel, 2006).

Take a look at the video to see what Rebecca Mason, RN, CNS, CEAP and Dr. Daniel Becker, MD, MPH, MFA have to say: VIDEO http://www.youtube.com/watch?v=l0HnYBPOYRE

Resources:

McBeth, BD, & Ankel, FK. (2006). Dont ask, dont tell: substance use by resident physicians . Journal of Academic Emergency Medicine, 13(8), 893-895.

CODA, Report. "Health Professionals and Substance Use." http://www.drugabuse.ca/. May 2009. Council on Drug Abuse, Web. 15 Nov 2009. <http://drugabuse.ca/newsletter_pdfs_v01_i07/Health_Professionals_and_Substance_Use.pdf>.