Behind the Numbers: Top-Tier Physicians’ Silent Struggle with Substance Use Disorder
A staggering 10 to 15% of healthcare professionals will struggle with a substance use disorder at some point during their career. Whether a physician, nurse, dentist, or veterinarian – no provider is immune to the disease of addiction. In fact, a USA Today report uncovered that within a given year, more than 100,000 healthcare professionals abuse prescription drugs. Problem drinking is also common among healthcare professionals. One study found primary care physicians were twice as likely to be “at risk drinkers” than the general population.
Like all people, healthcare professionals are affected by genetics, personality, and family of origin issues, as well as environmental factors. However, unlike others, they often carry the guilt and shame of believing, ‘I’m a provider, I’m telling people how to care for themselves and get better, how can this happen to me?’ Even healthcare providers who understand that addiction is a disease with neurological underpinnings somehow feel they have failed by letting this happen.
For these reasons, it can be uniquely challenging to treat this population. In addition to the excessive shame and guilt, these professionals are the best and the brightest. They are used to achieving and exceling in every facet of their lives and accustomed to being in control in delivering health care.
Therefore, the first days or weeks of treatment are an important transitional period for healthcare professionals because they must temporarily let go of their role as the provider and accept that they are now the patient. Being immersed in a community of likeminded peers makes a significant difference, providing support from people struggling with similar issues who might be further along in their recovery and can offer perspective. Whether a patient is a primary care physician, an orthopedic surgeon or a nurse practitioner, they must learn to surrender as they would if they went to the emergency room with chest pain.
Getting people to recognize that they need help is the most important step. Healthcare professionals tend to be self-reliant, thinking they can solve everything themselves. It is important for those suffering in addiction to know that they are not alone and that it is possible to recover, but they will need help to do it. The support of peers, colleagues, and loved ones is tremendously important in both recognizing the need for treatment and achieving long-term recovery.
Disclosure and the pathway to recovery
There can be multiple layers of issues affecting a healthcare professional’s ability to seek treatment, not the least of which is the issue of disclosure and then transitioning back to the professional role following treatment.
We recommend to patients that they consider entering their state’s advocacy program. Such programs are supportive of healthcare professionals and usually done in complete confidence. The programs typically involve toxicology monitoring, individual and group therapy, check-ins regarding worksite monitors, meaning many eyes are on the healthcare provider when they return to work.
Once healthcare professionals begin treatment and recovery, there will be some credentialing and licensure questions that will arise. Various licensure renewal forms carry questions about substance use in different forms. Our goal is to support these individuals through these processes, so they feel safe enough to enter treatment without the fear of jeopardizing their career. Our objective is always recovery and to help professionals make the best decisions for their professional stability. We see that once these individuals are supported by others in the community while sharing their experiences with monitoring programs, they’re motivated and successful.
The encouraging news is that studies show doctors who get treatment and are part of a physician monitoring program have a strong chance of remaining in recovery. In one study carried out with the Pennsylvania Medical Society, 92% of the physicians who have participated in such programs are successful in recovery after 10 years. That’s because of several factors. First, they have been referred to a treatment center that provides adequate treatment from the start. Second, they remain throughout treatment and recovery in a structure that requires participation in adequate recovery activities – including toxicology – and documents those activities carefully. Third, they are introduced to a 12-Step community of physicians and then into the broader 12-Step community that, over the monitoring period, engages them in an active system of support. This system of support is combined with ongoing toxicology that makes them accountable. Fourth, their ability to continue in a healthcare career depends on successful recovery. Those are all factors that weigh very heavily towards this long-term success.
Entering a program like the specialized Healthcare Professionals program at Caron allows professionals to embrace self-compassion and start on a healthy road to recovery without judgement. We’ve seen our healthcare professionals return to practices where patients are very supportive, receptive and caring. In time, they realize that their careers and personal lives have grown beyond their expectations because of their recovery.