Second of two parts – Read part one here. For Cathy Johnson-Delaney, the drug of choice was sevoflurane. Twice in June 2013, employees at her Kirkland, Washington, animal clinic witnessed Johnson-Delaney, a veterinarian of more than 30 years, inhaling the sweet-smelling anesthetic through a mask in the operating room. When confronted by her staff, Johnson-Delaney swore she wouldn’t do it again, but, according to the records of the Veterinary Board of Governors in the state of Washington, it was the last straw. She was already on probation for abusing an anesthetic and diverting Xanax from the clinic for personal use two years earlier. Plus, the occurrences in June were not isolated events. Another employee had heard the unique sound from the machine that administers sevoflurane in the early morning hours on a dozen occasions between April and June that same year, and surgical staff also reportedly witnessed Johnson-Delaney inhaling the drug while performing surgical procedures. Turned in to the licensing board, Johnson-Delaney surrendered her license in January 2014, bringing a sad end to her veterinary career. She told the board she no longer wished to practice. The record of an administrative board hearing is cold and factual, providing a chronology of events but little discussion of motive or exploration as to how a successful and capable veterinarian could lose her career to what was apparently an inescapable need to self-medicate. And there is no postscript to Johnson-Delaney’s story. Hopefully, away from the clinic, there was a happy ending. What is known, however, is that Johnson-Delaney is not alone.
The Unlikely Face of Addiction
The American Veterinary Medical Association’s Committee on Wellness estimates that 11% to 13% of veterinarians are substance abusers, a rate slightly higher than the National Institute on Drug Abuse’s estimates for all medical professionals. Veterinarians are not unlike many other people who turn to substances to cope with life’s ills. What does set them apart, however, is the dangerous combination of unique stressors that set them up for serious psychiatric disorders and much easier access to medications that are potentially addicting. Handling ethical dilemmas is the worst stressor for veterinarians, according to psychotherapist and compassion fatigue specialist Elizabeth Strand, PhD, associate clinical professor and founding director of veterinary social work at the University of Tennessee. The moral stress of “convenience euthanasia,” in which a vet is asked to kill a healthy animal to indulge the owner, is absorbed by the veterinarian and can increase the likelihood a vet will turn to alcohol or drugs to feel better. “Moral stress affects the mind and the body,” Strand said. “It’s very difficult to process and one might turn to substances to numb it out. There’s a constellation of causes that could trigger substance use in veterinarians, including moral stress, but also working long hours, genetic predisposition and family upbringing. The issue is something we’re just now starting to talk openly about with veterinarians.”
Stigma Impedes Treatment
The American Veterinary Medical Association recommends that veterinarians impaired by alcohol or other substances seek help from qualified organizations or individuals. But that’s not enough to get many into treatment. “Veterinarians in need of assistance fear losing their license and the stigma attached to suffering from an addiction or mental issue,” Jeff Hall, DVM, told Veterinary Practice News in 2008. Hall, a self-described recovering addict who formerly chaired the American Veterinary Medical Association Wellness Committee, died in July but not before helping to shine a light on the problem. Hall, who said he once improperly sutured a Doberman puppy’s Achilles tendon when he was drunk, called drug abuse a “shame-based disease,” adding that addicts must first come forward “to get their act together.” That stigma, guilt and shame delays many drug abusers from reaching out for help, and that worries Strand. “Reducing the stigma and making getting help easy is important in turning things around [for addicted veterinarians],” Strand said. “But vets are a resilient bunch who care about one another. They’re going to do things to help each other.”
Helping Addicted Veterinarians Recover
Untreated substance abuse by veterinarians puts careers at risk. Assistance in achieving recovery can be instrumental in preserving a veterinarian’s license to practice and in ensuring patient safety. Treatment typically begins with detox and moves through stabilization to advanced recovery skills. Dr. Greg Skipper, MD, director of Professionals Treatment at Promises Treatment Centers and a former medical director of the Alabama Physician Health Program and the Alabama Veterinary Professional Wellness Program, said that veterinarians sign a contract when they leave treatment that holds them accountable for their recovery process. Strand says professionals treatment programs are “right on the money” when it comes to caring for addicted veterinarians. “They’re a great thing to do,” Strand said. “As long as they’re using evidence-based treatment, what we know works, I think it’s great.” Strand said veterinarians who are using substances to cope need to make “whole lifestyle changes” to find healthy ways to relieve stress. “They need to sleep, they need good, healthy social relationships, they need to have time for hobbies outside of being a vet. If they have a balanced life like that, many of the problems of anxiety and depression can be mitigated.” By Laura Nott Sources: Prevalence of Risk Factors for Suicide Among Veterinarians — United States, 2014 Substance Abuse: A Culture of Denial