Professionals Treatment Program
By Matthew Goldenberg, D.O.
Are you feeling stressed on the job? Here is some reassuring news: Stress is not all bad. In fact, research indicates that occasional episodes of stress can actually act as a performance enhancer, boosting focus and alertness.
By Greg Skipper, MD
A friend of mine went to play golf in Scotland, and while there he went to a pub to get a sandwich. The pub owner asked why he was in Scotland and my friend responded, “To play golf.” The owner retorted, “Laddie, you are in the right place.” The bartender then offered my friend a beer and he responded, “I don’t drink,” and the bartender then replied, “Laddie, you are in the wrong place.”
By Matthew Goldenberg, D.O., and Greg Skipper, M.D.
Doctors with substance use disorders need help finding their way back to health and to the safe practice of their profession. And how that help is given matters.
Kristin Waite-Labott vividly remembers the first time she took the opioid painkiller fentanyl. “There’s getting high and there’s getting lost, and I just feel like I got lost once I took that.”
A little bit of stress every now and then can be good for you. It keeps the brain alert and fortifies the immune system. Too much stress, on the other hand, can be a killer. A shocking new study from Stanford University and the Harvard Business School finds that stress on the job can damage one’s health just as much as exposure to secondhand smoke.
The idea of doctors as drug addicts is troubling. To think that your doctor could be high or suffering symptoms of withdrawal while treating you is terrifying. The unsettling truth is that doctors abuse drugs and become addicts at greater rates than the general population. There are many reasons for this, including stress and access to drugs, but there are also serious consequences. Thankfully there are physician health programs for addiction that can get doctors sober and back on track.
Imagine you are a doctor. You’re responsible for the health, safety and sometimes the lives of your patients. A wrong decision or a small mistake could be devastating. You work long hours and carry debt from years of medical school. The stress of being a physician can be overwhelming for some individuals, and while most cope in healthful ways, others turn to substance abuse. Doctors face the fear of not being able to practice anymore, which prevents many from self-reporting a problem with drugs or alcohol. Thanks to physician health programs or PHPs, there is help for addicted medical doctors and self-reporting is more realistic.
It may seem counterintuitive, but it’s true: People earning more than $75,000 per year drink more alcohol than any other economic group. About 81 percent of these high earners consume alcohol on at least a semi-regular basis, and while the majority of them drink in moderation, a sizeable minority will eventually fall victim to the disease of addiction.
It’s easy to tell that you’re an alcoholic when drinking causes you to become unable to hold a job or keep a job, or when it causes you to have major health problems or legal problems. It’s not quite as easy to acknowledge that you have a problem when you are very successful in your career, particularly when you make six figures.
An alcoholic who is able to be successful in his or her career or family life in spite of drinking too much is known as a functional alcoholic or a high-functioning alcoholic. This type of person appears so productive and responsible that the people in his or her life probably overlook the drinking problem.
Twenty percent of alcoholics could be labeled high-functioning alcoholics, according to a recent article on alcoholism. What exactly is a high-functioning alcoholic? What separates this 20 percent of drinkers from the rest of the alcoholic demographic? Can an alcoholic ever really be classified as high-functioning?
The high-functioning alcoholic is the alcoholic who doesn’t look like one. These men and women aren’t bums. They aren’t panhandling for money to get their daily fix or locked up in their darkened dens drinking the day away. They’re clean cut, dressed in suits, sitting in corner offices and generally filling the office buildings of our country. They drive sporty cars, live in nice houses, have spouses and children and hold positions of esteem within their companies and communities.
When you come across the term ‘drug abuser,’ chances are that you immediately think of people who use drugs as a matter of circumstance. As recently as 2008, epidemiological studies have shown that the rate of drug abuse is higher among certain groups, which includes people with lower socioeconomic status. Other risk factors in the United States include being male, being Native American, living on the West Coast, and being unmarried, widowed, or divorced. However, these correlations aren’t as strong as they have been in previous years, and people who abuse drugs more frequently come from backgrounds that aren’t normally considered at risk. In fact, a stronger risk factor for drug abuse is a high level of everyday stress, which is becoming more prominent in the lives of people that society considers successful professionals. The type of drug abuse is generally somewhat different in this demographic, with alcohol, marijuana and prescription drugs being the drugs of choice.
A new European study shows that well-educated career women drink more than other women both in terms of frequency and quantity. British researchers examined female drinking habits in Denmark and the United Kingdom where populations are characterized by heavy alcohol consumption. Their findings reveal that even though fewer young women in Great Britain and Denmark are drinking excessively at pubs and restaurants, the rates of upper-class women who drink at home and into later life have risen. Equally worrisome was the finding that the problem over-drinking appeared to climb alongside the rise in household income.
If someone were told to close his eyes and visualize what a stereotypical alcoholic or drug user looks like, odds are that he won’t imagine his highly-respectable neighbor, his loving mother, or his doctor. But, researchers and physicians caution that even those individuals that seem to be living the ideal life may have a hidden problem. Although hidden, their addiction can be very dangerous to them.
Recent reports have shown that addicted anesthesiologists monitored by physician health programs have good outcomes and high success rates upon return to work. Yet, there continues to be a lack of empathy among physicians toward addicted anesthesiologists, and an assumption that they can’t recover. Speak Confidentially with a Promises Recovery Advisor at 844-876-5568.
Societal disdain for substance abuse finds no greater recipient for stigma than addicted physicians. Among physicians, anesthesiologists have received the brunt of this stigma. Physicians hold a position of trust, necessary to their trade, and so it is understandable that betrayal of that trust would be met with incredulity. It also seems appropriate that fellow physicians would be among those most offended, perceiving a threat to the profession and the societal standing of the physician.
Among anesthesiologists, however, a combination of very understandable defensiveness and very poor research has amplified their hostile response to their fallen colleagues. The negative response among anesthesiologists to one of their own who develops a substance abuse or dependence problem is profound and disturbing.
Two survey studies of anesthesiology training programs (Meeks et al and Collins et al) are often cited to support a negative view toward outcomes for anesthesiologists. These studies amounted to opinion polls and by their nature emphasized the cases wherein outcomes were poor.
Other studies, less often cited, show excellent outcomes for anesthesiologists, even with return to anesthesiology (Pelton et al, Paris et al, Domino et al, McClellan et al). It is our opinion at Professionals Treatment at Promises that most anesthesiologists can safely return to practice if safeguards are in place.
Professionals Treatment at Promises can conduct evaluations and/or treatment that can allow us to advocate for return to work. Call Dr. Skipper at (310) 633-4595 to discuss these programs or call our admissions team at 844-876-5568 for other questions or to make arrangements for admission.