Results 155 of 802 physicians (19.3%) with known outcomes failed the programme, usually early during treatment. Of the 647 (80.7%) who completed treatment and resumed practice under supervision and monitoring, alcohol or drug misuse was detected by urine testing in 126 (19%) over five years; 33 (26%) of these had a repeat positive test result. At five year follow-up, 631 (78.7%) physicians were licensed and working, 87 (10.8%) had their licences revoked, 28 (3.5%) had retired, 30 (3.7%) had died, and 26 (3.2%) had unknown status. Conclusion About three quarters of US physicians with substance use disorders managed in this subset of physician health programmes had favourable outcomes at five years. Such programmes seem to provide an appropriate combination of treatment, support, and sanctions to manage addiction among physicians effectively.

Methylphenidate (MPH) has a long history of being an effective medication for attention deficit/hyperactivity disorder (ADHD). Recently, the nonmedical use of MPH has increased, particularly among college students. To investigate this, we surveyed 2,087 students regarding MPH misuse. Of 2,087 respondents, 110 (5.3%) used MPH nonmedically at least once. Most obtained MPH free from a friend, acquaintance, or family member. Misuse of Ritalin(R) occurred four times more frequently than Concerta. Among Ritalin abusers, Intranasal use was reported more often than oral. Students reported using MPH nonmedically for recreational reasons as well as to improve academic performance.

ABSTRACT. This article summarizes recent research findings on nonmedical use of prescription stimulants and outlines a multi-pronged strategic approach for responding to this unique problem among college students. Students, health professionals, parents, the pharmaceutical industry, and institutions of higher education all play roles in this response. Moreover, the academic community should view the translation of research findings as an important responsibility that can help dispel the myths often perpetuated in the media. The nonmedical use of prescription stimulants is a complex behavior and should be viewed in the larger context of alcohol and drug involvement among young adults. Strategies to reduce nonmedical use of prescription stimulants might have direct application to the abuse of other prescription drugs, including opiates.

Anxiety disorders are estimated to affect 26.9 million individuals in the United States at some point during their lives. This study used the human capital approach to estimate the direct and indirect costs of these highly prevalent disorders. In 1990, costs associated with anxiety disorders were $46.6 billion, 31.5% of total expenditures for mental illness. Less than one‐quarter of costs associated with anxiety disorders were for direct medical treatment; over three‐quarters were attributable to lost or reduced productivity. Most of these indirect costs were associated with morbidity, as mortality accounted for just 2.7% of the total. Greater availability of effective, relatively low‐cost outpatient treatment could substantially reduce the economic and social burden of these common and often crippling disorders. Anxiety 2:167–172 (1996). © 1996 Wiley‐Liss, Inc.

No abstract