Substance Abuse Among Physicians: A Survey of Academic Anesthesiology Programs

Abstract

This survey indicates that the frequency of controlled substance abuse among anesthesiologists has changed little in the past few years, despite an increase in the control and accounting procedures for controlled substances as well as increased mandatory education.

Substance-Related Disorders Among Anesthesiologists

“…25,28 During the last 30 years of observation, it appears that there is an annual incidence of 1% to 2% of controlled substance abuse within anesthesiology training programs. 29 This consistently grim statistic is particularly troubling because it has persisted, despite the increased emphasis placed on education and accountability in recent years.…”

“…However, despite widespread application of protocols to enforce greater accountability, such as satellite pharmacies for operating suites, the frequency of substance abuse has changed little, if at all, in recent years. 29 An interesting debate has emerged regarding compulsory drug testing of physicians. 30 Pre-employment screening, random drug screening, or both are already well established in various industries, especially those with high public health profiles (eg, nuclear, aviation, and military arenas).…”

“…32 Many chairs of academic anesthesiology programs have indicated their willingness to initiate a program of random drug screening of their staff. 29 The California Society of Anesthesiologists has recently adopted a policy that would authorize drug screening if probable cause exists http://www.csahq.org /xtpl.php?tplϭinternal.xtpl&sectionϭnews&nameϭnews_view& idxϭ11. However, serious questions remain about the legality and effectiveness of this approach.…”

“…Menk et al 39 found 14 drug-related deaths among the 79 residents who had been re-enrolled in their training programs after treatment. In the most recent study, 29 an experience spanning the years 1990 to 1997, 30 of 167 chemically dependent anesthesiologists died or required resuscitation as a consequence of their addiction.…”

Drug Diversion, Chemical Dependence, and Anesthesiology

“…Gravenstein and colleagues [6] also reported a 1% per year incidence with a disturbing mortality of 7 of 44 addicted residents. Booth and colleagues [7] reported incidences of 1.6% per year in residency and 1.0% per year for junior staff between 1985 and 1995. Collins and colleagues [8] reported data from 1991 to 2001, with 80% of programs who responded reporting one incident or more, and 19% reporting at least one mortality.…”