Alcohol and Drug Dependence does not discriminate.  Contrary to popular belief, addiction among health care professionals is as prevalent as the general population, possibly even higher in some specialties (i.e. anesthesiologists).  Several popular TV shows such as “ER” and “House” have highlighted alcohol and drug problems among physicians, nurses, residents, and medical students.

One of the hallmark defense mechanisms of substance dependence, DENIAL (Don’t Even (k)now I Am Lying), makes it difficult for those afflicted to get help.  Denial may be particularly pronounced in health care providers because they may see themselves as “all-knowing” health care providers who don’t need help.  They may also have a quite reasonable fear of losing their license to practice their profession.

So, what do you do when you notice that a colleague or another health care provider such as a physician or nurse may have a problem with alcohol or drugs?

1. It is paramount to consider the pros and cons of confronting and not confronting the individual directly.  For example, without the proper preparation and support, a well-meaning attempt to address a potential problem directly with the individual may not only fall flat but may elicit hostility or push the person even further from getting help.  Choosing to not confront the individual may directly or indirectly result in patient harm.
2. Seek support and guidance from a colleague versed in alcohol and drug treatment.  They may be able to provide the insight, language, and knowledge to help approach the individual directly.
3. Every state has a program for impaired health professionals.  The Federation of State Physician Health Programs is an excellent resource to report a problem anonymously or to seek free expert consultation about how to handle a specific situation.

Photo by karawynn

Though not a big fan of animal studies (rats!), I appreciate the value of this research.  Several rats who became “addicted” (showed preference) to cocaine after repeated exposure displayed more ambivalence for the drug when exposed to novel stimuli (PVC pipe, a white sock, scouring pad, crumpled newspaper).

The “real-life” suggestion that can be made is that certain kinds of drug users may be optimally treated using exposure to novel behaviors, sensations, activities or any combination.  Hmm… I like the idea.  I am a novelty-sensation-thrill-seeking person myself.  My impression of this study, however,  is that it highlights the difficulty treating addictive disorders more than it points to new treatments.

Addiction is an “equal opportunity destroyer.”  It does not discriminate against different personality types, races, creeds, etc.  There are as many people with a predisposition to novelty- or sensation-seeking behaviors that become addicts as those whose same predisposition actually buffer them from developing addictive disorders (adrenaline junkies!).

I have led many groups with addicted people, young and old, male and female.  The subject of replacing one’s addictive behavior (or drug of choice) with another activity is a common topic in treatment.  I have repeatedly been advised by recovering addicts that there is no comparable experience or worthy competitor to chasing the chemical high, no matter how novel or exhilarating.

The study has merit in that it proposes a possible essential tool in the toolbox of treatment methods that may make the difference between a sober and joyous life and a life of continued addiction and misery.  What are you thoughts?

Photos by Andy Ciordia and Andrew Ressa.