Addictions in Physicians: An Overview

Abstract

An estimated 10-14% of physicians are said to be at risk of becoming chemically dependent at some point in their careers. Defense mechanisms (such as denial, minimization or intellectualization), greater stigma associated with mental disorders amongst doctors, and easy access to self-treatment with licit drugs, added to specific individual risk factors may account for this increased vulnerability. Substance use can appear as an unhealthy strategy to cope with unpleasant emotional states or it can be for recreational purposes. When it becomes an addiction, it poses risks both to the individual's wellbeing and to their safe clinical practice. Among physicians, alcohol, sedatives and opioid misuse are the most prevalent substance use disorders (SUDs). In recent decades, Physicians' Health Programs (PHPs) have been developed in several countries to address this problem. Although sharing some similarities, they differ in organizational and clinical aspects. Addicted physicians in treatment demonstrate significantly higher abstinence rates (70-80%) compared to other patients. However, concerns about ethical issues related to the treatment of sick doctors at PHPs, mainly in the US, have recently arisen in public discussion and need to be carefully considered.