Health Professionals Are Not Immune to Substance Abuse

As if working in the healthcare field wasn’t already stressful, overwhelming, and sometimes downright depressing, the COVID-19 pandemic has added tremendous pressure to already overworked medical staff. They’ve witnessed unspeakable tragedy and loss of life on a scale they couldn’t possibly be prepared for. Many are facing mounting mental health challenges as a result.

Unfortunately, this perfect storm puts these essential workers at tremendous risk of developing a substance use disorder (SUD). In addition to stress and burnout, healthcare professionals also have a unique “advantage”: easy access to drugs. Whether it’s through self-prescribing, prescription fraud, or simply diverting medications from the hospital or office, opioids, anti-anxiety medications, anti-depressants, and many other drugs are readily accessible.

I know because I’ve been there. Thanks to an old injury that caused nagging pain, coupled with the stress of running a busy surgery practice while also serving as head of the surgery department at a major metro hospital, I turned to opioids to self-medicate.

When my usage got out of control, I knew I needed help, but I was afraid — afraid of facing disciplinary action, afraid of losing my license, afraid of losing my job and everything I’d worked so hard for. The shame was overwhelming; I was afraid for anyone to find out.

In hindsight, I should have been more afraid of making a mistake, hurting someone (or worse), or going to jail.

I learned there is actually a reasonable and fair system in place that enables impaired professionals to get the help they need, while also helping to protect jobs and medical licenses.

If you’re a medical professional with an SUD, and you’re afraid to come forward like I was, there are several things you should know that will make it easier to reach out for help.

You don’t have it under control. One of the caveats of having medical knowledge and experience with drugs is that it tends to reduce your level of fear about using them. Because you understand how they work, it’s easy to feel like you know what you’re doing — and to delude yourself into thinking you’re somehow better equipped to handle chronic use without becoming addicted. This is a dangerous, false assumption. In fact, studies show medical professionals are more likely to become addicted to prescriptions than the general population, and any use that goes beyond medical necessity is cause for concern.

No one is out to get you. When I was first in contact with the monitoring agency in my state, I was suspicious that they were just trying to get dirt on me and report me to the Department of Health. I didn’t realize they were actually there to help me, to provide a process by which I could both overcome my addiction and keep my job. Paranoia and denial can go hand-in-hand with addiction, so if someone tells you they’re concerned about your behavior and offers you help, please know they’re genuinely concerned and not looking to destroy your reputation. The damage you could do on your own by continuing to use is far worse.

Self-reporting is the best option. Reporting yourself to the state monitoring agency is a critical early step. As much as they’re there to protect patients, they’re also there to protect you. They’ll help get you into a recovery program and work with your employer to keep your job by demonstrating that you’re taking steps to seek treatment. Taking a medical leave of absence to enter a treatment program is no different than taking a leave because you’ve had a heart attack or cancer. I urge you, please don’t wait until someone reports you to your employer or the health board. The consequences are far worse. Being proactive shows that you want to continue doing what you love, and your monitoring agency and employer will be much more accommodating.

The consequences of not getting help are almost universally worse than not coming forward. I was terribly afraid for someone to find out I was addicted to opioids. I was worried about the harm to my reputation, my business, and my career. But the consequences of not getting help are much worse. If you have an adverse event or harm someone — even if it were potentially unavoidable and under normal circumstances wouldn’t be questioned — it can be disastrous if it’s discovered that you were impaired. At the very least, you could face extremely high malpractice judgments or worse, manslaughter charges. In the state of Florida, a felony DUI charge could mean losing your license for up to 15 years. A charge for simple possession, which for opioids could be as little as 14 to 15 tablets, carries a penalty of 5 years license suspension. In either case, you don’t even have to be convicted to suffer these penalties. Not to mention, these are in addition to criminal penalties, which could be up to 25 years in prison. Without question, the repercussions of getting help are exponentially less than the risk of getting caught.

There are programs just for you. A lot of people fear that treatment centers are full of the stereotypical, often commercialized characters like we see on TV. But the reality is, many are people just like you and me: professionals with families and busy social calendars who became another statistic in a disease that doesn’t discriminate. In fact, many facilities now operate programs specifically for licensed professionals or first responders designed to work in conjunction with monitoring agencies to help preserve your license and your career. I can’t tell you the number of times I’ve seen a look of tremendous relief from a new patient when I tell them I’m in recovery. Their guard immediately falls, and it facilitates an open dialogue when they realize this is a safe space for them to share and get help without judgement.

Right now, thousands of medical professionals are struggling with stress and anxiety from a year of unprecedented challenges. If you’re one of them, you may feel there’s no way you can take time off to get help during this crisis. But the truth is, if you’re working while impaired, you could be more of a liability than an asset to your patients, your employer, and yourself.

There’s no shame in admitting you need help. There are systems in place to help you keep your job and your license. Get help so you can keep doing the work you love.

Forrest Arthur, MD, is a Former Addiction Medicine Fellow at River Oaks Treatment Center, an American Addiction Centers facility.