Substance use disorders in physicians: Assessment and treatment
- Lisa J Merlo, PhD, MPE
Lisa J Merlo, PhD, MPE
- Assoicate Professor of Psychiatry
- University of Florida
- Scott A Teitelbaum, MD
Scott A Teitelbaum, MD
- Professor of Psychiatry
- University of Florida
- Kenneth Thompson, MD
Kenneth Thompson, MD
- Clinical Associate Professor of Medicine
- Pennsylvania State University
The term "impaired physician" has been used to refer to physicians with psychiatric, cognitive, behavioral, or general medical problems that have the potential to adversely affect the physician’s ability to perform specific duties. Because not all physicians with these conditions exhibit occupational impairment, it is becoming more common to describe these individuals as “physicians with potentially-impairing conditions.” The subgroups of greatest concern, and thus of study as well as clinical and regulatory attention, are physicians who exhibit excessive alcohol use, illicit drug use, and/or prescription drug misuse.
Most of the published data on this topic are limited to physicians in the United States, where treatment of physicians with substance use disorders is typically overseen by physician health programs (PHPs). Much of the information may be relevant to other types of clinicians [1,2] and other countries where these problems have received attention [3-12]. PHPs in the United States provide coordination, monitoring, and expertise in the care of physicians (and other healthcare professionals) with potentially-impairing conditions , which when combined with treatment of the person’s substance use disorder (SUD), have generally led to high rates of sustained remission and return to medical practice [14-19].
This topic addresses the assessment, treatment, and oversight of physicians impaired by SUDs. The epidemiology, clinical manifestations, identification, and engagement of physicians impaired by SUDs are discussed separately. Prescription drug misuse and continuing care for addiction are also discussed separately. The epidemiology, pathogenesis, clinical manifestations, assessment, diagnosis, and treatment of specific SUDs are also discussed separately.
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- Physician health programs
- Other health professionals
- COORDINATION AND MONITORING
- Contingency contracts
- Not specific to physicians
- Return to work
- Ongoing monitoring
- OUTCOMES OF PHYSICIAN HEALTH PROGRAMS
- - Anesthesiology residencies
- Risk factors for relapse
- MEDICATION FOR OPIOID USE DISORDER
- SOCIETY GUIDELINE LINKS
- SUMMARY AND RECOMMENDATIONS