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Substance use disorders in physicians: Epidemiology, clinical manifestations, identification, and engagement

Lisa J Merlo, PhD, MPE
Scott A Teitelbaum, MD
Kenneth Thompson, MD
Section Editor
Richard Saitz, MD, MPH, FACP, DFASAM
Deputy Editor
Richard Hermann, MD


Alcohol and other drug use (including prescription drugs) can impair a physician’s ability to practice medicine proficiently, putting patients at risk of harm. Substance use disorders (SUDs) in physicians have thus been subject to considerable clinical and regulatory attention. Physicians with SUDs have long been described in the United States and other countries as "impaired physicians," a term that is also applied to physicians with psychiatric, cognitive, behavioral, or general medical problems with potential to adversely affect the physician’s ability to perform specific duties. Terminology has evolved to “physicians with potentially impairing conditions,” in order to reflect the reality that not all physicians with a diagnosable SUD demonstrate workplace impairment.

Most of the published data on this subject are limited to physicians in the United States, where treatment of physicians with SUDs is typically overseen by a physician health program (PHP). Much of the information may be relevant to other types of clinicians [1,2] and other countries where these problems have also received attention [3-12]. PHPs in the United States provide coordination, monitoring, and expertise in the care of impaired physicians (and sometimes other healthcare professionals) [13], which when combined with treatment of the person’s substance use disorder, have generally led to high rates of sustained remission and return to medical practice [14-19].

This topic addresses the epidemiology, clinical manifestations, identification, and engagement of physicians with SUDs. The assessment and treatment of physicians with 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.

See related topics:

(See "Substance use disorders in physicians: Assessment and treatment".)

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Literature review current through: Nov 2017. | This topic last updated: Jul 13, 2017.
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