Academic journal article Social Work

Help Seeking for AOD Misuse among Social Workers: Patterns, Barriers, and Implications

Academic journal article Social Work

Help Seeking for AOD Misuse among Social Workers: Patterns, Barriers, and Implications

Article excerpt

Misuse of alcohol and other drugs (AODs) is a public health issue, at great personal cost to individuals and their families and at great financial cost to businesses and the general public. In 2001, 7.3 percent of the U.S. population (ages 12 and over) met the criteria for abuse or dependence on either illicit drugs or alcohol (Substance Abuse and Mental Health Services Administration [SAMHSA], 2002).

Helping professionals are not immune to AOD misuse, and the potential for harm extends beyond personal consequences to compromised patient care. The prevalence rates of drug and alcohol misuse among helping professionals are not well established, because the few population-based studies of helping professionals provide competing estimates of prevalence (Hughes et al., 1992; McAuliffe et al., 1991; Trinkoff & Storr, 1998). Although most studies found that alcohol misuse among helping professionals is at least as common as it is in the general population, there is little agreement about the prevalence of drug misuse, particularly prescription drug misuse (Dabney & Hollinger, 1999; Hughes et al., 1992); (Trinkoff, Eaton, & Anthony, 1994; Trinkoff, Storr, Wall, 1999).

A study of physicians found that almost 8 percent of respondents self-reported AOD abuse during some period of their lives and that physicians were more likely to use alcohol, benzodiazapines, and minor opiates than the general population (Hughes et al., 1992). McAuliffe and colleagues (1991) surveyed physicians and medical students and compared their alcohol use and abuse with previously surveyed samples of pharmacists and pharmacy students. This study found low rates of problematic alcohol use. Only 4 percent of respondents in each sample reported ever having a drinking problem since entering college, and only 2 percent of the physicians reported still drinking heavily. Nevertheless, 17 percent of physicians thought they might be drinking too much, and only 3 percent had sought help for their drinking. A comprehensive study of nurses conducted by Trinkoff and Storr (1997, 1998) found that 32 percent of respondents reported past-year use of all substances (tobacco included), 17 percent reported past-year binge drinking, and 10 percent reported past-year drug use. Binge drinking rates were comparable to rates for the U.S. population; the rates for marijuana and cocaine use were lower and prescription drug use was higher (Trinkoff & Storr, 1997, 1998).

Differences in methods may account for some of the discrepancies (for example, use of convenience samples and different measures), and social desirability bias likely accounts for some of the low estimates of AOD misuse. Nevertheless, even the most conservative estimates point to thousands professionals misusing drugs and alcohol and a risk of harming patients, as evidenced by a number of reported dysfunctions (for example, missing work, providing less than best client care) in McAuliffe and colleagues' (1991) study. Because no rigorous studies about these issues among social workers have been conducted, the literature offers no reliable data for our discipline, although some have estimated that 10 percent of social workers are significantly impaired by drug addiction or alcoholism (NASW, 2000b). Even if social workers experience AOD abuse or dependence at the same 8.5 percent rate as the general public (National Institute on Alcohol Abuse and Alcoholism [NIAAA], 2004), this would mean that as many as 13,000 NASW members could be affected. If all of the 600,000 people holding social work degrees (NASW, 2004) were included, the estimate would be almost 51,000.

Leaders in some of the helping disciplines such as medicine, nursing, and pharmacy recognized these risks and developed professional assistance programs in the 1970s and 1980s (Bissell & Haberman, 1984; McCrady, 1989), with the goal of intervening before professionals made costly or life-threatening mistakes. …

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