It's a New Day for Doctors with Addictions
Childress, Karen, Medical Economics
RECOVERY PROGRAMS CAN HELP YOU BEAT THE MADNESS AND GET YOUR LIFE AND CAREER BACK ON TRACK [ By KAREN CHILDRESS ]
In the not-too- distant past, physicians who were addicted to alcohol or drugs tended to hide in the shadows for years- sometimes for decades- before reaching out for help, getting into recovery, and putting their lives and careers back on track. Few admitted openly to having a problem until they were forced to either seek treatment or be faced with the very real possibility of losing hospital privileges and their medical licenses. Today, thanks in part to supportive systems that allow physicians to step forward and ask for help without fearing that doing so will be a career-ender, doctors who struggle with alcohol and drugs are finding ways out of the darkness of addiction.
Family physician Harry Haroutunian, MD, tried for years to manage his alcohol addiction on his own or by using 12-step programs, so-called "half measures." Having begun drinking in medical school as a way to cope with the rigors and demands of being a student, on finishing training, he practiced family medicine in a remote location with little peer oversight Working long hours to meet the needs of many patients resulted in seeking solace during his rare off hours through alcohol.
"I knew I had a problem, but I wasted time starting and stopping and getting improper treatment The drinking just resurfaced, again and again," Haroutunian says.
In his mid-50s, Haroutunian finally got the help he needed to get sober and stay sober. "I received a 3- day, full clinical diagnostic evaluation, followed by 90 days in a residential treatment program with other physicians," he says. "I then enrolled in my [state] physician health program, and [it was] extraordinarily helpful. They guided me through those first few years [of sobriety]."
Once back at work, Haroutunian soon received inquiries from other physicians who wanted to know about recovery. "I fully understand that it is a disease. My dad died from this disease, plus one brother and a couple of uncles," he says. "It's not anything to be ashamed of, and until we accept the totality of the disease and understand that there is hope, we remain cloaked in a shroud of denial. People hide out, go without treatment, and die for fear of retribution."
Today, Haroutunian is physician director of the Licensed Health Professionals Program at the acclaimed Betty Ford Center in Rancho Mirage, California, where he helps doctors and other licensed professionals reclaim their lives and careers by achieving sobriety.
PHYSICIANS AT HIGH RISK
It's estimated that 10% to 12% of the general population suffers from an addiction of one sort or another. Haroutunian says these numbers are about the same among physicians. What makes doctors different when it comes to addiction is that they tend to delay seeking help for longer than nonphysicians (in part because they are sometimes "protected") and that they have easy access to prescription drugs.
Doctors at any stage in their careers can find themselves facing an addiction to alcohol, prescription drugs, illegal street drugs, gambling, sex, or even shopping. But by and large, alcohol and prescription drugs are the substances of choice among healthcare professionals, and they may be at higher-than-average risk at a couple of career points in particular.
Charlene Dewey, MD, MEd, FACP, is an internist and co-director of the Center for Professional Health at Vanderbilt University School of Medicine in Nashville, Tennessee. She says that residency and midcareer are two points in time during which physicians should especially be aware of their risk for addiction.
"Residency is hard- mentally, physically, and emotionally. Suddenly, doctors have access to drugs that they didn't have access to before, and use goes up as they look for ways of coping," she says. Instead of making an appointment with a primary care physician, residents are apt to convince a colleague to give them a prescription for "a few [alprazolam] to get me through," when what they really need is to see an objective physician for the issues they struggle with. …