Prevalence of substance use disorders among medical professionals

On the whole, physicians tend to engage in healthier habits than the general population, but this does not extend to substance use. It is estimated that 10-12% of doctors will develop an SUD during their careers. Rates are similar for nurses and pharmacists. This is not only a source of personal concern for the medical professionals affected, it is also a serious public health issue. Healthcare workers hold positions of authority and responsibility, and when impacted by SUD, can do great harm.

Occupational challenges facing medical professionals

Working in the medical field brings unique pressures and challenges that often become risk factors for SUD.

• Stress

  Medicine is a high-pressure field. Patient care never really stops, and work hours are often long. Many in the healthcare industry are shouldering both the weight of patient outcomes and the burden of institutional pressure to work more and faster. Many in the field cope with this stress by self-medicating.

• Access to substances in the workplace

  One challenge that is unique to the medical field is access to medications and controlled substances. Working in a pharmacy, doctor’s office, or hospital often provides access to medications that laypeople don’t have.

• Physical pain

  People outside the healthcare industry often have no idea how physically demanding many medical roles are. From nursing assistants all the way up to surgeons, healthcare professionals deal with heavy lifting, long hours on their feet, repetitive stress, pulled muscles, and more … often contributing to chronic pain. Managing physical pain is cited as one of the most common reasons medical professionals misuse drugs.

• Confidence in self-medicating

  Years of medical training and professional experience can lull many into a false sense of security. After all, if they know how meds affect a person, surely they can avoid the dangers. Some call this fallacy “pharmaceutical invincibility.” Unfortunately, history shows that neither medical degrees nor experience protect against substance use disorder. Addictive substances affect highly knowledgeable brains in the same ways they affect others.

• Compassion fatigue

  Compassion fatigue is a risk among healthcare professionals. This is a secondary traumatic stress disorder that can develop from helping others, leading to symptoms of anger, depression, and apathy.  Like other mental health concerns, compassion fatigue can lead to substance misuse in an attempt to escape or manage it.

Obstacles that keep medical professionals from seeking help

Despite experiencing SUD at the same rates as laypeople (some studies say higher), medical professionals are often loathe to seek treatment. Here are a few of the most commonly cited concerns:

• Stigma

  Reputation can feel like everything in the medical field, and many are unwilling to risk their professional reputation if others learn that they are in treatment for an SUD. The other side of this coin is that by not seeking treatment, they make it more likely that their active addiction or substance use will be discovered. 

• Disciplinary action and professional sanctions 

  Despite the existence of health professional monitoring programs and health professional recovery programs that help medical professionals, many in the field fear the consequences if they are discovered to have an SUD. They are concerned with the loss of license to practice, and with employers levying professional consequences.

• Distrust of the treatment

  It is a conundrum that many medical professionals make the worst patients. Their own knowledge can make it difficult to trust in the expertise of others to prescribe them care, especially if they have not been able to vet the clinicians or counselors who are treating them. This is especially true if they have any disagreement with their own healthcare provider about the course of treatment.