OAKLAND — Physicians hooked on their own medicines, strung out on illegal narcotics or killing themselves with alcohol are finding help through a new discipline--addictology--and a growing network of support systems for health care professionals.
With the American Medical Assn. this year classifying all addictions as diseases, usually genetically triggered, some of the stigma attached to drug and alcohol dependency is diminishing.
Doctors and nurses, in particular, understand the word treatable, and thousands of them nationwide are entering recovery programs to shed addictions that have shattered or threaten to destroy their personal and professional lives.
One doctor asked for chemical-dependency treatment after his family life fell apart, his finances collapsed and his practice started deteriorating. Other addicted doctors report such frightening scenarios as falling asleep in the operating room. One surgeon was sent to a recovery program by intervening colleagues after he tried to remove an organ by hand while experiencing toxic psychosis from cocaine.
10% Have Dependencies
The AMA estimates that 10% of the nation's half a million doctors suffer from alcoholism or drug dependency, with 100 practicing physicians dying annually from their disease.
Experts say statistics show that those at most risk of becoming drug or alcohol dependent are critical-care nurses and among doctors, anesthesiologists who work full time in the operating room.
A tough program to help physicians and nurses recover from addictions has been put together at the Merritt Peralta Institute near Merritt Hospital in Oakland. Those accepted must already have gone through an inpatient or outpatient program for chemical dependency and be willing to sign a "tailored contract" agreeing to follow an intensive one-year monitored regimen.
"People need to devote as much time to recovery as they did to the disease," said program coordinator Millicent Buxton, who makes clients agree to change their "survival tools" from drugs to active participation in a 12-step program such as Alcoholics Anonymous or Narcotics Anonymous, join a professional support group, meet weekly with a program staffer and agree to random urine testing.
Abstinence from all drugs, including alcohol, is mandatory, she said. Participants must also agree to a work-site monitor who will report any unusual behavior that might indicate a relapse.
"We believe in a chemical-free philosophy as the appropriate treatment," said Buxton, adding that researchers are now finding genetic similarities linking all addictions, from alcoholism to obsessive gambling.
Addiction to prescription drugs is the biggest danger to doctors and nurses because the "cookie jar is always available," Buxton said.
Especially in high-stress situations, she said, self-medication is sometimes a coping mechanism. The key words, she added, are "high stress, high access."
"For health professionals, the role as healer may increase their denial when the disease develops in themselves. Because of their knowledge of pharmacology, many think they are immune to the addiction."
Medical Schools Ignore Subject
Dr. Lyman Boynton, a surgeon and recovering alcoholic at Kaiser Hospital in San Francisco, recently taught a weekend primer course on drugs and alcohol abuse for doctors who want to specialize in that area. The doctors were among 800 who then took a national addictology exam that certifies them as having expertise in the emerging field. Only three other such national exams have so far been administered, with 645 doctors receiving certification from the AMA's committee on alcoholism and other drug dependencies.
"Obviously, a major goal is education, teaching an awareness of addictions and cross-tolerances," Boynton said. "The disease is chemical dependency, it's not cokism or valiumism or alcoholism."
Boynton, who heads a support group of doctors recovering from addictions, said a large number of those who enter the practice of addictology have suffered the effects of the disease. Unfortunately, he adds, medical schools virtually ignore the subject, except in elective courses, despite the fact that alcoholism alone is the nation's third-leading cause of death.
Doctors in recovery, he said, benefit from such programs as Merritt Peralta's monitoring and re-entry, because the addiction is treated as curable and doctors are permitted to resume practice, without putting patients or the hospital in jeopardy, by signing the sobering "contract" agreement. Being able to work, rather than being disciplined by a license suspension, also helps in the physician's recovery, Boynton said.
"Chemical dependency is an eminently treatable disease and that's the real key," Boynton said. "People can be returned to their workplace and be a real asset to their profession."