MDS MAKE LOUSY PATIENTS, SAY DRUG ADDICTION EXPERTS

Doctors commit suicide more often than the general population and of those
admitting to substance abuse, one-third say prescription opiates are their
drugs of choice, surveys show

Their drug addictions are tougher to treat because doctors make lousy
patients, say experts in substance abuse. Doctors rarely admit or discuss a
weakness and often choose to treat themselves, sometimes with dire
consequence, say experts in physician addiction.

"Doctors believe that giving in to illness, or admitting an addiction is a
weakness and people will judge them as weak," said Dr. Michael Kaufmann,
physician in charge of the Ontario Medical Association's physician health
program (PHP).

The PHP is a confidential service for physicians at risk of, or suffering
from, substance use and/or psychiatric disorders, and other stress,
emotional or family problems.

When it began in 1995 , 11 physicians asked for help. In 2002 the PHP
opened 208 new cases and experienced a 40-per-cent increase in calls over
the previous year. In 2003 the PHP opened 260 new cases. Over the past
eight years, about 1,100 Ontario physicians have asked for help.

Kaufmann said drug or alcohol use was the initial focus of the PHP, but 65
per cent of cases opened in 2003 identified psychiatric, stress, emotional
and family issues as the primary reason for seeking help -- a 15-per-cent
increase over 2002.

"One-third (of the doctors) rate opioid prescriptions as their drug of
choice, 50 per cent choose alcohol, seven per cent use cocaine, five per
cent sedatives and hypnotic drugs and six per cent use a variety of drugs
such as cannabis, solvents and anesthetic agents," said Kaufmann.

A 1992 survey of more than 9,000 physicians showed that almost eight per
cent reported substance abuse or dependence problems at some times in their
lives, Kaufmann said.

"At least 50 per cent of physicians we see are self referrals, but when it
comes to drugs and alcohol, generally it's not more than 25 per cent, with
referrals coming from someone else," said Kaufmann.

"Over 90 per cent of doctors who call for help, get intervention and are
compliant, can and do return to work successfully."

Physician suicide rates are estimated to be at 30 to 40 per 100,000
population per year -- at or above those of the general population.

Female physicians commit suicide at 30 to 40 per 100,000, compared with
matched groups of women in society which are 10 to 12 per 100,000.

Kaufmann said badly kept records mean the physician suicide rate could
actually be higher.

"Suicide is strongly associated with psychiatric illness, including mood
disorders, especially depression and substance use disorders," Kaufmann said.

"Significant loss is an issue, including failure of important
relationships, death of loved ones, financial setbacks, revocation or
suspension of professional licence, reputation damage by any real or
perceived insult and an inability to work or enjoy work for any reason.

"Doctors fear retribution from the College of Physicians and Surgeons of
Ontario, or blackballing by insurance companies. But this pattern of
behaviour may be deadly for a doctor prone to suicide."

SUICIDE RATE

According to an unpublished study by Dr. Douglas Graham of the Physician
Support Program in British Columbia, the physician suicide rate between
1991 and 1998 was 21.9 per 100,000 population. The suicide rate in the
entire population was 13.9 per 100,000.

Graham found that lawyers and nurses take their lives at about the same
rate as the general population, while the rate for dentists was 27.6 per
100,000.